COMBAOTING DISEASES.

New Zealand Herald, Volume LV, Issue 17033, 14 December 1918, Page 1 (Supplement)

COMBAOTING DISEASES.

VACCINES AND SERA.

BY H.J.O.

The epidomio of influenza which has been raging with more or less severity throughout New Zealand during recent weeks, and which is now rapidly abating, has drawn , attention to the system of preventing and treating infectious and contagious diseases by the use of vaccines and sera. The system is by no means an exact medical science, and it is only possible to secure a practical vaccine or serum after a long series of experiments and close observations. During the height of the epidemic in Auckland a supply of vaccine was received .by the Public Health authorities, but on account of the divided opinion among local medical men regarding' the risk of using a vaccine which had not been adequately tested, it was deemed inadvisable to employ its use.

The fascinating study of the production of immunity or insusceptibility to disease is one that dales back to remote times, though in the early and middle ages the insusceptibility aimed at was mainly against poisoning. During the middle; ages, injections of blood were given for various purposes, lamb's blood being used in the treatment of leprosy. It was not until comparatively recent times that the study of the natural and the artificially-, produced immunity from disease was systematically pursued by physicians, and ! bacteriologists. The first pre-eminent' landmark was the discovery by Jenner, more than a century ago, of the protective action of vaccination against smallpox. The honour of being the first to pro-, duce artificial immunity from infectious diseases is reserved to Pasteur. His dis- ( covery was related to anthrax, cholera, and rabies, but his methods have been in- ' troduced in the treatment of typhoid fever and other diseases, both as a preventive' and a cure. -•'■'

Two, Forms oil Immunity. ££*.;•• Immunity or insusceptibility is never absolute. There are two forms of immun- ; ity—natural and acquired. Natural Immunity may be racial. It is, however, a/s----aired immunity, and especially artificially produced Immunity.: that is of the chief interest. Acquired immunity is frequently produced as a result of an attack of disease. For instance, if a person conracts scarlet fever, he or she will in allprobability; never contract it a second time. Why! After an attack, certain indefinable something is left in the body, ' whioh 'gives the person affected an acquired immunity. If, therefore, scientist* were able to Isolate the particular something which gives immunity, and were able to inject it into the bodies of schoolchildren, or others who might be likely to come into contact with scarlet fever patients, obviously the disease could be prevented from spreading among large sections of the community. This is precisely what the Australian authorities are aiming at. in regard to the present ' epi- j demic In regard to mfluenia, pneumonia, and diphtheria, immunity as a result of an attack of the disease is transient and ill-defined. So far as the two first-named diseases are concerned, susceptibility may even be increased shortly after an attack. Vaccine Treatment. Vaccine treatment has secured the best results when the vaccine is prepared with the: particular strain of,organisms with which tie patient is infected. In. other. words, the. object to be aimed at is to secure a vaccine which is the exact antithesis of the disease. •; To put the matter: so that it will be readily understood by ; laymen, the principle is* to introduce something into the blood that. will render the soil, as it were, unfit for the growth of the organism. Vaccine works in the human system as an anti-toxin, that is, it neutralises the poison given off by the action of micro-organisms. , , > '•■-..] .• Anti-diphtherio serum,,;', or diphtheria anti-toxin, elands . foremost , among the' anti-toxic sera, , on < account of its extensive use and the excellent results obtained therefrom. The mortality from diphtheria is practically nil when «■ the disease is treated with anti-toxins : from the first day, and steadily rises on each suceeding day. that the treatment ia delayed; Medical men state that the immense value, of diphtheria anti-toxin in the treatment of the disease cannot be doubted by any unbiassed : observer. ■ In \ the. hospitals <of the Metropolitan Asylums Board, London, there has been a progressive fall in the case mortality ;; sines the ' Introduction, of anti-toxic treatment * In 1894, the: year in which \ anti-toxio; treatment Was commenced, down to 1908, the case mortality, fell from 29.3 to 9.7. :' Statistics published by the Chicago Board of Healthy although some years old,. are so striking as to be worthy ,of attention. .'?■', During •. the '; l. '-, five years preceding anti-toxio treatment there' was an aggregate of 7411 deaths -.; from diphtheria and croup, an ' annual average of 1482 deaths, and an annual death rate of 11.23; per-10,000 of * the ■ f population. Antl-toxio, treatment commenced on October sth, 1895,. and during' the five years ended ! December, 1900, the deaths aggregated 4309, an annual average of 862 and an annual mortality rate of 5.45 . per, 10,000 ;of ; the population. Estimated .on' the economic basis of the value of a. human life, the saving of life during the anti-toxin j period .'. in 1900 represented a' saving of nearly £1,500,000. |j

f '." Diphtheria Anti-toxin. $ The .prophylactio use of diphtheria antitoxin la especially indicated. . Statistics published by the New York Health DeEartraent show that of; 3100 individuals'! hown to have been exposod to infection and injected with a prophylactio dose of anti-toxin only nine contracted the disease and six of those in a mild form. ~. 1 In regard to the treatment, of pneumonia, the weight of medical opinion indi-' cates that tho mortality is not lessened by the two,of serum. In many. '. oases serum, combined with other treatment, has been ' beneficial in the'" treatment of pneumonia, but on tho whole is not considered to have been very successful, and vaccine treatment.has superseded it. According, to the majority of records the rise of vaccine has not been strikingly beneficial, except before definite pneumonio symptoms show themselves. Tuberculosis. There have been numerous attempts made to prepare a serum or anti-toxin for the treatment of the scourge of civilisation —tuberculosis. Tho results of the use of serum in one or two instances have been fairly promising. One physician is reported to have claimed that of 2899 cases of pulmonary tuberculosis in various stages treated with tuberculin, 14 per cent, were cured, 50 per cent, improved, and only .in 18 per cent, of the cases did the disease progress during treatment. Tuberculin treatment for tuberculous glands or sores has been shown to he beneficial while the injections are continued, but occasionally on . discontinuance of the treatment there is a recrurles'ence of the trouble. A famous bacteriologist, Denys, conceived a method of treating pulmonary tuberculous cases with a tuberculin of his own preparation. It was tested on 442 patients in a more or less advanced 6tage. Of these 193, or 43.6 per cent., are stated by him to have been cured. He claimed considerable improvement in the physical signsdiminution of cough, increase of appetite, gain in weight, cessation of fever, and the disappearance of the. baccilus. Tuberculin is largely used for. diagnostic purposes•An anti-serum has been .prepared, for epidemic ' cerebro-spinal-mcningitis, ,or spotted fever,, and used with decided benefit, the mortality rate in man having been reduced from 60-70 per cent, to 30 per cent,- •.,-,. !■• , ~' . ,

Vaccine t and sera are used with more or leu success . in; the • treatment of a number of other diseases, \. ... I.i«!