Sanitation for public health nurses : (the fundamentals of public health) / by Hibbert Winslow Hill.

  • Hill, Hibbert Winslow, 1871-1947.
Date:
1919
Catalogue details

Licence: In copyright

Credit: Sanitation for public health nurses : (the fundamentals of public health) / by Hibbert Winslow Hill. Source: Wellcome Collection.

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    Tonsilitis, on the other hand, has not been shown to be due to any one definite germ, but appears to be the result of the activities of several different germs, operating singly or together. It appears to be a far less specific disease than is diphtheria, and probably awaits, as typhus did up to a hundred years ago, some brilliant student of medicine who will differentiate it into two or more different diseases now inextricably confused. Septic sore throat and Vincent’s angina are examples of exactly this differentiation applied, however, to the older conception of diphtheria, rather than of tonsilitis. In former days there can be no doubt that all membranous throat affections were indiscriminately labeled as diphtheria, while nonmembranous throat affections were labeled as not diph¬ theria: the diagnosis was, in brief, anatomical, that is, based on the physical condition found, rather than etiological, which means based on the cause. On the latter basis we now recognize several distinct diseases, besides diphtheria, amongst the membranous affections; and we also recognize that diphtheria is not necessarily a membranous disease itself. Diphtheria in two common situations was not recognized as diphtheria until the diphtheria germ was shown to be present as the cause. One of these clinical varieties is the old membranous croup, now recognized as laryngeal diph¬ theria; the other was not even dignified by a name, but was considered a simple affection of the nose: we now recognize it as nasal diphtheria and as responsible for many a “ mys¬ terious” and “ untraceable ” diphtheria epidemic. Diphtheria is a disease intensely interesting in its every feature: one of these is the confinement of its membrane in most instances to a very limited area in the throat. Why does it not spread forward over the insides of the cheeks, over the tongue, over the roof of the mouth? Why does it not spread down the oesophagus, the stomach, the intestine?