Practical observations on diphtheria and erysipelas / by Charles Bell.

  • Bell, Charles, Sir, 1774-1842.
Date:
1864
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Licence: Public Domain Mark

Credit: Practical observations on diphtheria and erysipelas / by Charles Bell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    epidemic in England a few years ago^ and more recently in the sporadic form in several places in Scotland, it is an error to suppose, as has been generally the case, that it is a new disease. It has long been known to the profession, and is well described by many of our medical authors, among the earliest of whom, in England, according to Dr. Osmerod*—who gives an interesting account of diphtheria as it appeared in Brighton —was Dr. Fothergill,t who treats of it under the head of sore throat with ulcers. In Scotland it was noticed by Dr. Cheyne,J Dr. Mackenzie,§ Dr. Thomas Brown,|| of Glasgow, Dr. Hamilton,^ and Dr. Abercrombie,** who, with his usual acuteness and observation, gives an ex- cellent description of the disease as it prevailed in Edinburgh in 1826. He considered it as being primarily an affection of the mucous membrane of the fauces and oesophagus, which may go no further, or may extend, in the one case to the stomach, in another to the larynxand it is distinguished fronl the cynanche maligna and the sore throat of scarlatina by the absence of ulceration. This, however, is not en- tirely correct, as I have observed that ulceration does exist in some instances. It is remarkable that, while the primary symptoms of the disease have been clearly described, the secondary symptoms, or the neuralgic and paralytic affections, have been altogether overlooked by our authors; and even on the Continent they did not receive the attention their importance requires until they were brought prominently before the profession by M. Maingault, in his admirable treatise, ' De la Paralysie Diphtherique.^ They are not referred to at all by M. Briton- neau in his elaborate work, ' Des Inflammations de Tissu Muqueuse.' This circumstance may be accounted for by the fact already alluded to, namely, that these symptoms have been attributed to some other cause, or that they may not have been so common in the epidemics he describes. Like the secondary symptoms of syphilis, they form a distinct series of phenomena, which do not in general appear until the primary affections of the throat have been overcome. It * 'Lancet,' 7th Dec, 1861. t Tract, published in London in 1748. % ' Pathology of the Membrane of the Larynx and Bronchia,' p. 35. Pubhshed 1809. § ' Edinburgh Medical and Surgical Journal,' vol. xxiii, p. 296. II Vide a paper read before the Medical Society of Glasgow, May, 1820. 5[ 'Edinburgh Journal of Medical Science,' Oct., 1826. ** ' Pathological and Practical Researches on Diseases of Stomach,' p. 50.