Report of the Scientific committee appointed by the Royal medical & chirurgical society to investigate the relations between membranous croup and diphtheria.

  • Royal Medical and Chirurgical Society of London
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Report of the Scientific committee appointed by the Royal medical & chirurgical society to investigate the relations between membranous croup and diphtheria. Source: Wellcome Collection.

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    influence, bear to those in which it can with any probability be ascribed to cold, together with the uncertainty which forbids us in any case to regard the causation by cold as more than a probability, makes it important to inquire whether there be any mode of distinction between the mem- branous inflammation and the non-membranous or catarrhal laryngitis, the frequent production of which by exposure to weather does not admit of dispute. The inquiry presents a difficulty in our necessarily less perfect knowledge of the pathological conditions which are followed by recovery than of those which lead to death. In the fatal cases of croup, membrane, as proved by post-mortem examination, is almost always to be found. Among the cases which end in re- covery there is rarely any evidence of membrane; but of these our knowledge cannot be such as to enable us to say with certainty that at no time nor to any extent was mem- brane there. Could it be generally inferred that in a case in the course of which no membrane had ever been seen none had existed, the facts would at once indicate a broad and simple division between membranous croup almost always fatal and non-membranous croup almost always not so. The facts before the Committee are striking, however they are to be interpreted. Dr. Fagge examined the records of Guv’s Hospital without meeting with a single case of croup (using the term in the clinical sense) of which the subject was examined after death without the finding of membrane.1 One exceptional case afterwards occurred and is mentioned in a foot-note to his tabulation. Dr. Dickinson relates 23 instances of post-mortem examination in cases of inflamma- tory laryngeal obstruction : membrane was found in 22, the solitaiy exception being one of oedema of the glottis. And Dr. Gee’s search into the records of experience, of the other physicians of the Hospital for Sick Children found 60 fatal cases of membranous laryngitis, but not one fatal case of the non-membranous variety. 1 One such case, which occurred in 1869, has been discovered in the records. The patient was a male child three months old.