. A practical treatise on medical diagnosis for students and physicians . ly to the larynx. The subsequent phenomena are thoseof stenosis of the larynx, toxaemia, with or without superadded uraemia,or marked cardiac weakness; it is further characterized by the liability toparalysis as a sequel. Diphtheria is contracted by inhaling the expired breath of a diphtheriticpatient, or breathing air which has been contaminated by the clothing ofthe patient or the discharges from his nose or throat. It may also betransmitted directly, as when a fragment of membrane is ejected by cough-ing and infects t
. A practical treatise on medical diagnosis for students and physicians . ly to the larynx. The subsequent phenomena are thoseof stenosis of the larynx, toxaemia, with or without superadded uraemia,or marked cardiac weakness; it is further characterized by the liability toparalysis as a sequel. Diphtheria is contracted by inhaling the expired breath of a diphtheriticpatient, or breathing air which has been contaminated by the clothing ofthe patient or the discharges from his nose or throat. It may also betransmitted directly, as when a fragment of membrane is ejected by cough-ing and infects the mouth or eye of the physician or attendant. More-over, air contaminated by diphtheria is contained in the sewers of largecities while the disease is endemic, and may persist in damp cellars ifthey have once been infected. Hence, sewer-gas and cellar-air may carrythe disease. There is reason also for believing that a similar diseaseaffects birds, fowls, and cats at times, and by them may be transmittedto man. These facts must be borne in mind in making the Diphtheria. (Original.) The specific poison is the Klebs-L5ffler bacillus and its toxin. While children from one to six years of age are especially liable to it,no age is exempt—neither the new-born babe nor the very aged. Oneattack does not protect a person completely against a subsequent attack. DIPHTHERIA. 791 The temperature range is variable. The infection may be intense, andyet the temperature remain subnormal, especially if the fever is due Inthe toxin, and not, as is frequently the case, to a mixed infection. The period of incubation varies from a few days to two weeks, orperhaps longer in exceptional cases. As a rule it is less than a week. Itis shorter when the poison is virulent and when infection has been uponabraded surfaces. The onset in mild cases is deceptively free from positive child is languid, perhaps slightly chilly, and has a little fever, withthirst, impaired appetite, and d
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