CHAPTER VIII 



DIPHTHERIA * 



Diphtheria in England - - The Diphtheria Bacillus The 

 Pseudo -Diphtheria Bacillus Clinical Diagnosis The Xerosis 

 Bacillus Diphtheritic Affections of Birds and Animals. 



DIPHTHERIA seems to have been known from the 

 earliest ages, being recognised by the classical (medical) 

 writers, and it was epidemic in England and on the 

 Continent during the Middle Ages. Bretonneau 2 experi- 

 enced an outbreak at Tours, 1818-1821, and gave to the 

 disease the name " Diphterite " (afterwards changed to 

 " Diphterie ") from the formation of membranes which is 

 so marked a feature in it. In England the diphtheria 

 deaths have only been separately scheduled since 1855. 

 Since 1881 until recently there has been a steady increase 

 in the prevalence of diphtheria, particularly in the large 

 towns, but latterly the prevalence seems to be decreasing. 



As regards croup, it is universally admitted that the 

 vast majority of cases of membranous croup are cases of 

 diphtheria. 



Diphtheria is distinctly a disease of the young, espe- 

 cially at the ages from two to ten, and this holds good 

 both for London and for England and Wales. The 

 disease occurs in all grades of severity, from the classical 

 ones with wash-leather-like membrane and great prostra- 

 tion to those which present a mild tonsilitis or angina. 



1 See The Bacteriology of Diphtheria, Cambridge University Press, 1908. 



2 See Memoirs on Diphtheria, New Sydenham Soc., 1859. 



