The Press., 1902-07-17
DIPHTHERIA.

DIPHTHERIA.
Extracts from paper on the recent diphtherfa
epidemic In STAFFORD Springs, by DR.. g. B.
Newton, read before the Tolland County Med
ical society at Rockville last April.
The epidemic of diphtheria began In
September last at Stafford Springs, and
did not disappear until the last Of March.
The first cases appeared somewhat inl
disguise, but Its specific character was at
once recognized and it's insidious toxin
was neutralized In great degree By the
diphtheritic antitoxin.
II the antitoxin had not been used we
might have suffered as great mortality
as In the epidemic Of 1860 and 1870. But
large and repeated hypodermic injections
did not prevent occasional paralysis In
slight and fatal degree. One thousand
units was the smallest given and often
repeated In 10 hours and the next day.
The immunizing did not always fully pro-
tect the child, but the prophylaxis of iso-
lation at the earliest moment was impera-
vent the disease, owing to their extreme
susceptibility to this contagion, but they
were the only means. The disease can
not be checked by sending the exposed
child away who might carry 1t beyond
the quarantine. The above course brought
the epidemic slowly to close, keeping 1t
Within the limits Of its first appearance.
The use of antitoxin is no longer an ex-
pertinent, and already has become the ac-
cepted practice. believe In this we are
expressing the opinion of the profession
In Europe and America yet we know
not what may further be discovered In the
laboratory Of the chemist and biologist.
The whole number of cases reported at
Stafford Springs since September to last
week In March, 1902, is 11s; 1O7 within
the borough limits. The whole number
of deaths, Is, showing very low NOR
tality rate.
One curious fact was noticed, that after
the membrane had entirely disappeared
from the throat and nasal surfaces there
still fingered the microbe. The children
had otherwise made perfect recovery.
No trace even of the effects of the dis
ease, being well. We would send Gull
ture by inoculating tube containing gel
atine with the secretion from the throat,
and the report often came back that the
culture shows the presence OF the diph-
theritic bacilli' even at the end of five
weeks.
We would not omit frequent throat and
nasal cleansing, SO that we may as soon
as possible with safety get a clearance
from quarantine.
The question is, can child be safely
allowed its liberty after perfect conva-
leecence and full restoration to health af-
ter the throat, voice and nasal surfaces
are entirely restored, so far as we can
see, after most careful examlnation2
Is our eye and judgment accurate
enough at this time without the aid of the
culture test !? We make a correct differ
ential diagnosis In the first stage between
follicular tonsilitis and diphtheria, except
when the membrane formation Is delayed,
which Is rare or an atypical putting on a
false appearance. 1t Is then so important
that we make no mistake that 1t Is best
to act on the worse supposition and give
the serum and decide later by miscroscor-
ical test and isolate the child. This path
ogenic microbe has been found In the
throat during an epidemic in persons In
perfect health.
II in one 1t Is presumable that it may
be found among many who were not
aware Of their presence by throat infam-
nation or illness, would such person be a
subject for quarantine Our quarantine
was most complete. The schools, the
churches, the opera house and the library
were closed. The hotels, stores and shops
were as though they were not. We were
In business and social suspense, except
that all the mills were running full time.
People living outside went to other parts
of the town to trade. Some who had chill
dren went visiting, remaining until the
diphtheria storm had cleared away.
At the close of family quarantine the
acting health officer, A.. N. Nichols, used
the formaldehyde gas, the most deadly
germicide. Mice were found dead from
It's inhalation, it being 80 destructive to
animal as we'll as germ life. All clothing
was disinfected or destroyed. One Of the
great annoyances of quarantine was the
temporary separation Of the family, those
engaged in the mills and in other indus
lrles remaining away In many instances
while the little ones were suffering al
nome with the disease. They had one
little satisfaction In visiting face to face
at the closed window. The Isolation
though for their own safety and that oi
the public, was keenly felt.
Those confined with the sick adopted
other means of immunization besides the
antitoxin. Sulphur was burned 10 appre.
ciaDle quantity. 1t was also used In the
throat, which probably had germicidal
effect. ! prepared solutions of potassium
/ permanganate to be used In the mouth
throat and nose with the atomizer. An.
other, which is the germicide and purifier
Of the civilized world, Is soap and water.
The man who introduced soap and water
was u benefactoI of his race. After leav.
Ing the sick room washed my face
hands, nose and throat, and with little
nicotina was immune.
1 SO sensitive are children to this infec.
tion that extreme caution was impera
tive; an exposure was almost sure to In.
feet. An immunizing with 500 or 1,00(
units did not always immune, though, az
above stated, tho attack would be less
violent.
4 Adults re.by no means exempt. DIR,
Frank Newton contracted the disease