Diphtheritis or the membranous disease, commonly called membranous croup, as it appears in Roxbury and the vicinity of Boston / by B. E. Cotting ; reprinted from the Proceedings of the Boston Society for Medical Improvement.

  • Cotting, Benjamin Eddy, 1812-1897.
Date:
1859
Catalogue details

Licence: Public Domain Mark

Credit: Diphtheritis or the membranous disease, commonly called membranous croup, as it appears in Roxbury and the vicinity of Boston / by B. E. Cotting ; reprinted from the Proceedings of the Boston Society for Medical Improvement. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    vesicular murmur is totally absent in the hums, when the pulse becomes frequent and small, when a sort of quietude succeeds to efforts of the most violent character, when, in fine, an indescriba- ble expression of countenance gives unmistakable signs of ap- proaching dissolution.* Tracheotomy having been decided upon and performed, the after treatment devised and recommended by Trousseaut and his con- freres in Paris, and improved upon by Dr. George H. GayJ and other members of the Boston Society for Medical Improvement, should be followed, and adapted to the exigencies of each particu- lar case. The introduction of calomel, caustics, and other agents through the wound, though suggested and advised by some high authorities, needs further trial and proof to warrant acceptation. In estimating the probability of recovery in any single case, there are many things to be considered. In infants, the disease, occupy- ing perhaps only the posterior nares or the pharynx, may be of little moment. In children, the constitutional symptoms may be a greater source of danger than the membrane. The location of the membrane may endanger life by suffocation, although the ex- tent of surface attacked may be very small. The amount of sur- face involved may be such as to destroy life even after the whole of the membrane has been spontaneously thrown off. Again, the membrane may be of such amount and in such position as to cause so great an obstruction to free respiration (though short of suffo- cation) that the excessive exertions in breathing, continuing through several days and nights without remission or the possi- bility of the least rest, may exhaust all the vital power. This is not an infrequent termination. The patient dies like an over- tasked animal, and there is reason for believing that a change takes place in the arteries, not unlike that when an animal is dri- ven to death. As it is very difficult if not impossible to ascertain very accurately the actual condition and extent of the parts in- * Trousseau, Rapport, Nov. 2, 1858, p. 25, 1. 18 &.c. t A canula of a diameler superior lo that of the glottis ; a doable-tubed canula ; a neck-cloth of good, thick materials, obliging the patient to inhale the air from around the jaws and not a mere piece of murimj a warm temperature, and a proper moisture of the air; cauterization of the lips of the wound ; lastly, supporting the patient by food, &c.-Trous.seau op cit p 58 t See published Records and Papers of the Boston Society for Medical Improvement' 1858 Q in Boston Medical and Surgical Journal, Vol. LIX., pp. 413, 417) 509. ,,nProve™nt, 1858-9, ,n