LARYNGEAL DIPHTHERIA, Formerly Called Membranous Croup

Categories: Infectious Diseases

Diphtheria in
the larynx may occur alone or with the pharyngeal kind, and was formerly

called "Membranous Croup." After several days of hoarseness and coughing

the breathing suddenly becomes hard, generally at night, and it is at

first in paroxysms, but later it is constant. The space above the breast

bone (sternum) is depressed and there is a drawing in of the spaces

between the ribs during inspiration accompanied with a hus y voice and

blue look. The fever is slight. If the obstruction in the larynx is severe

the cyanosis,--blueness,--and difficulty of breathing increase, and

gradual suffocation leads to (coma) deep sleep and death.



Diagnosis. Diagnosis can only be made certain by proper chemical tests.

The presence of membrane on a tonsil and a small patch streak, or speck of

membrane, on the adjacent surface of the uvula or tip of the uvula; a

patch of membrane on the tonsil and an accompanying patch on the posterior

wall of the pharynx; the presence of a croupy cough and harsh breathing

with small patches of membrane on the tonsil or epiglottis. These symptoms

are very suspicious and warrant separation of the patient. If such

conditions are seen in any one, it will be the part of prudence to send

for your doctor immediately. You give the patient a better chance by

sending early, protect yourselves and also your neighbors.



Recovery. Chances in mild cases are good. Antitoxin has brought the death

rate down from forty to twelve per cent. Death may occur from sudden heart

failure, obstruction in the pharynx, severe infection, complications or

paralysis.



MOTHERS' REMEDIES. Diphtheria is such a dangerous disease and so rapidly

fatal that the family physician should be promptly called. Until he

arrives the following may be used to give some relief:



2. Diphtheria, Kerosene Good for. "Kerosene oil applied to the throat of

child or adult is very good."



3. Diphtheria, Hops and Hot Water Relieves. "Make two flannel bags and

fill with hops which have been moistened with hot water; place bags in a

steamer and heat. Keep one bag hot and the other around the throat. Change

often, relief in short time." Mrs. Shaw has tried this in a case of

diphtheria and other throat trouble and recommends it as an excellent

remedy.







PHYSICIANS' TREATMENT for Diphtheria. Prevention. The patient should be

isolated as soon as the spots or membrane are seen. Other children who

have been with the sick one should at once be given "immunizing" doses of

antitoxin, and the furniture of the sick room such as hangings, carpets.

rugs, etc., should be removed and disinfected, only the necessary articles

being kept in the room. The room should be kept well ventilated, but no

draught should get to the patient. The one nursing the patient should not

come near the other members of the family. All articles of clothing worn

by the patient should be dipped in a 1 to 2000 solution of corrosive

sublimate before they are removed from the sick room. (Other solutions may

be used; see Nursing Department). Dishes, etc., should be treated in the

same way and foods left over should be put in a vessel containing an

antiseptic solution, and then burned. Everyone going into the sick room

should cover their head with a cap and wear a robe-covering over their

clothes, and on leaving the room should gargle or rinse their mouth with a

solution of boric acid, about one or two teaspoonfuls to a glass of water,

The infant should not be nursed at the breast lest the breast become

infected; the milk should be pumped out and fed to the infant with a

bottle. If the infant has diarrhea milk must be stopped, the bowels

irrigated, and no milk given until all danger from this source is past.

The nurse must be careful of the discharges from the nose, mouth and

bowels. Discharges from the bowels and the urine must be received in a

vessel with an antiseptic solution in it like copperas, lime, etc. Cloths

used to receive the discharge from the nose and mouth should be thrown in

a vessel containing a solution of 1 to 2000 of corrosive sublimate and

then burned. The nurse should wear a gauze protection over her nose and

mouth when she is near the patient, and glasses, so that no sputum or

discharge from the patient can enter these organs. When the nurse leaves

the sick room for a rest or walk, she should change her clothes in an

unused room and put them where they can air, wash her hands, face and hair

in an antiseptic solution. Great care must be taken by the nurse, or she

will carry the disease. The doctor also must take the same care.



PHYSICIANS' MEDICAL TREATMENT. Antitoxin is the best. 1/100 grain of

corrosive sublimate or more according to age is frequently given in the

severe cases and is beneficial.



Local Treatment. In older persons, inhaling steam may benefit. Gargling

the throat or spraying the nose and throat is cleansing and helpful; but

in children it is sometimes hard to do this, for they may struggle and

thus injure and weaken themselves more than they can be benefited by the

spraying or gargling. Swab the throat if you can with solution of

corrosive sublimate, 1 to 1000. Peroxide of hydrogen, one-sixth to one-

half to full strength, is good in many cases, used as a gargle and a swab.

Wash out the nose with a normal salt solution. One dram to a pint of

water. The persons doing this must take great care or the patient will

cough and the discharge will go over them.



When in the Larynx. Steam inhalations without or with medicine in them

and the application of cold or hot to the neck are good. Compound tincture

of benzoin is good to use in the water for steaming; one-half to one

tablespoonful to a quart of water. A tent can be made by putting a sheet

over the four posts of the bed and steam vapor introduced under this

covering.



Diet. The main food is milk, albumin water, broths, eggs given every two

hours. Some doctors give stimulants with the food.







Cautions. Members of the family have no idea how much they can aid the

physician in this terrible disease. Pay particular attention to the

directions the doctor gives you, if you are doing the nursing, watch so

that you may detect any bad symptom, and immediately inform the physician.

A harsh cough with increased difficulty in breathing may mean that the

disease has extended to the larynx. If such symptoms are first noticed in

the physician's absence, he should be sent for at once so he can treat it

properly at the start. If the kidneys do not act properly he should be

informed. One may take nephritis in diphtheria also. I was called one

morning at 3 a. m., to see a case I was attending; she seemed to the

parents to be worse; she was, but today she is living, and I believe her

life was really saved by her parents. I would rather a loving mother and

father nurse a case any time than a selfish, lazy professional nurse. Good

nurses are a blessing; selfish ones are a curse; I have met both kinds.

After an attack of this disease the patient is left "weak" in many organs.

He should be careful, not only of taking cold, but of over-doing. The

heart and nervous system in some cases have been terribly wrecked. Take

life easy for some time, for you may be thankful that you are alive.