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3.° Neither is the occurrence of an attack of diphtheria a protection against
scarlet fever. The following instance is an illustration. Three children of a
family in the West Sub-district, were attacked with Diphtheria in August,
1858, two of them died, and the third, aged 3 years, recovered. I satisfied
myself on visiting these patients, that they were cases of true diphtheria. In
January, 1859, the child that recovered was attacked by scarlet fever, after
playing upon a carpet brought from a house where this disease had been
fatal. There was the usual throat affection of scarlet fever, but no diphtheritic
exudation, and the child died.
I may mention in passing, that among all the cases fatal, or otherwise, that I
have investigated, I have not met with any instance in which diphtheria has
been apparently communicated from a patient with scarlatina, except where
the latter disease has been communicated also. Neither have I at present
met with more than one instance in which cases of diphtheria and scarlet
fever occurred in the same family about the same time, in such a manner as to
favour the idea that they were varieties of the same disease.
Some other members of the family suffered
from diphtheria in
other forms of sore throat in
Some members suffered from diphtheria and
other forms of sore throat in
Neither diphtheria nor sore throat occurred
in other members of the family
9 Families
15 ,,
8 ,,
15 ,,
Total
47
The severity of these cases of sore throat varied considerably. In some it was a
slight attack, congestive in character and lasting but a few days; in others there was
so much febrile disturbance as to demand medical assistance; in others again there
was ulceration, suppuration of the tonsils or mortification. In some families the
earlier cases were sore throat, in others the earlier cases were diphtheritic.
29. Is Diphtheria Contagious ?—This again is a practical question to which you may
fairly look to me for a reply. The following considerations may prove of value in
assisting to determine this important point. Their tendency is towards the affirmative.
28. Relation of Diphtheria to other forms of Sore Throat.—The prevalence of
other and non-diphtheritic forms of sore throat during the past year has been matter
of general remark. Congestive and Inflammatory sore throats have appeared to bear
the same relation to diphtheria as diarrhoea bears to cholera in epidemic seasons.
With respect to the latter diseases, the general opinion in the profession is, that they
arise from the operation of the same morbid poison. I think it may be maintained
that diphtheria and the other varieties of sore throat I have mentioned are similarly
related. As is any case of diarrhtea in an epidemic season, it is impossible to
predicate that it will not pass into cholera if neglected, so in the cases of ordinary sore
throat which have lately presented themselves, no one would be bold enough to
assert, that any one might not before long exhibit the characteristic symptoms of true
dipththeria. A fact upon which I would especially rely in the support of this view,
is the occurrence of ordinary sore throats equally with diphtheritic sore throats
among the number of families where deaths from diphtheria had taken place. Out
of 47 families in which a death from diphtheria had occurred, (Class 1.)