Report of investigations into the pathogeny of diphtheria / conducted by Edward Curtis and Thomas E. Satterthwaite.

  • Curtis, Edward, 1838-1912.
Date:
[1877]
Catalogue details

Licence: Public Domain Mark

Credit: Report of investigations into the pathogeny of diphtheria / conducted by Edward Curtis and Thomas E. Satterthwaite. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    PART I.—GENERAL REPORT. By the broad instructions to investigate the “causes and nature of diphtheria,” we conceived that we were desired to work at some point in the pathogenesis of the disease, whose solution was important and at the same time seemingly within the means of laboratory experimenta- tion. Accordingly we took for our subject the question which has already attracted so much attention from its supposed solution in Germany, viz: what is the nature of the infectious principle of diphtheria, and what are the circumstances that determine the infection. Considering it already sufficiently proven that the false membrane of diphtheria is able to communicate the disease, we made our search for the infectious principle in this material. The first point was to know the morphological elements of the membrane. Concerning most of these there has never been any doubt; fibrin, epithelial cells, leucocytes and granular matter being easily recognizable. These elements we found in varying proportion in most of the sixteen1 membranes examined by us, and in three2 there was also the mycelium, and in one3 of the same also the spores of a fungus, apparently an aspergillus or penicilium. But the important point was to determine the presence or absence in the membranes of bacteria, since these organisms have been alleged to be not only always present, but also to contain or be the noxious element. Accordingly we searched our membranes with special care for bacteria, with the following result: Small rod-bacteria, precisely similar in form and size to those found upon the mucous membrane of the healthy mouth, we found almost always present, though in greatly variable quantities, scattered throughout the tissue of the false membrane. Besides these rod- forms there also occurred in many, though not in all, of our membranes, distinct collections of closely packed bacteria, apparently either firmly glued together or else encased in a delicate invisible envelope. For these collections, or “ balls ” or “nests,” could be isolated and rolled about and subjected to heavy pressure by pressing upon the cover of the microscopical slide, without losing their form or coherence. Similar balls or masses have been repeatedly seen by us in non-diphtheritic matter infested with bacteria. On treating membrane contain- ing these bails with an alkali, the balls disappear as such, and the field becomes crowded with short rod-bacteria. From this fact it is likely that these balls are not, as their appearance first suggests, wholly collections of spherical bacteria, but that much of their contents at least is the ordinary rod-form of bacteria, which here looks spherical simply because the individuals are closely packed side by side with their ends presented to view. The same illusion of minute spheres is commonly met with wherever, as upon the papillae of the healthy tongue, rod-bac- teria are closely massed together. In addition, free spherical granules presenting the optical characteristics of bacateria were often met with, but rarely except in company with the free rods and the balls of massed bacteria already described. Upon these granules we tried the various chemical and coloring tests for bacteria proposed by Hiller, Letzerich and Eberth, but we found the tests so unreliable that we dared not base conclusions upon their showings. Inasmuch furthermore as the granules in question were almost always associated with unmis- takable bacteria, and were in no wise different in appearance from the similar granules found commonly in all bacteria-infested matter, whether diphtheritic or not, we did not attach much 1 Several specimens were examined which do not appear in Part II., because no use was made of them for experimentation. 2 Cases VI., XI., and XIII. See Part II., pp. 677, 689, 690. 3 Case XI.