The heart in diphtheria / by Charles Bolton.

  • Bolton, Charles.
Date:
1902
Catalogue details

Licence: In copyright

Credit: The heart in diphtheria / by Charles Bolton. 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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    day. The attacks were certainly not in any way connected with the entrance of saliva or food into the larynx, as there was no coughing or other symptom of respiratory disturbance. Case 7.—A. P., male, set. 2; was admitted to University College Hospital on 17th March 1901. Onset of the disease was 16th March, and on admission there was membrane on both tonsils and uvula, with enlargement of the cervical glands on each side. The voice was a little hoarse, and there was a trace of recession of the lower portion of the chest. Pulse quite regular and heart normal. Temperature 99°. The urine contained half albumin on boiling and setting aside. Anti- toxin, 6000 units administered. March 21.—Fauces quite clean. March 26.—Occasional vomiting; pulse irregular. March 31.—Several times during the day the child has become cyanosed, the pulse being barely perceptible. Palate does not move very freely. No change in the character of the respirations. Cardiac impulse in the fifth interspace outside the nipple line. April 13.—Internal strabismus. The attacks of cyanosis and pallor of the face with a feeble pulse continue. April 17.—Knee-jerks absent. Diaphragm normal. No signs of paresis anywhere except the eyes and palate. April 22.—Child is generally limp. Vomited twice during the day. Has not had a bad cyanotic attack for ten days. April 26.—Vomiting stopped, and pulse perfectly regular ; still very limp, but paralysis is clearing off. After this, recovery was gradually completed. Apart from irregularity, the frequency of the pulse may be affected alone. As a rule, in acute diphtheria the pulse is as a whole rapid, but exceptionally it may be slow. In the following case the pulse was rapid till the eighth day of the disease, after which for a fortnight the highest record was about 72 in the morning, and later in the day it varied between 48 and 64; the frequency rose after this, but until the date of discharge it sometimes fell to 60 at night. Case 8.—N. H., female, set. 10; was admitted to University College Hospital on 2nd September 1901.—The onset of the disease was 31st August, and on admission the right tonsil was inflamed and the left covered with thick membrane, at the upper part creeping on the soft palate. The cervical glands were enlarged on each side, and there was slight rhinorrhoea. The cardiac impulse was in the fifth left intercostal space internal to the nipple line, and the sounds were normal. The pulse was 124 and regular. Temperature, 100° A. No albumin in the urine. Antitoxin, 8000 units administered. September 6.—Fauces clean. September 8.—Slight nasal voice ; pulse slow during the night. September 10.—Nasal voice distinct; palate not drawn up on the left side on phonation; knee-jerks present; pulse regular but slow during the night.