, 1878-03-15
Diphtheria.

In this ailment false mem brane
accom- panied 10y inflammation, appears
almost invariably in the throat. L
sometimes extends, more or less, over the
mucous surface within the mouth anC
nostrils. 1t also is not infrequenty pro
duced within the larynX or windpipe
and then the chances Of recovery are few
as death generally takes place from suf
location. In fatal cases in which the
windpipe is not affected, death is usually
due to exhaustion. Paralysis of the
muscles of the throat, or OF the lower
limbs, or ofan upper and lower limb on
one side, frequently occurs as a sequel
to the malady. Strabismus, or squinting
as well as injury to the hearing, taste and
smell, are also rare consequences of the
disease. These various affections are as
likely to follow mild as severe forms OF
the disorder, and generally occur within
few weeks of the patients GONZALES
cence. AS rule, however, when re.
Covery takes place, it is complete; but in
such cases it leaves the sufferer feeble
and bloodess for considerable time,
and sudden death from fainting fits, due
to some muscular effort, has repeatedly
happened after convalescence; hence the
necessity of quietude until the patient
strength has been restored.
In almost every case the first symp-
toms of the disease are slight huskness
in the voice and weakness of utterance,
These are generally soon followed by a
high fever and more severe trouble with
the throat. On examining the palate and
tonsils there will be seen a whitesh
exudation Of various shapes aud from
the size of pins head to that of five
cent pece--not like pus, loose and cap
able Of being easily detached, but tough,
like wash leather. If the disease is not
checked, this spot-the commencement
of the false membrane from which the
malady derives its name-grows larger
and thicker until, like dirty whiteish
bridge, it stretches from one tonsil to
the other, and invades the upper and
lower wind-pipe as we'll as the bronchi-
al tubes, unless life is sooner ended. Up
on it is frequently found parasitic fun
gus, the spores and sporules Of "a crypto-
gamic plant, to the presence of which
some consider the disease is. due, while
others deem that these are merely in
cidental to the local affection. Other
symptoms are muscular weakness, eX.
treme listlessness, greater difficulty in
swallowing liquids than solids, swelling
of the glands of the throat, stertorous
respiration, and the complete loss of
appetite the last very unfavorable
sign.
1t has long been a noticed question
whether this disease is spread by conta-
gion or infection, that is, by contact, the
breath or bodily etfluvia, or by Il hidden
miasmatic influence. Recent develop.
ments, however, strongly indicate that
it is propagated in both ways. Persons
between three and twelve years old are
most likely to be affected by it, but no
age is exempt from liability to it, and
like measles or the smallpox, the danger
from it increases with the age of those
whom it attacks. 1t is most frequent
and malignant wherever dampness and
dirt prevail, and one of the best pre-
ventives is a scrupulous attention to
cleanliness. Abundant sunlight, dry
ness, cleanliness and pure air, ventila-
ton of living and sleeping rooms, disin-
tection aud adjustment of overtlowing
cesspools, undrained cellars, decaylng
garbage, defective sink traps, leaky
dran-pipes, and all other sources of foul
ness are the best safeguards against this
devastating maady.
The chief objects Of the treatment in
this disease are to mitigate the symptoms
and to support the vital powers by the
judcious employment Of tonic remedies,
nutritious food, and alcoholic stimulants.
The latter are often given in large guam.
titles without producing any exciting or
intoxicating effects, and are, without
doubt, frequently the means of saving
life, Numerous specifics are advertised
for this aiIment but the frequent fatal
ity that still attends its attacks is sut-
| tcient proof that the best of these are
only partially successful. If treated in
its early stages its dangers are vastly di-
minished, and on the appearance Of its
first symptoms the services of a skillful
| physician should be promptly obtained.
Whenever a case occurs in family, the
sick person should be at once isolated,
and nursed, if possible, by one person
only; the sick room should be well
warmed, well ventilated, exposed to the
sunlight and freely disinfected, as should
also the vessels containing the expecto-
ration and other discharges of the pa
tient. For this purpose, solutions of nj
rate of lead and chloride OF zinc are
among the best disinfectants, as they de-
stroy bad odors without causing Others.
In case of death, the body should be
placed rs early as practicable in the
coffin, with disinfectants, and the lid at
once tightly screwed down. Children
certainly, and generally adults also
should not congregate for q funeral at a