Medical report on Diphtheria cases




75

from the body, and carefully laid open, displayed as follows:—Tongue considered loaded with a dark brown fur—the pharynx in its entirety, even to the rim of the glottis, but no involvement further of the air passages—exhibited a very deep blush of low unhealthy colored inflammation, but unattended by the slightest abrasion of the mucous covering, and without even a speck remaining of the supposed leathery-like membrane, which prevailed in the first and progressive stages of the disease. The upper portion of the œsophagus, to the extent of a couple of inches, had an unusually rough and reddish aspect in various patches of its circumference, but the space therefrom downwards, to about three inches of its gastric termination, there was no remarkable deviation from the usual healthy state. But these three inches indicated a great degree of morbid inflammation; and, moreover, had somewhat the aspect, here and there, of being stained, or dyed with inky-colored fluid; yet the inner coat of this, though somewhat thickened, was neither pulpy to the touch, nor loosened from its tissues. The stomach, as it lay in situ, was considerably collapsed, but of natural appearance, though to the touch rather flaccid. When opened, not much over an ounce of a dark-colored fluid was found—probably an admixture of port, with the altered gastric secretion, as shortly before death she had taken a small quantity of that wine. The cardiac portion, and beyond that to within little more than an inch of the pyloris, the villous coat had lost its rugosity, was greatly softer to the touch than natural, and was dotted over with dark, adherent, olive-colored spots, varying in size from a half-inch diameter to that of a pin's head. One portion of the tissue was quite gone, say about the size of a sixpence, and that immediately below the cardiac opening. In most parts the attachment of this membrane to the muscular coat was so slight that it could be removed easily therefrom by light friction of the finger and thumb. But the whole of the coat, except-ing the said small circumference around the pyloris, was thickened, and to the touch pulpy, while that pyloric portion appeared and felt to be quite in a normal, healthy condition. Hence, as there was not the slightest abrasion of the investing mucous membrane of the pharyngeal apparatus, it is a fair inference that the stomach was the primary and chief seat of the disease.

No. 2.

      • Brother of No. 1, aged ten years; complained first on the night of the 10th of July (after exposure, for an hour or two, to a cold rainy night) of some pain of throat, which, on the succeeding morning, exhibited apparent ulceration of the tonsils, and was, by account, treated accordingly; but died, with the usual symptoms of diphtheria, on the eighth day.

The body was opened twenty-four hours after death. The viscera of the thorax and abdomen seemed in normal state; but on removing the tongue, pharynx, œsophagus, and stomach, and opening and examining these, the following morbid appearances were observed:—Tongue not much, but somewhat covered with a dark fur—the entire pharynx more or less covered, with cream-colored lymph matter of toughish consistence, and, in some parts, about a line or more in thickness. This had no firm adhesion to the subjacent soft parts; and though there was no actual abrasion of the natural mucous membrane, that of the tonsils, and the surface of these also, were so indented as on first inspection to look like small irregular clean ulcers. The air passages were in a natural healthy state, though the pharyngeal inflammation extended to and involved the rima glottidis. The œsophagus exhibited a few patches of inflammation of the mucous membrane, particularly at and about its gastric termination. In other respects it was in usual integrity. The stomach was somewhat distended with flatus, and contained also a few ounces of a dark-colored fluid. The villous membrane had lost its rugæ, and was dotted here and there by inflamed arborescent spots, felt thicker than in healthy state, and soft and pulpy, and in the vicinity of the cardiac opening, a space about half the size of that in the sister's case was, as in that instance, altogether gone. The whole of the coat, excepting a portion around the pyloris, which seemed to be quite in the normal state of connection with the muscular tissue, all was so loosely attached thereto as readily to peel off, but in broken strips, thereby indicating that the membrane itself was disintegrated. The intestines and other viscera, as also their investing membranes, exhibited no departure from the healthy state.

No. 3.

      • Aged seven years. A case not at all of slow or insidious approach, as in the two previous instances, but symptoms, by account, ran high from the first. On opening the thorax and abdomen, nine or ten hours after death, the lungs, and, except the larynx which was inflamed, the air passages, heart, and investing membranes were found in hale integrity; the liver, spleen, pancreas,


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PDF PDF Nelson Provincial Gazette 1861, No 14





✨ LLM interpretation of page content

🏥 Publication of a report on Diphtheria by the Colonial Surgeon of Taranaki (continued from previous page)

🏥 Health & Social Welfare
13 September 1861
Diphtheria, Colonial Surgeon, Taranaki, Public Health, Medical Report, Autopsy

🏥 Case report No. 2: Diphtheria autopsy of a ten-year-old male

🏥 Health & Social Welfare
Diphtheria, Autopsy, Medical Report, Pathology, Taranaki

🏥 Case report No. 3: Diphtheria autopsy of a seven-year-old child

🏥 Health & Social Welfare
Diphtheria, Autopsy, Medical Report, Pathology, Taranaki