Are Your Children Healthy? Diphtheria

Hello, again History Lovers,

Today’s article discusses the seriousness of Diphtheria in children in the early 1920s. Written by Dr. Walter Ramsey M.D., a leading doctor of his time, he expresses the urgency in which the diphtheria antitoxin must be administered to a child who is suspected of having contracted the disease. With a forty percent mortality rate without the antitoxin, Diphtheria was a dreaded childhood illness. Dr. Ramsey’s article is prefaced by a clipping from a Charlotte, North Carolina newspaper from 1922 illustrating the tragedy of diphtheria. The title of the article links to the clipping.


Board of Health 1923 Diphtheria Warning Poster

Charlotte News, Births to Deaths and Everything Else, March 19, 1922

After an illness of three days with diphtheria, Sarah Hope, 6-year-old daughter of Mr. and Mrs. J.A. Cooper of Lawyers Road, died at the home of her parents Saturday afternoon. The body will be accompanied to Rockingham Sunday and interment will take place there. She is survived by her parents, two brothers, and one sister.

What You Should Know About Warding Off Diphtheria 1923

Dr. Walter R. Ramsey, M.D.

Twenty-five years ago, diphtheria was the most dangerous and the most dreaded of all the diseases which attacked children. There was scarcely a family to be found anywhere which had not lost some of its members from diphtheria.

In going through the files of the City and County Hospital of St. Paul, Minnesota for a period of ten years between 1887 and 1897, the death rate was between thirty-five and forty percent. That is, of every hundred cases which entered the hospital with diphtheria, forty of them died. These figures correspond to those of the large hospitals throughout this country and Europe.

In 1897, Behring and Roux, two European scientists, published their wonderful discovery of diphtheria antitoxin.

During the following ten years by giving antitoxin to diphtheria cases, the death rate had fallen to six per hundred. This rate has been maintained with slight variations up to the present time. In the rural districts of the United States, diphtheria still exacts a large toll in deaths, all of which are preventable.

Dr. Edwin H. Place of the Boston City Hospital has just brought out the fact very clearly that it is not the size of the dose of the antitoxin but the earliness with which it is given that counts.

If given in the first twenty-four hours the mortality is almost nothing but if delayed until the second or third day the death rate jumps up to seven or even ten percent.

There is a widespread idea among people in general, that the giving of antitoxin is frequently followed by serious results such as paralysis. Observing the use of antitoxin in large municipal hospitals over a period of twenty-five years, I have never seen a single death that could be attributed to the antitoxin but I have seen the mortality reduced in the same institutions from forty per hundred to less than six. The temporary paralysis which rather frequently follows or complicates diphtheria is not due to the antitoxin but to the toxin or poison of the disease which did its damage before the antitoxin was given.

These complications are very much less frequent than they formerly were and if the antitoxin were given in the first twenty-four hours there would be practically no complications. The worst thing I have seen following the antitoxin was a severe case of hives and this is rather common but not dangerous.

It is nothing short of criminal, in the light of our present knowledge, for a parent or guardian to refuse or neglect to have a child suffering from diphtheria given antitoxin and given early.

Antitoxin should be available, free of cost, in every hamlet in this nation.

If all cases of membranous sore throat or even (supposedly) “plain” sore throat, were at once assumed by the mother to be diphtheria and a physician called, there would be very few deaths from diphtheria. Antitoxin should be given even in mild cases.

Diphtheria patients should be kept in the recumbent (lying down) position for several weeks, as the most frequent cause of death is heart paralysis. This danger does not end when the membrane has disappeared from the throat but is even greater during the second and third weeks. Sitting up in bed suddenly is not infrequently followed by sudden death when the heart is weak even when the child is to all outward appearances well.

In cases of membranous croup (laryngeal diphtheria) the membrane forms in the larynx which is the upper end of the windpipe blocking the passage of air.

Every case of croup that does not respond to the ordinary home remedies such as a cold compress to the front of the throat, a dose of ipecac, or the steam kettle, should be assumed to be diphtheria, the physician called at once and the child given antitoxin.

If the obstruction to breathing increases, the child should be removed to a hospital, as it may be necessary to introduce a tube into his larynx in order to save his life.

In all epidemics of diphtheria or other contagious diseases, the source of the milk supply should be carefully investigated, as milk is a common carrier of infection.

In the case of any epidemics, all milk should be pasteurized or brought to the boiling point for three minutes.


The above article was originally published in The Farmer’s Wife–A Magazine For Farm Women, February 1923 Page 300; Webb Publishing Company, St. Paul, Minnesota. Articles may be edited for length and clarity.