Notes on an epidemic of diphtheria / by John Forman.

Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: Notes on an epidemic of diphtheria / by John Forman. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    amount of nitrates are present in the pump water, which are not in the dam water; and this fact taken in conjunction with the increase in the total amount of the matter dissolved in the pump water, as compared with what is present in the dam water, leads me to infer that the water, after it leaves the dam, gets contaminated with de- composing organic matter, in part, of animal origin. Considering the comparatively large amount of organic matter in the pump water, and its nature, I quite agree with you in considering it possible that the habitual use of this water might predispose certain parties, of peculiar constitutions, to an attack of diphtheria or other disease.—I am, dear Sir, yours sincerely, (Signed) Stevenson Macadam, Ph.D., F.R.S.E., Lecturer on Chemistry, etc. The next cases which came under my notice were in the village of Fettercairn, about two miles distant from the place where the cases just cited occurred. The most minute inquiry could not dis- cover any communication between the parties affected. On the 16th February, I was requested to visit a child of three and a half years of age, said to be very ill of croup. I saw the little sufferer at 9 A.M., when I at once pronounced him moribund. He had crowing inspiration, pallid face, staring eyes, and a very feeble pulse. Examination of his throat at once revealed the true cause of the strididous laryngismus : the pharynx and tonsils were coated with a thick greyish-white membrane, the adjoining parts presented a glazed claret colour, and the cervical glands were much enlarged. The crowing inspiration was observed by his parents at 6 A.M. of that day; it ceased at 2 p.m., and he sank an hour afterwards. No treatment was attempted, no post-mortem, allowed. The child was of a strumous diathesis, and had been in a feeble condition for some time before his fatal illness. This case led me to examine the whole family immediately, when I found the mother and other four children more or less affected with diphtheria. One child, 2 years old, far advanced in the disease ; both tonsils oedematous and ulcerated, with hurried breath- ing and feeble pulse. Ferri Perch, was freely applied to the fauces, and ten drops prescribed, with port-wine, every three hours; Tinct. Iodini Co. to the cervical glands. At 5 p.m. crowing inspiration com- menced ; the face assumed a livid hue, with small quick pulse. Ten-grain doses of Cupri Sulphas were given at varied intervals, with the view of detaching any false membrane that might have formed in the air-passages by vomiting, but none was discharged. In this respect diphtheria seems to differ from genuine croup : in the latter disease, when sulphate of copper is freely administered, copi- ous vomiting of mucous and. false membrane is invariably produced with great relief to the little sufferer. This circumstance induces me to believe that the crowing inspiration in diphtheria is not the result of false membrane in the air-passages only, but rather to