One who has followed the literature bearing on the use of diphtheria antitoxin must be struck by the divergence of opinion and practice characterizing the American and European authorities. In the United States great weight is attached to the potency of anti-diphtheritic serum measured in specific antitoxin units, and among the producers of this remedial agent a sharp rivalry exists, with the object of obtaining the greatest possible potency in the least possible quantity of serum. This commercial strife for the production of extrapotent antitoxin, for which only an occasional horse can be found adaptable after a laborious and expensive process, and the premium placed on the antitoxin unit per se, have resulted in relatively high prices for the diphtheria remedy as prepared and marketed in the United States, and corresponding misunderstanding and dissatisfaction on the part of physicians, particularly those preferring to employ quantitatively larger doses of the serum.
THE DOSAGE OF DIPHTHERIA ANTITOXIN.. JAMA. 1905;XLV(5):332. doi:10.1001/jama.1905.02510050036009
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