That sterile scarlet fever toxin administered by mouth may result in satisfactory immunization was reported in 1932.1 This observation was first made during attempts to learn whether or not some of the so-called intestinal rashes mentioned as occurring in children might be caused by milk which had been contaminated with a scarlet fever streptococcus and subsequently pasteurized at a temperature which kills the streptococci but does not destroy the toxin.
In these first experiments it was found that transient scarlatinal rashes might occur in susceptible persons when comparatively large doses of the sterile toxin were ingested. Subsequent cutaneous tests showed modification of the susceptibility, indicating the production of some degree of antitoxic immunity.
This observation led to further experiments in which sterile toxin, containing 0.5 per cent phenol, was administered by mouth in graduated doses. The results indicated that, if enough toxin was given, a degree of immunity sufficient
DICK GF, DICK GH. A PREPARATION OF TOXIN SUITABLE FOR ORAL IMMUNIZATION AGAINST SCARLET FEVER. JAMA. 1940;115(25):2155–2156. doi:10.1001/jama.1940.02810510031008
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