The Elk County advocate. [volume] (Ridgway, Pa.) 1868-1883, 1875-02-04
The Pathology of Diphtheria.

A physician says A lady writes us.
asking several questions upon this sub
ject. She says the disease is quite preva-
lent in her locality. Her first question
is, "Are 'diphtheria and 'putrid sore
throat the same 2" Second, eff death
is caused from choking-apn0o-or an
inability to get breath ?"
To her first question 1 answer Yes. -
1 know the laity (and some not over
well-posted doctors, too,) make dis
tinction from simply difference in the
severity of the complaint i'll two or more
cases; calling the more violent cases of
diphtheria "putrid sore throat"
The disease is a constitutional one.
The throat is only one place out of many
i'll which it gives us "local appear
ance. 1t attacks all mucous surfaces
ear, eye, mouth, nose, esophagus, stom-
ach, rectum, vagina, c.-indifferently
1t may be in any two or three of these
localities i'll the same person at once. 1t
also shows itself on any abraded surface
of an afflicted individual.
The most general seat, however, is on
the fauces (throat); yet cases are on rec
ord where, although evident in other
parts of the same patient, there was no
throat complaint.
Locally, then, the expression of the
disease is but an Inflammation of the
mucous membrane with an exudation of
an organozolete (fibrinous) lymph. This
shortly organizes (consolidates) to the
leaden or ashen- -colored membrane that
is pathognomonic of the complaint. This
membrane vou find wherever the inham-
matory process is set up, and it can be
readily pulled off, leaving the raw sur
face beneath. Sometimes it gets to be
very thick. 1t is the abundance of this
membrane in the trachea and bronchial
tubes that causes death by "strangula-
ton :" it itprevents the passage of air me-
chanically.
To answer her second question In
some cases it is; in others it is not.
Sometimes death occurs within forty
eight hours, and before this exudation is
poured out from the infamed surface
anywhere. Again, when the disease does
not attack the larynx or trachea, "chok-
ing to death " is impossible. Death, in
the majority of cases in children, does,
however, occur as she indicates In
older persons death by asthenia "a
gradual wasting of the power of life) is
full as common.
The disease is one of excessive vomit-
ing frequently, and loathing of food
hence, unless you are careful, your pa
tient verify starves to death. Again,
some deaths are from nervous lesions-a
paralysis somewhere-as for instance of
the nerve of organic life to the heart
Again, the blood (Which is normally sup
piled with fibrine) has the fibrine notably
increased; so much SO that it clots in the
heart, thus causing death.
1t is by no means so frequent dis
ease rs is supposed. Otler throat in
fiammations are very frequently called
diphtheria, either through a careless
diagnosis or an unlaudable motive of the
attendant. Babies always have "croup,"
you know, yet l venture my life that not
one i'll II hundred ever had any such dis
ease. Babies with Group are sick, and
not generally nine hundred and ninety
nine out of Thousand get well. So with
diphtheria, yet cases sometimes are very
mild.
give no treatment, as it is disease
that only physician should take hold of.