Surgery.

Date:
[1913]
Catalogue details

Licence: In copyright

Credit: Surgery. Source: Wellcome Collection.

    28/412 page 20
    cats, and fowls. The incubation period varies from two to seven days. Locally a false membrane forms on the fauces, soft palate, and tonsil. From there it may spread: {a) down the respiratory tract ; (b) along the Eustachian tube into the middle ear ; (c) through the posterior nares into the nose ; and (d) up the nasal duct, and affect the conjunctiva. The membrane is composed of epithelial debris, fibrin, blood corpuscles, and organisms ; it has the appearance of a dirty white kid glove. The organisms do not circulate in the blood, but remain localised, the toxin being conveyed by the blood-stream. The latter may cause paralysis of the soft palate and degeneration of the cardiac musculature. Give the Clinical Features. (ia) Fever. (b) Hypersemia, and swelling of pharyngeal and palatal mucosa. (c) Development of the false membrane. At first this can be readily detached ; later it becomes adherent to the tonsil. (d) Enlargement of the upper deep cervical lymphatic glands. (e) Dysphagia. (/) Dyspnoea. (g) Great prostration. In suspected cases a swab should be sent for bacteriological examination. What is its Surgical Importance Obstruction of the air passages by the membrane may require urgent intubation or tracheotomy. Post-diphtheritic paralysis may be confused with other lower motor neurone lesions.
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