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[Extracted from] [1912] LEICESTER: SANITATION versus VACCINATION BY J.T. BIGGS J.P.

CHAPTER 107: London Evidence Against Anti-Toxin.

The Metropolitan Asylums Board of London exercises its functions over probably the largest area and population, and deals with the largest number of cases, of any authority in the world. The authoritative official reports of this Board carry great weight, and may be regarded as conclusive. Especially is this the case when the evidence they afford is contrary to that which the compilers would have wished to present. The following figures are abstracted from the tables contained in the annual reports of the above Board from 1895 to 1910.

The most striking and dominant feature of the table is the high fatality-rate of those inoculated with anti-toxin when compared with the untreated cases. The highest fatality-rate of the injected patients is 28.1, and the lowest 9 per cent., whereas the highest fatality of the untreated cases is but 13.4, and the lowest only 1.5 per1, cent., showing a difference enormously against the use of anti-toxin.

The fatality of the treated cases is more than double that of those not treated with this dangerous concoction.

GRAPH   E.
ILLUSTRATING  TABLE  36.
LONDON.
DIPHTHERIA    FATALITY    OF    CASES.

Shown in Four-Year Periods, 1895-1910.

TABLE 36.    (See Graph E.) Metropolitan Asylums Board Annual Reports.
Summaries of Anti-Toxin Treatment of Diphtheria from Medical Supplements.

Fatality of anti-toxin cases      ■■■■■■■■   13.28 per cent.
Fatality of non-treated cases   ■■■              5.65 per cent.
Relative Difference in favour of non-treated cases nearly 58 per cent.

Total   cases,   88,445 ;   total   deaths,   10,837 ;   fatality   rate, over all, 12.25 per cent.

It will be seen from the foregoing table that 75,310 cases of diphtheria were treated with anti­toxin,  with an average fatality-rate of 13.28 per cent. ; and that 13,135 cases not so treated yielded an average fatality-rate of only 5.65 per cent.—a relative difference of nearly 58 per cent, in favour of the latter, and hence damaging to the claims made by the advocates of anti-toxin. But this is not all. From foot-notes to the tables in the reports, we find that of the 742 deaths in cases not treated, no fewer than 137 were moribund, and recovery hopeless on their admission to the hospitals, while there were at least 92 deaths from diseases other than diphtheria. This proves that low as was the average fatality-rate of the cases not treated with anti-toxin, it is also unfairly saddled with all the worst and absolutely hopeless cases. In addition, a number of deaths from other causes which ought in common fair­ness to have been excluded are actually included in the non-treated class, the elimination of which would have led to a further reduction of the non-treated fatality-rate.

It is, therefore, futile to contend that the group of cases treated with anti-toxin contained a larger proportion of severe cases. The tables all prove the very opposite.

If the 137 moribund cases are deducted from the 742 non-treated deaths, the fatality rate of this class is reduced to 4.66 per cent. ; and if the 92 deaths from other causes are also deducted, as they should in all fairness be, then the fatality-rate is reduced to only 3.9 per cent., against 13.28 per cent, for the serum-treated cases. Comparing relative percentages, this shows an advantage of over 70 per cent, in favour of the non-treated cases.

Now it is perfectly well known and established that the very essence of the treatment of diphtheria by anti-toxin is to secure the patients at the earliest moment—on the first day of infection if possible. It is argued that in the early stages of the disease, the diphtheritic poison is more amenable to the antidotal treatment by serum. Elaborate figures have been compiled by Dr. MacGombie (Medical Superintendent of the M.A.B. Brook Hospital) to show that in those injected with anti-toxin on the first day of infection, the fatality was nil ; on the second day, it was 4.5 per cent. ; on the third day, 11.9 per cent. ; on the fourth day, 17.5 per cent. ; and on the fifth day and after, it was 18.9 per cent.

On these figures one might argue, that the fatality is actually increased by the toxic poison, because in many of these cases the fatality is even higher than the average.

An attempt is made by the Medical Superintendents to explain away the condemnatory character of these facts. In their report for 1896, they   say  that:—

" To   compare   the   mortality   of those treated with anti-toxin with that of those which during the same period were not so treated would be to institute a comparison between two groups, one of which contained a very large and the other a very small proportion of severe cases. . . . And we are consequently led to express our deliberate opinion that to compare the mortality of the anti-toxin treated cases with that of those which during the same period  were  not  so  treated,   as  has  been  suggested, would not only be misleading, but also unfair."

In other words, we are asked to disregard the evidence, and to believe that this result is due to the anti-toxin virus being applied only to severe cases, while the mild ones are not treated at all! ! A crushing answer to this assertion is supplied by the reports themselves.

We need but remember that the whole, or principal, benefit of the treatment is alleged to depend upon the prompt, or very early application of the remedy before it is even known whether the cases will prove to be mild or severe, then the weakness of these excuses becomes palpable.

I commend the foregoing facts to the thoughtful and intelligent consideration of all who desire to see the human race healthy, vigorous, and strong, both mentally and physically. The evils of zymotic maladies will never be succesfully com­bated by adding disease to disease. In fresh air, sunlight, and hygienic conditions must preferably be sought the remedy, which so-called scientific research fails to provide. While the devotees of seratherapy cling so tenaciously to these artificial, but dangerous, cultures from the bacteriological laboratories, no benefit from the "science of medicine " is destined to accrue to the human race.