The Norfolk Virginian. [volume] (Norfolk, Va.) 186?-189?, 1896-11-19
THE BOARD HITS BACK
GuardIans Of the Public Health Reply to
Professional Criticism.
THEIR ANSWER TO Or. H.n.NAsH's CARD
Lengthy but Quite - spicy Controver.
81 ON the Subject OF Me,nbranous
Group, and Whether or Not 1t
should be CIassnd with Diptheria
as Contagious Disease.

ououiu ne Ciassed WIFI Ofptherio
as % Contagious Disease.
There were some spicy developments
at the meeting of the Board of Health
yesterday The regular proceedings
were dry and devoid Of interest but it
was in the executive session that the
fun took place. There were present DR..
Newbill, in the chair; DIR. Field, Dr.
Rlddick and DR.. Chiles.
The sensation originated in q publish
ed card. In which DIR. Herbert NJ Nash
criticised the action of the board in
CHASING membraneous Group with diph-
liberia, and the reply of the board is as
follows:
THE GAGE OF BATTLE.
1t has always been the purpose of the
board or Health to discharge its duty.
however dlsagreeable, impartally and
without fear or favor. Nor does It
deem 1t proper to relax or change its
regulations In any case where assumed
professional superiority is offered as an
excuse for infraction of its reg,fia TONS
Nor does the board desire to enter into
any newspaper or other controversy to
prove Its action right and proper How
ever, since Dr. Nash has forced the issue
ana endeavored to reflect upon the
board professionally and as the guard
ians of the public health, we must ac-
cept the gage of battle and give to the
public the reason for the faith that Is
in us.
DIR. Nash claims that the Board of
Health places itself in contempt for
passing regulation chasing membrane
eous Group with diphthcria. The board
has no apology to make for its action,
but feels impelled to define its position:
FIRST. The regulation passed three
years ago expressly says:
THE term scarlet fever shall include
n - n ff,n nj ,1,14,
'diphtheria' shall include membranous
Group"
This regulation is in accord with the
| regulations of New York, Philadelphia,
Baltimore. Boston and Washington, as
| can be seen by reference TO regulations
on file at this office.
This board claims to be progressive
and It's position in the matter of ci@ssing
the two diseases Is supported by the
| following competent authorities. In di-
rect communications to this board the
following experts thus express them
| selves:
| PROF. WEIGH SAYS.
Prof VIM. H. Welsh, of Johns Hop
kins Hospital. one of the leading bac-
| teriolosists of the United States, saws:
! i believe that the great majority of
cases of primary croupous laryingitis
uhat Is, not secondary to scarlet fever
or other infectious diseases) are gen.
uine diphtheria. This Is the opinion of
practically all leading bacteriologists
ana pathologists. Cases of pseudo
mebranous Inflammation Of the larynx,
as well as of the pharynX, occur, which
are due 10 other Heterogeneous than
the pihtheria bacillus. but they are ex-
ceptional and. In my opinion, Boards of
| Health should act upon the assumption
mat oil observation-disclosures inflamma-
ton OF the larynS are true diphtheria,
unless the existnce OF diphtheria is dis
ft,t o,,t. ,t41,
gical tests"
DR.. j. j. Kinyoun. Government eX-
pert on diphtherin and professor in the
University OF Georgetown, states:
There is such disease as mem
oranous Group, but 1t is so extremely
rare that II is seldom met with. My
observations confirm those Of others
that the 'membranous Group as return
ed by the physician is laryngeal Gipihe-
ria. All the cases OF memhranous
Group occurring in Washington during
| the past two years have been proven To
be diphtheria. The only way in which
the disease can be differentiated from
diphtheria Is by q ARCHAEOLOGICAL cx-
animation conducted by competent
person. Unless this has been done with
every case OF 'membranous Group you
Will find at least 997 of these cases to be
| laryngeal diphtehria. The above state
ment Is not an extravaganza, but found
ed on the observations Of the bacterolo-
| Hc SO-Calltu HemDFanOuS GROUP
cases are responsible for many epidem-
les Of diphtheria. They should always
| be classed as diphtehria unless they are
| proven to be otherwise by n careful
meteorological examination. New York,
| Brooklyn, Philadelphia, Boston and
| Washington do not recognize membrane
Gus Group unless diptheria is excluded
| This is the only way think the disease
| should be managed"
DIR. THOMAS NJ. ROTCH.
| DIR. Thomas NJ. Rotch, professor of
diseases of children. Harvard Univer-
sity. in his book on diseases of chill
dren, 1896, says: 1.-The most common
cause OF pseudo membranous laryn-
gifts and the one which probably in all
cases produces it is some form of micro
organism. These heterogeneous, as
have already stated in my lecture on
I diphtheria, may be of several varieties
/ Until 1t Is proven not to be So however,
pseudo membranous laryngitis must be
chemically looked upon as infectious
and due to the KleSs-Loeffier bacillus
1 must again impress upon you the fact
that simple catarrhal inflammation
localized in the larynX may not be pro-
duced by the Klebs-Loeffler bacillus
Pseudo membranous larynEitis may
then. until further Investigations prove
the contrary. be defined as an infectious
Inflammation of the mucous membrane
of the larynx accompanied by pseudo
membranous emulation. which may be
caused by number Of micro organ
isms, of which, according to our present
/ ,ytzI< Il LII.