The Manchester journal. [volume] (Manchester, Vt.) 1861-current, 1862-05-06
fTrSn i &eseesa Nesal Tats Apr y isss
DIPmTHERGA IN THE coUN-
TRY.
uAn ssisa. X


k8aH kA8 #ftfYffs \ saw tftF@ tstsHff 2ANAAt tNt
TIVE pTinslpal reasons. ls gss 70 the profession
the gssali, 4 soss observations uFsH the d!seas.
spd iis trcAinsnt-
IL the arst place. although mach has been sad
asd wriitss upon ,ss safest autll !, hss become
IL ali probability - dras 10 Jour marss'. yet
!, must b, rsA.smberei that i Is nov prcFailhg
extensively ,AFesgioas tbs coanlry, eHe.'ins .l's
sane ia,sTes, amsug the profession, aud ihssame
alarm shFoaghous tie e9amoai'y, lhas i dai 10
Nsa Tori ivo years ago. Again il has beea
stated b. high aa,boFly' tbs. the disease pre-
seats different type Ia the country from what it
does Ia the ei'y-lhe inGiHaiien being u q much
higher grade, requiring tie prompt uss q @atiph-
logistes before commencing tonic and stimalsG'
trealmsat
On referring 10 my notes end record q SIX
ty-ars eafcs occurring under ny own supervisor,
and si1 cases 10 which have been called 10 ecu
sal,aiioa. These we're sll well marked cases q
diphtbeiA--casss Ia which there was q dph,he-
rite dsposIt 81 greater or lesg extent. Gases q
angina, ,qnsiis with superficial alterations
Ng1tffttd bFfN Wv ANt+e4sff @AiN ~ti"NR
nomatltis (muguet) --all u which arc 80 onca
coaioandcd with diphibcria By the superficial OBJ
server although numerous, were RI .ialy cxclud.
ed. and the peculiar diphthsritic deposit made
tha exclusive test o. the sixty ayo cases seea IN
practice rxty-fgnr recovered. and one died OF
the SIX cases secn 10 consultation Eve died, and
one recovered,
In nearly al q the cases the febrile stage vas
strongly marked The pulse ranged from 10 to
100; the serrieal glands often enormously sNol-
len aud excessively tender 10 pressure; BREATH
aetid; inccssant erpecioraton ofthck, tenacious,
seni-lranspareni mueusi frequently marked ce-
rebral disturbance. and invariably intense cepha-
lAga. The diphlheriio deposit ine ssry case Gu
veloptd the ionsiis, involving the mares, and &C..
cosionally appearing upon the lips, tongue, and
Interior or the cheek.
Finding the grade " inflammation apparently
30 much higher than ! had Lcen accustomed to
in New York, Tie 6rst two cases, tbroueh lie al
Wee Of the consulting physician, were treated
for twelve hours With calomel ard ipe,ae in small
deess THIS Was followed by mild cathart.g
and afterwards sulph. guininein tonic doses with
s;imuIants. poiassa choras, ,inct ferri ehlordi
good nourishipg diet. etc. etc. They both event
ualy recovered after protracted Illness Of over
three weeks duration. followed by diphtheritic
paralysis Of the velum pendulum palati, partial
amasrosis. aud general debility, continuing for
several months, and yielding only to gavanism
and tonics. At the same time was Gated IN
consultation in a mogibund case which had been
subjected to the same treatment.
hos!sg eouadeuce in sutiphlogistcs the third
case was placed under lie plan oftreatment which
had seen prove 80 sminenhy successful With
Prof A. jacob. aud which be has 50 ably laid
before the profession in the FIRST volume Of the
.Hsdisal Tima.
This third case was boy Of eleven years Of
age. When called 10 see him there was a thick
diphtheritie deposit completely ea1elopins the
swollen tonslls, and orowdipg The uyula forward !;
pulse lao; face flushed almost purple; skin ho;
and dry, With marked cerebral disturbance, aal
great adeui,is hight grains Of quina sulpa,
vere Immediately given, followed by three gysins
every three hours. Brandy ,caspooutui every
hour saturated solution Of potassse choras,
acidnlated with hydrochloric acid, ia tablespoon
ful doses every hour. With each dose of brandy
vas mixed either sweet cream, eggs, or beef,ca.
To these were added insafsstions Of alum and
fannie acid equal parts mixed, every four hours,
Aad externally hot Concentrations with aanud
cloths to the swollen glands, as bot as could be
borne BY the patient, and changed every ffe
Rainnies. In little less than two hours the fe.
yer declined, the pulse dropped to 10, the mind
became clear. csphalaigia aba;ed, aud pro.ase
perSpirniien broke out over the aaols body, Gen.
tinuing for seysrai'hrars. There was no eSseeg-
haiion u the fever, the alarming symptoms rap
idly abatel. anu, va the fourth day, the diphlas-
rite emulation came of IL large fakes ene-ioaFth
of an inch IN thickness. leaving healthy surface
uudsrnezth, allowed by no secondary deposit
Tbs Femainlng sixiy-swo eases. With one excep-
slon. sers treated ia 3 similar manner. II seen
daFing the febrile stage qainine was gwen in
large doses q from I've TO eight grains every six
q twelve hours. for Two or thres days. according
70 the age aud severity q the case A rapid ana
permanent rvaission u the fever was the intari-
allie result, II was then given ia smaller doses
eg from ,wc 70 three grains every taree q fegr
hours. anll! the diphihsrtic deposit bad entirely
disappeared Inc single exception 70 ihis az
II ,reatneat. and the enly ene whieh proycd "a
I'll. eeaameneed with rather mere thas the aver
age mliAncas Il was seen during the setFiie
aags lpasss 1901. but Through Some oifeious ia
tsyfersnee the dirceiinns wsre not followed Qain-
lte wss given 10 ANAL doses. aud shs AlsoAalis
sshmalaEts olniite3 Ter twelve kaars. la tAat re-
rsed the paise aayapced 70 l50, 4scompaaiei viii
A tsnmease augmentation Of Tire diphthsrsic
deposit The ehij waS then placed a2oa the
sane FlaE u treatment which had p-esei ~ sge
eeasfal 10 the prcyisls cases, -. aafoT;aEs1els
ia a -. "a.
lost ground was nsssr regssHe3. and the patseni
fnecambes ca The SRA dag 10 80 extension u ths
gsxaA@siea int tas laFynr and traehsA.
OF The six eases sen ID ennsaiEAEsen shFes had
asM rressanssS ssaaae4 wils purgatise doses VI
sasesasi sEa iperae, followed " iOnsca 1aa stsm-
nlAaiss twg hsd bwen missaksa frr Isld tessiistss
By tbs attending FsysAciaH. Hhe l.&a Sssef bsaEe
seea ssss Il dsphlhsFsa And treated aosariitsl
sk.. .s4f-t. ~ Pr 49, = - n A.