A paper on diphtheria : read before the New York Academy of Medicine, January 1861 / by James Wynne.

  • James Wynne
Date:
1861
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Licence: Public Domain Mark

Credit: A paper on diphtheria : read before the New York Academy of Medicine, January 1861 / by James Wynne. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    This membranous exudation may extend over the whole palate, but in mild cases rarely does; nor is its color much deepened, or the odor emitted offensive or foetid. The submaxillary glands are slightly swollen, but do not attain the size which they acquire in the severer forms of the disease. Under favorable circumstances, or the applica- tion of judicious treatment, its progress is here arrested. The mem- brane ceases to spread, and slowly becomes detached from its connec- tions; the mucous membrane loses its red color; the glandular swell- ings subside; the pulse diminishes in frequency, and the patient becomes decidedly convalescent. The disease, however, does not always present itself in this form, but is ushered in by rigors and often vomiting, under whose influence the patient becomes so prostrated that it soon becomes obvious that the system is oppressed by a powerful poison. This condition is char- acterized by a high fever, a pungent skin, a rapid and feeble pulse, great difficulty in deglutition, hurried respiration, flushed countenance, and congested lips; the tongue becomes loaded by a yellow or dirty brown coat; the soft palate and pharynx assume a deep erysipelatous redness; the tonsils become greatly swollen, and the ash-colored mem- brane, nearly continuous and spread over one or both tonsils, extends to the uvula and the posterior walls of the pharynx. As the disease advances, these symptoms increase in severity; the breathing becomes more hurried and stertorous; the swallowing, which at first was but moderately impeded, becomes so difficult and painful, that the child is with great difficulty induced to take either food or medicine; the saliva flows from the mouth, and often a foul and acrid discharge from the nares. Should the little patient be induced to swallow, food or drink will be violently ejected, and a paroxysm of great intensity, in which the child will gasp for breath, and with great difficulty re- cover itself, will ensue. The case has now reached a point which portends the most unfavor- able results. The false membrane has seized upon every visible part of pajate and pharynx; the discharge of sanies mixed with blood, which issues from the mouth and nose, has become exceedingly offen- sive; the glands of the neck become enlarged and tender; the voice hoarse and indistinct; the pulse more rapid and feeble; and the poor patient, restless and embarrassed for want of breath, tosses about or ]ies on his back in a semi-comatose state; in most cases the medical at- tendant is apprised by a croupy respiration, when the membrane has invaded the larynx and trachea, at which time symptoms of asphyxia present themselves; the countenance becomes livid, the skin cold, the