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DIPHTHERIA:

66963
Its History, Causes, Symptoms, Diagnosis,
Pathology, and Treatment.
Illustrated with numerous Cases successfully treated.
BY
WILLIAM MORGAN, M.D.,
Member of the Royal College of Surgeons, England; Member of
the British Homœopathic Society; Physician to the Central
Londen Homœopathic Institution; lare Physician to the
Brighton Homœopathic Dispensary; formerly Physician
to the North London Dispensary; Accoucheur to the
West End Maternity Institute for Welsh Women ;
one of the Medical Officers to the London Homœo-
pathic Hospital, etc.
MORS
ÆQUO PULSAT REGUMQUE TURRES PAUPERUMQUE TABFRNAS.
-Her.
SECOND EDITION.
LONDON:
THE HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, E.C.
BOERICKE & TAFEL, NEW YORK & PHILADELPHIA.
And all Homeopathic Chemists and Booksellers.
1879.
En Memoriam.
FREDERICI FOSTER QUIN, M.D.,
THE PIONEER OF BRITISH HOMEOPATHY,
WHO, DURING A LONG CAREER IN THE MEDICAL PROFESSION,
!
WAS EMINENTLY SUCCESSFUL AS A PHYSICIAN ;
WHO, IN THE INTERCOURSE OF PRIVATE LIFE,
WAS A MAN OF THE MOST STARTLING WIT AND BRILLIANT
ACCOMPLISHMENTS;
WHOSE QUALITIES, BOTH PROFESSIONAL AND SOCIAL,
RENDERED HIM A WELCOME VISITOR AND PROFESSIONAL
ADVISER IN THE HIGHEST RANKS OF THE LAND;
AND IN THE ROYAL CIRCLE A DEAR AND
GUEST.
THESE FEW LINES ARE OFFERED
FAVOURED
AS A SLIGHT TESTIMONY OF RESPECT TO ONE WHOSE
LONG AND MERITORIOUS CAREER WAS MOST BENEFICIALLY
AND UNSELFISHLY DEVOTED TO UPHOLDING THE DIGNITY,
AND PROMOTING THE ADVANCEMENT OF HOMEOPATHY,
BY THE AUTHOR.
PREFACE.
SECOND EDITION.
THE first edition of this monograph
was presented to the reader in the form
of a pamphlet, being simply an extract
from a paper which was read at a
meeting of the British Homœopathic
Society in the year 1860, and has since
been out of print for some time.
The terrible and lamentable calamity
which has so recently thrown a gloom
and a curtain of mourning over this land,
by the sudden and untimely death of a
beloved Princess by the mysterious and
subtle poison, unfortunately too well
known under the name of Diphtheria,
has induced the Author to prepare for
the public and profession a more com-
plete résumé of this little work.
The greater portion of the pamphlet
has been rewritten, and a considerable
amount of historical and practical matter
has been blended, and the whole carefully
revised, which, the Author hopes, may
6
Preface.
1
throw some new light on the history,
symptoms, pathology, and treatment of
so mysterious and fatal an invader.
It may, however, be observed that the
section devoted to the selection of reme-
dies and topical applications has been
retained in its entirety. It is the one
the Author chalked out for guidance.
when he first encountered Diphtheria in
1858. It is the one which has acted as
his daily guide to the present time, has
but seldom failed him, and which has
enabled him to perform brilliant and
startling cures, and reduce the mortality
to a mere fraction.
Since 1858 the author has treated over
fifty cases of Diphtheria, some of a mild.
form, others of a most malignant type,
three only having succumbed to the
fatal influence of this dangerous malady
a form of disease which has hitherto
baffled or eluded the skill and ability of
the ablest physicians of our day, and has
formed a subject of critical disquisition
Preface.
7
in the allopathic ranks. This same
disease also continues a momentous and
crucial test of the ability of those pro-
fessors of the healing art, who frankly
and unreservedly confess that the death-
roll under their mode of treatment far ex-
ceeds that of Asiatic cholera in its most
malignant form-viz., 75 to 82 per cent.
"The following figures relative to the
deaths from Diphtheria, gathered from
the annual reports of the Registrar-
General, may be of some interest just
now. It is only since 1855 (the year of
the severe epidemic of Diphtheria in
France) that this disease has been placed
under a separate heading in the tables of
mortality. It appears that from 1855
until the end of 1876, 81,361 deaths.
from Diphtheria were registered in
England, or 0.78 per cent. of the total
number of deaths from all causes.
Excluding from consideration the first
three years of this period, in which
some of the deaths appear to have been
8
co
Preface.
recorded under other headings, it seems
that the greatest number of deaths
occurred in the year 1859, when as many
as 10,184 were registered, being 2:3 per
cent. of the total number of deaths in
that year. The lowest rate was in 1872,
when only 2,152 deaths occurred, or 0'43
per cent. of the whole number recorded.
During the ten years 1861-70, 18,467
males and 20,987 females died from
Diphtheria, or a total of 39,454, of which
no fewer than 22,150, or 56'1 per cent.,
were children under the age of five years,
and 9,925, or 25.1 per cent., were between
five and ten years old. Thus 81 per
cent. of the deaths during that period
occurred among children under ten years
of age. Between the ages of ten and
fifteen 3,082 were registered, or 78 per
cent., leaving just II per cent., including
those of fifteen years and upwards. The
disease seems to be most fatal to chil-
dren between one and two years of
age,
as over 13 per cent. of the total number
Preface.
of deaths during 1861-70 occurred at that
period. In the year 1876 the deaths
from Diphtheria were relatively more fatal
to children than in the period 1861-70; the
total number being 3,151, of which 90'1
per cent. were those of children under ten
years of age, and 27 per cent. those
between the ages of ten and fifteen years.
In the list of 115 causes of death in
England in 1876, Diphtheria comes 29th
in the order of fatality. The tables of
mortality published by Dr. Farr in
1875 disclose the curious fact that more
persons die of Diphtheria in the healthy
districts of England than in those where
the general mortality is higher. For
instance, in the healthy districts, out of
100,000 persons born 1,029 die of Diph-
theria; while in the less healthy districts,
such as Liverpool, the deaths from Diph-
theria amount to only 441. On the
other hand, the deaths from scarlet fever
in the healthy districts number 2,140,
while in Liverpool they are 3,830 out of
IO
Preface.
every 100,000 born. Again, the popula-
tion of the south-eastern counties is
about two-thirds that of London, and
yet the deaths from Diphtheria in those
counties exceeded by 37 the deaths
from that disease in the Metropolis.
The best medical authorities assert that
the disease has existed from the earliest
days of medical history; but it certainly
did not occupy a very distinct place in no-
sology until a comparatively recent date.
The severe epidemic at Tours in 1818 led
to a thorough investigation of the disease
by Bretonneau, who gave it the name
of Diphtherite. There can be no doubt,
however, that there is still much to be
learned as to the cause of this disease."
Having these imposing and formidable
statistics in view, I appeal to the whole.
profession to throw aside the cloak of
dogmatism, and give my mode of treat-
ment a fair and unbiased trial.
23, WELBECK STREET,
CAVENDISH SQUARE, W.
February 14th, 1879. .
PREFACE.
FIRST EDITION.
THE views propounded in the follow-
ing pages on the symptoms, causes,
pathology, and treatment of that terrible
disease, "Diphtheria," were submitted
to the consideration of the members of
the British Homœopathic Society, at
a meeting held on 4th October, 1860,
under the presidentship of Dr. Frede-
rick Foster Quin. Subsequently to this,
the Author was pleased to learn that
one of its most distinguished members,
"Dr. Madden, of Brighton," had applied
the mode of treatment suggested by
him; and in a letter to the Honorary
Secretary of that Society writes thus:-
"December 6, 1860.-Since the meeting at which
I expressed the above opinion, I have treated several
}
1
I 2
Preface.
cases of severe Diphtheria in the way recommended
by Dr. Morgan, and with COMPLETE SUCCESS. In
both cases, I think the alternation of Belladonna with
the Mercurius Biniodatus was advantageous; and in
one (the worse of the two) the throat was not pro-
gressing rapidly under the topical use of permuriate of
iron, and I used the Hydrochloric Acid with DECIDed
BENEFIT."
An Appendix has been added to the
original paper, containing a list of medi-
cines and their potencies, with brief
directions as to the mode of applying
the topical remedies.
CONTENTS.
Preface
In Memoriam
Introduction-Death of Princess Alice
Earl Beaconsfield's Speech of Condolence to the
Queen.
His Royal Highness the Prince of Wales's Pa
thetic Reference to the Princess Alice
Diphtheria the most terrible of all disorders
Hahnemann's Theory of Homœopathy illustrated
in Cholera Practical Test of the Law in all
parts of the World
:
•
History of Diphtheria-Authorities: Hippocrates,
Aretous, Villa Real, De Fontecha, Cartesius,
Alaymus, Fothergill, Bard, Bretonneau, etc.
Diphtheria in Rome, A.D. 580 .
•
•
Sup. osed Causes of Diphtheria similar to Asiatic
Cholera, Yellow Fever, Plague, Typhus,
Typhoid, Ague, etc.
Diphtheria appeared in Boulogne, 1855
Deal, Walmer, Canterbury, Ash, Dover,
1858
Author's Views as to Nature of Diphtheria
PAGE
5
3
17
•
18
21
22
23
23
26
27
28
28
30
14
Contents.
PAGE
Definition of Diphtheria-Derivation of
33
Symptoms of Diphtheria-Constitutional Stages 34
Diphtheritic Membrane, Character of: Appear-
ance of Mouth, Fauces, Tonsils, Uvula, and
Glands f Neck
1
Sequelae of Diphtheria, Paralysis, Anæmia,
Loss of Voice, Deafness, Squinting, Fotid Dis-
charge from Nose, Rheumatism, Purpura,
Prostration of Strength, etc.
→
Diagnosis of Diphtheria: Sir William Jenner's
Views and Abortive Treatment
•
•
35
39
Homœopathic Law a Guide to the Selection of
Preventive and Curative Agents. Illustrations.
Comparative Table of Mortality under Allo-
pathic and Homoeopathic Treatment of Diph-
theria and other Diseases: Yellow Fever,
Small-pox, Scarlet Fever, Asiatic Cholera,
Dysentery, Typhus, Typhoid, Ordinary Fevers,
Pleurisy; Inflammation of Lungs, Peritoneum,
and Brain; Apoplexy, etc. All diseases,
average of
42, 43, 44, 45
Statistics from Report of St. George's Hospital,
1864
•
39
46
Diphtheria supposed to be analagous to Dysen-
tery, Scarlet Fever, Croup, and Typhoid, in
mode of killing
48
True Diagnosis in Detection of False Membrane
with Eye on Pharynx, Tonsils, Uvula, etc. 49
History of Case, General Appearance of Patient,
whether similar disease in same locality
49, 50
Contents.
15
·
•
Diphther a same as Croup; Author's Views;
French Physicians' ditto
Diphtheritic Eruption on Skin
Distinguishing Characteristics between Diph-
theria and Scarlatina Maligna, Thrush, and
Croup
53, 54, 55, 56, 57
Membrane formed by a Blister similar to Diph-
theria
58, 59
•
Selec ion of Internal Remedies in accordance
with the Law of Similars: viz., Acon., Bell.,
Merc. -Sol., Mec-Biniod., Ars., Bichrom.,
Pot., Spong., Iod., Lach., Hep.-S., Cinch.
Seneg., Canth. their Pathogenesis
Cantharis-its Effects on Dogs .
Treatment--Preventive, Hygienic, and Hydro-
pathic Preventives of other Diseases
58, 59
The adoption of Specifics and Topical Applica-
tions to Mouth -Spray, Gargle, etc.; Avoidance
of Unhealthy Localities; removal of all Sewer-
age Stagnant Pools, and Ditches; avoidance
of North-East Winds; Hygienic Treatment of
Children, Baths, Clothing, etc.
Certain Hereditary Signs of Croupal Diathesis.
First Signs of Diptheritic Deposit: Rules to be
observed, and use of Topical Remedies-
Gargling, Painting, Mopping, Spray, and
Inhalation.
61, 62, 63
Allopathic Treatment useless-Mortality over 70
64
per cent.
•
PAGE
•
51
52
60
60
65
77
16
Contents.
Local Applications recommended by different
authors
Chemical Experiments on False Membrane
Hydropathic Appliances: Turkish, Hot Air,
and Warm Baths, Wet Sheet, Compresses, etc.
Hygienic Treatment: Condition of Room, Venti
lation, Temperature, Disinfectants, Diet, etc.,
in different stages of the disease
86
Cases Illustrative of Successful Treatment 88 to 123
Appendix: List of Medicines for Pharyngeal
Diphtheria-Do. Laryngeal Diphtheria 126, 127
Mode of Applying Hydrochloric Acid, Com-
presses, etc.
•
•
PAGE
77, 78
• 79
D
-
Chapter on Disinfectants-their respective effi-
cacy, etc.
131 to 144
83
127

DE
Diphtheria.
INTRODUCTION.
THAT irreparable national calamity, the
sudden and untimely death of Her
Royal Highness Princess Alice, Grand
Duchess of Hesse-Darmstadt, is my
plea for sending forth a second edition
of my practical experience of the terri-
ble disease which has robbed us of that
amiable and beloved Princess, whose
noble qualities are as "household
words," and whose passing away from
B
18
Diphtheria.
among us at so early a period of a happy
and bright career, has cast a deep gloom
over this and other lands. Long will
endure the memory of the sweet, wo-
manly virtues and graces that adorned
her self-sacrificing and beautiful charac-
ter. She is gone and has met the death
of a martyr. The Earl of Beacons-
field has well and pathetically told us
that, "A Princess who loved us, though
she left us, and who always revisited her
fatherland with delight-one of those
women the brightness of whose being
adorned society and inspired the circle
in which she lived-has been removed
from this world, to the anguish of her
family, her friends, and her subjects.
Princess Alice-for I will venture to call
her by that name, though she wore a
crown-afforded one of the most striking
contrasts that I can remember of richness
of culture and rare intelligence combined
with the most pure and refined domestic
Diphtheria.
19.
sentiments. You, my lords, who know
her life well, can recall those agonising
hours when she attended the dying-bed
of her illustrious father, who had sketched
out her studies and formed her tastes.
You can recall, too, the moment at which
she attended her royal brother at a time
when the hopes of England seemed to
depend on his life; and now you can
remember too well how, when the whole
of her own family were stricken by a
malignant disease, she had been to them
the angel of the house till at last her
own vital power was perhaps exhausted,
and she has fallen. My lords, there is
something wonderfully piteous in the
immediate cause of her death. The
physicians who permitted her to watch
over her suffering family enjoined her.
under no circumstances whatever to be
tempted into an embrace. Her admir-
able self-restraint guarded her through
the crisis of this terrible complaint in
1
20
Diphtheria.
safety. She remembered and observed
the injunctions of her physicians. But
it became her lot to break to her son,
quite a youth, the death of his youngest
sister, to whom he was devotedly
attached. The boy was so overcome
with misery that the agitated mother
clasped him in her arms, and thus she
received the KISS OF DEATH. My lords,
I hardly know an incident more pathetic.
It is one by which poets might be in-
spired, and in which the professors of
the fine arts, from the highest to the
lowest branches, whether in painting,
sculpture, or gems, might find a fitting
subject of commemoration. My lords,
it is impossible to depict at this moment
the sufferings of the husband whom she
has left behind and of the children who
were so devoted to her ; but our duty is to
offer our condolence to one whose happi-
ness and whose sorrows always excite and
command the loyalty and affectionate
#
Diphtheria.
21
respect of this House,
Upon Her
Majesty a great grief has fallen which
none but her Majesty, none but the
Queen, can so completely and acutely
feel. Seventeen years ago her Majesty
experienced the crushing sorrow of her
life, and then she was particularly sus-
tained by the daughter whom she has
now lost, who assisted her by her
labours, and aided her by her presence
and counsel. Her Majesty now feels
that the cup of sorrow was not then
exhausted. I feel it impossible to use
any language which could express the
consolation we wish to extend to her in
her sorrow. Her suffering is too fresh to
allow of solace; but, however exalted
her position, I feel that she will be sus-
tained by the consciousness that she
possesses the sympathy of the nation.”
Finally, to quote the language of her
illustrious brother, the Princess was "so
good, so kind, so clever. We had gone
с
22
Diphtheria.
through so much together-my father's
illness, then my own; and she has
succumbed to the pernicious malady
which laid low her husband and
children, whom she nursed and watched
with unceasing care and attention."
Among the various epidemic and
contagious diseases which afflict huma-
nity, there are few that have created
more alarm and anxiety in the public
mind, or claimed a larger percentage of
victims, than the fatal malady we are
about to investigate, which has just
turned a nation into a house of mourning.
Diphtheria is of all disorders at once
the most terrible, and the one least
known by the majority of the medical
profession. The laws which regulate the
incidents and course of typhoid fever,
cholera, scarlet fever, and most other
epidemic diseases, are to a certain
extent well understood; but diphtheria
remains, as in old times did the plague,
Diphtheria.
23
beyond the range of the medical science
as practised by a large section of the
profession; it is, however, as amenable.
to treatment under the homœopathic
system as the most trivial complaint.
When Hahnemann heard of the first
approach of cholera to Europe, he gave
it as his opinion that if there were any
truth in the homoeopathic law, Camphor,
Cuprum, and Veratrum were its specifics.
A practical test of these remedies in
all parts of the world by thousands of
physicians, have proved the wisdom of
such a selection. When diphtheria was
first encountered by me in 1858, I
adopted the same principle, and the
result having been uniformly successful,
I feel I can with the utmost confidence
recommend a similar course to the pro-
fession and public at large.
HISTORY OF DIPHTHERIA.
Before, however, I proceed to describe
the symptoms, pathology, and treatment
24
Diphtheria.
of diphtheria, it were well to take a
slight glance at its history and ante-
cedents.
Historically, diphtheria is no new
disease, but stands coeval with the
records of medicine as handed down to
us from the era of Hippocrates, centuries
anterior to the Christian era.
Aretous, an eminent physician of
Cappadocia, A.D. 200, gives a graphic
description of this disease under the
name of "Egyptian or Syrian ulcer."
In 1590-91 it assumed an epidemic
form in various parts of Spain, as clearly
described by Villa Real, De Fontecha,
and Herrera, who called it morbus suf-
focans, and by others Garrotillo.
In 1618 it invaded Naples, where it
was called epidemicus strangulatorius,
the popular name being male-de-canna.
In 1625 it broke out in Sicily, as
described by Cartesius, who called it
Gulæ morbus.
Diphtheria.
25
In 1632 it was very prevalent in Syria
and Colo-Syria, as described by Alay-
mus, and called by him the Syrian ulcer.
In 1747 it broke out in various parts
of Italy.
In 1739 we find it invading England,
as described by Dr. John Fothergill, in
a work entitled, "An Account of the
Putrid Sore Throat," who also called it
morbus strangulatorius.
From 1755 to 1762 it ravaged various
parts of Sweden, and in 1789 it first
appeared in America, as described by
Dr. Bard, of New York, and others.
From 1821 to 1826 it appeared in dif-
ferent parts of France, as described in
two admirable memoirs by M. Bre-
onneau, of Tours, who called it diph-
therite.
In 1855, after an absence of some
seventy years, it reappeared in England,
and from that date to the present time.
has committed sad ravages in the towns,
26
Diphtheria.
villages, hamlets, and secluded cottages
in various parts of the country.
As far back as A.D. 380 a similar
epidemic broke out in Rome, with such
virulence, and to such an extent, that
propitiatory offerings were made to the
gods.
It is therefore very clear from these
historical records that diphtheria is no
new disease, but, like other epidemic.
disorders, it appears, dies away, and
reappears at certain intervals.
SUPPOSED CAUSES.
As the principal object of this little
treatise is to convey to the reader a
practical knowledge of the leading
symptoms, pathology, and treatment of
diphtheria, I shall not indulge in vague
or speculative theories as to its pro-
bable cause and origin, beyond briefly
Diphtheria.
27
alluding to the fact, recognised more or
less by the profession at large, that as
every epidemic has its congenial clime,
and circumstances favourable to its pro-
duction-the Asiatic cholera, for in-
stance, springing from the delta of the
Ganges, the yellow fever from the
swampy banks of the Mississippi, or
lagoons of Africa; the plague hovering
around the Nile in Lower Egypt, the
banks of the Tigris and Euphrates; the
ague emerging from fens and marshes,
the typhus and typhoid fevers arising
from the ill-ventilated, badly-drained
courts and alleys of our towns-so the
development of diphtheria may perhaps
be attributable to the products of de-
composed animal and vegetable matter
in our sewers, and to the direct poi-
sonous influence of these noxious par-
ticles upon the mouth and its surround-
ing structures. It may be in the recol-
lection of many that prior to 1855
28
Diphtheria.
rumours reached England that an epi-
demic of a very fatal character, and sup-
posed at the time to be closely allied to
the malignant form of scarlet fever, was
committing great havoc at Boulogne-
sur-Mer; indeed, for some time the
disease was only known as the "Bou-
logne Sore Throat." In the early part of
1858 a similar epidemic broke out
almost simultaneously at several towns.
on the coast of Kent, such as Deal,
Sandwich, and
and that pretty village
Walmer, a spot of well-known salu-
brity, and rendered memorable to every
Englishman as the favourite resort of
the greatest captain of his age, and the
closing scene of that immortal hero's
life. From thence it would appear to
have taken an inland course by visiting
Canterbury and its surrounding villages
and hamlets, being particularly fatal at
a little place called Ash, a rural, well-
cultivated, and healthy district, situate
A
Diphtheria.
29
on a gentle slope about midway be-
tween Canterbury and the ocean; and
such was the disastrous effect of the
disease on that locality, that for a con-
siderable time it was only known to the
inhabitants of that part of the country
as the "Ash Sore Throat." In August
and September of the same year there
were certain indications afloat that some
such unwelcome and fatal visitor had
reached Dover. The sombre under-
takers were seen plying their sad avoca-
tion more frequently than usual, and
doctors might be seen at the corners
of the streets in close and friendly con-
verse—a rare sight on other occasions.
Deaths from diphtheria were registered
in the weekly papers, and it soon be-
came generally known that the disease
had in reality scaled the ramparts of
that impregnable fortress, and invaded
the town.
The disease was particularly fatal at
30
Diphtheria.
Dover; some scores of children and
many of mature age were swept away
by it. The series of cases which came
under my immediate notice were twenty-
five in number, the majority being of a
mild form, but several showed evident
symptoms of a decidedly malignant
type.
This was my first introduction to
diphtheria, and from the experience I
then derived I came to the conclusion,
which a further intimacy with the dis-
ease has not in any way altered, that-
Istly. Diphtheria is allied to the family
of epidemic diseases, and is more or less
contagious in its nature.
2ndly. That diphtheria is a peculiar
blood-poison, attacking principally, and
having a special affinity for, mucous
membranes, more prominently that of
the mouth and fauces.
3rdly. That diphtheria is closely allied
to croup, not only in its stage of incuba-
Diphtheria.
31
tion, maturity, and decline, but in the
nature, appearance, and structure of the
morbid product (false membrane), as
well as in its mode of killing.
4thly. That diphtheria has a tendency
to spread and attack other parts of the
body covered with mucous membrane,
namely, the lips, nose, and the glands of
the neck (doubtless by extending along
the ducts); it will also descend into the
pharynx, windpipe, and bronchial tubes,
developing there a species of croup, and
causing death by suffocation; in fact,
I am disposed to look upon diphtheria
as croup of the mouth, and croup proper
as diphtheria of the larynx.
5thly. That diphtheria, like other epi-
demic and contagious diseases, may
appear in a mild as well as a malignant
form, the one running a smooth and un-
chequered course to convalescence, and
leaving no signs behind in the form of
sequelæ, the other intractable from its
32
Diphtheria.
very commencement, and developing a
raging fever, delirium, enormous enlarge-
ment of the glands of the neck, present-
ing a strong resemblance to one of the
worst forms of scarlet fever, with pro-
fuse salivation, a filthy sanious discharge
from the nostrils, and the development
of large and thick patches of a tough
elastic membrane, resembling soddened
parchment or washleather, from whence
emanates the most fætid odour; leaving
behind as sequelæ a painful train of in-
tractable disorders of the nervous and
general system.
6thly. That diphtheria, in addition to
its special peculiarity of forming false
membranes, gives rise to a stench of a
very offensive nature-one sui generis-
which having once been encountered
cannot easily be forgotten. This I deem
an important feature of true diphtheria
and pathognomonic of the disease.
Diphtheria.
33
DEFINITION OF DIPHTHERIA.
Diphtheria may be described as an
epidemic and contagious sore throat
of great severity, running a rapid
and definite course, and due to some
mysterious specific blood-poison, which
has a marked affinity for the mucous
membrane of the pharynx, larynx,
tonsils, and uvula, on the surface of
which it deposits a plastic exudation
of lymph, forming by degrees a false
membrane of more or less thickness and
tenacity, like some unwholesome fungus,
which sends forth an intolerable stench.
When an attack of the disease is fol-
jowed by recovery it often leaves behind
an altered condition of the voice, partial
paralysis of the muscles of deglutition,
weakness of the limbs, impairment of
vision, and other secondary nerve dis-
orders. Children are more liable to the
invasion of this specific blood-poison
than adults. It is most common amongst
34
Diphtheria.
the poor, or such as reside in damp situa-
tions and badly drained houses. It does
not, however, spare the rich, the lordly
or the Royal houses, as witnessed by the
lamented death of our beloved Princess
Alice. The term diphtheria is derived
from the Greek, Aɩpfēpa, a skin or mem-
brane, and has as synonyms angina
maligna, cynanche membranacea, putrid
sore throat, and malignant quinsy.
SYMPTOMS OF DIPHTHERIA.
Diphtheria, like other acute specific
contagious diseases, has its stage of
incubation, stage of maturity, and its
stage of decline, and often leaves, par-
ticularly in its malignant form, painful
and obstinate sequelæ. The premoni-
tory symptoms are marked in some by
a gradual feeling of depression, uneasi-
ness, chilliness, some muscular debility,
headache, nausea, and drowsiness, with
at times a slight diarrhoea, and a pulse
somewhat quickened, with a slight in-
Diphtheria.
35
flammatory condition of the tonsils and
arches of the palate, followed, in the
course of two or three days, by the ex-
udation of lymph, forming a false mem-
brane, which may adhere only to a por-
tion of the uvula, or to one of the parotid
glands.
In other cases it is marked by high
fever, a quick pulse, a flushed face, a
hot dry skin, and anxious staring look,
with a rapid swelling and tenderness of
the glands situate about the angles of
the lower jaw, which more or less impede
its normal action. These symptoms
may continue with some severity for
two or three days, when, on opening the
mouth, there will be perceived a certain
redness and swelling of the parts in-
vaded by the poison; sometimes the
tonsils, sometimes the arches of the
palate, sometimes the posterior surface
of the soft palate, at other times the
nostrils or the mucous membrane of
36
Diphtheria.
the pharynx may be selected as the
starting-point for the local manifestation
of this terrible poison. On the surface
of the selected spot is first seen a kind
of half-transparent coagulated mucus,
which after a little while becomes
changed into a tough, elastic substance,
which has been aptly compared to soaked
parchment or washleather. This is the
true" diphtheritic membrane." Thus
starting from one or more centres, the
membrane spreads anteriorly to the soft
palate, upwards to the posterior openings
of the nose, and downwards to the epi-
glottis, the windpipe, trachea, and bron-
chial tubes; at other times it may de-
scend into the gullet, and from thence
into the stomach and intestines.
If this foul, fungous-looking growth is
mechanically removed, it exposes to
view an angry raw bleeding surface.
(which bears a strong resemblance to
those irritable bleeding ulcers which arise.
Diphtheria.
37
from other specific causes), upon which
the putrid miasma almost immediately
gathers itself together with renewed
strength.
When a part is severely or deeply in-
flamed, the lymphatic glands surround-
ing the neck, and to which the lym-
phatics of the inflamed part lead, become
the seat of active congestion, and ulti-
mately of inflammatory exudation,
marked in many cases by an enormous
enlargement of the whole neck, bulging
out beyond the margin of the lower jaw.
In this disease we have an illustration
of this general law; for the lymphatic
glands, to which the lymphatics of the
pharynx and surrounding parts lead, are
found to be much larger, redder, and
moister than in their normal condition.
When the membrane begins to sepa-
rate and decompose, there follows a
horrible fœtid breath, and when thrown
off there may be left ulceration, slough-
D
38
Diphtheria.
ing, or gangrene, or the tissues may
gradually assume a healthy appearance.
The constitutional symptoms of diph-
theria vary according to the virulence of
the poison, and the constitution affected.
In some the symptoms are slight, in
others there is rapid prostration of
strength, great restlessness, delirium,
and high fever; the pulse increases
rapidly, the saliva dribbles from the
mouth, and the breath is highly fœtid.
There is no desire for food or the slight-
est exertion, there is bleeding from the
nose, mouth, or bronchial tubes, and a
highly albuminous condition of the
urine. Death may take place from ex-
haustion, from hæmorrhage, uræmic
poisoning, gangrene, or suffocation,
consciousness, as a rule, remaining to
the close of the scene.
Even should the natural strength and
vigour of the patient ultimately prove
superior to the poison, the danger is
Diphtheria.
39
not yet passed. Of all epidemic poisons
diphtheria is the one the subsequent
effects of which are most to be dreaded.
The patient who has escaped with his
life is rendered liable to disorders of a
painful and distressing nature, not the
least frequent of which is a form of
general or partial paralysis. Some are
affected with paralysis of one half of
the body, others of the lower half of ---
the body, others again with general
anæmia, loss of voice, deafness, squint-
ing, a fœtid discharge from the nose and
ear, rheumatism, purpura, and a peculiar
prostration of strength which may con-
tinue for many months in spite of the
most tender care and nourishing diet.
…..
DIAGNOSIS.
A correct diagnosis, in other words.
a correct knowledge, of any disease,
40
Diphtheria.
¡
will lead us to a correct and successful
treatment of the same; for it has long
since been maintained that a thorough
knowledge of the disease is half its cure.
Strike at the root of a tree, the leaves
fall and the branches wither. Diphtheria
is no exception to this rule, and it is
with pain I record some observations
made by Sir W. Jenner in clinical lec-
tures delivered by him some years ago
on the symptoms and treatment of
diphtheria, that there existed no specific
remedy to counteract that complaint,
but that it must be treated on the same
general principles as other acute specific
diseases. "We have," says Sir William,
"no specific remedy for any of the
acute specific diseases; we save by
medical aid many lives that would be
lost from scarlet fever, typhoid fever,
typhus fever, measles, etc.; we save
such lives, however, only by from time
to time averting certain modes of
Diphtheria.
41
death. The specific disease is not cut
short, it is not cured by our remedies;
it runs its course, do what we may to
prevent it. To avert death in any given
acute specific disease, we must know
how it kills. Scarlet fever, for instance,
firstly by the severity of the general
affection; secondly, it kills by the local
throat disease and its consequences;
thirdly, it kills by producing an ab-
normal condition of the kidneys;
fourthly, it kills by extending its
ravages to the heart and lungs." If
Sir W. Jenner would condescend to
investigate the leading principles of
Homœopathy, he would find that there
exists in nature a specific remedy for
every specific disease. The records of
that system of medicine have already
brought to light the startling fact that
remedies not only act as preventives
or prophylactics, but also as specifics, if
carefully and judiciously selected in
42
Diphtheria.
accordance with its leading principles,
namely, Similia similibus curantur,which
simply signifies, "To cure a disease,
select a remedy which, in accordance
with its pathogenetic effects on the body
in health, is capable of producing a like
disease. To illustrate this, the Atropa
Belladonna has been found to protect
the system against the invasion of scar-
let fever; Pulsatilla against measles;
Quinine, Cedron, or Arsenic against inter-
mittent fever; Camphor, Copper, and the
White Hellebore against Asiatic cho-
lera; the Eucalyptus Globulus against
yellow fever; Mercurius Vivus against
syphilis; and vaccination against small-
pox. These illustrations might be inde-
finitely extended did space permit, but
the above will suffice for our present
purpose. As a further illustration of
Sir W. Jenner's sceptical views on the
efficacy of drugs as prophylactic or
curative agents, he calmly tells his
Diphtheria.
43
hearers that out of fifty-eight cases of
diphtheria which came under his imme-
diate notice, thirty-four proved fatal,
leaving to the King of Terrors an enor-
mous legacy of deaths, amounting to
over seventy-five per cent.
By way of further repudiating the
views propounded by Sir W. Jenner as
to the non-specific action of certain
drugs over certain specific diseases, I
append here a tabular statement of the
leading diseases as treated under both
systems of medicine.
COMPARATIVE TABLE OF MORTALITY.
Diphtheria.
Allopathy
Homœopathy.
•
70 per cent.
15
Febris flava-Yellow Fever.
Allopathy.
Homœopathy.
Variola-Small-pox.
Allopathy
Homœopathy.
"}
65 per cent.
3 "}
24 per cent.
8 >>
44
Diphtheria.
Febris rubra-Scarlet Fever.
Allopathy.
Homœopathy.
•
Cholera Pestifera-Malignant Cholera.
Allopathy
Homœopathy.
Allopathy
Homœopathy.
Dysenteria-Dysentery.
Allopathy
Homœopathy.
•
20 per cent.
3
Typhus-Typhus Fever.
16
Allopathy
Homœopathy.
50 per cent.
20
Allopathy..
Homœopathy.
در
22 per cent.
3 "
14
Ordinary Fevers.
در
per
Febris Enterica-Enteric, or Typhoid
Fever.
cent.
در
20 per cent.
10 **
9 per cent.
2
در
Diphtheria.
45
Pleuritis-Pleurisy.
Allopathy
Homœopathy.
Allopathy
Homœopathy.
Peritonitis-Inflammation of the
Peritoneum.
·
Allopathy
Homœopathy.
Inflammatio cerebri-Inflammation of the
Brain.
Allopathy
Homœopathy.
•
Allopathy
Homœopathy.
13 per cent.
3
Allopathy
Homœopathy.
"?
Apoplexia-Apoplexy.
•
Pneumonia-Inflammation of the Lungs.
23 per cent.
5,
40 per cent.
4
All diseases on the average.
رر
70 per cent.
6
""
87 per cent.
29 "
16 per cent.
3
ر,
46
Diphtheria.
Extract from the Report of St. George's Hospital for
1864, showing the
COMPARATIVE DEATH RATES
For I and 7 Years.
DISEASE.
Continued fever...
S arlet fever
Erysipelas
Acute Rheumatism
Anasarca...
Ascites
Epistaxis...
Hæmoptysis
Hæmaturia
Hæmatocele
Intestinal
...
····
...
...
...
...
**
...
...
Uterine
Purpura
Cachemia
Scrofula
Phthisis
Tabes Intestinalis
✰✰✰
···
...
...
...
...
...
***
•
Epithelioma
Tumors of bone
Delirium Tremens
Tetanus
Cephalitis
Epilepsy...
Apoplexy
...
···
...
..
Tubercles in Brain
Accretions in Peritoneum
Hydatids...
Encephaloma
Scirrhus
Colloid
❤
………
...
...
..
...
···
•
...
··
···
•*•
:.
:
:
**
...
...
:
Per cent.
14'53
23.07
20'0
5'55
28.2
14'3
14.8
16.4
33'3
44'4
39'6
50'0
100 0
100'0
65'4
28.5
1
40'0
100 0
27.2
64.2
Per cent.
for
7 Years.
11'5
13'04
14'7
4'39
35°2
46.3
13'7
21'I
8:00
9'09
19'1
5.35
23.6
43'I
20'7
34'3
50'0
95'0
89.6
53.8
73'3
19'4
50'0
66.6
100 0
22'I
16.6
89'9
16.2
61.1
Diphtheria.
47

DISEASE.
Coma and Convulsions ...
Inflammation of Spinal
Cord
Hemiplegia
Paraplegia
Pericarditis
Endocarditis
Hypertrophy
Dilatation
Valvular disease
A eurism
Phlebitis...
Laryngitis
Trachitis
Bronchitis
Emphysema
Pneumonia
Pleurisy
Pertussis...
Pneum -thorax
...
...
···
...
...
***
***
··
...
...
··
···
**
4.
:
:
...
•
...
Peritonitis (Acute)
...
Cirrhosis ...
Jaundice
Nephritis
Absce-s
Albuminuria
Diabetes...
Dropsy of ovaries
(Chronic)
•••
...
***
...
...
...
:
...
***
...
Ulceration of Tonsils
Ulceration of Stomach
Obstruction of Intestines
Diarrhoea
Dysentery
Ulceration of Intestines...
:
***
T
...
···
...
4.
...
:
...
···
...
...
...
•
•
1
✰✰
Per cent.
57'1
100 0
18.7
14.2
31.8
12'5
72.7
57.I
26.5
50%
50'0
25'0
75°0
17'5
30'0
38.8
33'3
JOO'O
18.1
42.8
1000
8.82
33.3
100*0
34.7
35.7
100 0
8·00
23.07
50'0
41.6
14'2
27'2
Per cent.
for
7 Years.
53°3
70.50
9 40
13.7
34°2
9 70
62.1
52.7
25.8
50'0
31'7
42.8
45'4
13.08
34.8
314
32.8
3·00
75'0
II.4
75.0
55'0
8.29
36.1
100 0
40 0
41'5
77'I
21'4
21'5
38.4
44'9
12.8
24'4
48
Diphtheria.
¡
!
Diphtheria is considered by some phy-
sicians to be analogous to dysentery, by
others to the malignant form of scarlet
fever; others, again, to the croup of
childhood. An eminent writer considers
that it bears a closer affinity to typhoid
fever than to any other acute specific
disease, particularly in its mode of
killing, for in typhoid fever the patient
may die quickly of the general affection,
namely the fever; or, the symptoms of
the general disease being trifling, the
sufferer may die of a local consequence
of such fever, to wit, perforation of the
bowels. Diphtheria kills in a similar
manner, and the patient may die quickly
of blood-poisoning or the false membrane
may escape from the mouth into the
windpipe, and cause death by suffocation,
many days after its first appearance on the
pharynx. That there are great affinities
between diphtheria and these diseases is
tolerably clear, but it is at the same
Diphtheria.
49
time difficult to establish the identity
of their ultimate essence. Scarlet fever,
typhus and typhoid fever, small-pox,
measles, and chicken-pox, have their
own special symptoms and outward
manifestations as indicative of a special
exciting cause; the premonitory symp-
toms may be similar, but their outward
manifestations are very dissimilar; so
also is diphtheria.
The absolute diagnosis of diphtheria,
in any given case, must rest on the de-
tection by the eye of the false mem-
brane in its various stages of develop-
ment on the mucous membrane of the
pharynx; but the experienced observer
may often suspect that the disease is
diphtheria, even before the slightest
indication of the exudative process takes.
place, just as in small-pox, scarlet
fever, or any other specific eruptive
disease. When diphtheria, for instance,
assumes an epidemic form, has recently
50
Diphtheria.
occurred in the same house, or is known
to prevail in the neighbourhood, and the
mucous membrane of the pharynx is
found red and swollen, the uvula
thickened, and the parts bedewed with a
thickish mucus, coupled with a certain
amount of pain and enlargement of the
glands behind the angles of the jaw,
with bleeding, or a sero-purulent dis-
charge from the nose, there will be
strong presumptive evidence that the
disease is diphtheria. The general
appearance of the patient will likewise
add weight to these local nianifestations,
as in many cases which I have seen
there is a peculiar dusky or leaden hue
of the skin, with a pallid, pasty aspect
of the countenance. Diphtheria is not
the only disease capable of throwing out.
a false membrane, as we find a similar
production occupying the same part of
the mouth in certain forms of scarlet
fever, in the thrush of childhood and
Diphtheria.
51
advanced age, and more particularly in
the croup of childhood, which bears an
almost identical resemblance in its
structure to that of the anatomical fea-
tures of the disease under consideration.
Indeed, as far as my knowledge ex-
tends I am disposed to look upon diph-
theria as croup of the mouth, and croup
proper as diphtheria of the windpipes,
This I am pleased to learn is fully
endorsed by the investigations of some.
of the leading physicians in France, to
whose deep researches and practical ex-
perience we are so much indebted for
valuable information on this very painful
subject. Some have endeavoured to
link a close relationship between scarlet
fever and diphtheria, and that it is only
another type of the same disease, modi-
fied more or less by certain telluric and
climacteric changes. In support of such
a theory, it is somewhat remarkable
that diphtheria and scarlatina maligna
52
Diphtheria.
have frequently been observed in close
alliance at one and the same time, and in
the same locality. In 1854-5, whilst the
disease raged with great virulence at
Boulogne-sur-Mer, I was able to ascertain
that these peculiar types were invading
the town at the same time, the scarlet fever
skirmishing along the upper part and
suburbs, whilst diphtheria was hugging
closely the lower part of the town and
harbour, decimating hundreds of its
young population. It is also worthy of
remark that diphtheria is represented
by a certain rash on the skin. This I
have noticed on several occasions. It is
of a dusky leaden hue, which comes and.
goes quickly. I have also seen the
sudden disappearance of the eruption
followed by a rapid swelling of the
glands surrounding the neck, and the no
less rapid appearance of the membrane
on the fauces and parotid glands.
In the following tables I shall en-
Diphtheria.
53
deavour to compare in detail the pecu-
liar characteristics which distingush the
anatomical features of the false mem-
brane of diphtheria from that of scarlet
fever, thrush, and croup.
In Starlet Fever.
1. The rash on
the body, and the
peculiar straw-
berry-like tongue,
forms its main fea-
tures, and are but
seldom absent.
3. The mem-
brane in the throat
is similar to that of
thrush, a soft pappy
deposit, easily de-
tached, and has no
tendency to spread.
2. The pulse runs
higher than in any
other epidemic quent.
fever.
-
In Diphtheria.
1. The rash is
only present in ex-
ceptional cases,
2. It is only
moderately
fre-
mem-
3. The
brane adheres
closely to the epi-
dermis, and has a
tendency to spread
to the air passages,
the nose, stomach,
anus, and vagina.
E
<
54
Diphtheria.
In Scarlet Fever.
4. Abscess of the
glands of the neck
is common.
5. Dropsy is a
common sequel.
6. Affections of
the joints are com-
mon after scarlet
fever.
7. Pericarditis
common.
8. Paralysis oc-
curs very seldom.
In Diphtheria.
4. Abscess very
rare, not having
met with
with one in
nearly a hundred
cases.
5. Dropsy is but
very seldom met
with.
6. They are
scarcely ever met
with after diph-
theria.
7. Pericarditis
never met with.
8. Paralysis very
frequently follows
diphtheria.
Bretonneau, and nearly all the French
writers, consider diphtheria and croup
as identical, particularly as croup in
France is, like diphtheria, considered a
contagious disease. I have for many
years entertained the same views.
Diphtheria.
55
Distinguishing characteristics between
Diphtheria and Thrush, the Muguet of
the French:—
Diphtheria.
J. In diphtheria
there is great force
of cohesion in the
membrane. True
membranes are
formed. The ad-
The ad-
hesion of the tis-
sues is such that
we are rarely able
to detach them
without causing the
raw part covered
by them to bleed
freely.
2. The diphthe-
ritic product has
the greatest ten-
dency to propagate
itself over the mu-
Thrush (Muguet).
1. Thrush pre-
sents itself in the
form of small white
points, at first dis-
tinctly separate
from each other,
then joining, and
constituting a white
soft membrane,
which is easily
wiped away; the
surface underneath
being only inflamed
and not raw, does
not bleed.
2. Thrush chiefly
affects the mouth,
pharynx, and ali-
mentary canal;
never extends to
56
Diphtheria.
cous membrane of the larynx or
trachea.
the air passages,
where its presence
constitutes croup
proper.
3. The first ap-
pearance of diph-
theria is preceded
by a very circum-
scribed irritation of
the parts of the
mucous membrane,
which are com-
pletely covered by
the membrane in
its early stages of
development.
GRA
4. Diphtheria is
preceded by a se-
rous exudation, is
never developed
above the epidermis,
and always adheres
with marked tena-
city to raw parts.
1
3. Thrush is in-
variably preceded
by general inflam-
mation of the mu-
cous membrane of
the mouth, charac-
terised by redness
and great sensi-
bility, which is a
serious obstacle to
suckling in young
children.
4. Thrush is never
preceded by a se-
rous exudation, but
it appears in the
mucous membrane.
when still covered
with its epithelium.
Diphtheria.
57
Distinguishing characteristics between
Diphtheria and Croup, as suggested by
Emphis and others :-
Diphtheria.
1. Depends upon
a peculiar blood-
poison.
2. Diphtheria
commences in the
fauces, and only
reaches other parts
of the body by ex-
tension.
3. In the first
stage the cough is
dry and sharp, and
the voice is low.
4. Insecond stage
breathing becomes
difficult and cough
moist.
Croup.
1. True croup is
apparently uncon-
nected with any
blood crasis.
2. True
croup
commences in the
larynx and trachea,
and stops there till
it kills, unless re-
moved by judicious
treatment.
3. In true croup
first stage, the voice
is frequently almost
extinguished.
4. In second stage
the cough has a
dry ringing metallic
sound, with fits of
suffocation.
:
!
58
Diphtheria.
The membrane formed by a blistered
surface bears a stronger resemblance to
the diphtheritic membrane than any
other I know of; both are fibrinous, both
are of a yellowish-grey colour, both are
tough, and both adhere closely to the
affected parts. The peculiar character-
istics of the diphtherial membrane are
that it is of a plastic fibrinous nature,
appearing first on one spot, but will ex-
tend to any excoriated surface or mucous
membrane, the surface underneath pre-
senting to the eye a highly vascular,
corroding looking ulcer, and to the nose
the most offensive odour.
A.
TREATMENT.
Having now briefly reviewed the
main features connected with the his-
tory, symptoms, causes, and pathology
of diphtheria, I shall at once proceed to
discuss the remaining and most im-
portant section of this little treatise-
Diphtheria.
59
namely, its treatment. In the treat-
ment of this terrible malady I have in-
variably adopted the following rules as
my guide, with a success which has far
exceeded my most sanguine expecta-
tions.
a. The adoption of preventive or pro-
phylactic means, general hygiene, with
the selection of suitable baths and diet
as applicable to its different stages.
b. A careful selection of such specifics
as mark their symptomological simi-
larity to its peculiar characteristics.
c. A judicious selection of topical
remedies, and such as possess the
largest amount of solvent and disin-
fecting properties.
In view of the general facts, which
seem to be now well established, that
defective drainage, impure water, impure
milk, stagnant pools, and ditches where
animal and vegetable matter have been
allowed to accumulate and decompose,
12
Spide
60
Diphtheria.
is a fruitful source from whence the
contagious poison may emanate, such
defective causes should at once be re-
medied. In view also of the facts now
clearly understood that many families
exhibit a hereditary or an acquired pre-
disposition to pharyngeal, laryngeal,
and bronchial affections; that such
affections are favoured by certain con-
ditions of weather, especially sudden
changes of temperature, and by the pre-
valence of north and north-east winds,
and that the disease we are now inves-
tigating is undoubtedly of a very con-
tagious nature, as proved by the “fatal
kiss" which has cast a gloom over
this land, and a nation into a house of
mourning; it becomes an imperative
duty on the part of every medical man
to study carefully the laws that regulate
the movements of epidemic and con-
tagious diseases, and protect the system
by certain prophylactic measures. We
Diphtheria.
61
know that scarlatina, small-pox, ague,
Asiatic cholera, measles, and yellow
fever, have their respective prophylac-
tics in Belladonna, Vaccination, Quinine
or Arsenic, Camphor or Cuprum, Pulsa-
tilla, Eucalyptus Globulus or Carbolic
Acid, as amply proved by many phy-
sicians in the West Indies and the
Southern States of America. When
such a predisposition exists in a child, it
should be gradually and cautiously sub-
jected to a process of hardening, for
which purpose nothing is better than
cold ablutions of the neck and chest, or
a cold bath, saturated with Tidman's
sea-salt, or a little vinegar. This should
be begun early in life, and persistently
and systematically carried out, together
with the use of cold water gargles two or
three times a day. The clothing should
be selected with due regard to the age,
temperament, and season of the year,
never permitting a child to go out of
!
:
Diphtheria.
doors when a north or a north-east wind
prevails-a frequent cause of croup.
If the family, on the father's or
mother's side, have at any time exhi-
bited a tendency to pharyngeal or
laryngeal troubles in the form of a
ringing metallic cough, such as may be
compared to the crowing of a cock or
the noise made by a fowl when caught
in the hands; or a crowing inspiration,
with paroxysms of spasmodic asthma,
unattended with cough; the parents
should be warned as to the risk of send-
ing their children out of doors during
the prevalence of cold, dry winds.
Again, when an epidemic of diphtheria
is raging in any neighbourhood, the
frequent inspection of the mouth and
fauces should be the primary duty of
the local practitioner or parents, in
order, if possible, to detect the first indi-
cations of the disease; and when they
have made their appearance, which may
62
Diphtheria.
63
only be in the slightest blush of redness,
with perhaps a thin transparent coating
of lymph, like the morning dew when
rendered transparent by the solvent
warmth of the rising sun, the patient
should, without a moment's delay, be
isolated from the rest of the family,
and a strict quarantine observed. As
soon as the first sign of a membranous
exudation is observed in the mouth,
whether on the pillars of the fauces, the
tonsils, the uvula, or the soft palate, it
should be treated with promptitude and
energy. If the patient be old enough to
use gargles, they should be used at
once; such as a solution of Hydro-
chloric Acid, Permanganate of Potash,
or Terebene. If, on the other hand,
the patient be too young, or have
not learned the happy knack of gar-
gling, the above-named fluids may be
injected into the mouth by means of a
female syringe, or, better still, by means
64
Diphtheria.
of the usual ether spray, or, again, by an
inhaler. In the case of restless or re-
fractory children, a good-sized camel's-
hair brush, a fine painter's brush, or a
piece of sponge attached to a whalebone
rod, saturated with the selected solu-
tion, will
will answer the purpose very
well. The latter instrument is especially
useful when it is found necessary to
follow the enemy into the larynx and
trachea, known as the probang.
As far as the special allopathic treat-
ment of laryngeal diphtheria is con-
cerned, it is frankly admitted by the
leading physicians of the day, that not-
withstanding the great number of ex-
ternal and internal remedies which have
from time to time been used and re-
commended, none exercise the slightest
influence on the false membrane. Litera-
ture has for centuries been inundated
with them, but the real object has not
in the least been advanced.
Diphtheria.
65
Secondly, internal remedies. These
should be selected from that group of
medicines the pathogenetic effects of
which upon the body in health bear the
strongest resemblance to the constitu-
tional symptoms and anatomical pro-
duct of diphtheria. Amongst such
medicines may be specially mentioned
the Aconite, Belladonna, Mercurius Solu-
bilis of Hahnemann, Mercurius Binioda-
tus, Arsenicum, Bichromate of Potash,
Spongia, Iodine, Lachesis, Hepar Sul-
phuris, Cinchona, Senega, and Cantharis.
The applicability of these medicines
I hold to be somewhat as follows:-
Aconitum Napellus.-This medicine
stands foremost as a powerful antiphlo-
gistic, and may well be described as the
Lancet of Homœopathy. It checks
fever, tones down the action of the heart,
subdues internal congestion, and deter-
mines the blood to the surface so as to
promote free perspiration, consequently
66
Diphtheria.
may be given with great benefit in the
premonitory stage of diphtheria, and
continued till the feverish symptoms
have subsided.
Atropa Belladonna.-This remarkable
drug I look upon as almost specific in
the milder forms of scarlet fever, sore
throat, and in the milder forms of
diphtheria. In scarlet fever it acts as a
powerful prophylactic, as recorded in
extensive statistics collected in various
parts of the world, more particularly
in Germany
Its pathogenetic or toxicological
effects give rise to a large group of
symptoms which bear a close analogy
to those of diphtheria; it produces that
wild delirium which I have frequently
observed in the early stage of the
malignant type of the disease; it
develops a yellowish-white deposit on the
mouth and fauces; it causes inflamma-
tion to appear on the tonsils, fauces,
Diphtheria.
67
velum pendulum palati, and uvula; lan-
cinating pains, and difficulty in swal-
lowing, with a spasmodic constriction of
the throat. But the deadly nightshade
will not complete the graphic picture,
with all its horrors, of true diphtheria; it
will require a few finishing touches from
one of the mercurial preparations to
accomplish this. Mercury develops a
filthy fœtor of the breath, most nearly
resembling that of diphtheria; it causes
a painful swelling of the glands of the
throat, with profuse salivation; it pro-
duces inflammation of the throat, fauces,
uvula, and tonsils, which often terminates
in a peculiar ulceration. Amongst its
other pathogenetic effects, we find it
producing a difficulty in swallowing; a
feeling of suffocation, causing food and
drink to regurgitate through the nostrils,
through which also a putrid sanguineo-
purulent matter occasionally flows.
Finally, Mercury is capable of generat-
68
Diphtheria.
ing a plastic fibrinous exudation around
the fauces and adjacent parts, thus com-
pleting as it were a true and graphic
picture of diphtheria. Indeed such is
the opinion I have formed of the efficacy.
of these two remedies from an experience
which has now extended from 1858 to
the present time, that I am disposed to
imitate the memorable words of Hahne-
mann, when he proclaimed to the world
the chief remedies for cholera, namely,
Camphor, Cuprum, and Veratrum. If
there be any truth in the homoeopathic
law, Belladonna and Mercurius are the
chief remedies in diphtheria, with Hydro-
chloric Acid as a local application.
Arsenicum Album.- This powerful
and valuable medicine is well indicated
both in the first as well as in the last
stage of diphtheria when it assumes the
malignant form.
The physiologico-therapeutical range
of Arsenic is only rivalled by the won-
derful health-disturbing, and therefore
Diphtheria.
69
health-restoring, properties of Aconite.
Where Aconite seems to exercise its
virtues on the surface of the organic
functions, Arsenic acts on the inmost
recesses of vitality. The Aconite fever
is simple and evanescent; the Arsenical
chill is deep, and seems to freeze the
vital blood in the very laboratory of the
heart. In typhoid fever Aconite is only
of service in the mild form, Arsenic in
the more severe and malignant form.
The typhoid fever to which Arsenic is
homœopathic is marked by the chills.
being more racking, the fever heat more
burning, the sweats more debilitating,
the vital fluids more deeply affected by
the morbid poison, the signs of decom-
position more evident, with a manifest.
tendency to the formation of sores and
petechiæ. I may draw a similar parallel
in every disease to which Aconite and
Arsenic are homoeopathic. Take a case
of Asiatic cholera, Aconite may be suffi-
F
70
Diphtheria.
cient to control a simple attack marked
by mild symptoms, but it would require
Arsenic to cope with the disease when it
assumes a malignant form, marked by
severe cramps, vomiting, and purging
of rice-water stools, a marble coldness
and lividity of the skin, excessive pros-
tration, a collapsed pulse, with an un-
quenchable thirst. Arsenic possesses
the wonderful power of penetrating the
very inmost recesses of organic life, and
poisoning the very emanations of vitality
as they diffuse themselves throughout
the finest tissues.
Arsenic is a potent remedy in certain
forms of paralysis and epilepsy; in
various fevers, such as the bilious remit-
tent fever, gastric and mucous fever, and
rheumatic fever, typhus and typhoid.
The cure of intermittent and contagious
fevers is one of the most brilliant
triumphs of this preparation, which is
fully endorsed by the majority of allo-
pathic practitioners.
Diphtheria.
71
The pathogenetic effects of Arsenic on
the mouth are remarkably striking, and
bear a very strong resemblance to the
malignant form of diphtheria, a kind of
angina gangrenosa. In this disease
the tonsils become covered with a yel-
lowish exudation, which soon changes to
a greyish-yellow colour. This layer of
exuded mucus frequently spreads over
the back part of the pharynx, the inner
surface of the cheeks, and even the lips.
It may even involve the larynx, causing
paroxysms of choking, and cough with
expectoration of lumps of fibrinous shreds
and matter. The breath has a cada-
verous odour. There is fever, dulness of
the head, a frequent pulse, a burning hot
skin, and towards evening delirium.
i
There are few drugs that share with
Arsenic the remarkable power to produce
gangrenous disorganisation of the mu-
cous membrane of the mouth, with the
exception perhaps of the mercurial
preparations.
72
Diphtheria.
1
Arsenic causes dryness and burning of
the throat, with excessive pain when
swallowing, and inability to do so.
It
causes great thirst, and a craving for cold
drinks. It likewise causes all the croupy
symptoms which may characterise the
disease, particularly in its last stage.
There is depicted the bluish colour of
the lips and face, an expression of dis-
tress and agony in the features, hoarse-
ness, and at times total loss of voice,
excessive wheezing, and
agony of
breathing, a feeble, tremulous, galloping
pulse, and icy coldness of the extremi-
ties. Taking into consideration the
valuable medicinal properties of Arsenic
in the various forms of fever of an epi-
demic, endemic, and contagious nature,
and its marvellous power of penetrating
the minutest structures of the body, I
claim for Arsenic a prominent position
both as a preventive and curative agent
in the various forms of diphtheria.
Diphtheria.
73
Mercurius Biniodatus.-This prepara-
tion should be given in preference to
Mercurius Solubilis in broken-down con-
stitutions, and those tainted with the
strumous diathesis, or those who have
been previously drugged with Calomel.
It produces a fair picture of diphtheria.
Lachesis.-This remarkable produc-
tion of the animal kingdom may always
be trusted as an auxiliary, in removing
that distressing and painful sensation of
strangulation and suffocation, as if at
cord were tied tightly round the throat,
which marks certain forms of scarlet
fever, the phlegmonous sore throat, and
diphtheria; indeed, I have never found
Lachesis fail in this important symptom.
Kali Bichromicum.-The action of
this drug on the mucous membrane is
quite as marked as Arsenic, Mercury,
and Tartar Emetic. It produces a false
membrane of a tough tenacious sub-
stance on the fauces, the nares, larynx,
74
Diphtheria.
trachea, and bronchi, evidently showing
its homoeopathicity to diphtheritic
croup.
Spongia.-Hahnemann, whilst proving
the common sponge, in order to ascer-
tain its relation to goître, brought to
light the remarkable fact that it exerted
a special influence on the larynx, indicated
by hoarseness, tenderness, dry and pain-
ful cough, and obstruction of respiration,
as if a plug were there. This accidental
discovery led Hahnemann to prescribe
Spongia in membranous croup. You
may, says the discoverer, first lessen the
febrile symptoms and local inflamma-
tion by a dose of Aconite, and you will
but seldom need the aid of Hepar
Sulphuris to complete the cure. Since
these words were uttered, thousands of
cases of true membranous croup have
been cured by Aconite, Spongia, and
Hepar Sulphuris. In diphtheria (which
is so closely allied to the croup of child-
Diphtheria.
75
hood), when it invades the windpipe,
these three medicines are worthy of our
most serious consideration.
Iodine. This remedy has been recom-
mended by Dr. Kidd and others as a
curative agent in diphtheria, both in-
ternally and by inhalation. I have given
Iodine as recommended in three cases,
one in 1859, and two six years ago, but
as it did not appear to exercise any
beneficial influence on the disease, I fell
back on my faithful Belladonna ; Mer ·
curius and the Hydrochloric Acid as a
topical application.
Sulphur and Cinchona.-These re-
medies I generally prescribe as auxili-
aries; the former as an intermediate
remedy when the system falls below
par, is deficient in reactionary power,
and will not respond to the action of
the specific medicine. In such cases
Sulphur acts in a very striking manner;
and so will a Turkish bath, or a hot
76
Diphtheria.
sponge bath saturated with vinegar or
sea salt.
Senega and Cantharis.-Although I
have not given these medicines a prac-
tical test of their ability to cope with
diphtheria, still I have included them in
the list of medicines as worthy the
attention of the profession.
Senega has been used for a long period
as a remedy for croup, particularly in its
last stage. It appears to influence the
mucous membranes of the air passages
in a marked degree, the secretion of
which it promotes and modifies.
On
these grounds I infer that Senega might
prove curative in certain cases of diph-
theria, particularly when it invades the
larynx and air tubes.
Cantharides.-The similarity of the
membranes produced by this insect to
diphtheria has led many physicians to
prescribe it exclusively in this disease.
Thus we have depicted inflammation of
Diphtheria.
77
the mucous membrane of the fauces and
tonsils, difficulty in swallowing, constric-
tion of the larynx, ulcers and vesicles in
the mouth, a fœtid breath, and profuse
salivation.
The local effects of this animal poison.
are:
1. Inflammation, with heat, pain, red-
ness, and some swelling.
2. The exudation of a light yellowish
deposit, which becomes transformed into
3. A yellowish tough membrane.
The injection of a small quantity of
the Oil of Cantharides into the trachea
of a dog will produce all the symptoms
of croup, even to the development of a
false membrane.
LOCAL OR TOPICAL REMEDIES.
Since the reappearance of diphtheria
in the British Isles in 1858, a large
number of nostrums have been thrust
upon the notice of the profession and
:
78
Diphtheria.
the public as certain specifics, which
when placed in the balance of experi-
ence were found, in the majority of
instances, to be perfectly harmless and
worthless.
Bretonneau recommended local blood-
letting, emetics, blisters, and mustard
poultices, with large doses of Calomel,
with no satisfactory results.
Pommiers, Alum, with the same re-
sults.
Trousseau, Nitrate of Silver, the Acid
Nitrate of Mercury, Sulphate of Copper,
and Hydrochloric Acid. Also Alum,
Corrosive Sublimate, and the Chlorides
of Potassium, Sodium, and Calcium.
Greenhow, the Tincture of Sesqui-
chloride of Iron, Borax, Alum, and
Chlorate of Potash.
Emphis, Hydrochloric Acid, Nitrate of
Silver, and Nitrate of Mercury.
Ranking, of Norwich, Hydrochloric
Acid.
į
Diphtheria.
79
Ranking, of America, the Tincture of
Chloride of Iron, Chlorate of Potash, and
Hydrochloric Acid.
Perry, Oil of Turpentine, and Car-
bonate of Ammonia.
Ramskill, a solution of Chloride of
Lime.
Bleyel, Lime-water.
Sydenham, Sulphuric Acid.
CHEMICAL EXPERIMENTS UPON THE
MEMBRANE.
Dr. W. T. Helmuth, St. Louis, U.S.A.,
has submitted the diphtheritic mem-
brane to a series of tests, in order to
ascertain its solvent properties under the
influence of certain chemical agents,
with the following results.
1. Experiment. The transudation is
serum or lymph holding in solution albu-
men; on adding Nitric Acid, a large
quantity of albuminous matter is thrown
down.
2. The Tincture of Perchloride of Iron
80
Diphtheria.
hardens the membrane, and converts it
in about twenty-four hours into a shri-
velled, black, dry, and tanned substance.
3. Nitric Acid in twenty-six hours
partly decomposed it; and in thirty-six
hours the continuity was destroyed, the
substance being separated into flakes.
4. Hydrochloric Acid first hardens and
shrivels the membrane, but in eight
hours the continuity of the substance is
entirely destroyed.
5. Sulphuric Acid softens and reddens
the solution, throws down a slight pre-
cipitate, but does not decompose the
membrane.
6. Benzoic Acid and Fluoric Acid pro-
duce a similar effect to Nitric Acid, but
take a longer time.
7. Caustic Ammonia dissolves the
membrane in the short space of twelve.
minutes.
8. Caustic Potash in the course of a
few hours.
{
Diphtheria.
81
9. Hydrocyanic Acid in about thirty
minutes.
10. Chloride of Zinc hardens and
blackens it, and renders it more friable.
11. Phosphorus and Lime-water whiten
the membrane, and cause it to separate
into flakes in about thirty hours.
From these interesting experiments it
will be seen that Caustic Ammonia, Hy-
drocyanic Acid, Hydrochloric Acid, and
Caustic Potash, are the most rapid sol-
vents of the diphtheritic membrane.
Hydrochloric Acid appears to me to
be more closely allied in its homoeo-
pathicity to diphtheria than any of the
others. Irrespective of its antiseptic
and anti-contagious effects upon the
internal organism, the Acid, if applied in
a concentrated form to the healthy
mucous membrane, develops a fibrinous
inflammation. A superficial touch first
whitens the epithelium, which becomes
detached and renewed without causing
82
Diphtheria.
a raw surface; but if the action of the
Acid is prolonged, it develops an angry,
irritable ulcer, which is covered by a
whitish-yellow membrane. This Acid,
like Nitric and Sulphuric Acid, does not
quickly dissolve the membrane, but har-
dens, shrivels, and detaches it. There is,
however, a class of topical remedies
which do possess the power of quickly
dissolving and converting these mem-
branous exudations into a transparent,
diffluent fluid; namely, the Caustic
Ammonia, alkaline solutions, Glycerine,
and a weak solution of Rennet and Hy-
drochloric Acid, which will quickly dis-
solve the hardest fibrine. So will Lime-
water in from ten to fifteen minutes.
The Hydrochloric Acid, however, to
my mind, stands foremost in the ranks.
of topical remedies; it was the first that
I selected on my first acquaintance with
diphtheria in 1859; it has since been
used by a large number of allopathic
and homoeopathic physicians in this and
Diphtheria.
83
other countries. It is one of the chief
remedies recommended in Ziemsen's
great work on the "Practice of Medi-
cine;" and in a strongly written article
on Diphtheria, by Dr. Heslop, which
appeared in the "Medical Times" for
May, 1862, he did not lose a case out of
a large number, after adopting the use
of Hydrochloric Acid.
HYDROPATHIC APPLIANCES.
In addition to the remedies enume-
rated, I desire to draw the attention of
my readers to the use of sweating baths
and hot or cold appliances as valuable
and powerful auxiliaries in the treatment
of diphtheria.
The skin, the natural functions of
which are of such vital importance to
health and the well-being of the animal
economy, should not be overlooked or
neglected. The allopathic physician is
quite alive to this fact, when he pre-
84
Diphtheria.
}
scribes for his fever patients cooling
salines and sweating medicines. The
skin in diphtheria is dry, hot, and even
parched; there is at times great thirst;
the urine is to a great extent suppressed
and high-coloured, and the bowels are
costive; in fact, every outlet for the exit.
of the impurities of the body is her-
metically sealed, which enables the poison
the more effectually to work out its
deadly mission and paralyse the very
mainsprings of life. It therefore becomes
incumbent upon the physician to avert
such a catastrophe in the shortest pos-
sible time, by throwing open the seven
millions of pores which stud the surface
of the body, and by acting on the other
secreting and excreting organs without
a moment's delay. This can effectually
be done by means of the Turkish, hot
air, or the vapour bath, and as soon as
free perspiration sets in the patient
should drink copious draughts of cold
¡
:
Diphtheria.
85
water, holding in solution some Per
manganate of Potassia, Terebene, or
Thymol. Let the bath be repeated
every seven or eight hours, and should
symptoms of exhaustion or faintness set
in, rouse the nervous system by means
of a cold shower or douche, and a diffu-
sible stimulant, namely, camphor, brandy,
or champagne. I have seen a free and
energetic action of the skin cut short the
mad career of a severe fever. Why not
diphtheria? Hot or cold compresses to
the throat, which should encircle the
neck, I also look upon as valuable ad-
juncts in the treatment of local diph-
theria. I generally use the ordinary
compress, or spongio-piline, saturated
with a hot or cold solution of Camphor or
Terebene; these applications act both as
disinfectants and local vapour baths,
which render the skin soft, moist, and
yielding, and so relieve the pain and
tension caused by the enlarged glands
G
*
C
86
Diphtheria.
¡
and diffused inflammation of the sur-
rounding parts.
The hygienic treatment should con-
sist in placing the patient in a large and
well-ventilated room having an abun-
dance of fresh air, with a temperature of
about 64° to 68° Fah.; and in order to
keep up a certain degree of moisture in
the air it is well to place several vessels
filled with water in the room, holding in so-
lution Terebene, Permanganate of Potass,
or Carbolic Acid. All superfluous furni-
ture, bed and window curtains, should be
removed; the bed linen should be fre-
quently changed; all soiled linen should
be immediately subjected to a strong
disinfecting process, and the excreta also.
The dietetic treatment should be se-
lected with due regard to the strength
and temperament of the patient, the
height of the fever, the general habits of
the sufferer, as well as the appetite. In
most cases it should consist of bland
Diphtheria.
87
nourishing food in a concentrated form,
such as veal, chicken, or mutton broth,
or beef-tea, thickened with a little pearl
barley or rice, and flavoured with a wine-
glassful of good dry sherry, port, or
burgundy; in other cases a selection may
be made of fresh milk, eggs, coffee,
arrowroot, tapioca, sago, or Scotch oat-
meal, with some of the light kinds of
meat and wheaten bread. A very ex-
cellent beef-tea can be made by selecting
equal parts of beef, mutton, and veal,
subjecting the ingredients to the same
process as if only one were used; the
mutton and veal tone down the harshness
of the beef, and render the last softer
and more mellow; with this view I shall
designate it the "Triple Alliance."
When symptoms of exhaustion set in
we must not be sparing in stimulants, or
the liberality and generous quality of
the food; neither should we flag in our
baths-particularly the ordinary pack
88
Diphtheria.
wet cold-sheet bath, which is often fol-
lowed by free perspiration and renewed
strength.
CASES ILLUSTRATIVE OF
TREATMENT.
CASE I-Simple Diphtheria.
Oct. 4th, 1858. Thomas B., æt. 4
years, a stout, healthy-looking boy, had
been ailing for two days. The pre-
monitory symptoms, as described by
the mother, were listlessness and rigors,
followed by headache, a flushed face,
hot skin, thirst, and swelling of the
parotid glands, with high-coloured and
scanty urine. On the third day of his
illness (Oct. 4, 1858), I first saw him.
The skin and lips were hot and dry, the
face flushed, the neck swollen, he looked
wild, and appeared frightened; he was
thirsty, the tongue was coated and
tremulous; the left tonsil was enlarged,
Į
Diphtheria.
89
inflamed, and studded with small white
spots (diphtheritic deposits); the uvula
and left palatal region were also in-
flamed, the former covered by a whitish
membranous crust, about the size of a
sixpenny-piece, but oblong in form; the
breath was highly offensive; the pulse
was quick and small; the bowels costive;
the urine high-coloured and scanty.
My treatment consisted in the applica-
tion of dilute Hydrochloric Acid to the
exuded surfaces; the administration of
Belladonna and Mercurius Solubilis (2
dec.) in alternation, every half-hour; and
a hot compress (spongio-piline) to the
neck.
On the following day he was less
feverish, and had perspired freely for
some hours during the night; the swell-
ing in the neck was reduced in size, and
less tender; the tongue looked cleaner
along the sides, but coated along the
dorsum; the membranous deposit on
-<
9o
Diphtheria.
the uvula was shrivelled, exposing un-
derneath a bright red surface; the white
spots on the tonsils had disappeared,
exposing bright red depressions, the
size of the exudations; he had passed
water freely, and of a lighter colour; the
bowels continued costive. The same
mode of treatment was continued, the
medicine being administered at longer
intervals. On the third day (Oct. 6) he
was better; the tongue looked cleaner;
the swelling of the neck had considerably
decreased; the tonsils and uvula looked
healthy; the bowels were moved co-
piously; the urine was clear and copious.
The same treatment was continued,
using the acid in a more diluted form.
On the fourth day (Oct. 7) he was
much improved. To take China (1 dec.)
three times a day, for three days. On
the seventh day (Oct. 10) he was
convalescent, and was ordered to take
China (2 dec.) twice a day, for a week.
Diphtheria.
91
CASE II-Malignant Diphtheria.
Oct. 15th, 1858. I saw a stout,
phlegmatic boy, æt. 3 years, of a
scrofulous diathesis, who had been ill
four days before I was sent for. The
early symptoms, as related by his
mother, were as follow:-On the first
day he appeared "out of sorts;" was
fretful and peevish; complained of
chills; sat on his mother's lap all day,
or clung closely to her side. On the
second day he was feverish; the skin
became hot and dry; he called fre-
quently for water, and drank it with
avidity; he looked wild, had slight
delirium, moaned and ground his teeth
when asleep; he passed but little water,
this only in drops, and highly coloured.
On the morning of the third day he was
no better; he had passed a restless
night; the skin was burning hot; there
was constant thirst. Towards noon, a
-
92
Diphtheria.
rash of a dark hue, with specks like flea-
bites, appeared on the chest and thighs,
remaining about an hour, and then sud-
denly disappearing. This was followed
immediately by symptoms of a more
alarming nature; the throat began to
swell; the breathing became hurried
and laboured; the child winced and
cried while swallowing. These symp-
toms increased in severity every hour;
and at half-past 9 p.m. on the following
day (the fourth) I was first called in. I
found him lying on his back, on a small
temporary couch in the corner of a hot
and closely-packed room, surrounded by
his parents, a number of children, and
several neighbours. He seemed in the
agonies of suffocation; the sides of the
neck and face were enormously swollen;
the eyes glassy, the lids half closed; the
lips dry and cracked, and coated with
dark-brown "sordes:" the corners of
the mouth were excoriated, and covered
I
Diphtheria.
93
with an aphthous deposit; a dark acrid
discharge escaped from the mouth; the
jaws were firmly clenched. On opening
the mouth-a somewhat difficult task-
the tongue presented here and there
yellowish brown patches; other parts of
that organ were red, dry, glossy, and
cracked. The tonsils were enormously
swollen, forming a complete embank-
ment between the mouth and pharynx.
The hard and soft palate, uvula, fauces,
tonsils, and the whole of the buccal
cavities, were lined with a cream-coloured.
membrane; the breath was very offen-
sive; a rattling suffocating noise at-
tended the efforts of respiration, the
breathing being chiefly carried on
through the nasal cavities, from whence
a constant discharge of muco-purulent
sanguineous matter poured forth; the
skin was hot and dry; the pulse quick,
small, and fluttering; the urine scanty
and turbid; the bowels relaxed and
Sta
94
Diphtheria.
offensive. Before commencing the treat-
ment, I had the child removed to a cool
and well-ventilated room; a band of
spongio-piline, saturated with hot water,
was applied round the neck; one drop
of the 2nd decimal dilution of Belladonna
was administered every half-hour, in
alternation with one grain of Mercurius
Solubilis (2nd decimal trituration).
Owing to the difficulty in opening the
child's mouth sufficiently wide to receive
the powder, this medicament was admin-
istered in the form of a "linctus," pre-
pared by thoroughly mixing 20 grains
of the trituration with six teaspoonfuls of
simple syrup, and introduced into the
mouth by means of a feather. I left the
little sufferer about half-past 10 p.m.,
with but slight hope of ever seeing him
alive again.
Oct. 16th.-At 7 a.m. I visited the
patient, and found him somewhat better.
He had passed a terrible night; the
↓
Diphtheria.
95
mother had been most assiduous in
carrying out my instructions; and every
dose of the medicine, according to her
statement, appeared to aggravate the
symptoms. This state of things con-
tinued until 5 a.m., when a change for
the better was observed; the dyspnoea
and symptoms of suffocation were some-
what diminished; in other respects he
was the same. At 9 p.m. I again saw
him, and found a marked improvement;
the dyspnoea was less distressing, the
face and neck less swollen; the tongue
less coated, but still exhibiting a cracked
and ulcerated condition; the lips and
teeth were loaded with sordes, and the
discharge from the nostrils still con-
tinued. The hot application to the neck
was kept up; the Belladonna was
omitted, and Arsenicum (third decimal
trituration) substituted, and adminis-
tered in alternation with the Mercurius.
Oct. 17th. This day he was better.
96
Diphtheria.
1
He had passed a good night; the
breathing was more free; the neck had
visibly decreased in size; the tonsils
smaller; the tongue slightly moist, but
studded with small ulcers; the diph-
theritic deposit in the mouth was disap-
pearing gradually; the discharge from
the nostrils was still profuse, but not so
offensive; the bowels were regular, and
the urine tolerably healthy. I ordered
the same treatment to be contiuued.
Oct. 18th.-He had passed a some-
what restless night, but was better when
I saw him. The breathing was more
natural; the tongue looked cleaner, and
the ulcers put on a healthy granulating
appearance; the bowels had been moved
naturally. Continued the same treat-
ment.
On the fourth day (Oct. 19) he was
still improving. He had slept soundly
in the night; the tongue was clean and
moist, and the ulcers almost healed. To
Diphtheria.
97
continue the same treatment. On the
fifth day (Oct. 20) he was going on well.
To take Mercurius Solubilis every four
hours. On the sixth day (Oct. 21) I
did not see him. On the seventh day.
(Oct. 22) he was going on well. I
ordered him Sulphur every night and
morning for three days. On the eleventh
day (Oct. 26th) he was again seen, and
I prescribed China night and morning
for four or five days, when I gave up
further attendance.*
CASE III-Simple Diphtheria.
Oct. 17th, 1858.-Emma L., æt. 6, a
thin, delicate girl, first showed symp-
toms of indisposition on the second day
* This boy was one of a family of five, only one of
whom besides became affected with the disease, viz.,
a girl six years old, the subject of the following case.
I may here observe that Belladonna and Mercurius
(5th dec.) were administered to the whole of the
children, as prophylactics, from the first moment of
my attendance.
1
98
Diphtheria.
of my attendance on her brother (see
Case 2). There was no eruption in this
case; she complained of headache and
pains in the back; she looked wild;
had a glassy appearance about the
eyes; she was feverish, and the face
flushed. There was slight enlargement
and tenderness of the cervical glands,
with pain and difficulty in swallowing ;
she felt as if a cord was tied slightly
round the neck; the tongue was tremu-
lous, red at the sides, and coated in the
centre; the pulse quick; the tonsils
enlarged and red, as well as the fauces,
the former being covered with a white
exudation; several spots of the same
kind appeared on the soft palate; she
was thirsty; the bowels were tolerably
regular; the urine scanty and high-
coloured.
The treatment consisted of the appli-
cation to the neck of a collar of spongio-
piline, saturated with hot water; paint-
Diphtheria.
99
ing the diphtheritic surfaces with dilute
Hydrochloric Acid; and the administra-
tion of Lachesis and Mercurius Solubilis
in alternation every hour.
On the following day (Oct. 18th) she
was better, was less feverish, and swal-
lowed better; there was no increase of
the diphtheritic deposit. The treat-
ment was continued, and the medicines
administered at longer intervals. On
the third day (Oct. 19th) there was a
further improvement. On the fourth
day (Oct. 20th) improving still, but there
remained some slight redness of the
tonsils. Belladonna every four hours.
On the fifth day (Oct 21st) she was
much better, when I prescribed Sulphur
night and morning for four days, after
which she was quite convalescent.
CASE IV.
Nov. 15th, 1858.-S., the wife of a
distinguished officer, consulted me on the
2
*
:
}
* * *
A
100
Diphtheria.
K
morning of the above date. This lady
was 55 years old, stout, and of a highly
bilious temperament. She was subject
to quinsy, and had had about twenty
attacks in the course of her lifetime.
When I first saw her, she complained
of sore-throat, pain, and a sense of con-
striction in swallowing. I found en-
largement and inflammation of the
tonsils; these, with the uvula and soft
palate, being of a purplish-red; she was
very subject to congestion of the liver,
and much troubled with costiveness;
the pulse was quick and full, the tongue
coated, and the breath offensive. Bella-
donna and Mercurius (2nd decimal)
were prescribed. On the following day
(Nov. 16th) there was more fever; the
breath was more offensive, and the
throat symptoms much the same. Aco-
nite and Belladonna (2nd decimal) were
ordered to be taken every hour in
alternation.. On the third day (Nov.
i
1
Diphtheria.
101
17th) she was less feverish, the throat
symptoms being somewhat better. I
now gave Hepar Sulphuris 6. On the
fourth day (Nov. 18th) I found no
change in the symptoms, but continued
the medicine. On the fifth day (Nov.
19th) she was not so well; she had
passed a restless night; she complained
of a good deal of pain in swallowing,
and a feeling of strangulation; the
tonsils were considerably enlarged; the
soft palate presented a bright red ap-
pearance, and covered with glairy
mucus, not unlike the white of an egg;
the breath continued offensive. Lachesis
and Hepar Sulphuris were prescribed, a
dose, alternately, every hour. On the
sixth day (Nov. 20th) she was not so
well; the symptoms had assumed
more aggravated form, the feeling of
constriction had increased, and there
was greater difficulty and pain in swal-
lowing; she was heavy and drowsy;
a
H
102
Diphtheria.
1
the tongue felt rough, but not much
coated; the conjunctivæ yellow, the
blood-vessels congested; the bowels
were costive; the tonsils, uvula, and soft
palate of a purplish-red colour, and
covered here and there with patches of
diphtheritic deposit; the breath highly
offensive. A powder containing ten
grains of the first decimal trituration of
Podophyllum was administered at once,
with the view of relieving the congested
state of the liver. Afterwards the fol-
lowing medicines were given: three
drops of pure Bromine, mixed with eight
ounces of water, and three grains of the
first decimal trituration of Bichromate of
Potassium, dissolved also in eight ounces.
of water, a tablespoonful to be taken
alternately every hour. She was also
advised to inhale the steam of boiling
water, in which Hydrochloric Acid had
been dissolved. On the seventh day
(Nov. 21st), morning, she spoke with
Diphtheria.
103
difficulty; the tongue was swollen, and
covered with a thick brownish mucus; a
copious discharge of offensive pus was
evacuated from an abscess which had
formed in the posterior palatine region,
with marked relief to some of the symp-
toms. The bowels were freely moved,
the fæces being highly charged with
dark acrid bile; she passed a fair quan-
tity of water; the diphtheritic membrane
had spread over the greater part of the
roof of the mouth. Belladonna and
Mercurius (2nd decimal trituration)
were administered, in alternation, every
hour. The mouth was for a time well
gargled with warm water, with the view
of encouraging a free discharge of pus
and blood from the abscess; afterwards.
a gargle of Hydrochloric Acid and water
was used. I again saw her in the even-
ing; she had passed a comfortable day,
and had had an hour's refreshing sleep;
the abscess had discharged freely, and
104
Diphtheria.
she could swallow better; the bowels
had again acted, and a quantity of acrid
bile had been evacuated; she was weak,
the pulse small and flagging. Continued
the same treatment, and ordered mutton
broth every two hours. On the eighth.
day (Nov. 22) she was better, and had
had a comfortable night; there was
little or no pain in swallowing, the breath
was less offensive, the tongue cleaner;
the diphtheritic membrane had sepa-
rated from the roof of the mouth and
tonsils in flakes. The same treatment
was prescribed, with the addition of beef-
tea thickened with arrowroot, every two
hours. On the ninth day (Nov. 23rd)
she was not so well, although there was
no increase of the diphtheritic deposit ;
yet she complained of pain in swallow-
ing, and a feeling of constriction in the
throat. Lachesis and Hepar Sulphuris
were administered in alternation every
two hours. On the tenth day (Novem-
Diphtheria.
105
ber 24th) she was better. Continued the
medicine and gargle. On the eleventh
day (Nov. 25th) she was improving. I
continued the same treatment. On the
twelfth day (Nov. 26th) she was much
improved. To take Sulphur every four
hours. On the thirteenth and fourteenth
day she still progressed favourably. On
the fifteenth day (Nov. 29th) she was
not so well, and complained of slight
irritation in the throat, with stiffness in
the angle of the right jaw, where redness
and puffiness were observed; she was
also feverish. Aconite and Hepar Sul-
phuris alternately every three hours was
prescribed. On the sixteenth day (Nov.
30th) she was less feverish; the stiffness
had increased, and a small abscess de-
veloped itself at the angle of the jaw-
this was opened, with marked relief;
several specks of diphtheritic deposit
were observed around this spot. Baryta
Carbonica (3rd decimal trituration) was
тоб
Diphtheria.
prescribed, a grain every three hours.
On the seventeenth day (Dec. Ist) the
patient was better; the abscess had dis-
charged freely, and the diphtheritic
specks had disappeared. To take Hepar
Sulphuris every four hours. On the
eighteenth day (Dec. 2nd) she was much
improved, and from this date all symp-
toms of diphtheria had disappeared;
but her convalescence was slow, as, in
addition to debility, consequent upon so
severe an attack, she suffered from her
old complaints, viz., a congested liver,
constipation, and indigestion.
CASE V.
Nov. 24th, 1858.-J. C., æt. 12 years,
the son of a pilot, had been ill three
days. On the morning of the fourth
day he was first seen by me. He looked
heavy and drowsy; the eyes were lustre-
less and the face puffed; the parotid and
submaxillary glands were enlarged and
Diphtheria.
107
tender. On opening the mouth, the
first symptom noticed was a stench of a
most offensive character; the soft palate.
and uvula presented a bright red appear-
ance, and over a portion of this there
was a yellowish-grey tenacious mem-
brane several lines in thickness, about
three-quarters of an inch wide and about
two in length; it bore a strong resem-
blance to a piece of wash-leather or wet
parchment, and hung down like a veil.
A portion of it having been detached by
means of the handle of a spoon, the
exposed surface looked highly con-
gested, and drops of blood oozed from
it. The tonsils were enlarged, and par-
ticularly the left one, to which side the
diphtheritic deposit was chiefly con-
fined; deglutition was painful and diffi-
cult; the tongue was thickly coated with
dark-coloured mucus; the pulse full and
quick (about 95); and there was general
tremor and fever.
108
Diphtheria.
The treatment consisted of the local
application of dilute Hydrochloric Acid
three or four times a day, and the ad-
ministration of Belladonna and Mer-
curius Solubilis (2nd decimal dilution
and trituration) alternately every half-
hour. On the following day (Nov. 25th)
there was a favourable change; the
diphtheritic membrane had nearly dis-
appeared; the surface from which ex-
uded this remarkable poison-growth
now presented quite a different appear-
ance, and instead of that which has not
inaptly been compared to a piece of
moistened parchment or wash-leather,
now presented the appearance of a
semi-transparent matter, doubtless a
fresh exudation in its first stage of de-
velopment; the efforts to swallow were
less painful, the glands had diminished
in size, the face had assumed a more
natural appearance, but the stench from
the mouth was but little diminished;
Diphtheria.
109
the tongue was less coated, and the
bowels had been freely moved in the
course of the night. The same mode
of treatment was continued, the medi-
cine being administered at longer inter-
vals. On the third day (Nov. 26th)
there was a marked improvement in the
condition of this boy; the breath was
less offensive; he swallowed with greater
ease and comfort; the tonsils and cer-
vical glands had materially diminished;
the exudation from the diphtheritic sur-
face was altered in its character, now ap-
pearing in the form of a thin glairy
mucus; the bowels were relaxed, the
evacuations very offensive; this I attri-
buted to the irritation caused by his
having swallowed fragments of the poi-
sonous membrane. The Belladonna and
Mercurius were continued at longer
intervals; the Acid, also, but in a more
diluted form, was used as a gargle. On
the fourth day (Nov 27th) a further
ITO
Diphtheria.
improvement had taken place; the
diphtheritic surface presented a healthy
appearance; the tongue was cleaner,
and the glands further reduced in size,
while the evacuations were healthy
and natural in colour. The same
course of treatment was continued. On
the fifth day (Nov. 28th) I did not visit.
him. On the sixth day (Nov. 29th) he
was again seen; the change was most
gratifying. He was rapidly progressing
towards convalescence; the eyes were
bright and natural; the cervical glands
were nearly reduced to their natural
size; the lips were red and moist;
the breath had lost its offensiveness;
the tongue was clean; the space covered
by the diphtheritic membrane was fast
returning to its natural colour; the ton-
sils had considerably diminished in size;
they looked healthy; the appetite was
keen; the bowels regular. To take
Sulphur (6) night and morning, for three
Diphtheria.
I 11
days, then China (2) twice a day for a
week; when he was discharged cured.
CASE VI
While paying a visit to the subject of
the last case on the 4th of December,
my attention was directed to his sister,
a stout, phlegmatic girl of 16, who com-
plained of sore-throat, pain and difficulty
n swallowing. A closer examination of
the case revealed the following symp-
toms. She complained of a dull, aching,
throbbing headache; the eyes looked
heavy; the face puffed, flushed, and
shining; there was enlargement and
tenderness of the cervical glands on both
sides; the breath was offensive; the lips
dry and cracked; she was feverish; the
pulse full and quick (about 90); the
tongue tremulous, and coated with a
thick slimy mucus; there was consider-
able ptyalism; the tonsils were enlarged,
and of a bright red colour; the soft
II2
Diphtheria.
palate, uvula, and fauces partook of the
same inflamed condition; the surface
of these parts was dotted with diph-
theritic deposit, and bore some resem-
blance to a crop of small-pox pustules;
some of these coalesced, and presented
the usual characteristics of the true
diphtheritic membrane; the bowels were
regular; the urine scanty and turbid.
The treatment consisted in the ad-
ministration of Belladonna and Mercurius
Solubilis (2nd decimal), and the appli-
cation of dilute Hydrochloric Acid to the
diphtheritic surfaces. On the second
day (Dec. 5th) there was no increase of
the diphtheritic exudation; some of the
old deposits had disappeared; the tonsils
were smaller, and the inflammatory blush
over these and surrounding parts paler;
the cervical glands had diminished in
size and were less tender; she was less
feverish; the tongue was cleaning from
the tip she perspired freely during the
Diphtheria.
113
night; the urine was passed in larger
quantities, and of a better colour. To
continue the same treatment. On the
third day (December 6th) she was going
on well. On the fourth day (December
7th) I did not see her. On the fifth day
(December 8th) she was very much
better, and I ordered her Sulphur (6)
once a day for a week, when I gave up
further attendance.
CASE VII.-Malignant Diphtheria.
Mr. G., æt. 32, a stout, well-built, florid
looking man, consulted me on the 10th.
of December, 1858. He complained of
sore-throat, rigors, pains in the limbs and
back. He attributed these symptoms
to the effect of cold arising from expo-
sure the day before. The mouth pre-
sented nothing abnormal, save slight
enlargement of both tonsils, and a blush
of redness over the soft palate and fauces;
his general health was good. Aconite
(2nd decimal dilution) was prescribed,
1:4
Diphtheria.
-a drop in a tablespoonful of water,
every two hours. He was recommended
to confine himself to the house for the
day; to put his feet into hot water at
night, and to take a basin of warm gruel.
This treatment, for the time, appeared
to have had the desired effect, for on the
morrow he felt much better, rose early
and went to work. Towards night he
was not so well; the old symptoms had
returned, but he took little notice of them,
and merely used a simple gargle of his
own prescribing and retired to bed. He
passed a restless night, having had no
sleep; the throat became more painful
and swollen, and as the day advanced
the symptoms became more alarming,
which urged him towards evening to
send for a medical man. At half-past
seven I found him in a half-sitting pos-
ture, in a general tremor; there was total
prostration of all vital energy. He pointed.
to his throat as the seat of all the
mischief: the cervical glands were enor-
Diphtheria.
115
mously swollen; the eyelids half closed;
his eyes heavy and glassy; his face and
neck red, shining, and puffy; his lips
dry; the angles of the mouth exhibited
superficial ulcerations; the jaws were
stiff; the mouth could be opened with
difficulty; the tongue was coated with
a whitish-brown thick mucus; there was
profuse ptyalism; his breath was tainted
with that offensive odour so peculiar to
diphtheria; his voice was hoarse; the
tensils swollen, and presented, with the
fauces, soft palate, and uvula, a dusky-
red colour; the surface of these parts
was studded with yellowish-white spots,
the size of split peas; these spots ex-
tended into the pharynx; the pulse was
quick and throbbing; the urine scanty.
and turbid; the skin dry and hot. I
prescribed a hot compress of Spongio-
piline, to encircle the neck; the admin-
istration of Belladonna and Mercurius
Solubilis (2nd decimal dilution and
[16
Diphtheria.
trituration), alternately, every half-hour,
and the application to the diphtheritic
surfaces of dilute Hydrochloric Acid every
three hours. On the following day (De-
cember 11th) he was no better; he had
passed a very restless night; the diph-
theritic spots had become larger and
darker in colour, several having coalesced,
forming patches; the breath was more
offensive, and he had great difficulty in
swallowing. The hot compress was kept
to the neck and throat; the first decimal
trituration of the same medicines was
given, and the acid was applied to the
membranes. The third day (Dec. 12th)
brought no amelioration of the symp-
toms save a slight diminution in the size
of the neck, and greater facility in open-
ing the mouth; the tongue was thickly
coated; deglutition painful and diffi-
cult; the tonsils touched each other;
the diphtheritic patches were more de-
veloped-one, in particular, about an
Diphtheria.
117
inch long, adhered to the surface of the
fauces like a piece of moistened parch-
ment; the breath continued very offen-
sive; the skin was hot and dry; the
urine scanty and high-coloured. The
same treatment was continued, and in
addition, three drops of Aconite (2nd
decimal) were administered at bed-time,
with the view of subduing the fever.
The fourth day (Dec. 13th) brought
better news; although he had passed a
distressingly restless night, yet he was
easier towards morning, after a free
and copious perspiration; the tongue
was clean at the tip; the tonsils had
somewhat diminished in size;
size; the
diphtheritic membranes were darker in
colour, and shrivelled; he could open
his mouth better; the pulse was softer,
and not so quick; the urine was lighter
in colour, and more copious; he had an
offensive discharge from both nostrils;
the breath was equally offensive. The
I
118
Diphtheria.
}
same treatment was continued. On the
fifth day (Dec. 14th) there was no change
in the symptoms. I continued the
treatment. On the sixth day (Dec.
15th) he was better; there was a marked
amelioration of the symptoms. Con-
tinued the same treatment. On the
seventh day (Dec. 16th) he was much bet-
ter; the discharge from the nostrils had
diminished; the tongue was cleaning
from the tip backwards; the tonsils
were smaller, and the diphtheritic mem-
branes dropping off in shreds; the
breath was still offensive; the neck was
smaller; the pulse soft, and about 85;
the urine clear and copious; bowels
regular. To continue the same medicine,
and use the acid as a gargle. On the
eighth day (Dec. 17th) progressing
favourably; continue the same treat-
ment. On the ninth day (Dec. 18th)
going on well; to continue same treat-
ment. On the tenth day (Dec. 19th)
Diphtheria.
119
improving; the diphtheritic membrane.
had all but disappeared; the discharge
from the nostrils had ceased; the tongue
moist, and cleaning nicely; the tonsils
smaller, and the neck reduced in size ;
the urine clear, and the bowels regular.
To go on with the same medicine. On
the eleventh day (Dec. 20th) going on
well. To repeat the same medicine.
On the twelfth day (Dec. 21st) I did not
see him. On the thirteenth day (Dec.
22nd) he was again seen, and was pro-
gressing favourably. To take China
and Sulphur, and to continue the gargle.
These he took and used for three days,
when I again saw him; was much im-
proved. The same treatment was con-
tinued for another week, when he was
declared well.
My paper contains three more cases;
but as they present no very important
features, I shall merely give a general
outline of them.
120
Diphtheria.
CASE VIII.-Simple Diphtheria.
The first was that of a boy, æt. 5
years, who had been ailing four or five
days before I saw him. His breath was
very offensive; tonsils swollen; tongue
coated and tremulous; pulse quick and
small. On the soft palate there was
a strip of yellowish-brown membrane, of
considerable thickness; this was re-
moved by grasping the upper end with
a forceps, and gently tearing it away
from above downwards; the denuded
surface was highly vascular, presenting
a very irritable appearance, not unlike
the irritable ulcer or chancre. This
case was treated with repeated doses of
Belladonna and Mercurius, the diph-
theritic surface painted with dilute
Hydrochloric Acid; was no renewal of
the membrane, and the child was well
in seven days.
Diphtheria,
121
CASE IX.-Simple Diphtheria.
The second was that of a lad 7 years
old. He also had been unwell for some
days before I first saw him. In this
case the left tonsil and uvula were alone
affected, being covered with a yellowish-
grey coating, some lines in thickness; a
blush of redness was diffused over the
soft palate of the same side; his breath
was very offensive; tongue coated
edges of the alæ nasi ulcerated; slight
salivation. This case was treated with
Belladonna and Mercurius, and the ap-
plication of Hydrochloric Acid. On the
second day the membrane looked darker
and puckered, 'On the third day
darker still and shrivelled. On the
fourth day of a dark brown, and partially
detached. On the morning of the fifth
day during a fit of coughing, it became
entirely detached, The Belladonna and
Mercurius were continued, the diphtheritic
I22
Diphtheria.
surface painted night and morning with
the acid, and at the end of ten days he
was well.
CASE X.-Malignant Diphtheria.
The third case was that of a little
girl 9 years old, of a strumous habit. In
this case the cervical glands were seriously
implicated; the neck was puffed out;
there was also dyspnoea and salivation ;
the tonsils touched each other, and
covered with a membrane about the size
and form of the bowl of an egg-spoon,
of considerable thickness and of a
yellowish-grey colour; she was feverish;
skin hot and dry; thirst; bowels costive;
urine high-coloured, and scanty; the
hot compress was applied to the neck.
Belladonna and Mercurius Biniodatus (2nd
dec.), in alternation, were administered
every hour, Aconite (3) at bedtime, and
the membrane painted with the acid.
On the following day, higher state of
Diphtheria.
123
fever; all secretions suppressed; intensel
thirst; tongue like leather; and every
outlet of the body sealed up. I ordered
a hot bath with mustard; this was
followed by profuse diaphoresis; urine
and bowels were freely evacuated. Con-
tinued the medicine and acid. She
improved daily under this treatment,
and at the expiration of fourteen days
was convalescent.
+
APPENDIX.
;
PRESUMING this little "monograph
will fall into the hands of many who
believe in the principles of Homœopathy,
and who might perchance be compelled
"on an emergency" to treat a case of
diphtheria, I append here a list of those
remedies which proved so efficacious in
my hands, coupled with brief instruc-
tions as to the mode of applying the
local medicaments. At the same time
I would strongly advise non-medical
persons, if possible, to avoid coping with
so formidable and malignant a disease.
The selection and symptomatological
effects of the drugs will be found por-
"J
126
Appendix.
trayed at from page 65 to 77, and the
repetition of the dose scattered through
the pages wherein are contained the
cases, from page 88 to 133.
Name.
Potency chiefly employed.
Tincture, 2 dec. dil.
Trituration, 3 do.
Tincture, 2 & 3 do.
Tincture, 2 & 3 do.
Sol., Trituration, I &
2 do.
Aconitum Napellus
Arsenicum Album
Belladonna
China
Mercurius
Hah.
Mercurius proto-
iodidus
Lachesis
Sulphur
Hep. Sulph..
Trituration, 2 do.
Dilution, 5 cent.
Dilution, 5 cent.
Dilution, 5 cent.
The remedies in the above list are the
most efficacious hitherto tested, so long
as the disease confines itself within the
cavity of the mouth; but should it escape
into the larynx and attack the air-tubes,
or primarily develop itself there, then
Appendix.
127
the following will be found the most
suitable remedies :-
M
Bromine
Tincture p
3 drops in a tumblerful of pure water.
Bichromate of potass Trituration, I dec.
Iodine.
Tincture, 4 drms.
Boiling water, i pint, mix; to be
administered by inhalation. Or,
Iodine
Spongia
Senega
Cantharis.
were-
Tincture, 3 decimal.
Tincture, 6 decimal.
Tincture, 3 decimal.
Tincture, 3 decimal.
The local remedies I found so useful
Firstly.-Constant warmth applied to
the neck by means of spongio-piline,
saturated in hot water, and renewed
as often as the temperature became
lowered.
Secondly.-The application of dilute
Hydrochloric Acid to the false mem-
branes. This was more or less modified,
128
Appendix.
according to the stage of the disease and
the condition of the diphtheritic deposit.
When the membrane was thick, and
thoroughly formed, I used a solution
composed of one part of acid to three
parts of water.
When the deposit was thinner, and
somewhat transparent, the solution
consisted of one part of acid to four or
five parts of water.
And when it assumed the character of
a glairy mucus, one part of acid to eight
or ten parts of water.
In slight cases, and during the stage
of convalescence, I prescribed the acid
in the form of a gargle, by mixing fifteen
to twenty drops in eight or ten ounces
of water.
The acid as prescribed in the above
formulas was applied by means of a
strong and moderate size camel's-hair
brush, care being taken not to allow any
of it to escape into the larynx.
Appendix.
129
The parts immediately bordering on
the membranes should also be painted.
with the same solution in a more diluted
form. An artificial irritation of a
“similar" kind is thus set up, which
confines within a given circuit the mor-
bid product. I am fully convinced that
this precaution will frequently avert the
spread of the disease and blunt its viru-
lence, and afford time as well as aid to
the action of the internal remedies.
K
A

Diphtheria.
131
ANTISEPTICS, DISINFECTANTS,
OR DEODORANTS.
In order to make this Monogram as
complete as its limits will permit, I ap-
pend here a brief description of some of
the leading disinfectants. Some have
been long and familiarly known to the
generality of persons; others are of re-
cent invention, and according to eminent
authorities are more potent and less dan-
gerous as counteracting agents against
miasmatic and other poisonous emana-
tions.
Among the old and familiar disinfect-
ants we recognise the Chloride of Lime,
Quicklime, Carbolic Acid, the Carbo-
lates of Lime and Magnesia, and Per-
manganate of Potash. In certain cases
the Perchloride of Iron, Sulphate of Iron,
132
Diphtheria.
Ammonia, Iodine, Bromine, Nitrate of
Lead, and Chloride of Zinc (Sir W.
Burnett's fluid) have been recommended.
Or, again, Chlorine Gas and Sulphurous.
Acid Gas, Charcoal or Dried Earth, have
been suggested. No night-stools or bed-
pans should be used without their con-
taining a solution of Permanganate of
Potash, or Carbolic Acid; Chloride of
Lime, Chloride of Zinc, or half an ounce
of Tincture of Iodine. The first agent
has the advantage of not being corrosive,
but the last is the most efficacious. The
door and window must be thrown open
so as to allow of a free current of fresh
air.
To disinfect linen and washing apparel,
they should be soaked in a mixture of two
ounces of the solution of Permanganate
of Potash to one gallon of water, being
afterwards plunged into boiling water.
Woollens, bedding, or clothing may be
thoroughly purified by exposing them
Diphtheria.
133
for two hours in an oven to a tempera-
ture of 220° Fahr.
CHLORINE GAS.-As a fumigating,
antiseptic, and disinfecting agent, this gas
stands unrivalled. It is made by inti-
mately mixing one part of table salt with
one part of the black or Binoxide of Man-
ganese, and placed in a shallow earthen-
ware pan; to these is added two parts
of Oil of Vitriol (Sulphuric Acid) pre-
viously diluted with two parts of water,
and the whole well stirred with a stick.
The Chlorine Gas is now set free, which
continues for three or four days. The
utensils containing the ingredients should
be placed in the highest part of the room,
as it is the nature of this gas to descend
by its own density, and become gradu-
ally intermingled with the surrounding
atmosphere.
SULPHUROUS ACID GAS.-This ele-
134
Diphtheria.
ment is obtained by sprinkling powdered
Sulphur on a few bright-red coals in a
shovel, or by burning part of a stick of
Sulphur in a crucible, or in a pipkin.
Powdered Charcoal or dry Earth may
be used in the same way.
· CARBOLIC ACID.-This preparation
is known as Phenic Acid, Phenol, Hy-
drate of Phenyl, and Phenylic Alcohol.
It is obtained from Coal Tar by distilla-
tion and subsequent purification, and sub-
sides into colourless acicular crystals. It
coagulates albumen, and does not redden
litmus paper.
MEDICINALLY.-It promotes free per-
spiration, reduces fever, and lowers the
pulse. In this respect it is an analogue
to Aconite, consequently may be admin-
istered as a disinfecting febrifuge in all
kinds of eruptive, epidemic, and conta-
gious fevers. Many physicians in the
Diphtheria.
135
Southern States of America and the
West India Islands administer Carbolic
Acid as a prophylactic in yellow fever
(Typhus Icterodes).
In diphtheria it may be used as a
preventive-one grain in water, taken
night and morning; also as a gargle, by
means of a spray, inhalation, or applied
to the fauces once or twice a day. For-
mula: 1 of acid to 100 of water. As a
lotion to diphtheritic exudations on sores
of mucous membranes. Formula: 15 to
30 grains to I ounce of water. And as
a hypodermic injection, of a grain in 20
drops of water has been found efficacious
in intermittent fever; why not in diph-
theria? As a gargle it quickly destroys
the fœtor of breath, which is a leading
characteristic of diphtheria. Formula:
2 grains to I ounce of water.
Carbolic Acid destroys the lowest
forms of animal and vegetable life, and
prevents fermentation and putrefaction.
136
Diphtheria.
Unlike Chlorine and Permanganate of
Potash, however, the acid is incapable
of destroying offensive gases; it only
prevents their formation. The astound-
ing revelations made by Pasteur and
confirmed by Sanderson, Braidwood,
Hallier, and others, as to the existence
of a contagium vivum as a cause of
disease and putrefaction, and the destruc-
tive element and antagonistic virtues.
of the acid, renders it one of the most
powerful antiseptics in the whole arena
of disinfectants.
It is now well proved that septi-
cæmia, pyæmia, relapsing fever, splenic
fever, carbuncles, chronic ulcers, indo-
lent sloughing wounds, are caused by
animalculæ, the bacteria, vibriones, or
microzimes; parasites which exceed the
twenty-thousandth part of an inch
in diameter, and which are found in
millions in the blood and excreta of
those affected. It is also proved that
Diphtheria.
137
cholera, typhus, measles, small-pox,
typhoid, hooping-cough, and diphtheria,
are caused by a parasitic fungus, which
is found in large numbers in the excreta
of those suffering from such complaints,
for destruction of which, Carbolic Acid
is represented to be one of the most
effectual remedies.
PERMANGANATE
OF POTASH.
Known also as Potassæ Permanganas,
presents itself in the form of dark pur-
ple, slender prismatic crystals, inodorous,
with a sweet astringent taste.
It is per-
fectly soluble in water (I in
ducing a rich purple colour.
16), pro-
MEDICINALLY.-The Permanganate
of Potash is a powerful antiseptic and
disinfectant. It forms the basis of
Condy's Antiseptic Fluid. It deodo-
rises foul ulcers, cancers, and the diph-
theritic fœtor; it corrects foetid effluvia,
138
Diphtheria.
offensive evacuations and expectorations,
when Carbolic Acid fails.
Used as a gargle, inhalant, spray, or
lotion, let the proportions be from one.
to five fluid drachms of the officinal pre-
paration to a pint of water.
As a medicine, one to two grains in
water two or three times a day.
IODINE. This agent has been re-
commended as a disinfecting agent, and
to check the progress of diphtheria;
it is used as an inhalant, and adminis-
tered internally.
Mg
CAMPHOR. This medicine is an
energetic diffusible stimulant; it acts as
a powerful prophylactic, and curative
agent in cholera and summer diarrhoea.
It is worthy of a fair trial as a preventive
in diphtheria; as a topical application,
and as a curative agent in the stages of
prostration and collapse.
Diphtheria.
139
Camphor is a powerful antiseptic. A
gentleman who enjoys the largest mid-
dle-class and dispensary practice in
London, uses no other than a solution
of Camphor as a dressing for chronic
ulcers of the lower extremities. I have
witnessed the most satisfactory results.
to follow such treatment. The micro-
scope in such cases would doubtless
reveal thousands of parasites (bacteria).
The next group of disinfectants are those
of recent discovery. They consist of
Terebene, Cupralum, Terebene powder,
and Thymol.
1. TEREBENE. This is comparatively
a new and powerful antiseptic, disinfect-
ant, and deodoriser; designed by Dr.
Bond, Medical Officer of Health for
Gloucestershire.
Terebene is a liquid, with a somewhat
camphoraceous smell in mass, resem-
bling that of Oil of Thyme (Thymol). It
140
Diphtheria.
is obtained by chemical means from the
juice of the Resinous Pine (Pinus palus-
tris), and some other coniferous plants.
When exposed to the air it volatilises,
emitting an odour of a fragrant and
agreeable character, which when diffused
through the atmosphere, somewhat
recalls that of pine wood. When thus
exposed it acts upon the oxygen of the
air, developing ozone in it, and at the
same time becoming itself charged with
peroxide of hydrogen (antozone of
Schönbein). When added to any decom-
posing and offensive matter, Terebene
acts as a powerful deodorant. It pro-
duces the same effect upon
a foul
atmosphere, not simply by masking the
offensive smell of its own odour, as in
the case of Carbolic Acid, and other
* "The sleep-givi g, soothing fragrance of t'e
Resinous Pine, cleanest, sweetest, and most healing
of all scents, fills the air."-Travels in the Rocky
Mountains, by the Earl of Dunraven.
Diphtheria.
141
similar strongly-smelling disinfectants,
but by developing in the air an agent
(ozone) which rapidly oxydises and
destroys the malodorous emanations.
It is therefore truly an atmospheric
purifier. Terebene has also distinct
antiseptic powers, and when added to
putrescent matters, arrests putrefaction
for a considerable time. It is non-poi-
sonous, and may be taken internally with
impunity. When thus taken it acts as an
inward antiseptic, producing, in addition
to other effects, the arrest to a great
extent of fæcal putrefaction; the fæces
becoming under its use almost entirely
odourless, which is suggestive of its ap-
plicability in various cases. It may be
noted that Terebene is almost identical
in its general physical characters and
chemical composition with Thymol, the
chief constituent of Oil of Thyme, ano-
ther recently discovered disinfectant,
of the antiseptic properties of which a
142
Diphtheria.
very strong report will be found in the
"British Medical Journal," May 2, 1875.
So also with Salicylic Acid.
When Terebene is gently heated it
gives off a peculiar aromatic odour. By
holding a saucer containing some over
a candle, a most agreeable fragrance
may be diffused through a sick-room.
In diphtheria it may be used in the
form of a gargle; topically by means of
a brush or sponge; by inhalation or a
spray. As a medicine it may be admin-
istered several times a day, particularly
when we suspect the disease has entered
the stomach and intestines.
W
2. CUPRALUM TEREBENE Pow-
DER. This is another new and most
powerful disinfectant, designed by the
same gentleman. It is a compound of
Terebene, Cupric Sulphate, Potassic
Dichromate, and Alumenic Sulphate;
thus forming a combination (according
Diphtheria.
143
to the views of the designer) which is
unsurpassed as a disinfecting agent in
destroying emanations and infectious
germs. This combination possesses in
a higher degree than any other the
power of developing ozone in the air, of
coagulating albumen, of neutralising
ammonia and sulphurated hydrogen,
of destroying offensive odours, and of
emitting an aroma which is distinctly
agreeable and pleasant; a great boon in
the sick-chamber. It should be chiefly
used as a deodoriser.
<
THYMOL. This is another antiseptic
and disinfecting agent of recent birth,
which consists of a peculiar crystal ex-
tracted from the Wild Thyme (Origa-
num vulgare); it is pronounced by
many eminent chemists and physicians
to be far superior, and much stronger,
than Carbolic Acid, or any other so-
called antiseptic or disinfecting agents
144
Diphtheria.
hitherto known, and has been proved by
the experiments of Lewin and Bucholtz
to be about eight times as powerful as
Carbolic Acid. It has also a great
advantage over the latter, like its pro-
totype, Terebene, in being perfectly
harmless and free from all poisonous
constituents, and like Terebene also
in possessing its own delicious and
fragrant odour derived from the Wild
Thyme
MEDICINALLY.-It may be admin-
istered as a medicine, and used as a
gargle, lotion, inhalant, or spray, and also
as a topical application.
MOU
INDEX.
Aconite, therapeutic range,
65.
pathogenetic effects in
febrile stage, 65.
Alice, Princess, death of,
17.
Ague, springing from fens
and marshes, 27.
Allopath c
treatment of
diphtheria nil, 64.
Appendix, 125.
Aretæus, 24.
Arsenic a powerful preven-
tive of ague and cholera,
61.
Arsenic,
effects on mouth, 71.
Arsenicum,
range of, 68.
Ash sore throat, 29.
Ash, diphtheria very fatal
a, in 1858, 28.
Atropa Belladonna, thera-
peutic range of, 66.
Author's views of diph-
tueria, 30.
pathogenetic
therapeutic
Baths, Turkish or vapour,
valuable adjuncts in treat-
ment, 59.
Belladonna, pathogenetic
effects on mouth, 66.
therapeutic range of,
66.
Bichromate of potass, thera-
peutic range of, 65.
Boulogne sore throat, 28.
Bretonneau's views of the
identity of diphtheria and
croup, 54.
Camphor a powerful pre-
ventive of cholera, 61.
Canterbury,
diphtheria
very fatal at, in 1858, 28.
Cantharides, local effects of,
76.
Carbolic acid as a disinfect-
ant, 86.
Cases illustrative of cures,
•
88.
Causes of diphtheria, 26.
146
INDEX.
Chemical experiments on
membrane, 79.
Chief remedies for diph-
theria, 65.
Cholera, springing from
delta of Ganges, 27.
preventives pointed
out by Hahnemann, 23.
Cinchona, therapeutic use,
65.
Cuprum a powerful pre-
ventive of cholera, 61.
Deafness a sequel of diph-
theria, 39.
Deal, diphtheria very fatal
at, in 1858, 28
Definition fdiphtheria, 39.
Diagnosis of diphtheria, 39.
Diagnosis absolute of diph-
(
theria, 49.
Diphtheria, history of, 24.
- Authorities, Alaymus,
25.
Aretceus, 24.
Bard, 25.
Bretonneau, 25.
Cartesius, 24.
Fothergill, 25.
Hippocrates, 24.
Villa Real, 24.
Diphtheria analogous to
other diseases, 45.
sim lar to other
diseases, 48.
most terrible and less
known than other dis-
eases, 22.
Diphtheria springing from
decomposed animal and
vegetable matter, 27.
a peculiar fungous
growth, 36.
Distinguishing characteris-
tics between diphtheria
and other diseases. viz. :
Scarlatina Maligna,
53.
Thrush (Apthæ), 55.
Croup. 57.
Dover, diphtheria very fatal
at, in 1858, 29.
Emphis's characteristics of
diphtheria and croup, 57.
Gangrene a sequel of
diphtheria, 38.
Hæmorrhage a sequelæ of
diphtheria, 38.
Ha' nemann's theory of ho-
mœopathy, 23.
Hepar Sulph., its thera-
peutic range, 65.
Hereditary tendency to
diphtheria, 62.
Heslop's, Dr., views on
diphtheria, 83.
History of iphtheria, 24.
Hydrochloric acid, mode of
using, 126.
best topical applica-
tion, 82.
Hygienic treatment, 59.
INDEX.
147
In Memoriam, 3.
Introduction, 17.
Iodine, therapeutic range
of, 75.
Jenner, Sir W., theory of
diphtheria, 40.
mortality
treatment, 40.
under his
Kali Bichromicum, its pa-
thogenetic effects
mouth, 73.
on
Lachesis, its pathogenetic
effects on throat, 65.
therapeutic range of,
73.
↓
Local appl cations-
ગ્રી
Trousseau, 78.
Greenh w, 78.
Emphis, 78.
Ranking, 78.
Perry, 79.
Ramskill, 79.
Ranking, 79.
Bleyel, 79.
Sydenham, 79.
Loss of voice a sequelae of
diphtheria, 39.
Malignant diphtheria treat-
ed successfully, 91.
Medicines, list of, 125-127.
Mercurius Biniodatus, the-
rapeutic rauge of, 65.
Mercurius Solubilis, thera-
peuti: range of, 65.
Mercurius, its pathogenetic
effects on mouth, 73.
Mode of using topical re-
medies in children, 64.
Otorrhoea a sequelæ of di¸h-
theria, 39.
Ozæna.a sequelæ of diph-
theria, 39.
Paralysis a sequelæ of
diphtheria, 39.
Permanganate of potas,
therapeutic range of. 86.
Plague springi gfrom Nile,
lower Egypt, 17.
Port wine, its uses, 87.
Preface, 5.
Premonitory symptoms of
diphtheria, 69.
Preventive local remedies,
63.
Prophylactic remedies for
diphtheria, 42.
Scarlatina, 42.
Measles, 42.
Cholera, 42.
Ague, 42.
Yellow fever, 42.
Syphilis, 42.
Report of St. George's
Hospital, 46.
Rheumatism a sequelæ of
diphtheria, 39.
148
INDEX.
Senega, therapeutic range
of, 76.
Sherry, when required, 87.
Spongia, therapeutic range
of, 74.
Spongiu-piline a substitute
for poultice, 85.
Squ nting a sequelæ of
diphtheria, 39.
Suffocation a cause of death
in diphtheria, 38.
Sul hur, therapeutic range
f, 75.
Supposed causes of diph-
theria, 26.
Symptoms of diphtheria-
Premonitory stage, 34.
Development, 38.
Decline, 38.
Sequelæ, 39.
ין
Tables of mortality, 43.
Temperature of room, 86.
Terebene, its therapeutic
and disinfecting range,
86.
Topical remedies, 77.
Authorities-
Trousseau Arg. -Nit.,
Acid. - Nit., Merc.,
Cup., Sulph., Hydr.
Acid, Alum., Merc.-
Cor., Pot. Chlorid.,
Sodium and Calcium,
78.
-
Bretonneau : Chiefly
Alum, and Calomel,
78.
Greenhow: Tr. Iron,
Borax, Alumn., and
Potas. -Chlorid, 78.
Emphis: Acid. - Hydr.,
Arg.-Nit., and Merc.-
Nit., 78.
Ranki g, Norw ch: Ac.-
Hydr., 78.
Ranking, America: Tr.
Ferri., P. t. - Chlor.,
Ac. -Hydr., 79.
Perry : Ol. - Tereb.,
Ammo.-Carb., 79.
Ramskill Chloride of
Lime, 79.
Bleyel Lime-water, 79.
Sydenham: Ac. -Sulph.,
79.
Typhus ani Typhoid
springing from bad sewer-
age, 27.
Uræmic poisoning, mode of
death, 38.
Water, copious dra ghts
of, in Turkish or hot-air
bath, 84.
Yellow fever springing 'rom
banks of Missisippi, 27.
LONDON: R. K. BURT AND CO., WINE OFFICE COURT, FLEET STREET.
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contains more practical matter than is to be found in much larger
works. The treatment is sensible and in accordance with so nd
pathological views."—Public Opinion.
"The man who makes a discovery in medicine that gives him
more power over disease is a benefactor to his species; and we have
no doubt Dr. Morgan's Ibours will be productive of substantial
benefit to many a constitution."-Catholic Times and Opinion,
Oct. 18, 1878.
:
6th Edition, Crown 8vo, 208 pp. Price 2s. 6d.
INDIGESTION, CONSTIPATION,
HÆMORRHOIDS, HYPOCHONDRIASIS, FISTULA,
PRURITUS ANI, &c.
Their Curability by Hydro-Homœopathy.
REVIEWS.
·
}
"This is a very sensible and well-written book on an important
subject; particularly teresting to those (unfortunately so numerous)
who habitually digest with difficulty. A perusal of this work wo d
give them some useful insight into the nature of their being, and the
conditions under which it may, humanly speaking, be maintained
with comfort.”—Bentley's Monthly Review,
"We congratulate Dr. Morgan upon the issue of a Sixth Edition
of his very useful work. Dr. Morg n's style of writing is always
clear and sensible, and thoroughly practical." Homeopathic
World.
"The Sixth Edition of any work scarcely requires a critical
notice, and the fact of a demand for such reissue stamps it with the
mark of public approbation."-Monthly Homeopathic Revierv.
"
We most conscientiously recommend the Sixth Edition of Dr.
Morgan's treatise on Stomach Derangements as a first-class work,
and in every way worthy of its eminent author."-The London
Second Circuit Advocate.
4
Other Works by the Author.
151
Crown 8vo, 264 pp. Price 38. 6d.
THE LIVER AND ITS DISEASES, FUNCTIONAL
AND ORGANIC.
Their History, Anatomy, Pathology, Physiology, and
Treatment by Hydro-Homoeopathy.
REVIEWS.
"This work, which treats on perhaps the most prolific source of
human suffering, will prove not a little interesting to the student and
practitioner. It is forcibly and earnestly written, and contains a
large amount of practical matter."-Brighton Fashionable Visitors'
List.
"This volume, in a pleasing, chatty style, gives an outline of the
functions of the liver, and of the pathology and treatment of those dis-
orders in which it is most prone. The book is interesting, and will
doubtless be found very useful in directing attention to the class of
remedies from which the practitioner has to select when prescrib-
ing."-Monthly Homœopathic Review.
Now ready, Fcap. 8vo, 160 pp. Price 2s. 6d.
PREGNANCY,
ITS SIGNS AND CONCOMITANT DERANGEMENTS,
With Instructions on the Selection of a Nurse, and the
Management of the Lying-in Chamber.
REVIEWS.
"A thoroughly practical book on a common subject, which gives
some plain and sound directions for ladies, that will, we hope, have
the effect of sending the 'intolerable monthly nurse' soon to the
right-about. A most elaborate table is annexed for the purpose of
ու
152
Other Works by the Author.
noticing accurately certain necessary calculations."-Public Opinion,
July,
1
"This book is dedicated in high-flown language to the Mothers of
England. It is associated with Homoeopathic Medication, an ex-
cellent system for pregnant women and children."-Chemist and
Druggist.
Now ready, Crown 8ve, 216 pp. Price 35. 6d.
Syphilis and Syphiloidal
Diseases.
Their History, Anatomy, Physiology, Pathology, and
Treatment, "Preventive" and "Curative."
WITH COMMENTS ON THE CONTAGIOUS DISEASES
ACTS.
REVIEWS.
"A well-written book on a difficult and delicate subject, in which
the author vindicates in a forcible and sound common-sense manner
the successful working of the Contagious Diseases Acts. The
method of treatment advocated is alike simple and sensible."-
Public Opinion, August 25, 1877.
LONDON:
THE HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, E. C.
Homeopathic Publications.
153
NOW READY.
NEW AND ENLARGED SERIES, VOL. XIII., 1878,
THE HOMEOPATHIC WORLD.
A JOURNAL FOR THE EXPOSITION OF THE LAW OF SIMILARS
AND ELUCIDATION OF ITS OPERATION.
INCLUDING MEDICAL NEWS AND
LITERATURE,
CASES FROM PRACTICE, SOCIAL AND SANITARY
SCIENCE, AND CORRESPONDENCE.
Elegantly bound, bevelled boards, gilt lettered, price 7s. 6d.
post free.
HOMEOPATHIC WORLD VOLUME FOR 1878.
SPECIALLY SUITABLE FOR PRESENTATION
TO LIBRARIES, READING-ROOMS, &c.
Monthly Parts, 6d.; by Post. 7d.; or prepaid, 6s. per annum,
post free monthly.
An idea of the Contents may be gathered from the
Index in the December number. Each volume fur-
nishes profitable reading, and will be found very useful
for reference.
THE YEARLY
VOLUMES
From 1866 to 1874, inclusive, well bound in cloth, gilt
lettered, price 5s. each, post free.
Covers for binding, for 1873 and 1874, and previous years,
price is. each.
Covers for 1875, 1876, 1877, and 1878, Is. 6d.
"A welcome addition to ordinary reading."-Public Opinion.
"We can recommend this Journal as the best our School ever
published."—New England Medical Gazette.
154
Homeopathic Publications.
HOMEOPATHIC WORLD.
"Fills a void in homeopathic literature.
The cheapest
jour al published.
Filled with well-written articles.”—
Boericke and lafel's Quarterly Bulletin.
..
Ranks much higher than any other popular homeopathic
journal.”—American Homœopathic Observer.
"This jurnal has been established twelve years, and has re-
ceived contributions from some of the best writers in the School.
This, and the two preceding journals, have very faithfully repre-
sented the profession in England, and upon the establishment of a
School of Homoeopathy in London, as proposed, will have addi-
tional opportunities to disseminate the teachings and illustrate the
practice of our system of cure."-Ohio Medical and Surgical
Reporter, January, 1877.
HOMEOPATHIC MISSIONARY TRACTS.
I.-Fallacies and Claims. Being a Word to the World on
Homœopathy. Fifth Edition.)
<<
"It is the clearest and most comprehensive little treatise we have
in our literature."-Dr. Hering
Fourth Edition, revised.
II.-Ministers and Medicine. An Appeal to Christian Ministers
on the subject of Homeopathy. By Rev. THOMAS SIMS, M.A.,
Author of "Letters on the Sacred Writings," &c.
III.- Principles, Practice, and Progress of Homœopathy.
(Fourth Edition.)
IV.-The Practical Test of Homœopathy; or, Cases of Cure
by Homeopathic Remedies, in the Practice of various Physicians.
V.-Measles: its Complications and Fatality prevented by
Homœopathy. Being contributions from more than twenty
medical men. (Second Edition.)
VI.-Homœopathy Explained; a Word to the Medical Pro-
fession. By Dr. JOHN WILDE.
VII.-Constipation: its Origin and Homœopathic Treat-
ment; and on the use of Enemata. By Dr. JOHN WIlde.
VIII-Scarlet Fever: being an attempt to point out how the
ravages of this very fatal disease may be limited. By Dr. JOHN
MAFFEY.
The above Tracts are published at One Penny each, or for En-
closure in Letters, &c., post free, 25 copies for 15 stamps; 50 for 26
stamps; 100 for 48 stamps.
List of British and Foreign Homeopathic Medical Books
on application.
LONDON: HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, E.C.
Homeopathic Publications.
NOW READY.
Seventh edition, 36th Thousand, thoroughly revised and improved,
with new Sections, toned paper, handsomely bound in patent
morocco, bevelled boards, burnished edges, price 5s. Cheap
edition, in cloth, 3s. 6d.
THE LADY'S MANUAL
OF HOMEOPATHIC
155
TREATMENT IN THE
VARIOUS DERANGEMENTS INCIDENT
TO HER SEX.
BY DR. RUDDOCK.
"Written in clear language.
Women's diseases are here
treated as clearly as the most exacting student could require."—
Chemist and Druggist.
"The work of Dr. Ruddock is precisely what every woman needs,
and contains information for the want of which she often suffers
permanent loss of health. The whole range of functions and
diseases incident to women is treated with care and precision.”—
New England Medical Gazette.
"We do not hestitate to say that The Lady's Homeopathic
Manual' is the best book of its kind we ever examined. The author
knows what to say, how to say it, and how to stop when it is said."
United States Medical and Surgical Journal.
"The Lady's Manual' is a work that should be in the hands of
every lady in the land. The remedies prescribed are mainly homœo-
pathic and hydropathic, and are extremely judicious.
We never
examined a medical work which pleased us so well."-Western
Rural.
"
P
The fact that this is the 'Seventh Edition' shows the estimate
placed upon it by the public; and the estimate is a just one, for the
work is in every respect meritorious. As a book to be placed in
the hands of married women it stands unrivalled, and yet it is full
of just such information as the general practitioner should possess,
and will here find easily and quickly. We have, seen nothing of
the kind that pleases us so well.” --Cincinnati Medical Advance.
In one handsome volume. Third edition, half-bound,
with full Index, price 32s.
CLINICAL LECTURES ON THE
DISEASES OF WOMEN.
BY R. LUDLAM, M.D.
"Each_reader will surely find every page filled with carefully
reported facts and observations, satisfactory and intelligible to the
men who have seen much, and instructive as well as suggestive to
all who earnestly desire to see and know more."-American Journal
of Homeopathy.
156
Homeopathic Publications.
There is a great charm in the author's style and method of
elucidating his topics, which involve many moot points in diagnosis
and pathology; while the treatment adopted includes the medical,
hygienic, dietetic, and mechanical, providing for all the exigencies
of each case.”—The Homœopathic World.
<<
THE DISEASES OF INFANTS AND
CHILDREN,
AND THEIR HOMEOPATHIC AND
GENERAL TREATMENT.
By E. H. RUDDOCK, M.D., L. R.C.P., M R.C.S., L.M.
(Lond. and Edin ), &c. 15th Thousand, 12mo,
pp. 228, 35. 6d.
"A very valuable contribution to the pathology and therapy of
the diseases of children It contains for physicians much interesting
matter, and also not a little that is new."-Allgemeine Homep
Zeitung.
**
Admirable hints on the general management of children,
hygienic and medical prescriptions being intended for preventive as
well as for curative treatment."-Public Opinion.
"The Doctor traverses the entire domain of therapeutics."
Daily Review.
"Full of familiar notes on disease, and of simple remedies and
expedients. Written in a popular and pleasing style, and its
arrangement is creditable and convenient. An improvement over
other works of its kind in its excellent remarks on the differential
diagnosis between diseases which are so rearly alike as not only to
puzzle the lay practitioner, but oftentimes the doctor also."-United
States Medical and Surgical Journal.
"A great accession of practical knowledge relative to the diet
and general treatment of the young, which is really available for
use."-Ladies' Own Journal and Miscellany
"This book is another of the series of pleasing, practical, and
valuable domestic treatises which have done so much to spread a
knowledge and increase the popularity of homoeopathy in England,
and have made Dr. Ruddock famous.
"It is a work worthy of commendation; for while written in
plain language so that all may understand its teachings, it preserves
a sound pathology and diagnosis throughout, and its treatment,
which embraces the new remedies 'as well as the old, is in accord
with the experience of most practitioners, and is thoroughly safe.
<
Ci
This volume is in keeping with the handsome style in which
other volumes by the same prolific author have been presented."-
Hahnemannian Monthly.
HOMEOPATHIC PUBLISHING COMPANY,
2, FINSBURY CIRCUS, E.C.
Filmed by Preservation 1991
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