CAN ANTITOXIN STATISTICS BE RELIED UPON? 
BY GUSTAVUS BLECH, A. B., M. I)., 
Surgeon to the German Free Dispensary, Detroit, Midi. 
The many fiascoes in modern medicine have taught me a 
lesson, viz.: Never to be the first and never to be the last one, to 
adopt a new remedy. Liberality is one of the first conditions for 
progress and success in medicine; conservatism, the preventative 
of poetic illusions and errors, undiscovered on account of the 
blinding effect of enthusiasm. 
I have quietly watched the reports of cures of diphtheria with 
antitoxin, and have wondered how easy it is to catch the masses, 
even if one knows next to nothing about the modus opcrandi of a 
remedy. Besides, its origin and composition is mystery as yet, its 
preparation being controlled entirely by a few enterprising chemists. 
But neither this nor the fact that its introduction into the human 
system is apt to cause a good many dangers like leucocythemia, shall 
be brought as an argument against its value; even the fact, that a 
good many eminent and thoroughly reliable physicians have re- 
ported their experiments with it as failures shall not be mentioned, 
and only one modest question shall be asked: Can antitoxin statis- 
tic's be relied upon ? I dare answer, no, not always. 
I do not doubt for one moment the honesty of the reporters and 
their noble intentions; for the sake of the honor of the profession, I 
will say that “figurers will not lie,” but I cannot help asserting that 
“figures will.” The fact is, that every case reported as diphtheria, 
is indeed, not always true diphtheria. In some cases the micro- 
scopic examination alone was sufficient for a diagnosis, and that 
was false. In other cases, the physical signs, the clinical picture 
was the medium, and that was false also. Both together, micro- 
scope and thermometer, eye and hand, must be employed to ob- 
tain a correct diagnosis. ■»— 
Published by The Journal of the American Medical Association, for January 25, 1895. Diphtheria, true diphtheria, in spite of horse, jackass or any 
other quadruped serum, is a grave, constitutional disease, the prog- 
nosis of which is always doubtful. It is exaggerated when one of 
my friends asserts, that he makes a diagnosis of true diphtheria 
post mortem only; but there is some truth in that intended joke. 
There are plenty of poor children running around the streets with 
sore throats, follicular tonsilitis, rhinitis fibrinosa and never take 
a drop of medicine and get well. And in some of these a physician 
is called in, and a few hours later, the health inspector is placard- 
ing the house. If, by chance, the parents are smart enough to 
call in a more experienced physician, off goes the red sign. 
I had quite a number of such cases in my practice, but in one 
of my last ones, I had an encounter with our local board of health, 
which ended in my victory. 
The case I refer to is that of a little boy, R. S., aged 4 years. 
He was taken sick with sore throat, and nose, the latter bleeding 
on touch, membranes being expelled on sneezing. A reputable 
physician was called who pronounced it diphtheria. He sent a cul- 
ture to the local board of health where Klebs-Loeffler bacilli were 
found. For some unknown reason to me, the parents discharged 
the physician and called me in to attend the case. I made a 
careful examination of the nose and throat, found a somewhat 
accelerated pulse and a temperature below 100 degrees F. The 
boy ran from one room to another, and would not agree to be 
confined to bed. While the mucous membrane appeared to be, 
on the first look, diphtheria, a closer examination revealed the 
double malady of follicular tonsilitis and rhinitis fibrinosa. 
Both affections simulate diphtheria almost to delusion. The 
clinical picture of a grave constitutional disease, high fever, etc., 
which symptoms are a conditio sine qua non for a diagnosis of 
true diphtheria, were absent. On the other hand some authors 
have lately classified rhinitis fibrinosa with diphtheria, but the 
best authorities in the old and the new world strongly object to 
such classification. The argument that if the Klebs-Loeffler ba- 
cillus be found, the case must necessarily be one of true diphtheria, 
does not always hold good, as Baginsky and others have found the same bacillus in different forms of rhinitis and pharyngitis. While 
I must admit, that not every case of diphtheria is associated with 
a high temperature, constitutional depression, etc., such is the rule 
without any exception in nasal diphtheria. After nose and throat 
have been sprayed with hydrozone there could be found no mi- 
crobe in the culture taken the other day. 
The number of cases of this kind which I have successfully 
treated approaches closely to one hundred. If, according to the 
Board of Health of New York, Chicago and other institutions, 
they ought to be styled diphtheria, well then, what is the use of 
injecting blood serum taken from some animal ? We have in 
hydrozone (30 volumes aqueous solution of anhydrous peroxide of 
hydrogen) a remedy which not only kills instantaneously the Loef- 
fler bacilli, but also changes chemically the nature of the soil in 
which their spores can develop. Its deadly action is limited to veget- 
able cells (pathogenic germs) and it is the most powerful stimulant 
to healthy granulations, having no injurious action upon healthy 
animal cells. In fact, my experiment taught me that hydrozone 
is a safe and most reliable remedy to use in the treatment of diph- 
theria. On the contrary, I will say: 
How can we rely upon antitoxin ? 
203 E. Columbia Street.