8 
The first monograph on post-diphtheritic paralysis was by Main- 
gault, of Paris, in 1854, which appeared as an inaugural thesis entitled 
“De la paralysie du voile du palais a la suite d’angine.” Maingault’s 
more important work, ^^Sur les paralysies diphteritiques,” appeared in 
1860. Between 1854 and 1860 several isolated cases of diphtheritic 
palsies had been described by observers, especially by Trousseau, who 
by tliis time had collected 90 cases, 29 of which were in children, with 
a mortality of 12. 
The first histological investigations as to the nature of diphtheritic 
paralysis were made by Charcot and Vulpian® in the case of a woman 
who had died with palatal paralysis. They showed that the motor 
nerves alone were affected, and consisted of tubules entirely devoid 
of medullary substance. The neurilemma contained numerous 
granular cells, mostly elliptical in shape and in some cases nucleated. 
A few of the muscle fibers were fatty. The sensory nerves showed no 
signs of alteration. 
In 1883 Klebs ^ found ver}" peculiar and striking bacteria constantly 
present in the pseudo-membranes in the throats of those dying of true 
epidemic diphtheria. The next year Lofiler^ isolated these organ- 
isms in pure culture and produced more or less characteristic pseudo- 
membranes by inoculating the cultures upon the mucous membranes 
of susceptible animals, frequently causing characteristic lesions with 
death. 
In 1888 Koux and Yersin^ published their notable ‘Contribu- 
tions to the study of diphtheria.” They were the first to prove that 
paralysis is a common sequel in the lower animals after recover}^ 
from experimental diphtheria. They observed the palsies in pigeons 
and rabbits following pharyngeal and tracheal inoculation. ‘ They 
also observed the same sequel in rabbits recovering from intrave- 
nous inoculations. Roux and Yersin concluded that the existence 
of these palsies following the inoculation of the Klebs-Loffier bacillus 
completes the resemblance between the experimental and the nat- 
ural disease and establishes the specific role of this bacillus. 
The introduction of the antitoxin treatment in 1894, followed by 
an increase in the number of palsies observed, has led to the publica- 
tion of several monographs and experimental work dealing with the 
subject. 
“Comp. rend. Soc. bioL, 1862. 
& Klebs: Congres de Wiesbaden, 1883. Arch. f. exper. Path., I and IX. Also, 
“ Verhandlungen des Congresses fiir innere Med.,” 1883. 
cLoffler: Untersuchiingen iiber die Bedeutiing der Mikroorganismen fiir die Ent- 
stehung der Diphtherie biem Menschen. Mitt. a. d. kais. Gesundheitsamte, Bd. 2, 
1884. 
Roux, E., and A'ersin, A.: Contribution a I’etude de la diphterie. Ann. de I’lnst. 
Pasteur, vol. 2, 1888, p. 629. 
