Report on a new method of treating diphtheria / by Charles Smith.

  • Smith, Charles.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Report on a new method of treating diphtheria / by Charles Smith. 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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    a bucket at the foot in which boiling water is renewed every half hour, clay and night. In the mixture soak two cloths, linen or otherwise, about a foot square; place one close to the face, the other on the pillow near the head, on pieces of paper to avoid unnecessary soiling of the bed clothes ; in adults, or children over- eight or ten years of age, one or two other cloths of the same size may be soaked and hung about the cot; these must all be kept moist with the mixture, as they tend to become dry, but need not be actually dripping. Care must be taken that they do not touch the face, although very close to it, otherwise the skin will become burnt; a wire cage might possibly be arranged to avoid this difficulty. The nurse must watch to see that they are always sufficiently near to give off a strong odour close to the patient's mouth, or several cloths must be used in the tent, so that it may be filled with the vapour. If old enough to keep the mouth open, he should do so volun- tarily, a piece of cork or wood being placed between the back teeth to assist him, for there is considerable difficulty in maintaining the mouth long in this position. I have found that a child of four will do this without trouble; if younger, or unmanageable, or if the case do not progress satisfactorily, plug the nostrils loosely with cotton-wool as well, or instead. This necessitates keeping the mouth open in order to breathe. The actual impact of the vapour on the diseased spot is essential to cure, and by the method mentioned this is facilitated. Sometimes the child will talk or sing, while at others he will simply sit in his cot and roar; in either case, plugging of the nostrils is not necessary, but it is often of the greatest assistance, and should seldom be omitted, especially during sleep. This, of course, applies only when the deposit is chiefly on the tonsils or soft palate ; when laryngeal only, it is unnecessary, and even if pharyngeal as well, it will generally be safe to omit at any rate the nostril plugs, for the cure of the laryngeal portion of the disease takes so long that the pharyngeal portion almost certainly disappears at the same time. Should there be nasal diphtheria also, the nostril plugs must be omitted, at any rate at intervals. The vapour must be applied in the manner described, and in no other. One of my patients was nearly lost through the nurse putting the mixture into the hot water whence the stearn was derived, and omitting to put it on the cloths, it appeared to be almost inert; while, on the other