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IMMUNITY RESULTS OBTAINED WITH DIPHTHERIA TOXOID (MODIFIED TOXIN) AND ONE-TENTH L + MIXTURES OF TOXIN-ANTITOXIN IN THE PUBLIC SCHOOLS OF NEW YORK CITY (MANHATTAN AND THE BRONX)

W. H. PARK, M.D.; ABRAHAM ZINGHER, M.D.
Am J Dis Child. 1924;28(4):464-478. doi:10.1001/archpedi.1924.04120220060010.
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INTRODUCTION  The large and increasing use of subcutaneous injections of some form of modified toxin for purposes of active immunization, makes it important to utilize this toxin in the form in which it will produce the greatest amount of immunity, with the minimum amount of deleterious after effect. It is important to grasp that in any preparation it is the diphtheria toxin or derivatives of it, and nothing else, that immunizes. Ehrlich, in 1895, discovered that when fresh diphtheria toxin deteriorates in strength a peculiar change takes place. The toxicity for the guinea-pig drops faster than its power to neutralize antitoxin. At a certain stage in deterioration the toxin in even large doses no longer causes death in animals, but it still neutralizes a considerable percentage of its original amount of antitoxin. Thus, if the preparation drops in toxicity from 100 minimum lethal dosage to 5 minimum lethal dosage per

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