The bacteriology of diphtheria, including sections on the history, epidemiology and pathology of the disease, the mortality caused by it, the toxins and antitoxins and the serum disease / by F. Loeffler et al. Edited by G.H.F. Nuttall and G.S. Graham-Smith.

  • Loeffler, Friedrich August Johannes, 1852-
Date:
1908
Catalogue details

Licence: In copyright

Credit: The bacteriology of diphtheria, including sections on the history, epidemiology and pathology of the disease, the mortality caused by it, the toxins and antitoxins and the serum disease / by F. Loeffler et al. Edited by G.H.F. Nuttall and G.S. Graham-Smith. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    Virulent outbreaks of the disease between the years 1818-1826 in Tours, La Ferriere and Chenusson, comparable with the notorious Garrotillo in Spain, provided Bretonneau (1826) with the material for his admirable investigations. In the year 1818 the garrison of Bourbon-Vendee was transferred to Tours, and many fell ill there of a disease characterised by ulcers in the mouth, inflammation of the gums, and breaking of the teeth followed by grey-green deposits upon the mucous membranes of the lips and cheeks. From the mouths of the sick persons there emanated a pestilential odour, and the neighbouring lymphatic glands began to swell. The disease was at first regarded as scorbutic gangrene of the mouth, but Bretonneau soon recognised that it could have no connection with scurvy, because the persons attacked were in other respects healthy, and also because it assumed all the features of angina maligna when it attacked the tonsils and throat. Bretonneau attributed the striking fact that it primarily attacked the gums to the use of drinking vessels in common. When the garrison was replaced after a time by another section of troops the disease appeared among the latter in the form of severe angina maligna. Within a few months of the introduction of the disease by the soldiers from La Vendee to Tours 60 persons of all ages, mostly however children, died from it. Some fell ill of severe gangrenous angina, others of typical croup. An accurate clinical and pathologico-anatomical investigation of all these cases led Bretonneau to the conviction that all of them were caused by one and the same disease, to which he gave the name diphtherite ij] Si(f)6€pa, the skin) in order clearly to distinguish it. The production of membrane by the action of the virus was to him the characteristic mark of the disease, because in the severe, apparently gangrenous, forms he found at the autopsy not the expected gangrene of the mucous sur- faces, but a membrane of a greyish-green colour, owing to the decom- position of the blood mixed with it, lying upon the slightly altered tissues. This was the source of the pestilential odour which had suggested a gangi'enous condition. The association of malignant angina with typical croup, which he had observed in many cases, at first led him to think that the condition might be due to the occurrence of two diseases simultane- ously, but the observation that adults who were suffering from malignant angina could infect children with typical croup, and the fact that the deposits on the tonsils and pharynx exhibited the same structure as the membranes of croup, convinced him that croup and malignant angina miist he dependent on the same disease-producing factor. He further states very decidedly that scarlet fever angina has nothing in common
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