Diphtheria and its sequels : a narrative / by James Begbie.

  • Begbie, James, 1798-1869.
Date:
[1862]
Catalogue details

Licence: Public Domain Mark

Credit: Diphtheria and its sequels : a narrative / by James Begbie. Source: Wellcome Collection.

    17/18 (page 17)
    I 17 inflammation, previously confined to the tonsils, uvula, palate, and posterior wall of tlie pharynx, had now extended to the larynx, and the child suffered all the agonies of croup. Before evening, asphyxia had nearly done its work, when it was arrested by the timely aid of Mr Spence. Tracheotomy lengthened out the life of the little suf¬ ferer, and placed him in comparative ease. He breathed; he slept; he took nourishment. He passed a tranquil night; and on the morrow we found him cheerful and happy, surrounded by his toys, in which he took a full interest, and little disturbed by the simple mechanism which science had interposed between him and death. The respite, alas! was very short. As the day advanced he was seized with vomiting ; he became restless and oppressed ; his pulse rose in frequency and fell in strength; his breathing became hurried ; the obstructed air-cells obtained no adequate relief; and, before the evening closed, he expired, exactly twenty-four hours after the operation. It was a tranquil .death compared to that with which he was threatened; and in justice to the operation of tracheo¬ tomy, and to those who advocate its performance, it may be allowed that, if it secured nothing more than relief from the agonies of slow suffocation, by substituting a less painful and distressing mode of dying, it is surely entitled to our grateful consideration. The histories now recorded tend to confirm the views generally entertained in regard to the nature of diphtheria, and go to establish— ls£, That it is a constitutional disorder having the character of fever, running a definite course, and bearing a closer affinity to scarlatina and typhoid fever than to any other specific disease. 2d, That its local manifestation is chiefly observed on the mucous membrane of the mouth and throat; the tonsils, uvula, and palate with the pharynx being first affected; but that it has a tendency to spread to the adjoining passages, and is particularly prone to invade the larynx. 3d, That this local disease is of the nature of inflammation of asthenic character, with exudation of lymph in the form of pellicle. 4th, That the disease is contagious, and that youth and consan¬ guinity powerfully predispose to it. 5th, That it is fatal from the severity of the general disorder, or from the exudative inflammation invading the larynx, and causing suffocation; or that death may result from the nervous disorder supervening in the form of paralysis. And, lastly, that as we have no specific remedy for diphtheria, the disease and its sequels must be treated on the general principles which regulate our practice in fever, and in inflammation, and in nervous disorders of asthenic character. EDINBURGH : PRINTED BY OLIVER AND BOYD.