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

  • Wynne, James, 1814-1871.
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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    pulse feeble or gone, and the patient, either distressed for want of breath, anxiously awaits the moment when death shall relieve him of his suf- ferings, or rapidly sinks into an asthenic or comatose condition. The croupal anxiety and suffocation are inimitably painted by Aretseus in the following passage: Tussis spirandique difficultas enascitur, et modus mortis quam miserrimus accedit. Pallida his seu livida facies, tristior autem cum tonsillar comprimuntur. * * * Cumque decumbant, surgant, aut sedeant, decubitum non ferentes. Quod si sedent, quiete carentes, iterum decumbere coguntur. Pleruraque recti stantes obambulant nam quiescere nequeunt. Inspirato magna est—expiratio verb parva. Raucitas adest vocisque defectio. Hsec signa in pejus ruunt, cum subito in terram collapsis anima deficit. The patient is usually enabled to be up for several days after the invasion of the disease, but is finally confined to bed in grave cases by extreme prostration. There is often, indeed, great danger in assuming the erect position under these circumstances, as is evidenced in case of Dr. Cooke. Death by syncope in the advanced stage of the disease is not an unfrequent result upon any extraordinary exertion, and an ag- gravation of the grave symptoms is quite common. These descriptions exhibit the mildest and most obstinate forms of thft disease, between which it may present itself in every variety of in- tensity; at times yielding easily to medicine; and at others, although apparently attacking the patient with less force, proceeding slowly but surely to a fatal termination. The prognosis should therefore be always guarded, because it is not always possible to predict the effect of remedial agents, or the hidden force with which it may at any period develop itself. Duration.—When diphtheria runs its course without complications, it seldom proceeds beyond the seventh, eighth, or ninth day. The re- sult of M. Bretonneau's extended experience is, that its usual period of continuance is six days. When, however, it is complicated with croup, or scarlatina, or measles, its duration is much more uncertain; M. Bourgeois has known it, when associated with other diseases, to con- tinue eighteen days. Dr. Ranking says that its duration is very vari- able; he has known it to prove fatal in forty-eight hours from the first seizure, and to continue for two weeks or more, and finally to prove fatal long after all active symptoms had subsided, either from pure exhaustion or the supervention of other lesions.* * Ranking on Diphtheria.