{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:52:16Z","timestamp":1777863136128,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[1941,3,1]],"date-time":"1941-03-01T00:00:00Z","timestamp":-910051200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Proceedings of the Royal Society of Medicine"],"published-print":{"date-parts":[[1941,3]]},"abstract":"<jats:p>Diphtheria.\u2014Immunization is safe and effective. Compulsory measures are indicated, especially for the younger age-groups. The Schick test may be reserved for selected groups and to control modified methods. Proper spacing of doses of prophylactics and periodic reinoculation will ensure a high level of immunity. It is important to beware of \u201cone-shot\u201d methods. Indiscriminate swabbing is to be discouraged; high carrier rates are an indication for widespread diphtheria prophylaxis.<\/jats:p>\n                  <jats:p>Enteric fever.\u2014Mass immunization is desirable in many areas, although there is no justification for compulsion except for people exposed to special risks. In deciding upon dosage of vaccine, more attention should be paid to physical state and body-weight. After the primary course, very small periodic doses (for example o.i.c.c) are worthy of trial. Vaccine can be given during an epidemic without increasing the chances of infection.<\/jats:p>\n                  <jats:p>Tetanus.\u2014Two doses of toxoid spaced by six weeks give useful immunity. Women give significantly higher titres than men. A third dose of i.o.c.c. after a long interval\u2014seven to nine months\u2014often produces a dramatic rise in circulating antitoxin, and counteracts any tendency to waning immunity.<\/jats:p>\n                  <jats:p>Smallpox.\u2014As vaccination has not been made compulsory in this country, infection by virulent strains from the continent may tax the resources of the public health services.<\/jats:p>\n                  <jats:p>Whooping-cough.\u2014The large number of injections of vaccine usually recommended is a deterrent to mass immunization. Research into the possibility of fewer doses and wider spacing is indicated.<\/jats:p>\n                  <jats:p>Other diseases are considered briefly.<\/jats:p>\n                  <jats:p>Combined immunization.\u2014It may be useful to combine diphtheria T.A.F. and tetanus toxoid, also tetanus toxoid and T.A.B. vaccine. T.A.F. plus T.A.B. is probably contra-indicated for adults on account of severe reactions. Diphtheria A.P.T. should not be mixed with tetanus toxoid as it may go into solution and become ineffective.<\/jats:p>\n                  <jats:p>Sterilization of syringes and needles.\u2014An intensive inoculation campaign is no excuse for slip-shod methods.<\/jats:p>","DOI":"10.1177\/003591574103400503","type":"journal-article","created":{"date-parts":[[2019,7,19]],"date-time":"2019-07-19T02:44:18Z","timestamp":1563504258000},"page":"247-256","source":"Crossref","is-referenced-by-count":1,"title":["Discussion on Active Immunization\u2014Some Present-Day Problems"],"prefix":"10.1177","volume":"34","author":[{"given":"H.J.","family":"Parish","sequence":"first","affiliation":[{"name":"Wellcome Physiological Research Laboratories"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,9]]},"reference":[{"key":"bibr-bibr1-003591574103400503","first-page":"755","author":"Bensted H. J.","year":"1940","journal-title":"Lancet"},{"key":"bibr-bibr2-003591574103400503","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1136\/bmj.1.4135.582","author":"Bigger J. W.","year":"1940","journal-title":"Brit. M. J."},{"key":"bibr-bibr3-003591574103400503","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S0035-9203(40)90016-5","volume":"33","author":"O'Brien R. A.","year":"1940","journal-title":"Tr. Roy. Soc. Trop. Med. & Hyg."},{"key":"bibr-bibr4-003591574103400503","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1136\/bmj.2.4173.891","author":"Marvell Doris M.","year":"1940","journal-title":"Brit. M. J."},{"key":"bibr-bibr6-003591574103400503","first-page":"301","volume":"24","author":"Glenny A. T.","year":"1925","journal-title":"J. Hyg."},{"key":"bibr-bibr7-003591574103400503","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/S0140-6736(00)91531-9","author":"MacLean I. H.","year":"1940","journal-title":"Lancet"},{"key":"bibr-bibr8-003591574103400503","first-page":"241","volume":"1","author":"Ramon G.","year":"1939","journal-title":"Internal. Clin."},{"key":"bibr-bibr9-003591574103400503","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0140-6736(01)08280-0","author":"Schutze H.","year":"1940","journal-title":"Lancet"},{"key":"bibr-bibr10-003591574103400503","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1084\/jem.54.3.373","volume":"54","author":"Shope R.","year":"1931","journal-title":"J. Exper. Med."},{"key":"bibr-bibr11-003591574103400503","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1084\/jem.66.2.169","volume":"66","author":"Shope R.","year":"1937","journal-title":"J. Exper. Med."},{"key":"bibr-bibr12-003591574103400503","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/S0140-6736(00)78541-2","author":"Smith W.","year":"1933","journal-title":"Lancet"},{"key":"bibr-bibr13-003591574103400503","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0140-6736(00)95033-5","author":"Vaughan A.","year":"1941","journal-title":"Lancet"}],"container-title":["Proceedings of the Royal Society of Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003591574103400503","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/003591574103400503","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:21:17Z","timestamp":1777526477000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/003591574103400503"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1941,3]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2016,9]]},"published-print":{"date-parts":[[1941,3]]}},"alternative-id":["10.1177\/003591574103400503"],"URL":"https:\/\/doi.org\/10.1177\/003591574103400503","relation":{},"ISSN":["0035-9157"],"issn-type":[{"value":"0035-9157","type":"print"}],"subject":[],"published":{"date-parts":[[1941,3]]}}}