Cases of diphtheria, with some remarks on the treatment of croup and of the throat affections in scarlatina / by G. Hamilton, M.D.

  • Hamilton, George, M.D.
Date:
1863
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Licence: Public Domain Mark

Credit: Cases of diphtheria, with some remarks on the treatment of croup and of the throat affections in scarlatina / by G. Hamilton, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    19/34 (page 17)
    asleep. Touched; sponged; incised tonsils in three places. Cont. iod. pot. u. a. 21ih.—His father in his anxiety administered during the night an antimonial emetic, as I had said if he became croupy this should be given. Pulse 120, softer; breathing quite quiet; tonsils won- derfully improved, liis mother remarking when she saw them that they were diminished one-half in size since last night; inflamed appearance of tliroat also much less. Touched and sponged. Cont. iod. pot. every three hours. 28</i.—Wonderfully better; breathing easy; pulse 88, soft; throat clean and nearly free from inflammation, though tonsils still a little swollen; nearly convalescent. Touched and sponged throat. Cont. iod. pot. u. a. 2^th.—All but well; sponged; to continue iodide for a few days. An infant in the same family became croupy on the 27th, and two other members had inflamed throats, but all quickly recovered under the treatment mentioned. At a later period of the epidemic, I had another case in which the tonsils were atFected even more seriously. A brother having been threatened with diphtheritic croup a few days previously, the parents fortunately at once took the alarm, and I saw this patient (W. L., three and a half years old), whose tonsils were usually abnonnally large, as soon as he complained. I imme- diately gave an emetic, sponged the throat and glottis with the caustic solution, and ordered a dessert-spoonful of the sol. iod. pot. every third hour. Notwithstanding this active treatment was con- tinued, on the third day the pulse was upwards of 150, the tonsils were enormously swollen, and the breathing was rough and very loud and alarming. I then incised both tonsils, making two incisions into the one and three into the other. In the evening, the relief from this was very decided, and next day the pulse was 120. On the fifth day, my report says that he had passed a restless night; pulse small (120 to 130); tonsils clean, but large on upper part of right side, and uvula elongated and interfering with respiration. Excised a portion of the right tonsil, which was so spongy that there was some diffi- culty in laying hold of it, and also part of the uvula, after which the breathing became comparatively quiet. Continued the other meas- ures, dropping also, twice daily, a little of a caustic solution (two grains to the ounce of water) into the windpipe from the india-rubber tube I mentioned at the close of the first part of this article (page 12). This patient also made a rapid recovery. Wine was given here to a moderate extent. These cases seem to me most encouraging examples of what can be done in cutting short one of the most dangerous complications of this disease. From what I have very often seen in scarlatina, I cannot doubt that the state of the throat presented here from the outset would, if not determinedly combated, have rapidly gone on to partial or complete sloughing of the tonsils, and probably also to