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In the USA, Tetanus toxoic was developed in 1924 [or 1923], Licensed in US in 1933 and introduced in 1948 as part of DTwP. See

See the note below on Toxin-Antitoxin use in New York.

Excellent Diphtheria Vaccine History page.


Toxin-antitoxins were produced and tested in animals in the 1900s - and between 1913 and 1924, 14 varieties of toxin-antitoxin were used in New York(6), where in 1926 a programme was started to eradicate diphtheria(7) - but cases of, and deaths from, diphtheria rose - from 7,530 cases and 477 deaths in 1926 to 10,776 cases and 642 deaths in 1928(8). Two years later, ` Journal of Medical Society of New Jersey` reported "During the period covered by the increased use of toxin-antitoxin, the incidence of serum disease has also increased"(9).

RAMON`S TOXOID (Anatoxine)
Ramon reported, in 1924, that he was able to immunize guinea pigs with his toxoid(17), which became known in Europe as Anatoxine(18). Five years later, reports were being received that patients were refusing to complete the course of treatment because of adverse reactions to the toxoid(19). Despite this, a law in France, in 1938, made Ramon`s toxoid compulsory(20). French cases of diphtheria rose from 13,569 in 1940 to 46,539 in 1943(21).


In some countries cases of the diphtheria increased -
in Germany from 64,138 cases in 1932 to 149,971 in 1936;
in Copenhagen, Denmark from 41 cases in 1942 to 1,754 in 1944(24);
in Holland from 1,273 cases in 1939 to 56,603 in 1943(25);
in England and Wales there were 46,283 notifications in 1940,
the next year (with a mass vaccination program) there were 50,797 cases(26).

Diphtheria mortality fell as much as 99 percent before vaccination became wide spread.

by Hilary Butler

Common environmental factors throughout history which have greatly increased the incidence and severity of diphtheria are shown in the following quotes

: "There is no doubt that exposure to sewage emanation is a fruitful source of diphtheria...the statistics of the association between the two are very positive." (Quain 1894, in Beddow-Bayly, 1939, p.105).

"…shows in interesting and conclusive fashion the definitive effect of school buildings, their construction and sanitation, on the spread of diphtheria. The highest incidence was observed in those schools where sanitation is most deficient and ventilation and lighting the least satisfactory. The brightest and airiest school showed the lowest incidence, and the incidence throughout all the schools placed them in exact order of sanitary virtue. Moreover, the incidence indicated the schools where malnutrition in the children is most conspicuous." (Medical World, 1931, p. 627.)

Read the whole article at:

Graph of U.S. Diphtheria Mortality Rates

Toronto, Canada.

Prior to the present century this disease was the major scourge of infancy and childhood. The mortality rates in the United States, for consecutive ten-year periods from 1900 to 1940, were as follows:
40, 21, 15, 5 and 1.
For the city of Toronto, for ten-year periods from 1885 to 1945, the rates were as follows:
132, 66, 34, 19, 8 and 3.
These figures show a steady reduction in mortality which began over 60 years ago. The age incidence has also advanced into older brackets.

From increasing evidence of the anti-toxic and anti-infectious action of vitamin C, and from personal clinical experience in the prophylactic and therapeutic application of this vitamin, the author is firmly convinced that the major factor in bringing about this gradually changing picture in infectious-disease incidence has been the steady and phenomenal increase in the consumption of vitamin-C-rich fruits, notably citrus fruits and tomatoes, during the period in question. This hypothesis would not only account for the gradual decline in incidence, but would also explain the shift in age incidence of tuberculosis, diphtheria, poliomyelitis, etc., from the younger to the older age brackets, due to the fact that in the nursery the full benefit of this nutritional reform is obtained; whereas, during childhood and early youth perverse dietary habits are gradually acquired through lack of parental guidance and inadequacy of public-health education. The increased use of candy, carbonated beverages, tea, coffee, tobacco and alcohol tends gradually to displace the more wholesome nutritional habits of early childhood, and malnutrition with increased susceptibility to disease is the price we pay for this diversion.

The Author's Experience
During this period the author has made intensive application of vitamin-C therapy, orally and parenterally, in many such infectious diseases, including even septicemia and tuberculosis, with results in every case even more rapid and favorable than could be expected from the use of the modern antibiotics, and with the added advantage of complete exemption from toxic or allergic reactions.

The late Dr. Alexis Carrel 17 has said: “Microbes and viruses are to be found everywhere, in the air, in the water, in our food... Nevertheless, in many people they remain inoffensive... This is natural immunity... But natural immunity does not exclusively derive from our ancestral constitution. It may come also from the mode of life and alimentation... Some diets increase the susceptibility of mice to experimental typhoid fever. The frequency of pneumonia may also be modified by food. The mice belonging to one of the strains kept at the Rockefeller Institute died of pneumonia in the proportion of 52 per cent while subjected to the standard diet. Several groups of these animals were given different diets. The mortality from pneumonia fell to 32 per cent, 14 per cent and even to zero, according to the food. We should ascertain whether natural resistance to infections could be conferred on man by definite conditions of life. Injections of specific vaccine or serum for each disease, repeated medical examinations of the whole population, construction of gigantic hospitals, are expensive and not very effective means of preventing diseases and of developing a nation’s health. Good health should be natural.”

Read the whole of the excellent article from which the above quotes come from: ...

What You Should Know About Vaccines

From Dr.Monteith's Letter July 2002
October 24, 2002
     Diphtheria Pertussis Tetanus  Measles
1901  48,839    33,094    28,065   11,956
1911  20,350    20,285    11,503    7,615
1921  12,267    14,724     7,818    4,919
1931   4,388     9,850     4,709    2,957
1941   1,135     4,399     2,384    1,013
1946     467     1,460     1,697      469
1951     125       558     1,093      268
1956      45       206       788      203
1961      22        82       550      162
1966      15        32       282       44
1971-5    12       122       122       17
Clean water, good nutrition, sanitation, warm homes, and antibiotics brought most communicable diseases under control long before vaccines were introduced. Would the death rates have continued to decline without vaccines? The yearly death rate from measles fell to 44 before the measles vaccine was introduced. [15] Dr. Edward Shorter discussed the decline in diphtheria deaths before all children were vaccinated:

". . . as the list of diseases that penicillin would cure . . . became longer and longer. . . . Between 1945 and 1955 in the United States, mortality from influenza and pneumonia fell by 47 percent; deaths from syphilis dropped 78 percent. Deaths from diphtheria - for not all children had been vaccinated - virtually vanished, the mortality from that disease falling by 92 percent." [16]
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Disease, history, Vaccines and Statistics: Diphtheria Index

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