Rensselaer Republican, Volume 28, Number 17, Rensselaer, Jasper County, 26 December 1895 — Diptheria and Its Treatment. [ARTICLE]

Diptheria and Its Treatment.

Editor Republican :Diphtheria and more especially its treat--ment,' are receiving much attend tion by the medical an 4 secular press at the present time. The •‘•probable reason is because the i disease is prevalent at this season Icf the year, when the days are short, dark and the weather damp. Dr. Klebs first discovered and d esc ribs d’•t he germ t hapis no w considered the cause of diptheria. Later Dr. Loeffler more fully described it and iiow in medical parlance it is known as the “Kiebs Loeffler or diptheYu&J&acillis. Those investigators who have given it the most attention believe it is conveyed by contact with the germs.., Timmot-readily conveyed in clothing as the germs of scarlet ■fever. Sun light kills them in a few hours. It is believed by some that pigeons, fowls, dogs and cats convey the disease from place to place. When a member of a family is attacked the sick one should be • kept in one room, the carpets and all unnecessary clothing and furniture should be removed from that room. All persons, and especially children, who are not needed to care for the sick should be excluded. All handkerchiefs, clothes, paper and in fact everything that saliva, mucous or piec^Kofgembrane come in contact witmtshbuld be burned or carefully cleansed before they become dry.

Diphtheritis was the name given first because it was thought the inflanimatory action-formedamem-brane. Hence all eases—wherepatches appeared were called ‘diphtheritis,” That practice is largely followed yet by the majority of physicians. The name -diphtheria was substituted because the disease is not iuflamatory. It is not infrequently very difficult to distinguish between the membrane of tonsilitis, scarlet fever and diphtheria. Physicians in hospitals and those who know how to take some of the mucous or membrane and place it in a cup containing beef broth or the serum of blood and made what tney call a “culture” after this has stood 24 hours inp a place at blood heat- they then put some of it under a microscope and if they find the Klebs-Loeffler bacillus thby are positive it is a case of diphtheria.

If they cannot find the dipththeria germ but some other they decide it is not diphtheria. There are very few . .physicians in Indiana who can make such a bacteriological examination; Since our State Board of Health requires that all cases of diphtheria shall be -reported, the hottsps carded and the inmates quarantined, the.disease is noijvery popular, as people do not care to be shut in from business or pleasure. Those who do not have the disease are most anxious to have the law enforced. In son& cases the membrane is formed in the larynx (Adam’s apple), wind pipe and even down into the bronchial tubes. These cases have in the past been called “membranous croup” and “croupous diptheria.” They are very fatal, a very small per cent, of them recovering. In 34 years practice I have seen but one case recover. Those who entertain the theory that the disease Is caused by the diphtheria bacillus find the germs in “membranous croup” as well as in diphtheria of the'throat and nose, and they cajl it “laryngeal diphtheria.” Dr. Botch, professor of diseases of children in Harvard University, whose work is latest out on the subject does not mention membranous croup as a distinct disease. So far as I can learn all who accept the germ theory discard the name “membranous croup.” Physicians differ very widely as to the treatment of diphtheria. Those “old timers” who retain the

idea that it is an inflammation use calomel and caustics. Others try to disinfect and cleanse the throat. They also give stimulants find tonics Ao uphold the strength. In those bases termed “laryngeal I diphtheria” or • “membranous ' croup” emetics are given to loosen i the membrane. In some cases a tube is passed through the mouth into the larynx; in others the wind pi pe is opened nuda tub e Ts piss sed .through there for.them to breathe through. The latest remedy for diphtheria is the anti toxin injections. Very few physicians believe initr as a rem ed y. -Proj 5 . A. C. Cotton of Rush Medical College in a recent lecture said it had come to stay. Prof. Welch of the John Hopkins University in a recent number of the Hospital Bulletin lauds it very-highly. The anti-toxin of 1895 ’is much improved over that of 1894. The methods of using it are better. Prof. Welch says as to ti me of treatment: Those treated the Ist and 2nd days, there were 814 with 45 deaths, equal to 5| per cent. The 3rd and 4th days 534 treated vsith 81 deaths, equal to 15 2 10 per cent. After the 4th day 286 treated, 91 died, equal to 31 8-10 per cent. If all physicians werp expert with the microscope they could be pretty sure in such cases, within a few hours as to the real difficulty, but they are not and are generally too busy or too poor or too lazy to equip themselves for the work. I am too poor to take the necessary instruction from competent instructors. Medical colleges should not issue a diplomaMu auatmteaT who cannot make such a diagnosis. I. B. Washburn, M. D.