Diphtheria / by William P. Northrup ; measles, scarlatina, German measles / by Theodor von Jürgensen ; ed., with additions by William P. Northrup ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

Northrup, William P. (William Percy), 1851-

Date:: 1902

Credit: Diphtheria / by William P. Northrup ; measles, scarlatina, German measles / by Theodor von Jürgensen ; ed., with additions by William P. Northrup ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

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$heart’s blood, diphtheria bacilli 7 times; in the liver, 30; in the spleen, 19; in the kidney, 25 times. In a majority of the cases the bacilli were found in pure culture; in others, associated with the streptococcus, staphylococcus, Diplococcus lanceolatus, pneumococ- cus, etc. In the second group of cases the diphtheria bacilli were found: In heart’s blood, 5 times; liver, 12 times; spleen, 7 times; kid- nev, 12 times. The authors do not speak positively as to the significance of this general infection, but note the fact that it occurred generally, but not always, in the cases of septic diph'theria. This would bear out the truth of the statement of Kanthack and Stephens, quoted above, and also the opinion held l)y Genersich, that the sepsis may be caused by the diphtheria bacillus alone, and that the association of other organ- isms, especially the streptococcus, is not essential to the production of various septic conditions. Councilman and his associates also found in one case of general infection complicated by scarlet fever and pneumonia, and one of ulcerative endocarditis, diphtheria bacilli in pure culture in a soft clot-like mass adherent to the mitral valve. Howard and A\d’ight have reported cases in which the bacilli were found in valvular vegetation. In l)oth cases, however, the bacilli were non-pathogenic for guinea-])igs. In the lungs in cases of dil)htheria without conqdications with other exanthemata, the diph- theria bacillus was ])resent in 52 of 9cS cases examined. It occurred alone fifteen times and in the rest of the cases in combination with other organisms. In the lungs of the diphtheria cases com])licated with scarlet fever, measles, or both, out of 24 cases from which cultures were made the diphtheria bacillus was present in 20. The authors agree with the opinion of the majority of observers that a combination of pathogenic organisms is generally responsible for the occurrence of pneumonia in these cases. In abscesses of the lung the di])htheria bacillus was found 4 times in II cases, and always associated with other germs. In 7 cases of em- pyema the diphtheria bacillus occurred twice, associated with cocci. The accessory sinuses of the nose were examined in (>3 cases, and were frequently found to contain diphtheria bacilli alone or in com- bination with other organisms. The authors believe that this infec- tion may in all probability account for the persistence of di})htheria bacilli in the nose. As to the occurrence of the diphtheria bacillus in the middle ear, the report of the above writers is given under Complications of Diph- theria.$