The vexed question of the diagnosis of diphtheria is now a thing of the past.
In the 1920s, we got a vaccine for diphtheria, pertussis, tuberculosis, and tetanus.
Thus, to mention examples, diphtheria toxin produces inflammatory oedema which may be followed by necrosis; dead tubercle bacilli give rise to a tubercle-like nodule, &c. Furthermore, a bacillus may give rise to more than one toxic body, either as stages in one process of change or as distinct products.
In other cases such changes cannot be detected, and the only evidence of their occurrence may be the associated symptoms. The very important work of Ehrlich on diphtheria toxin shows that in the molecule of toxin there are at least two chief atom groups - one, the " haptophorous," by which the toxin molecule is attached to the cell protoplasm; and the other the " toxophorous," which has a ferment-like action on the living molecule, producing a disturbance which results in the toxic symptoms. On this theory, susceptibility to a toxin will imply both a chemical affinity of certain tissues for the toxin molecule and also sensitiveness to its actions, and, furthermore, non-susceptibility may result from the absence of either of these two properties.
Quite irrespective of the nature of the anatomical lesion, the finding of the diphtheria bacillus on the part affected and the inoculability of this upon a suitable fresh soil are the sole means by which the diagnosis can be made certain.
In 1870 Pasteur had proved that a disease of silkworms was due to an organism of the nature of a bacterium; and in 1871 Oertel showed that a Micrococcus already known to exist in diphtheria is intimately concerned in producing that disease.
Thus the organisms of suppuration, tubercle, glanders, diphtheria, typhoid fever, cholera, tetanus, and others were identified, and their relationship to the individual diseases established.
A new field of inquiry was, however, opened up when, by filtration a bacterium-free toxic fluid was obtained which produced the important symptoms of the disease-in the case of diphtheria by P. P. E.
In the case of the tetanus and diphtheria bacilli, the production of soluble toxins can be readily demonstrated by filtering a culture in bouillon germ-free by means of a porcelain filter, and then injecting some of the filtrate into an animal.
Thus paralysis following diphtheria is in all probability due to a different toxin from that which causes the acute symptoms of poisoning or possibly to a modification of it sometimes formed in specially large amount.
A later research by Brieger along with Fraenkel pointed to the extracellular toxins of diphtheria, tetanus and other diseases being of proteid nature, and various other observers have arrived at a like conclusion.
In the case of diphtheria Sidney Martin obtained toxic albumoses in the spleen, which he considered were due to the digestive action of an enzyme formed by the bacillus in the membrane and absorbed into the circulation.
Thus in cholera the bacteria are practically confined to the intestine, in diphtheria to the region of the false membrane, in tetanus to some wound.
Thus in diphtheria changes in both nerve cells and nerve fibres have been found, and in tetanus minute alterations in the nucleus and protoplasm of nerve cells.
In the case of diphtheria the antitoxic power of the serum may reach Boo units per cubic centimetre, or even more.
Such serums are injected subcutaneously in diphtheria, tetanus, streptococcic infections, plague, snake-poisoning, cholera and other similar diseases.
The most unhealthy period is from 1st May to 31st October, when there are, from time to time, outbreaks of typhoid, small-pox, diphtheria and other epidemics.
Von Behring completed the sphere of the new study by his discovery of the antitoxins of diphtheria and tetanus.
Of such are tetanus and diphtheria, now known to be due to the establishment from without of a local microbic infection, from which focus a toxin is diffused to the nervous matter.
The grave palsies in such diseases as influenza, diphtheria, beriberi, or ensuing on the absorption of lead, are in the main not central, but due to a symmetrical peripheral neuritis.
Epidemic outbreaks of other diseases - for instance, cholera, diphtheria and typhoid fever - are often preceded and followed by the prevalence of mild illness of an allied type; and t he true significance of this fact is one of the most important problems in epidemiology.
Yersin has prepared a serum from horses in the same way as diphtheria anti-toxin, and this is said to have a curative action during the attack.
Diphtheria, than adults.
In practical medicine the subsequent results of Behring and his followers have in diphtheria attained a signal therapeutical success.
Diphtheria, long no doubt a plague among mankind, was not carefully described until by Pierre Bretonneau in 1826; and since his time our conception of this disease has been extended by the study of later, secondary and incidental phases of it, such as neuritis, which had always formed part of the diphtheritic series, though the connexion had not been detected.
Again, all accounts of diphtheria show a tendency on the part of the disease to recur in the same districts year after year.
Greenhow in 1858 stated that diphtheria was especially prevalent on cold, wet soils, and Airy in 1881 described the localities affected as " for the most part cold, wet, clay lands."
In the laboratory absolute soil dryness is as distinctly antagonistic to the vitality of the diphtheria bacillus as soil dampness is favourable.
Billings: Average Annual Death- rate per Ioo,000 Popuia- Consum ti Pneumon Typhoid Diphtheria an tion for the ciues of the p on.
Oxygen may be applied locally as a disinfectant to foul and diseased surfaces by the use of the peroxide of hydrogen, which readily parts with its oxygen; a solution of hydrogen peroxide therefore forms a valuable spray in diphtheria, tonsillitis, laryngeal tuberculosis and ozaena.
On the whole Hungary is a healthy country, excepting in the marshy tracts, where intermittent fever and diphtheria sometimes occur with great virulence.
Amongst these may be mentioned the neutralizing of the toxins in cases of diphtheria, tetanus and poisonous snake-bite; " serum therapeutics "; and treatment by " vaccines."
By the continuous injections under the skin, in increasing doses, of the toxins of certain pathogenic micro-organisms, such as that of diphtheria, an animal-usually the horse-may be rendered completely refractory to the disease.
Diphtheria first appeared in 1868 and continued as a severe epidemic until 1872, since when it has only occurred at rare intervals and in isolated cases.
The facts with regard to passive immunity were thus established and were put to practical application by the introduction of diphtheria antitoxin as a therapeutic agent in 1894.