CHAPTER XV. 

 DIPHTHERIA. 



THERE is no better example of the valuable contributions 

 of bacteriology to scientific medicine than that afforded in 

 the case of diphtheria. Not only has research supplied, 

 as in the case of tubercle, a means of distinguishing true 

 diphtheria from conditions which resemble it, but the study 

 of the toxines of the bacillus has explained the manner by 

 which the pathological changes and characteristic symptoms 

 of the disease are brought about, and has led to the dis- 

 covery of the most efficient means of treatment, namely, 

 the anti-diphtheritic serum. 



Historical. As in the case of many other diseases, various organisms 

 which have no causal relation to the disease were formerly described in the 

 false membrane. The first account of the bacillus now known to be the 

 cause of diphtheria was given by Klebs in 1883, who described its charac- 

 ters in the false membrane, but made no cultivations. It was first culti- 

 vated by Loftier from a number of cases of diphtheria, his observations 

 being published in 1884, and to him we owe the first account of its 

 characters in cultures and of some of its pathogenic effects on animals. 

 The organism is for these reasons known as the Klebs-Loflfler bacillus, 

 or simply as Loffler's bacillus. By experimental inoculation with the 

 cultures obtained, Loftier was able to produce false membrane on damaged 

 mucous surfaces, but he hesitated to conclude definitely that this organ- 

 ism was the cause of the disease, for he did not find it in all the cases 

 of diphtheria examined, he was not able to produce paralytic pheno- 

 mena in animals by its injection, and, further, he obtained the same 

 organism from the throat of a healthy child. This organism became 

 the subject of much inquiry, but its relationship to the disease may be 



23 



