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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    appeared. Four died between the fourth and fifth weeks. No streptococci were obtained from either the blood or viscera of the fatal cases. Description of the Willard Parker Hospital.—This hospital is under the control of the New York City Board of Health and to it are sent diphtheria and scarlet-fever cases. The diphtheria wards, in which the majority of the cases here studied were treated, comprise three large, high rooms, connected by a hallway. Two are used for the women and children, and one for the men. As far as possible, the convalescent and doubtful cases are separated from those having true diphtheria ; but owing to the frequently crowded condition of the wards, this often cannot be done. The floors are of hard wood, and are washed daily with i to i,ooo bichloride solution. The iror- bedsteads are carbolized each morning. Where patients soil their beds, the sheets and spreads are changed daily; in other cases, v/eekly. All patients have their nostrils and throats syringed with a i to 4,000 bichloride; solution, the bad cases every half hour, the convalescents three times a day. No swabbing of throats is allowed. All clothes brought to the hospital are disinfected, and are only returned when patients leave. Patients are also required to take a bath when they go (also, if possible, when they come), washing the hair with a i to 1,000 bi- chloride of mercury solution. Cases of laryngeal dyspnoea when urgent, or when not relieved by vomiting and calomel fumigations, are intu- bated. The only routine constitutional treatment is to give alcoholic stimulants throughout the course of the disease to those showing any tendency to heart failure. Tube cases are fed lying on the lap with lowered head. These details are necessary to show the conditions under which the patients were placed, and to avoid a repeti- tion of the account of the treatment in the clinical histories which follow. The wards for scarlet fever are on a different floor, and have the same arrangement of rooms. Methods of Clinical Study.—I made daily rounds with Dr. Lester, the resident physician ; each case was care- fully observed, the appearance of the throat, and the complicating conditions of the larynx and nostrils were noted. As far as possible sketches were made, and the changes occurring from day to day noticed. The figures for pulse, temperature, and respiration were taken from the hospital charts—the temperature in children being always taken by the rectum, in adults by axilla. The urine analyses were also obtained from the hospital rec- ords. Cultures were made from every case on the day of admission, those which showed very numerous col