The Brinkley argus., 1909-03-05

itant single fact about the course os l the disease. and that is that the ichef source of danger is net so much from direct suffocation as from ger- eral collapse. and particularly failure of the heart
 Thus has given us two other data of great importance and value, namely. that while the immediate and greatest oeril is ever when the membrane has become Ioosened and the temperature begun to subside. fin both ordinary throat and in laryngeal forms of the disease, the patient is by no means out of danger. While the antitoxins poured out by his body have complete 1 Iy defeated the invading toxins in the open field of the blood, yet almost every tissue Of the body is still satur- ated with these latter and has often been seriously damaged by them be- fore their course was checked. For instance. nearly two-thirds of our Ediphtheria cases which are properly examined will show albumin in the urine. showing that the kidney cells have been attacked and poisoned by | f. ~ the toxin. This may go on to fatal attack of uremia; but fortunately, not commonly, far less so than in scarlet fever The kidneys usually recover completely, but this may take weeks and months. Again, many cases CT diphtheria will show weak and rapid pulse which will persist for weeks after the patient has apparently recovered; and if the little ones are allowed to sit up too soon, or to indulge in any sudden movements or muscular strains, this weak and rapid pulse will sudden lily change into an attack of heart fail- ure and, possibly, fatal collapse. 1 This, again, illustrates the ssturation l of the poison. as these effects are now known to be due in part to a d. rect poisoning of the muscle of the heart itself and later to serious damage done to the nerves controlling the heart, chiefly the pneumogastric.5 Moral: Keep the little patient in bed for at least two weeks. or. better, three. He will have to spend 9 month or more in quarantine, anyway.
 Last of all, and by no means least interesting. are the effects which are produced upon the nervous system One day while the child is recovering, and ;spossibIy beginning to sit up in bed, a glass of milk is handed 10 him. I The little one drinks it eagerly and at 1 tempts 10 swallow, but suddenly t ] chokes, half strangles. and back con es the milk. pouring out throhgh the nos trils. Paralysis of the soft palate has occurred from poisoning of the nerves controlling it, caused by direct pere- tration of the toxin. Sometimes the external muscles of the eye become paralyzsd and the little !. one can no longer see 10 read.
 Fortunately, most of these alarming results go only to certain degree and then gradu1lly fade away and disappear; but this may take months or ev-n longer. In csrtain number however. the nerves of Fespsration or those controlling the Eaart beat be- come effected. and the patient dies suddenly from heart failure.
 This strange after-efsect upon the nervous system, which was first clear- ly noticed in diphtheria and one other disease, has now been found to occur in lesser degree in large number of cur infectious diseases. SC ti1at many Of our most serious paralyses and other diseases of the nervous sys-
 
 tenn are now t.acesble to such causes.
 These effects of the diphtheria tox- In are also of interest for somewhat unexpected reason. sinceit has been claimed that they are effects of the antltoxlr by those who are opposed to Its use. Every one of them was well recognized ss 3 possible result Of dphtheria long before the antitoxip was discovered. and every one of them can be readily procured by injections of diphtheria bacilIi or their toxin in- : to animals.
 It is quite possibly true that there are more cases of nerve poisoning (neuritis) and of paralysis following diphtherla than there We're before the use of antitcxn. but that Is for the 1, simple and sufficient reason that there ! -l .1