DIPHTHERIA. 405 



their nuclei is scattered about in granular form. Similar 

 necrotic foci, to which attention was first called by Oertel, 

 are present in nearly all the organs in cases of death from 

 the toxin. The bacilli are constantly absent from these 

 lesions. Welch and Flexner ' have shown these foci to 

 be common to numerous irritant poisonings, and not 

 peculiar to diphtheria. 



The lymphatic glands are usually enlarged ; the adrenals 

 are also enlarged, and, in cases into which the live bacilli 

 have been injected, are hemorrhagic. 



It might be argued, from the different clinical pictures 

 presented by the disease as it occurs in man and in 

 animals, that they were not expressions of the same 

 thing. A careful study, however, together with the evi- 

 dences adduced by Roux and Yersin, who found that 

 when the bacilli were introduced into the trachea of 

 animals opened by operation a typical false membrane 

 was produced, and that diphtheritic palsy often followed, 

 and of hundreds of investigators, who find the bacilli 

 constantly present in the disease as it occurs in man, 

 must satisfy us that the doubt of the etiological role of 

 the bacillus rests on a very slight foundation. 



All possible skepticism of the specificity of the bacillus 

 on my part was dispelled by an accidental infection that 

 kept me housed for three weeks during the busiest season 

 of the year. Without having been exposed to any known 

 diphtheria contagion, while experimenting in the labora- 

 tory, a living virulent culture of the diphtheria bacillus 

 was drawn into a pipette and accidentally entered my 

 mouth. Through carelessness no precautions were taken 

 to prevent serious consequences, and as a result of the 

 accident, two days later, my throat was full of typical 

 pseudomembrane which private and Health Board bac- 

 teriological examinations showed contained pure cultures 

 of the Klebs-Loffler bacilli. 



One reason for skepticism in this particular is the 

 supposed existence of a pseudodiphtheria bacillus, which 



1 Bull, of the Johns Hopkins Hospital, Aug., 1891. 



