Clinical observations upon the use of antitoxin in diphtheria, and a report of a personal investigation of this treatment in the principal fever hospitals of Europe during the summer of 1895 / by Joseph E. Winters.

  • Winters, Joseph Edcil, -1922.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Clinical observations upon the use of antitoxin in diphtheria, and a report of a personal investigation of this treatment in the principal fever hospitals of Europe during the summer of 1895 / by Joseph E. Winters. 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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    later. There were no heart sounds, but artificial re- spiration was kept up for ten minutes and stimulants were also given. Patient gasped several times and died.” Case XXVII.—Aged twenty-one months; admitted September 28th; illness began September 25th. Antitoxin, 1,000 units, on admission. Thick white membrane on uvula and both tonsils; slight nasal dis- charge. Child became cyanosed, apparently from ac- cumulation in the throat; turpeth mineral given, re- sulting in free vomiting and relief. September 29th, antitoxin, 1,000 units. September 29th, became cyanotic from slightest ex- ertion, and was very restless, seeming to indicate a considerable cerebral irritation; considerable retrac- tion and stenosis—so much so that it was thought ad- visable to see if intubation would give any relief. The result of operation was unsatisfactory and the tube was removed. September 30th, still more stenosis; restlessness even more marked. Patient almost pulseless. September 30th, 9 140 p.m., patient died. This child had no evidence of croup nor of laryn- geal complication on admission. According to the record its illness was certainly slight and unimportant. After each injection of antitoxin there were restless- ness, weakness, and feeble, imperfect respiration. The bad breathing, for which intubation was tried without relief, was undoubtedly due to the action of the anti- toxin on the nerve centres and not due to croup. Case XXVIII.—Aged three and one-half years; ad- mitted December 25th; four days sick. Dirty necrotic membrane on both tonsils, palatine arches, and uvula. Prognosis good. Antitoxin, 2,000 units, on admis- sion. December 26th, antitoxin, 2,000 units. December 27th, urine scant; cream-of-tartar water, diuretin. December 30th, strychnine. January 2d and 3d, thirty per cent, of albumin, granular casts; aromatic spirits of ammonia, tincture