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21
or nasal passages there are found the so-called pseudo
diphtheritic or Yon Hoffman bacilli. Now, bacteriologists
say that there is no connection, directly or indirectly,
between the bacillus of Klebs Loffler (the true
Diphtheria) and the bacillus of Von Hoffman (the pseudo
Diphtheria); this is true from an academic point of view,
but it is a coincidence that in many outbreaks of
Diphtheria at schools it has been found that a large
number of the children in an invaded classroom have
the bacillus of Von Hoffman in the throat or nasal
passages, and that it is impossible to find that the
children themselves have been ill at all. It is also a
remarkable fact that in a great number of cases where
repeated bacteriological examinations of the throat have
been made throughout the whole of the illness, the
Klebs Loffler bacilli has alone been found during the earlier
weeks, although every endeavour has been made to find
co-existing with the Klebs Loffler the Yon Hoffman;
still, as the case approaches convalescence the Klebs
Loffler bacillus disappears and the Yon Hoffman
appears. Now, excluding the direct evidence of
bacteriologists with regard to the relationship of the two
bacilli, it would seem, from a purely clinical point of
view, that the one bacillus is merely an attenuated form
of the other, and it is most desirable that some definite
decision amongst sanitarians should be come to as to
what should be done in all cases where the bacillus of
Von Hoffman alone is found. Personally, I am inclined
to consider and treat them as mild cases of true
Diphtheria, and not to confine the term "Diphtheria"
to merely those cases where the Klebs Loffler bacillus