DIPHTHERIA 119 



tion, while infection of the conjunctiva (membrane 

 of the eye), and the mucous membranes of the genital 

 organs is not uncommon. 



Diphtheria is a typical toxaemia; the bacillus is 

 almost never found anywhere outside of the point of 

 infection, which shows a false membrane accom- 

 panied by necrosis of the tissues beneath it and a 

 profuse exudate, while the general symptoms indi- 

 cate grave lesions of the heart, the nervous system, 

 and the kidneys. 



Fatty degeneration of the heart and nervous system 

 causes the extreme weakness and prostration so 

 frequently observed in diphtheria, as well as the 

 attacks of paralysis following. The gravity of a 

 diphtheritic infection cannot be measured by the ex- 

 tent of the false membrane, as many fatal results 

 follow apparently mild cases, showing that a small 

 amount of toxin may do fatal damage to vital organs. 

 McCollom says, "A patch of membrane the size of a 

 thumb-nail on the tonsil may generate sufficient 

 toxin to cause death." 



In most instances the Bacillus diphtheria is not 

 alone in causing an infection, but is associated with 

 the pyogenic organisms, the streptococcus pyogenes 

 occurring oftenest, the staphylococcus and pneumo- 

 coccus being found occasionally. 



