240 THE TREATMENT OF DISEASES. 



should be made into the muscles every second day, or even daily. This, of course, 

 is a method of treatment which could be practised only under the immediate 

 superintendence of a medical man. 



It must be distinctly understood that the remarks we have made concerning the 

 treatment of diphtheria are for those only who are unable to obtain personal medical 

 advice. There are many different methods of treating this disease ; and if the plan 

 adopted by the doctor in attendance is at variance with the directions we have laid 

 down, it should be remembered that one who has had the opportunity of seeing and 

 examining the patient is likely to prescribe better for him than one who has not. 



Sometimes the amount of obstruction caused by the membrane in the throat is 

 so great that the windpipe has to be opened to admit air and prevent the patient 

 from dying of suffocation. The operation, which is technically known as " tracheo- 

 tomy," was performed by Trousseau in more than two hundred cases, and of these a 

 quarter recovered. An eminent authority thus describes an instance in which tra- 

 cheotomy was performed on the person of a physician ill with diphtheria : "There 

 is not a shadow of doubt," he says, " on my mind that he would have been dead in 

 two minutes had his larynx not been opened at the moment it was. I never saw 

 any one so manifestly brought back from the threshold of death. His complexion 

 had the bluish pallor that precedes immediate dissolution. My hand was on his 

 wrist. I felt his pulse failing under my finger, until at last it was imperceptible. 

 His eyes closed, and his diaphragm was making those convulsive contractions which 

 indicate that respiration is about to cease, when the knife entered the larynx, and air 

 was drawn, by what really seemed the last effort of the diaphragm, into the lungs. 

 The natural hue of his face returned ; his pulse was again perceptible ; his eyes 

 opened ; consciousness was restored, and the patient was alive again. He finally 

 recovered. Now, a thousand failures of the operation in saving life cannot, after 

 seeing this case, prove to me that tracheotomy ought not to be performed when 

 suffocation is imminent from the presence of lymph in the larynx or trachea ; for 

 here is a man whose life was invaluable to his family and most useful to society 

 restored to health, who, but for the operation, would have been dead." 



When the softer parts of the chest recede whilst a breath is being taken, or the 

 patient looks ever so slightly blue or livid, it is to be regarded as an indication that 

 there is some obstruction to the free entrance of air into the lungs, and the doctor, if 

 not present, should be at once sent for. 



At the conclusion of a case of diphtheria, whether it terminate favourably 

 or unfavourably, the room in which the patient has slept should be thoroughly 

 disinfected. 



DROPSY. 



Dropsy is regarded by medical men rather as a symptom of disease than as a 

 disease itself. It consists essentially in the accumulation of fluid, either beneath the 

 skin or in one or more of the large cavities of the body. It is known by different 

 names, according to the situation in which it is found. Thus, when the brain 

 becomes distended with fluid, as it does sometimes in children, we call it " hydro- 

 cephalus," and the patient is said to have water on the brain, or to be " hydrocephalic." 



