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August 28, 1937

The Dosage of Antitoxin in Diphtheria: Report of Departmental Committee Appointed by the County Medical Officer of Health and School Medical Officer

JAMA. 1937;109(9):736. doi:10.1001/jama.1937.02780350104031

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Abstract

This report is "an attempt to establish criteria for the guidance of the medical officers of the Council's hospitals." It takes up the matter of diphtheria toxin, its tissue combination, and the aim of antitoxin treatment. Emphasis is laid on the time factor and it is insisted that "every hour, every minute of delay—and this is not a figure of speech—is damaging. If the amount of toxin is near the lethal dose, life itself is at stake" (Schick). Intravenous administration is designated as the ideal route when rapidity of action is necessary, but not all cases are recommended for this technic. The intramuscular route is recommended when speedy absorption is less urgent. A single dose is recommended rather than repeated doses. Serum reactions and other unusual effects are briefly but adequately discussed and desensitization is outlined. There is an excellent brief outline of the clinical manifestations of diphtheria. The booklet

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