Causes.—It may be contracted from some person suffering from the disease, from a healthy “carrier” harbouring the specific micro-organism (Bacillus diphtheriæ) in his throat or nose, or from infected milk, etc.
As the disease is a very grave one, and skilled treatment is often an absolute necessity, measures should be immediately taken to summon medical assistance on the first appearance of diphtheria, or the patient should be sent as speedily as possible to a place where medical aid is likely to be obtained; for if the breathing becomes so difficult that the patient gets blue in the face, an operation for opening the windpipe will be necessary.
Incubation period, two to six days or even longer.
Symptoms.—Headache, discomfort, loss of appetite, sore throat, and sickness, with swelling of the glands at the angle of the jaw. On examination the palate and tonsils are seen to be swollen, with a white deposit of membrane upon the surface. The membrane may be thick and tough, and if stripped off will leave numerous small bleeding points.
The temperature may run up, and is irregular in type. The pulse is rapid and feeble, and the bodily strength is quickly lost.
If the nose be affected there is copious discharge from the nostrils, with difficulty of breathing and much discomfort. If the windpipe is affected the voice will become hoarse or absent, and there will be greater difficulty in breathing, accompanied by a loud crowing noise.
Diphtheria may be accompanied by cough and pneumonia.
Treatment.—Isolation. Bed. If diphtheria anti-toxin is obtainable, it should be administered at the earliest opportunity, but this should only be carried out by a doctor.
Nourishing foods and stimulants should be given frequently in small quantities. The throat should be thoroughly and frequently washed out with chinosol (1 in 1000) or other antiseptic lotion. If the difficulty in breathing is marked, warm baths should be given at intervals of about four hours. A steam kettle should be placed near the bed. The expulsion of the membrane may often be aided and great relief afforded by the administration of emetics, such as ipecacuanha, but these must be given with care owing to the risk of heart failure.
Complications.—Diphtheria may be followed by paralysis of the windpipe with loss of voice, or paralysis of other parts of the body, therefore great care should be taken not to allow convalescents to get up too soon, no matter how well they may appear.