Diphtheria and scarlet fever in relation to school medical officers / by R.A. O'Brien.

  • O'Brien, Richard Alfred, 1878-1970.
Date:
[1926?]
Catalogue details

Licence: In copyright

Credit: Diphtheria and scarlet fever in relation to school medical officers / by R.A. O'Brien. Source: Wellcome Collection.

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    diately after admission and before testing and immunisation could be completed. The same decrease in incidence has been noted by Sir John Robertson at Birmingham in the hospitals under the care of Dr. Harries. This method of prevention involves a moderate amount of work, a Schick test, three injections for the positive reactors, another Schick test a few months later to detect those not yet immunised, and a further injection of prophylactic with subsequent Schick test for the small percentage of “ obstinate ’’ people who fail quickly to become immune. We are hoping to improve this procedure. My colleague, Mr. Glenny, has recently made various mixtures which indicate in guinea-pigs with reasonable accuracy the Schick condition of the patient and at the same time act as immunising or prophylactic injections. They are therefore called Diphtheria Prophylactic Immunising Mixtures (D.P.I.M., formerly D.P.M.). Dr. Harries, of Birmingham, has made a number of observations on the action of these mixtures. He very kindly supplied me with clinical details which show that those mixtures already prepared indicate approximately though not exactly the same level of immunity as the Schick test, and that they also act as immunising agents. I have not much doubt that we shall soon have a mixture which will in a dose of 0*2 c.c. injected intradermallv indicate exactly the same level of immunity as the ordinary Schick test, and at the same time will produce as much immunity as 1 c.c. of the ordinary diphtheria prophylactic. With such a combination one will at each injection discover how the patient's immunisation is progressing and one can cease the injections as soon as a negative response occurs. Scarlet Fever. Here the modern methods help in the diagnosis of ‘ doubtful cases,’ in active immunisation, in passive immunisation in the presence of epidemics, and finally in treatment with antitoxin. In scarlet fever ‘ swab diagnosis ’ does not at present help much. In America a few workers treat all haemolytic streptococci found in the throats of patients convalescent from scarlet fever as potential causes of scarlet fever, but public health administrators are not at present prepared to accept this line of action for we have no readily applicable means of deciding whether a given streptococcus is the scarlet fever streptococcus. The final and probably the only really reliable proof is that a suspected organism makes a toxin giving a skin reaction and that the toxin can be neutralised by