CHAPTER XXIV

THE CURE OF DIPHTHERIA

[Sidenote: Nature of diphtheria poison]

The germs of diphtheria do not get into the blood through the

skin, but grow on the surface of the mucous membrane (skin of

the throat), and there produce a poison that gets into the blood

through this membrane. It is this poison that makes you sick,

and it is called a _toxin_. You already know that when people

have diphtheria, they are sometimes very sick and sometimes only

slightly sick, and that the germ can live in some throats without

causing any ill effects whatever.

[Sidenote: How diphtheria toxin is fought]

As soon as the diphtheria germ begins to grow in a throat, the

little cells of the body begin to make a certain substance and to

pour it into the blood. This substance we call _antitoxin_, which

means opposed to the toxin in the blood. If the little cells make

the substance fast enough, the germs will stop growing, or in some

cases they never really get started growing, because they cannot

exist where there is much antitoxin. Antitoxin looks like clear

water. The following experiment will show you something that acts

in very much the same way that antitoxin does.

If you take a solution of litmus that is made alkaline, it will

be very blue, like indigo; but if you drop a few drops of lemon

juice into this solution it will turn red.[3] Lemon juice is acid,

and is just the opposite of alkali. Now, if you put a few drops of

ammonia, which is alkali, into the red solution, it will turn blue

again. If you put a little more lemon juice, very carefully, drop

by drop, into the blue solution, it will gradually turn lighter,

until it is entirely clear.

[Sidenote: How antitoxin acts]

We will suppose that the blue is due to the toxin produced by the

diphtheria germ, and that the lemon juice is the antitoxin produced

by the cells in the body. If the antitoxin is made fast enough,

the blue disappears; but if the toxin is made faster than the

antitoxin, the blue remains. It is the same way in the body, only

it is not litmus and acids and alkalies that we have to deal with.

If the toxin is made faster than the antitoxin, the germs grow, and

we get sicker and sicker; but if the antitoxin is made faster than

the toxin, then the germs cannot grow, and we soon get well, or

perhaps do not get sick at all.

[Sidenote: How antitoxin was discovered]

Doctors knew that this was what happened, but for a great many

years they could not discover the composition of the antitoxin that

is made in the body. One day a doctor suggested, "If we cannot

find out the chemical nature of this thing that is made in the

body, why can we not make it in the body of some animal and then

use the blood of the animal?" And that is just what they did. They

put diphtheria germs into beef tea, and let them grow very fast

and make all the toxin they could. Then the doctors strained the

germs out by passing the beef tea through a fine filter, in this

way getting the poison, and not the germs. Then they gave a strong,

healthy horse a small quantity of this poison; they did not feed

it to him, but injected it into his blood. Of course the horse was

sick for a while, but soon he began to get well again, for the

cells in his body immediately went to work making antitoxin.

When the horse was well, the doctors gave him more of the poison;

this time he was not so sick and got well even more quickly. This

treatment with toxin was repeated in gradually increasing doses

until the poison did not affect the horse at all. Then the doctors

said, "His blood is full of antitoxin, and we will see what it will

do when injected into some other animal." So they drew off some of

the horse's blood and took out all the little red cells, leaving

nothing but the clear fluid of the blood. They planted diphtheria

germs in a rabbit's throat, and when the rabbit became very sick,

they gave him some of the antitoxin from the horse. The rabbit

immediately got well. Afterward they gave some of this antitoxin to

a little boy who was very sick with diphtheria, and he, too, got

well. Ever since then the doctors have been saving many lives by

the use of antitoxin.

[Illustration: FIG. 56. Showing the number of deaths in 100 cases

of diphtheria when antitoxin is used on the first, second, third,

fourth, and fifth days.]

[Sidenote: Evidences that antitoxin saves lives]

Someone may ask, "How do we know that it is the antitoxin that

saves lives?" In just this way: before we knew anything about

antitoxin, about half of all the people with diphtheria died; but

since we have had antitoxin, only about twelve die out of every

hundred who have this disease. More than this, we know that when

the antitoxin is given within the first twenty-four hours after the

patient is taken sick, there is only about one death for every one

thousand cases of diphtheria. Do you not think that this is strong

proof that antitoxin saves lives?

[Sidenote: How antitoxin saves lives]

Antitoxin saves lives not only by curing those who have diphtheria,

but by preventing others from having it. If a person who has been

where there is a case of diphtheria is given a dose of antitoxin,

he will not have the disease, because his blood will contain enough

antitoxin to destroy the diphtheria toxin present. If you will

watch a careful doctor when he makes his first visit to a case

of diphtheria, you will notice that, as soon as he gets through

treating the patient, he gives all members of the family who have

been near the patient a dose of antitoxin to keep them from getting

sick.

[Sidenote: Antitoxin not a poison]

Some people may tell you that antitoxin is a poison and should not

be used. The statement that it is in itself a poison is true. But

it is also true that in your body there are many things that would

poison you if you got too much of them. For instance, there is a

gland in your throat (the thyroid) which secretes a substance that

is necessary for your health, but if you were to take the secretion

of ten such glands it would kill you at once. Now, if the cells in

your body make antitoxin when you have diphtheria, it is probable

that antitoxin is the very thing needed. And if you can help these

cells by giving them antitoxin, ready-made, does it not seem a

reasonable thing to do? People who give the name of poison to a

substance which is known to have saved many lives are not worthy of

attention. Anything may prove a poison if taken in excess; too much

play will prove a poison, and too much work also.

=Questions.= 1. What is the poison of diphtheria called? 2. What

is antitoxin? 3. Compare the action of antitoxin on the blood

with the action of an acid on the litmus solution. 4. Tell about

the discovery of antitoxin. 5. How do we know that antitoxin

saves lives? 6. How does antitoxin prevent diphtheria? 7. Why

should antitoxin not be regarded as a poison?

=Remember.= 1. Antitoxin is what the cells in your body make

when you have diphtheria. 2. By using the antitoxin taken from

a horse, you save your own cells the struggle necessary to make

it fast enough to kill the diphtheria germs. 3. If you have

diphtheria, and antitoxin is given promptly, you will get well.

4. If you have been exposed to diphtheria, antitoxin will prevent

your having the disease. 5. Antitoxin is no more a poison than

are many other medicines.

Principles of Public Health A Simple Text Book on Hygiene, Presenting the Principles Fundamental to the Conservation of Individual and Community Health · 第 10 / 19 章