The morning call. [volume] (San Francisco [Calif.]) 1878-1895, 1891-03-28
THE OUTBREAK OF DIPHrHERIA.

THE OUTBREAK OF DiPHThEItlA'
The prevalence of diphtheria is naturally
causing alarm. Up to the evening of the 10Th
the deaths from that disease during the
month of March numbered Il, as against
for the whole of the same month in 1890
and 1889. Z in March, 1888. 10 in March,
1887 and IA in March, 1886. The cOnSe-
ouence is that a number of children have
been taken from school, and some excite
ment prevails in quarters where several
deaths have occurred.
When asked to explain the severity of the
outbreak doctors generally ascrbe it to the
foul condition of the sewers. That many OF
the sewers, though flushed by the late rains,
are still unelean, and that the gases which
escape from the manhoes are injurious to
health, no one denies. But it is far from
being proved that diphtheria is caused by
bad sewerage. On tile contrary, the latest
scientific Investigations fail to trace con-
neetion between the two, and in view of
their revelations it seems as reasonable to
ascribe the prevalence of the disease to de-
frctive drainage as it would be to follow
Dr. Beverley Cole, who says that is caused
by planetary influences.
Th- malady which we call diphtheria is
>
septicemia, a putrefactiOn causing blood
poisoning What causes the septicemia
science does not know 1t is evidenced by
the presence in the throat of minute or
ganism called the mierococcus. which is not
distinguishable from the bacilli which are
found in cases of malignant scarlet fever,
erysipelas and other septic diseases. The
generally received theory of the disease Is
that child is attacked with severe sore
throat resulting from cold, which caused in
tiammation and emulation; in that child 5
throat, as in most Threats. microcOcci are
present in small numbers, and in an inert
condition; the exudatiOn furnishes the in
Sc organism with food, and il multlpleS
and acquires vigOr; a struggle then takes
places between the child's vitality and the
bacilli; if the former be vigorous the insect
is thrown of and convalescence ensues II
the vitality be low the insect may prevail,
may work its way into the mucous men,
brane and into the blood, and septicemia in
fatal shape may ensue. All this may and
does occur in the most healthy localities
and iu places where the drainage is perfect
and no mephitc eXhalatiUns pUllnte the air.
If this be the origin and the cause of the
disease, ii is evident that it is the child S
throat which should be flushed 10 effect a
cure.
i is going too far TO say that foul air, re-
81 ting from whatever cause, will not gen.
crate morbid organisms, among which the
micrococcus Of iiphtheria may be found. In
the famous Michigan case, which is quoted
in all the text books, the subsoil of the town
was composed of rottng sawdust. and the
terrible outbreak Of diphthrrla which at
tackled almost every child i'll the place was
rightly ascrbed 10 the generation OF micro
cucci IN that nursery of insect life. SO here,
| if an evil-smeuing manhole is found in proX-
| imity to the dwelling or the play ground OF
children who take diphtbeTla, II Is not I'M
reasonable to suspect that the fatal organ
ism may have originally come out OF that
mauhule. All that is c0ntended is that de-
| fective sewerage is not the only or even the
chief cause of the disease, and that, as eX-
perience proves, the best possible sewerage
aud the most perfect sanitary plumbing arc
not q perfect guarantee against its appear
| ance.
In the present condition of scientific knowl-
edge the judiciuus physician will concen-
| trate his attention on the real points in the
| case. checking the march of inflammation in
the patients throat and fortifying his vital
ity so as to enable him to throw off the organ
ism which is threatening lis life. A great
many children die of diphtheria from want
of vitality, which proper course of treat
ment might have strengthened. If theiI
vital power had been Te-enfOTced they might
have lived. The instinct Of life is more
potent than any drug, but at times it run,
down and needs a stimulus. II to this treat.
meut the physician adds, in regard for those
who are still in health, rigid system of $50
! latien, he has done all he can do. The
! breath Of patient attacked with diphtheriG
is full of micrococci They may OCCASION
ally be inhaled with impuuity. But it is I'M
prudent to risk the experiment