Identifier: 39002086411023.med.yale.edu
Title: The diseases of infancy and childhood : designed for the use of students and practitioners of medicine
Year: 1918 (1910s)
Authors: Koplik, Henry,1858-1927
Subjects: Children Pediatrics
Publisher: Philadelphia : Lea & Febiger
Contributing Library: Yale University, Cushing/Whitney Medical Library
Digitizing Sponsor: Open Knowledge Commons and Yale University, Cushing/Whitney Medical Library

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ngeal forms should receive large doses. Fully twice the abovedoses are given at the outset of the laryngeal symptoms. An infantwith laryngeal diphtheria may safely be given 10,000 units as aninitial dose. There is rarely a necessity of giving 20,000 units asan initial dose. Doses beyond 20,000 units rarely benefit. Immunization.—The dose of 500 units is given for immimizing pur-poses to very young infants, and 1000 units to older children. The immunizing power extends over a period of three weeks. Itis best to give an initial dose of sufficient amount, so that a repetitionof the dose will not be necessary. The toxin-antitoxin immunizationof Behring lately elaborated by Parke and Zingher extends over amuch longer period but has not been generally perfected. In all hos-pitals and institutions children should be subjected to the toxin test(Schick) or its modification (Koplik and Unger) in order to indicatewhich children in an outbreak of diphtheria possess immunity and > X w < IX
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W7^^ >> CO D o c 0 *->OSd: ^w X0 h aQ ooh DIPHTHERIA 3S3 which shall receive antitoxin immunization. The concentrated anti-toxins are preferable both on account of the diminished bulk and theinfrequency with which skin and jomt affections follow their injection.Recently prepared antitoxin should be obtained, for it has been shownthat this agent deteriorates with age (Abbott), and then no longercontains the original unit values. The Diphtheria Toxin Skin Reaction.—The Schick reaction is a reac-tion discovered by Schick, of Vierma. By this we can determine whetherany individual has a natural immunity agamst diphtheria. The reac-tion depends on the local uritant action of mmute quantities of diph-theria toxin when injected intracutaneously. If antitoxin is absentfrom the blood or present in very small amounts, insufficient forprotection, a positive reaction will appear on the skin in twenty-fourto forty-eight hours. This consists of a circumscribed area of rednessand infiltrat

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