DESENSITIZATION VS. HOMOEOPATHY.-In the Journal of the American Medical Association for June 2, 1923, is an interesting article by Albert Strickler, M.D., Dermatologist to the Samaritan Hospital and Assistant Dermatologist to the Philadelphia General Hospital, Philadelphia, entitled “The Value of the Toxin (Antigen_ of Rhus Toxicodendron and Rhus Venenata in the treatment and Desensitization of Patients With Dermatitis Venenata.”
Dr. Strickler states:
“In this contribution I present a statistical discussion of two problems. The first is a study of the relative value of the antigen method of treating dermatitis venenata due to poison ivy or poison oak, as compared with the older methods of local applications. The second phase of the discussion is whether or not this specific toxin (antigen) treatment is of value in the prevention of attacks of dermatitis venenata due to poison ivy or poison oak, as compared with the older methods of local applications. The second phase of the discussion is whether or not this specific toxin (antigen) treatment is of value in the prevention of attacks of dermatitis venenata in those who are highly susceptible to it. The data represent the accumulated experiences, not only of myself, but of many other physicians throughout the country who have utilized this method of treatment.
“TREATMENT OF THE ATTACK OF DERMATITIS VENENATA.
“The attack of dermatitis venenata represents a state of hypersensibility on the part of the person affected to this particular form of irritant. The old method of local application utilized remedies of dermatitis venenata due to poison ivy or poison oak, which were either slightly astringent and itch- relieving, or medicinal substances which were, in themselves, irritants. The first group of remedies, by their cooling and soothing influences, attempted in this fashion to quiet the inflammatory reaction of the skin, diminish its subjective and objective cutaneous manifestations, and thus limit the spread of this form of dermatitis.
The second group of remedies, those applied in the nature of counter-irritants, attempted to overcome this specific cutaneous inflammation by increasing the amount of defensive substances sent to the inflamed skin, and thus conquer the inflammation and control its spread. This method, owing to the possibilities for harm, has never enjoyed great popularity among the profession. The great weakness of this mode of treatment is the attempt to overcome a specific reactionary inflammation with nonspecific remedies. It has occurred to us that the employment of the active principles derived from the plants, capable of producing a dermatitis venenata in the susceptible subjects, represented the rational therapeutic method of procedure.
“The most authoritative work shows that the active principle of poison ivy or oak is a substance of glucosidal nature. This substance is nonvolatile even when mixed with acetic acid and alcohol. The method of isolating the substances has already been discussed.1 Strickler, Albert: “The Toxin Treatment of Dermatitis Venenata.” J.M.A., 77: 910 (Sep. 17) 1921.
“The toxin (antigen) treatment of dermatitis venenata, caused by poison ivy, which is the most common type in the eastern United States, consists in the intramuscular injection of a solution of this specific antigen. The authors technic consists in giving a series of from three to five injections, the number administered varying with the severity of the attack and the response on the part of the patient. The dose of the present preparation varies from 0.3 to 0.5 cc., although doses up to 0.7 cc. may be given.
“The first two doses are given at a twenty-four hour interval, the remainder at intervals of from forty-eight to seventy two hours, depending on the response of the patient. As a rule, to which there are few exceptions, the itching associated with this form of dermatitis disappears completely, or is greatly modified, within twenty-four hours after the first injection.
“With the relief of the itching, the swelling and redness of the parts affected begin to disappear, and vesicles present begin to dry up and form crusts, which soon fall off. The skin is usually restored to normal in from four to five days after treatment is instituted, expect in those generalized and violent cases of dermatitis venenata in which the restoration of the skin to normal may be more delayed. These results are accomplished without the aid of any external remedies whatsoever.
“Tablet I gives a detailed account of the results achieved in the treatment of more than 350 cases of dermatitis venenata due to poison ivy or oak treated with the toxin (antigen) method.