40 The Philippine Journal of Science 1920 
two cases studied there were seventeen whose pulse rate aver- 
aged 130 per minute or higher. This tachycardia seems to 
bear relation to the prognosis; among the seventeen cases of 
rapid pulse rate there were eleven with 130 per minute, four, 
or 36.3 per cent, of whom died ; five cases with 140, three, or 60 
per cent, of whom died; and one case with 150, that proved 
fatal. The above concurs with the studies of Hibbard and Bur- 
rows (3) as to the importance of the pulse rate in regard to the 
prognosis. 
The respiration ranges between 22 and 28 per minute, a 
rate of 30 or above usually indicating danger. 
The disease lasts on an average from five to nine days, de- 
pending to some extent on the promptness of the administration 
of antitoxin and the presence of complications. In our study 
there were twelve cases in which the disease lasted from ten 
to twenty days and one case that lasted fifty-two days. 
The disease was frequently complicated with bronchopneu- 
monia and albuminuria. Our data regarding post-diphtheritic 
paralysis are rather meager. Dr. Victor Sevilla, a throat and 
nose specialist, told us in a personal conversation of two cases 
that had come under his observation in which paralysis of the 
soft palate had occurred as a sequel to diphtheria. In the Phil- 
ippine General Hospital there is a record of one case, in the 
service of Dr. Jose Albert, some of the symptoms of which 
might have been brought about by a previous attack of diph- 
theria. The patient was a Filipino child, female, 3 years old, 
admitted to the hospital on April 9, 1919. A diagnosis of 
diphtheria was made and the child was transferred imme- 
diately to San Lazaro Hospital where the diagnosis was con- 
firmed. The patient was discharged as cured on April 16, 1919. 
On May 27, 1919, she was again admitted to the Philippine 
General Hospital suffering from aphonia, strabismus, paralysis 
of the muscles of the neck, paresis of the lower extremities, 
bronchopneumonia, and acute dilatation of the heart. She died 
the next day, May 28; no autopsy was made. 
Among the sixty-two cases here studied, there was one case 
of nasal diphtheria; the patient was a Filipino male child, 2 
years old, and was sent to the hospital by Doctor Sevilla. This 
case showed the following interesting points: The child was 
sick forty-four days previous to admission and eight days in 
the hospital; there was beginning paralysis of the soft palate; 
the temperature, at least while the child was in the hospital, 
was practically normal, except one day when it rose to 37.4° C. 
