Diphtheria and allied pseudo-membranous inflammations : a clinical and bacteriological study / by William Hallock Park ... Reprinted from the Medical record, July 30 and August 6, 1892.

  • Park, William Hallock, 1863-1939.
Date:
1892
Catalogue details

Licence: Public Domain Mark

Credit: Diphtheria and allied pseudo-membranous inflammations : a clinical and bacteriological study / by William Hallock Park ... Reprinted from the Medical record, July 30 and August 6, 1892. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    to be diphtheria. These cases were mostly young chil- dren in two asylums where they had been exposed to scarlet fever and measles, and in some of whom these diseases had existed as a complication. In not one of these were the Klebs-Loeffler bacilli found, but in all but two streptococci. These were present in most of the cases in enormous numbers, as shown by the cultures. In three cases in which the viscera were examined they were found to contain a moderate number of strepto- cocci. In the ducts of the mucous glands and in the lymph-spaces of the submucosa, the streptococci were found in greater or smaller numbers, also rarely in the tracheal and bronchial glands. The staphylococcus py- ogenes aureus and albus were present in varying num- bers, but hardly more frequently than in many apparently normal throats. In sixteen of the twenty four cases, broncho-pneu- monia ^' was present, and cultures made from the fresh broncho-pneumonic areas in fifteen of these gave large numbers of streptococci. The streptococci obtained from all these cases presented the same morphological and biological characters. They appeared to be identi- cal with the streptococcus pyogenes. From his investigations Prudden concluded that in a certain class of cases pseudo-membranes were caused by streptococci. Kolisko and Paltauf, Wurz and Bourges,^ Sevestre,^^ Tangl,^* Baginsky,^^ and others have found streptococci but no Loeffler bacilli in the pseudo-mem- branous inflammations occurring early in scarlet fever. Baginsky,^^ in his recent studies, found that in one hun- dred and fifty-four cases clmicaily diagnosed as diph- theria, there were thirty-four in the pseudo-membranes of which no Loeffler bacilli were present. In two cases of membranous rhinitis he found the bacilli present. These ran the usual mild course. Martin,^'^ in Paris, has just pubUshed a clinical and bacteriological study of the croupous deposits of two hundred children suspected of diphtheria. He found in seventy-two no Klebs Loeffler bacilli; of these, twenty- nine were croup cases. The mortality of these was far less than in those having true diphtheria. Some of the children had been exposed to scarlet fever and measles. He is of the opinion that the certain clinical diagnosis of these cases is impossible. A few examples of infection with diphtheria in the wards are given. He regards the association of different bacteria with the Loeffler bacilli as greatly modifying the course of the disease. As he used only blood-serum tubes, he probably has often overlooked the almost invisible colonies of the strep- tococci. He also believes that from the form of the