[Report of the discussion on the Dick reaction and the serum treatment of scarlet fever, held by the Society of Medical Officers of Health Fever Hospitals Medical Service Group on May 22 1925.].

Date:
1925?]
Catalogue details

Licence: In copyright

Credit: [Report of the discussion on the Dick reaction and the serum treatment of scarlet fever, held by the Society of Medical Officers of Health Fever Hospitals Medical Service Group on May 22 1925.]. Source: Wellcome Collection.

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    Reprinted from The Lancet, June 20th, 1925, p. 1294. SOCIETY OF MEDICAL OFFICERS OF HEALTH. FEVER HOSPITALS MEDICAL SERVICE GROUP. At the annual meeting of this group, held at the Society’s house in London on May 22nd, a discussion took place on the Dick Reaction and the Serum Treatment of Scarlet Fever. Dr. E. W. Good all (N.W. Fever Hospital, Metro* politan Asylums Board), Vice-President, occupied the chair. Dr. R. A. O’Brien (Wellcome Physiological Research Laboratories), in opening the discussion, said :— I should like to give some short account of what progress has been made in England in the application of the results obtained in America, notably by the Dicks, Dochez, Park and Zingher. But I would prefer to draw your attention at greater length to the difficulties ahead and the urgent problems awaiting solution before much progress can be made. Progress in England. Dick Test.—The results obtained in England, such as the series published by Okell and Parish in July, 1924, and April, 1925, and the longer series by Ker (The Lancet, 1925, i., 230), as well as a number of shorter series by various observers (over 200 cases, 70 per cent, being positive to the Dick reaction) agree in the main with American findings. Some 60 per cent, to 90 per cent, of cases of scarlet fever if tested during the first two or three days of the disease give a positive response. If tested two to five weeks after the onset of the disease some 70 per cent, to 90 per cent, of patients have developed a sufficient immunity to give a negative reaction to the Dick test (100 cases, 89 per cent, negative). Schultz-Charlton Test.—Although the observations made in England up to the present are few in number, the results agree broadly with the American findings. The serum of a patient taken some weeks or more after the end of the disease will, when injected intradermally into the rash of a scarlet fever patient within 60 hours of its appearance, blanch an area of from 10 to 40 mm. ; this blanching appears in from 6 to 12 hours and lasts usually from 24 to 48 hours. We have immunised several horses with toxin and strepto¬ cocci, and the serum of these horses when injected intra¬ dermally also causes the characteristic blanching in rashes due to scarlet fever but not in rashes due to other diseases. In England this blanching has been obtained in some 70 per cent, of over 100 cases tested. Active Immunisation.—Apparently very little work has been done in England. We have injected many minimal skin doses into ourselves without producing any troublesome reaction. Passive Immunisation.—Apparently 5 to 10 c.cm. of our horse serum injected intramuscularly will convert a “ positive reactor ” into a “ negative ” overnight. The serum should therefore efficiently protect children unwittingly exposed to infection. Treatment.—The serum of several horses has been used therapeutically in some few dozen cases. The results can be characterised broadly as promising, and in some instances as very promising. The number is far too small to enable one to draw any satisfactory conclusions, but the evidence is such as to lead us to commence the immunisation of a