108 THE ACUTE SELF-LIMITED INFECTIONS 



only their toxins are absorbed and are responsible 

 for the clinical symptoms of the illness, such as mod- 

 erate fever with rapid pulse and great prostration. 

 They are also responsible for the paralyses which 

 frequently follow an attack, such as heart weakness 

 or laryngeal failure. 



Diphtheria is contracted by receiving, on a suscep- 

 tible surface, some of the bacteria themselves. They 

 usually come from an active case. However, after 

 recovery from the attack, at a time when no symptoms 

 exist, fully virulent bacteria may remain in the throat 

 for many days. People with such a condition are 

 called "carriers" and strict hygienic measures are 

 being taken now by all health authorities to prevent 

 spread of the disease by such means. Coughing or 

 sneezing dislodges particles containing diphtheria 

 bacilli, and spreads the disease. Infection has been 

 known to travel by milk, where the dairyman had 

 a case on his farm. The milk had become infected 

 by those handling it. Nurses and doctors contract 

 the disease frequently by their close association with 

 the patient. They can protect themselves while inspect- 

 ing a throat by placing a piece of glass before the 

 patient's mouth so that if he cough the organisms will 

 not get into the examiner's face. The absolute isolation 

 of patient and nurse is now demanded by health 

 authorities. 



All materials that can be so treated should be 

 burned. Utensils and fabrics should be soaked in 

 carbolic acid solution and then boiled. Great care 

 must be used by the nurse with her hands, face, nose, 

 throat, hair, and clothes. The lodgement of diph- 



