Catarrh
Authors: C. H. Jones
Journal: BMJ (1859)

3. Every variety of weather corntributedl its share of cases; but no exact meteorological register was kept.4. Contagion.Some facts would seem to favour this view; e.g., a boy, aged 19, brought the disease from a village eight miles away, where many cases had occurred, to his home.There had been no prior disease in the house or in the village.A sister and brother had the disease not very severely.Two female children, agecl 12 and 10, residing next door in the same block of houses, exhibited the disease severely; the youngest of the two died in two days.All these cases occurred within ten days.-Armiaid servant, aged 30, had the disease.Ier mistress, aged 83, and two children (a boy, aged 6, and a girl of 5), showeed the disease within ten days.All were re- covering, when another maid servant, aged 25, also took the disease, went home on its appearance, and died within a week.5. Scarlatina.Nothinrg occurred to prove any connection between the two diseases.Several of the children and nearly all the adults had had scarlatina prior to the occurrence of diphtheria.In one family (not quoted in the list, but personally known to me), three children lhad diphtheria in turn, and all died from the disease-all of theml havinog two years previously been the subjects of undoubted scarlatina.6.The symptomns attendant on the first appearance of the disease have almost uniformly been those of extrelue depression, with consequently more or less of febrile reaction.Ex. ternal swelling of the neck has not usually been observed as a very early symnptom; nor is dysphagia early in its appearance or actually necessary in the course of the disease.In one well marked case of a child, aaed 4 (dving rapidly with exten- sion of disease to the air-passages), there was never any dysphagia whatever.I am almost disposed to give as the very first local symptom (and the statement is borne out hy at least two of the cases in the table) the existence of marked cderna both of the uvula and tonsils-the mucous membrane appearing to be infiltrated with serous exudation, and then studded by the characteristic lymph deposit. 7. Exudationt.In by far the majority of cases, the exuda- tion was present when the patient was first seen.In the few instances where the progress of the disease could he fairly watched, it came on fronm the first to the third day after the first complaint of illness.8. illici-oscopic examination of the e-fused material in three cases gave no evidence of fungoid arowth.'9.Albumen in the urine existed in one instance, hut was not found in the other instances.Various accidental compli- *cations were noted in some of the cases. 10.Treatment.I have never resorted to salines, diapho- retics, or, in short, to lowvering treatment of any kind; bIut, on the other lhanid, hiave freely given tonics, e.g., tincture of ses- quichloride of iron, in doses of ten to twenty minims every four hours; or bark with ammonia; stimulants, as sherry in ftll quantity, either witlh or without wvater, or good beer; nutriment in the shape of beef-tea, essence of meat, arrowroot.Local Applications.I believe the best to be the strong hydrochloric acid, applied freely, in the first instance, to the parts affected, and repeated if lnecessary; and followed by the use of gargle of two drachmas of hydroclhloric acid and an ounce of glycerine wvitlh seven ounices of water. 11.Tracheotomy.I have no evidence on this point.One