The Hillsborough recorder. [volume] (Hillsborough, N.C.) 1820-1879, 1861-01-30


n each family have been more intractable
han those that followed week ar ten days
Why this was so, will not
now undertake to explain.
The disease is ushered in with slight, feb,
rile, symptoms; strength and appetite at first
not much disturbed The thirst remains
natural, tongue sometimes coated over with
a white. but often, in bad cases, with thick,
lealhery looking fur. The parotid glands,
somewhat tender and swollen. As the DIS
ease progresses. the strength begins to fail,
the appetite becomes impaired, with slight
headache, aud some soreness, or stiffness Of
the muscles ia the back Of the neck, for two
or three days. Most frequently on the sec
ond or third day, in the morning, the patient
wakes up and complains for the first time of
sore throat. sometimes. though not always,
accompanied with difficulty Of deglutition,
or swallowing, and have been struck with
the frequency in which the patient complain
ed more Of swallowing liquids than solids,
The above symptoms are frequently 50
slight, and so insdious, rs often to mislead
both friends and physician.
Upon close examination of the throat,
however, which is best male by pressing
down the tongue with a spoonhandle. lingu-
al depresser, or your Iinger will answer We
ry well, and 50 bending the head backwards.
as best to throw the light down the throat, i
will be observed the tonsilary glands. uyu-
la and pharynx are odematuus, and exhibit
an eusypetetic redness, and small circular
patches of false membrane my be seen on
one or both tonsis; (irom INV mite book
find of the first thirty cases that fell ande my
observation, the membrane was formed on
the left tonsil first;) though | often after.
wards found i; appearing upon these parts
simultaneously and at the same time.
This membrane is Of a yellowish white, OF
grayish colour, of variable thickness, and
rather tough consistence; sometimes It !:
-cooured, somewhat soilened by pharyn.
gal or mucous secretions, occasionally tinged
with blood.
The skin IS generally hard. dry and chat.
lfy; stomach and bowels normal, the pulsS
has but little volume, and ranges from on'
hundred TO one hundred and tWenty pulsa
tions per minute.
In the secondary form Of the disease, ihi,
membrane being more violently infaned and
densely fibrinized, presents deep dark col
our, and is more hard and firm in its centre
II is very adherent in its attachment TO mu-
cous surfaces. and not easily torn Or remoy.
ed therefrnm.
1t sometimes spreads rapidly, and in 1
few hours is found to cover the posteriOI
fauces. tonsiIlIry glands, uyula and roof o
the mouth, extending forward nearly to tn,
teeth.
The ceryicaI aud submaxillarY glands ar
very liable TO swell, the front part II tht
neck Is lndlrated and o19natnus. There
is usually at this stage Of the disease yer,
ichorous discharge iron the nose, the voic'
becomes obscured and nasal; more or les
soreness is felt or complained Of over the ira
cheal regions. with slight croupal cough an,
regurgItatiOn of liquids through the nose
When these symptoms are present. begir
to tremble for the safety Of the patient.
10 very many cases. a few days after III,
appearance Of the pseado-membrane, III,
breath is offensive but not ietid. Ii left I,
pursue is natural course, in favourable cas-
IS, the membrane becomes thinner, assumes
a grayish tint, and fails OF in small particles
or shreds, in from FIVE or six to eight days
and these PARTICLES, or pieces OF membrane
may be best seen when the sputa IS elected
or expeetoraiel 10 blson Of water.
| When topical remedies are carly and as
siduoa.ly applied. the false deposit Or mem
brane nav often be detached in two or tire,
days, but nsy, ard frequently IS, rcprOduc
ed several times before the faal conclusion
or termination Of the case.
In the still more violent cqses, the pseudo
membrane, after the disease his run on foul
Or FIVE days, assumes still darker or black
II ish colour, and often is peripheral surfac
hangs loosely in shreds from is central al
tachment. The parts now begin 20 look gan
grenous, AMI the membrane has the appear
anee Of sioBghing, the pulse rises TO one hun
dred and fifty aud upwards; there is no,
salvation, with an abundant discharge frOa
the mouth, Of ssmi.transparent or sanqui
nolent fluid, which the patient Is unable 4
spit Of. AMI which hangs 70 the mouth iron
six, twelve ID eighteen inches IN length. Th
quantity Of this discharge nften amounting I
one, two, three aad four pin.s 10 tweniy.fDn
hours. There is now, very marked langioi
depression. and loss Of strength.
! Independent Of complication, the durltio
Of this form Of Diphtheria IS usually abol
eight OF nine days.
The third classification u Diplheria, whic
have previously stated " be lis almost OH
" fatal form, i early marked by change
voice, DRY, hOarse. croupal cough. a hard
dry surface; yascilating, quick, irritabl
pulse, Running up TO one hundred aud siKt
or one hundred and seyenty.liye pulsation
per minute; and the inlammatofy diathesi
IS generally more predominant than in Ii
second variety; The patient is restless, an
refuses all kinds 81 food Or drink.
In forty-eight hours Or less the voice BE-
comes very hOarse, aad soon degenerates in
70 mere whisper; the degree Of hoarsene.
depending very much think upon the spa,
modie action Of the laryhx and extent Of el
udation.
As the disease progresses, the rushing
&c air through a CONSTRUCTED CLOTHS and Il
rynH, produces stridulous breathing.