Tracheotomy in laryngeal diphtheria (membranous croup) : with especial reference to after-treatment to which are added a few general remarks on diphtheria, and its earlier treatment / by Robert William Parker.

  • Parker, Robert William, -1913.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Tracheotomy in laryngeal diphtheria (membranous croup) : with especial reference to after-treatment to which are added a few general remarks on diphtheria, and its earlier treatment / by Robert William Parker. Source: Wellcome Collection.

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    themselves of the truth of this view as regards cause and effect, because in many cases of well-marked diphtheria the organisms in question have not been found. The false membrane varies much in character and in amount. Thus, mainly owing to the greater amount of the submucous tissue, it is much more adherent in the pharynx than in the larynx; whilst in the trachea and bronchi it is readily separable, and indeed it is often quite detached. This fact is very important in its rela- tion to after-treatment. The membrane is sometimes as soft as cream, sometimes resembling wash-leather (Jenner). Microscopically it consists of altered epithelial cells, granular corpuscles, with more or less of fibrillar tissue. Occasionally vegetable growths are found. The exact nature of these products varies according to the part examined. The condition of the subjacent mucous membrane differs greatly. Sometimes, after removal of the false membrane, there is no appreciable breach of surface ; at other times, there is a very considerable breach of surface ; and between these two extremes, almost any gradation may be met with. The mucous and sub- mucous tissues present various degrees of inflammation; they are infiltrated with leucocytes, and their vessels are distended with blood. Sometimes the mucous membrane, without appearing to be abraded, is so oedematous, in- filtrated, and swollen as to necessitate tracheotomy even when there is no false membrane present upon it. Sjrmptoms: Mode of onset.—Briefly stated, it may be said that membranous laryngitis begins in one of two ways. It may attack the larynx primarily; or, begin- ning elsewhere, may spread to the larynx secondarily. In the former case, the chief symptoms are those of