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DIPTHERIA.--The first symptoms are great debility, fever, and the characteristic
deposits. These may appear on one or both tonsils, the back of the throat, or
the arches of the palate. Frequently, there is some swelling of the glands on
the neck and under the jaw. Its progress is shown by an increase of the fetor of
the breath; by an extension of the deposits into the cheeks, or into the larynx
and bronchi; by an extension upwards through the passages into the nose or into
the passage to the ear. The swelling of the glands increases with the progress
of the attack.
The unfavorable symptoms that may present themselves while the deposits are
spreading, are: Decrease of, or entire suppression of urine, great restlessness
and tossing about, followed by stupor, from which the patient is awakened by
attacks of suffocation. The fever during this time has been increasing, the
pulse becomes smaller and harder, or intermittent or slower.
The favorable indications are an arrest of the further development of the
characteristic deposits and their gradually more definite boundaries, the edges
standing out more prominently above the mucus membrane, the swelling of which
diminishes, and the patches begin to break up into smaller sections, or separate
and come off by the efforts of coughing or to clear out the throat.
The characteristic symptoms of this disease are the great weakness, the small,
hard, and frequent pulse, and the odor from the secretions of the parts
affected. The attendant symptoms are as various as the modifications of
individual constitutions and temperaments.
When attacked with diphtheria the patient must be kept in bed with sufficient
clothing over the body to give the utmost comfort, and no more. The mind must be
kept tranquil by quiet, and the room thoroughly pure by indirect ventilation. At
the same time give nourishment regularly every two hours of well prepared
beef-tea. If made by putting the beef into a bottle without water, and boiling,
a large spoonful will do for an adult, and less according to the age. The
neglect to nourish the patient well in the early stages of the disease is the
one persistent error of the profession. The rapid destruction of the blood by
the disease does not, as in typhoid states, suspend the functions of nutrition
by diversion of the vital forces, but creates a demand for supply of blood to
meet the exhaustion incident to the waste which the results will demonstrate.
The appropriate medication may arrest the local manifestation of the
blood-poison, but will not re-supply the loss of vitalized blood upon which,
after all, the recovery depends.
The domestic treatment of this terrible disease will be confined to the earliest
stage, unless it be in the milder cases, and hence only the more common symptoms
will be anticipated. If possible, obtain a competent physician at once in any
event, and get his decision as to the gravity of the case, for many which appear
as the slightest are really the most serious, while, as is often the case, a
simple, common sore throat gives friends the direst apprehension.
A case having arisen, begin at once with aconite and belladonna, alternately
every hour. If after four hours there is no improvement, and the
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