Semi-Centennial Volume. 29 



one case. A prominent man in one of our state institutions was a 

 suflferor from this disease. It had well-nigh caused him to give up his 

 work when he was induced to have his tonsils removed. A rather 

 severe infection of the lacerated surface followed unfortunately, and he 

 suffered another severe attack of rheumatism, worse than ordinary. 

 The infection soon ceased, he recovered at once from the rheumatism, 

 and up until recently during a period of several years, he has not had 

 a single recurrence of his former malady. Other forms of rheumatism 

 respond less favorably. 



Many cases of appendicitis are now successfully treated when be- 

 fore our period they were probably unrecognized, or would have been 

 disastrous without antiseptic and aseptic measures. 



Diphtheria is of especial interest because of the discovery of diph- 

 theria antitoxin by Behring and Kitasato in 1890. They found that the 

 toxin produced by Mycobactermm diphtheria provokes the production 

 in the animal body of a substance that will neutralize the free toxin 

 either within or outside of the animal. Its action is not upon the germ 

 but upon the toxin produced by it. Because the horse is found more 

 suitable than other animals for the purpose, it is used for the prepara- 

 tion of diphtheria antitoxin. This is largely because of the large 

 amount of blood that may be withdrawn without serious harm to the 

 animal. At the present it is often purified and concentrated, is then 

 standardized by the use of a government standard unit, tested aerobic- 

 ally and ansrobically, including animal reactions for its bacterial purity, 

 placed in the proper receptacles, and is ready for use. It has robbed 

 this dread disease of many of its terrors, and if administered in time 

 (during the first twenty-four hours of the disease) the mortality is 

 practically none. In cases taken as they run in ten states and cities 

 of the United States the fatalities in the decade ending with 1914 

 ranged from 9.67 per 100 in Michigan to 3.09 per 100 in Newark, N. J. 

 0.001 cc. of filtered broth culture of this germ has been known to kill 

 a guinea-pig. This is an extreme case, but it illustrates with what man 

 has had to contend in fighting this disease. 



Schick has devised a test for the presence or lack of immunity in a 

 person. On injecting one-fiftieth of a minimal lethal dose for a 250 gram 

 guinea-pig into the skin of a person, if there is no local reaction, the 

 person is immune. If there is a white spot at the point of reaction, 

 with a reddened area around it, then there is no antitoxin present in 

 the blood and the person is not immune. Through this test it is quite 

 possible to discover just whom to treat or not in an epidemic. It is 

 supposed to act on the same principle as the tuberculin reaction in 

 tuberculosis. 



Among the common diseases of man malaria is one of the most inter- 

 esting. An historical account of it with the steps taken to come to 

 a definite understanding of its etiology, the modes of its transference, 

 the means of its prevention, etc., reads like a fairy tale. It has long 

 been known. It has probably been one of the causes of the non-develop- 

 ment or decay of nations or peoples. Some have thought that Paul's 

 "thorn in the flesh" may have been this disease, contracted in the 



