Vol. 60, 1909 - University of North Carolina at Chapel Hill

The Charlotte Medical Journal
Antitoxin or Serum Tberapy in the Treatment
of Whooping Cough, Measles
and Scarlet Fever.*
By Stephen Harnsberger, M. D., Catlett, Va.
This paper is the compliment of a paper
read at George Washington University Hospital,
Nov. 14, 1908. r read that paper for
three reasons:
(1) To emphasize the fact that textbooks,
the general practitioner's main source
of information, holds to the same treatment
of whooping cough that was used a half
century and more ago.
(2) To suggest a modification in the
treatment cf whooping cough that not only
adds to tlie comfort of the patient hut keeps
down complications; and as the complications
are the usual causes of death in this
disease, it lessens the mortality.
(3) To impress the importance of a better
individual initiative and to urge the
profession to wake up to the probable good
to be had from antitoxin in the treatment
of whooping cough.
About three years ago, I read of where
an injection of diphtheria antitoxin in a
whooping cough patient was followed by
almost immediate disappearance of the
paroxysms and a rapid recovery. This interested
me. I read another such statement
during the early part of last year and
I determined "to wage an instant trial" as
soon as opportunity favored me.
During the session of the Medical Society
of Virginia in Richmond, last October, 1
called to see Mr. Belt, representing the II.
K. Mulford Co., as I wanted to know on
what terms I could get diphtheria antitoxin
for experimental purposes. Reporting our
conversation to his Company, their Dr.
Stewart wrote me promptly, offering nie
every assistance and help at his command.
In my next letter, I asked to be furnished
with all the printed matter he could gel
bearing on the use of diphtheria antitoxin
in the treatment of whooping cough and
other diseases of childhood. In reply he
gave me a letter of introductio!i to Dr.
Henry B. Kryan, of I'hiladelphia: evidence
sufficient that nothing of importance had
been written on this subject. I wrote Dr.
Bryan, telling him what I wanted, as well
as of my inclination to thoroughly study
the action of antitoxin in such diseases.
Dr. Bryan's reply was plainly to the point.
He mailed me clinical experience and ob-
•Read before Tri-State Medical Society, Charle.ston,
S. C,
CHARLOTTE, N. C, SEPTEMBER, 1909.
servation taken from his case records, and
which I shall take pleasure in presenting to
you presently.
In the meantime I mailed letters to a number
of painstaking physicians requesting
them to notify me of cases of whooping
cough, measles and scarlet fever occurring
in their practice, offering to furnish the
antitoxin and my services free of charge.
I was anxious to be able to add something
to Dr. Bryan's statement of bed-side facts;
but the time has been so short in which to
make my observations, that I shall defer
my personal report to some future meeting.
Dr. Bryan's report: "Antitoxin—a substance
developed in the body counteracting
poisons generated or planted there.
"Without at the present time going into
any explanation why diphtheritic or any
other specific antitoxin could be rationally
of any benefit in the treatment of measles
or scarlet fever, it may be of interest to
some physicians to learn of some of my experience
in the use of diphtheritic antitoxin
in the treatment of such diseases, while in
charge of the children of St. \'incent's
Home and Maternity Hospital of Philadelphia,
Pa.
"As a reason for having used the diphtheritic
antitoxin in scarlet fever and meas-
les, it will be well to remember that it is
generally conceded that the tissues and
fluids of the body contain, or at once manufacture
antitoxin, the effects of which are
directly antagonistic to the toxin of disease.
The secretions thus formed are capable of
protecting the body from invading bacteria
and are distributed to all the tissues of the
body and found especially in the serum of
the blood.
"In the treatment of measles—a disease
which Osier asserts stands third in the deathrate
of eruptive fevers, and Ilolt speaks of
an epidemic in 1892, in the Nursery and
Children's Hospital, of New York, in which
the mortality was .35 per cent., and in nine
thousand three hundred and thirty-nine
(9339) cases of measles in the hospitals of
Paris, there were three thousand and ninetysix
(3096) deaths, or a mortality of thirtythree
and five tenths (33.5) per cent.
"In the year of 1906 of the history of St.
Vincent's Home and Maternity Hospital
an outbreak of measles occurred among
our four hundred children. One hundred
and seventy-one children contracted the
disease, most of whom were under three
years of age. This occurred in January,
1906. As each child showed the first symp-