CHAPTER XXII 



DIPHTHERIA 



History. Under various names this disease is described in the 

 most ancient medical records. Competent authority states that a 

 disease mentioned in the Babylonian Talmud must have been diph- 

 theria. The Greeks held that it came to them from Egypt, to which 

 country they were wont to ascribe most of their ills. The descriptions 

 of Aretaeus are regarded as accurate records of this disease. Galen 

 spoke of false membranes in the larynx and pharynx and said that the 

 former were sometimes removed by coughing, and the latter by hawk- 

 ing. During the dark ages diphtheria was recognized here and there 

 and undoubtedly added much to the high death-rate of that period. 

 During the sixteenth century it was reported from time to time in 

 malignant epidemic form in Spain, France, Holland and Germany. 

 The unusual mortality in Spain in 1613 gave to this year the name of 

 the disease. In the same country and in the same century, Heredia 

 recognized the asthenic and suffocative types and wrote concerning 

 diphtheria paralysis. Before the middle of the seventeenth century 

 it had found its way into the American colonies and we are told that in 

 the year 1659 Samuel Danforth lost four of his eleven children of "a 

 malady of the bladders in the windpipe." As early as 1761, an Ameri- 

 can physician, Bard, made important contributions to the study of the 

 disease and held that croup is laryngeal diphtheria. However, we owe 

 the beginnings of the modern study of this disease, also its present 

 name, to Bretonneau. He traced an outbreak in a garrison at Tours 

 to common drinking-cups and other table utensils, and demonstrated 

 the infectiousness of the disease. He claimed that croup is laryngeal 

 diphtheria and that the angina of scarlet fever is quite distinct. These 

 views were accepted and emphasized by the great clinician, Trousseau, 

 and were adopted by the profession in France and America, but were 

 ignored in Germany until the development of bacteriology rendered 

 their demonstration possible. 



