A Study of Cutaneous Sensitiveness to Scarlatinal Toxin in Pregnancy and the Puerperium

Burt-White, Harold; Colebrook, Leonard; Morgan, G.; Jervis, Beatrice J. W.; Harre, Gertrude E.

doi:10.1136/bmj.1.3605.240

BMJ

1930

DOI: 10.1136/bmj.1.3605.240

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A Study of Cutaneous Sensitiveness to Scarlatinal Toxin in Pregnancy and the Puerperium

Harold Burt-White¹,

Leonard Colebrook²,

G. Morgan³

et al.

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1930

1941

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Cited by 7 publications

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Streptococcus Convalescent Serums (Scarlatinal)

Platou¹,

Dwan²,

Hoyt³

1941

JAMA

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the time span during which they were given. Patients who received any stated amount of arsphenamine did better the shorter the time period in which it was admin¬ istered, serving further to emphasize the necessity of absolute continuity of treatment.SUMMARY AND CONCLUSIONS 1. The results of the long-term post-treatment obser¬ vation of a group of 551 patients with early syphilis were studied, just less than two thirds of whom attained "cure" as defined.2. Among those with an unfavorable outcome, there were the same race and sex predilections and relation between outcome and stage of disease at the onset of treatment which previously have been noted by others.3. Comparative examination at approximately five and ten or more years of observation revealed that all patients who satisfied the criteria of "cure" at the former continued to do so at the latter.4. The final outcome was found to depend on both type and amount of treatment.5. The results clearly indicate the superiority of the alternating continuous treatment system and emphasize that continuity should be absolute.6. The results from irregular treatment were so infe¬ rior as strongly to suggest its complete uselessness, especially after the first few injections.

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Streptococcus Convalescent Serums (Scarlatinal)

Platou¹,

Dwan²,

Hoyt³

1941

JAMA

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On the part played by the erythrogenic (Dick) toxin of the hæmolytic streptococcus in puerperal infection

Kenny¹,

Colebrook

1937

J. Pathol.

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Two practical suggestions have been frequently made in recent years with regard to puerperal fever, viz. (1) that women susceptible to Dick toxin (as shown by a positive skin reaction)-and therefore also, it is assumed, to infection by haemolytic streptococci-should be actively immunised against that toxin towards the end of pregnancy, or given antitoxic serum at the time of labour ; and ( 2 ) that treatment of the fever, when it occurs, should be by the administration of antitoxic serum, in order to neutralise the erythrogenic toxin liberated by the streptococcus in the mother's body.The assumptions involved in both these suggestions are as yet unsupported by definite evidence. They have been made too readily, perhaps, by analogy with scarlet fever. Susceptibility to that infection does appear to be in some measure related to the absence of antitoxin from the patient's blood as evidenced by the Dick test (Joe (1925) records no less than 95 per cent. of cases as Dick positive during the first five days), and there is also indirect evidence that Dick toxin is produced in the body during the infection, since the skin reaction changes from positive to negative in nearly 50 per cent. of cases within two weeks and in over 70 per cent. within three weeks (Joe).With hzmolytic streptococcus infections other than scarlet fever the situation is somewhat different. There is as yet no clear evidence that liability to these infections is intimately correlated with the patient's inability to neutralise Dick toxin (as shown by a positive Dick test), nor has there been evidence that Dick toxin is elaborated by the streptococcus in the patient's body during the course of these infections when no rash is present. The

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Experimental Studies of Puerperal Infection

Torrance

1935

American Journal of Obstetrics and Gynecology

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A Study of Cutaneous Sensitiveness to Scarlatinal Toxin in Pregnancy and the Puerperium

Cited by 7 publications

References 0 publications

Streptococcus Convalescent Serums (Scarlatinal)

Streptococcus Convalescent Serums (Scarlatinal)

On the part played by the erythrogenic (Dick) toxin of the hæmolytic streptococcus in puerperal infection

Experimental Studies of Puerperal Infection

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