It is said by opponents of experiments on animals, that the active principle, in antitoxin, is not the antitoxin, but the carbolic acid which is added to it. They take this statement from the Medical Brief; and we have learned something of the style of that journal. Here is a sentence from the official journal of the National Society:—
"The Medical Brief calls antitoxin 'the fraud of the age,' and says: Would that physicians could all realise the hideous horror of using this nasty stuff as a remedial agent. It would be nothing less than ghoulishness to inject the matter from an abscess into a child's arm, yet antitoxin is not much better; it is the decomposing fluid from a diseased horse, partially neutralised by carbolic acid."
For a commentary on this sentence, take the following letter from an eminent bacteriologist:—
"As regards diphtheria antitoxin, the addition of an antiseptic is by no means necessary or universal. For fully two years I added none to the serum which I prepared, but contented myself with filtration through a Kieselguhr filter, and bottling under aseptic conditions. At one time Roux used to put a small piece of camphor in each bottle as some sort of safeguard against putrefaction. Nowadays I believe that most makers preserve their sera by adding a trace of trikresol—I am not quite sure of the amount, but it is either .04 per cent. or .004 per cent.!"
But it is probable that the Zoophilist will still accept the authority of the Medical Brief. Baccelli got good results, in tetanus, from the administration of carbolic acid; therefore, in diphtheria, the good results from diphtheria-antitoxin are due to the carbolic acid in it. That is the argument. But there is no carbolic acid in it? Oh, then the patient got well of himself, the treatment didn't kill him, it was not diphtheria after all, the disease has altered its type lately, he was well nursed, the back of his throat was painted with something, the doctor got half-a-crown by calling it diphtheria, the bacillus diphtheriæ may be found in healthy mouths, and all bacteriology is base and blatant materialism.
The Argument from the Death-rate
There is another argument against diphtheria-antitoxin; we may call it, for brevity, the death-rate argument. It is this. The doctors say that the antitoxin does save lives; they give us statistics from every part of the world. But, if it saves lives, then the total mortality ought to go down. But the Registrar-General's returns do not go down; indeed, they tend to go up. Therefore diphtheria-antitoxin is useless, or worse than useless. By this kind of logic, umbrellas are useless. If they were useful, then the more umbrellas there were, the less rain there would be. But the increase in umbrellas coincides with a positive increase of rain. Therefore umbrellas are useless, or worse than useless.
Despite the absurdity of this argument, Mr. Coleridge and Mr. Somerville Wood, the National Society's lecturer, have worked hard with it; Mr. Coleridge in the press, Mr. Wood on the platform. Surely this confusion between the total mortality and the case-mortality of an epidemic disease is a very serious offence. That there may be no doubt of the confusion, let us consider a set of quotations, out of a correspondence published in September-October 1902, between G. P., whose initials we may take to mean general practitioner, and Mr. Somerville Wood. This correspondence is a good instance of the argument in its usual form:—
G. P.: "The antitoxin treatment of diphtheria has lessened the mortality from that disease by nearly 50 per cent. In the hospitals of the Metropolitan Asylums Board the average case-mortality for the last five years of the pre-antitoxin period, i.e. previous to 1895, was 30.6; that for 1895 and the successive four years was 18.1, the successive figures being 22.8, 21.2, 17.7, 15.4, and 13.6, the mortality steadily falling with increased familiarity with the use of the remedy. This has not been the result of a diminished virulence of the disease, as similar experience has been gained all over the world. The figures for Chicago are even more striking, as the averages are 35.0 and 6.79 for the pre-and the post-antitoxin periods respectively."
Mr. Wood: "Nowadays, almost every sore throat is called diphtheritic, antitoxin is given, and wonderful statistics are formulated to bolster up the latest medical craze. The real test is whether the introduction of antitoxin has lowered the death-rate generally from diphtheria. Here are the Registrar-General's figures: In 1887, the death-rate from diphtheria per million persons in this country was 140. In 1897, after the treatment had been used several years, the death-rate from this disease increased to 246 per million."