The daily intelligencer. [volume] (Seattle, Wash. Territory [i.e. Wash.]) 1876-1881, 1880-11-14
DAILY INTELLIGENCER.
Sunday, Nov. ID. 1880.
DIPHTHERIA.


ssse. Some have classified it with
Group. others hsve'rsgsrded it as G
modification Of malignant scarleiin.
while others have considered it as Cd
Affection sui genera The term diph-
iberia. in lis most literal Specification.
Implies Inflammation OF the skin.
Diphtheris generally prevails as an
epidemic. 10 which form it often exists
eotemporaneously over considerable
tracts of country, or 1t may occur in
Smaller groups, limited TO particular
nsighborhoods. or even to particular
houses. The disease 10 sometimes pre-
coded, and usually accompanied. by
fever. which, In seYers cases, is only
Transient. speedily giving place 10 de-
preston. There is often 9 Stiffness Of
the neck at the commencement OF an
attack. sad usually more or less swell
ing and tenderness OF the glands at the
angles of the lower jaw. The tonsils
ere COMMONLY swollen. aud together
with the contiguous parts Of the mucous
surface. more or less infamed. Some
times the swelling aud inHsnm alton
subsids without farther lecal mischief;
st others, the infsnod surface presents
from an early stage Of the disease
whitish speoks.or patches, or continued
covering Of membransous aspect, va
rying 10 color from white or brownisi
10. IN some instances, o blackish tint.
IL the pstches are small and remain
distinct the case ordinarily runs fay
orable course; If they rapidly spread
end ooslesce. il the membrane becomes
thick. and especially II It assumes
brownish or blaokish color. danger is
imminent.
The following are the usual form and
course Of the disease in its ssverest
type. The patient is suddenly. and
generally in the morning, seized with
violent vomiting Of thin yellowish.
white matter OF very offensive char
acter. These objections last an hour or
90. sud are followed by great prostrs-
ton and stupor. The patient lies for q
period varying from six to sixteen
bours 10 heavy sleep. from which be
10 with difficulty aroused, and then
only to sleep again. The skin is hot.
pulse 100. the tongue Of bright red.
Drink Is taken with svidity If offered.
but only to be Immediately returned.
II you ask. Ia the throat sore ? the an
swor 10 always the same: Not in the
least And this reply 10 tho inexpe-
rienced IN the dreadful malady, may be
fatal to the patient, for it may lead to
che conclusion that it is not a case of
diphtheria. The experienced person
will. however. expect this reply, aud
will carefully examine the throat, and
then he will see the disease. In this
early stage the toasils, the soft palate.
and the back Of the pharynx present a
bright, shining red appearance. Hang
ing from the velum to the tongue is
seen. in this stage. q transparent film
G. Q tenacious fluid whichsis burst by
expiration. sending its PARTICLES over
She mouth and the instrument used to
depress the tongue. The next moment
n similar curtain Is formed. After q
period varying from six to sixteen
hours the condition Of the patient ma
tsrially changes. The stupor has
passed Off and dslirium takes ITS place.
The fever runs high. Breathing is
Qnickensd. The voice is changed to u
tt;ok yet shrill tone. There is short.
drS cough. The neck is puff and flushed
aud the tongue is coated with fur
an ell those spots hitherto SD bril-
tiantly red ars thickly spotted with a
whitish Substance. which. in wouder-
fully short period. forms one thick.
plastic deposit. giving the appearance.
on opening tho mouth. as though it
were lined with plaster of Paris. The
violent delirium then subsidies. The
powers Of life fail rapidly. The horri-
bic sensation OF choking ADD sutiocation
comes on. The sufferer tears his neck
with his nails aud tries to open his
mouth; yet full power Of swallowing
still oontinnes, aud he gresdily gulps
snything given him in the shape Of
drink. Large livid spots form on the
extrsmities. Muttering delirium comes
on. aud IN long tetanic convulsiou
death closes the. scene Thus. in s,s
days or less. = previously strong and
healthy inau may cease Ia exist.
Diphtheria is frequently attended
with very slight Constitutional iistur-
bAnees ut the commencement of the ct.
tsok, evea where the disease IS dcstin ed
to = fatal termination. The patient il
often 30 little Affected that, with tn,
exception of some slight difficulty il
the oct OF swallowing. he exhibits nc
evidence of the disease. and Il is with
difficulty that parents can be brough,
to consider this symptom as ore el
much importance, or the child In very
serious danger. Generally the patient
fssls somewhat unwell for day or 90
tstors the affection of the throat d
aasnitess His appetite fsila Peshaps
nassau aud vomiting are the first symp-
toms. A child loses his inclination 10
play aud is Inclined 10 be drowsy.
There may DO restiessness at night,
gritting Of the teeth And fsvsrish mesa.
Not unffequently noue Of the precur.
cory signs appear. or, IL any OF them
occur. they are not thought of at the
time. bat arc recalled to mind by the
patient, or tho parsats Of the child.
after the more patent symptoms set In.
WHAT II prHrHgRIAl
Medical writors agree that IL Is On
inflammation or fever, or both. But
What b Inflammation or fever THIS
problem the profession has not 20,
solved. The relation of diph,heris 4,
Group and 10 malignant scarlet fever
has been mach discussed through med.
icAi journals. soms regarding diph,heria
As identical with thaqfosm of scarls,ina
ia which the sxcretioa Ct morbid mat
tef. L uasiaiy dsierminsd to thu throat
with little or 40 cutaDeous eruption.