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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    called diphtheria, and settle the question, whether or no, under this name we should include more than one dis- ease. At the outset the difficulties were very great, owing to the multitude of bacterial forms present in the mouth. However, persistent investigation, aided by the improved methods of bacteriological study, has overcome all these obstacles. Although recent reviews by Loeffler,' Welch,^ and others makes it almost unnecessary, it is thought best, in order to have the whole subject fresh in mind, to give as briefly as possible the reasons which have led to the ac- ceptance of the Klebs-Loeffler bacillus as the cause of true diphtheria, this sketch to be followed by a summary of the chief characteristics of the bacillus, and the more important lesions produced by it. Finally, to present the evidence that a streptococcus is the most frequent agent of infection in cases of pseudo-membranous inflammation in which the Klebs-Loeffler bacillus is absent. True Diphtheria.—In the year 1883, Klebs ^ demon- strated, morphologically, the constant occurrence of a bacillus in the pseudo membranes of those subject to epi- demic diphtheria. Loeffler,* in 1884, published the re- sults of a very thorough and extensive series of investiga- tions. He found the bacillus described by Klebs in the pseudo-membranes in nearly all cases examined. He proved by inoculating that this bacillus was pathogenic in certain animals. When inoculated on the injured mu- cous membrane it produced a pseudo-membrane some- what like that present in human diphtheria. He failed to find the Klebs bacillus either in the blood or organs of fatal cases of human diphtheria, or in the same re- gions of animals dying after inoculation. He came to the conclusion that the Klebs bacillus was the probable cause of true diphtheria. He considered, however, that further investigations were necessary to prove his conclu- sion. Since then the whole subject has been examined with great care, not only by Loefiler himself, but also, inde- pendently, by a large number of investigators, both in Europe and America. The work of Roux and Yersin,^ in Paris; Loeffler, in Berlin ; Kolisko and Paltauf, in Vi- enna; Ortmann,'in Konigsberg; Zarniko,^ in Kiel; Es- cherich, in Munich; Beck,' Brieger, and Fraenkel,'^in Berlin ; Tangl,'' in Tubingen; Babes,'' in Bucharest; d'Es- pine, in Geneva; Klein,' in London ; Welch and Ab- bott,''^ in Baltimore ; Prudden,'' in New York, and many others, has established that in all cases of typical infec tious diphtheria the Klebs-Loeffler bacilli are present in large numbers in the pseudo-membranes, either alone or associated with other bacteria, and that the Klebs-Loef-