Licence: Public Domain Mark
Credit: Diptheria [sic] / by David Wooster. 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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![is whitish or grayish, and opaque, while its periphery becomes more and more translucent'until it is lost entirely in the natural tissue.] Our author continues: • • u The surface which it covers is usually of a slightly red tint, sown with points of a deeper red color ; this tint is more vivid at the periphery of the laches. If the false membrane be detached, and leave exposed the mucous surface, the redness which appeared subdued under the concretion, re- developes, blood transudes through the deep red points, the concretion re- appears, and becomes more and more adherent upon the points first invaded ; it often acquires a thickness of several lines, and passes from a vellowish white to yellow, grey, and finally to black. At the same time the blood transudes with more facility and constitutes those stillicida which have been generally remarked by authors. [There is none of this stillicidia in our diphtheritis ; on the contrary, the parts covered with exudation do not bleed except when violence is used to tare off or scrape off the false membrane, and then the bleeding stops with remarkable promptitude, and does not occur again except on the repetition of the violence. Our false membrane never becomes black ; indeed it is paler after than before death.] Now, the alteration continues the illustrious physician, of the organic surfaces is more apparent than at the beginning ; often portions of concrete matter are effused (epanchees) into the substance itself of the mucous mem- brane ; there is observed also a slight erosion, and sometimes ecchymosis in points, which, by their situation, are exposed to friction, or from which the avulsion of the false eschars has been attempted; it is especially about this period that the concretions which are corrupted exhale an infections odor. If the concretions are circumscribed, the cedematous swelling of the sur- rounding cellular tissue makes the former appear depressed, and judging from this appearance only, we might be tempted to believe we had under observation a foul (sordide) ulcer, with considerable loss of substance. If, on the contrary, they are extended over considerable surface, they become partially detatchod, and hang in lambeaux more or less putrefied, and simu- late the last stage of sphacelus; but when we open the body of those who, after several days of illness have succumbed to tracheal diphtherite, we shall find in the air passages all the shades of this inflammation from its first de- gree, as shown on the parts just invaded, up to that which has by its decep- tive appearance, led us, for a moment, to dread the supervention of gan- grene. **#»*#** Gangrene was not present a single time, in fifty cadavres examined by me. The salient character of the pellicular phlegmasia? is the tendency to pro- gression towards the larynx and trachea; it is this tendency which gives to them their dangerous character, especially in epidemics, as the first that occurred, so well developed by M. Bretonneau.—Diclionaire de Medecine, Art. Diphtherite. [We submit that that this is only a family resemblance, but not an identity, scarcely a similarity.] 9. We now give M. Duche's description of the Diphtheritis which has for the last few years proved so fatal, as it occurred in the department de l'Yonne, in France, in 1858. _ The principal features of this epidemic are Cephalalgia, fever more or less intense, pain in the fauces. Upon examining the mouth, the tonsils are found swollen and red, and on the surface of one, sometimes both at the same time, there is a while patch of variable dimensions. These patches quickly enlarge, reach the velum palati, and uvula, which latter at times becomes enormously enlarged ; later they invade the posterior walls of the pharynx and descend gradually into the larynx and bronchia, and even info the (esophagus and digestive organs. Then different accidents are manifested according to the region invaded. \](https://iiif.wellcomecollection.org/image/b22323090_0007.jp2/full/800%2C/0/default.jpg)
