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14
It does not always produce such serious symptoms as it is
popularly supposed to do; very often nothing more may be thought to
be the matter than an ordinary cold and sore throat; and the question
can only be decided on medical examination.
Such mild cases going about frequently convey the disease in its
most virulent form, and unless these mild cases are recognised and
medically treated it is impossible to stamp out the disease, and there
is no telling when it will end.
Always therefore seek medical advice if any of the following
symptoms are noticed in a child :
1. Bad cold with sore throat but otherwise apparently well.
2. If a child previously well vomits, is feverish and drowsy,
and especially if there is any difficulty in swallowing.
Such symptoms strongly point to Diphtheria in the early stage.
The epidemic has been remarkable in several ways. For instance,
the disease broke out in June, whereas epidemic prevalences of this
disease commonly commence in September.
The first cases which occurred were the most severe and fatal, but
taken as a whole, the disease has been of a mild type and the
mortality low.
This is in accordance with the known fact that the smallest
amount of mortality is witnessed in those epidemics which commence
in summer. A more remarkable circumstance is the absence of
notifications relating to Membranous Croup, since Diphtheria and
Membranous Croup are believed to be identical ; and in most
epidemics the "earlier cases may be referred to Croup, and the later to
Diphtheria." (Dr. Thome Thorne).
In many cases the difficulties of diagnosis have been very great,
and when Medical men can differ—and very reasonably differ,—as to
whether a case is, or is not, Diphtheria, it is not unreasonable to
suppose that the difficulties to the public are greater still, and that
many cases are allowed to go about unrecognised; indeed there is as
much Diphtheria during an outbreak out ot doors as there is indoors,
and the continuance of the disease must be put down to the occurrence
of these mild unrecognised cases.
A mild Diphtheria often runs its course without attracting
attention, although prostration is one of the chief characteristics of the
complaint. Still it has been my experience to occasionally see
children with well-marked Diphtheretic patches on the throat and
with nothing else to suggest the existence cf such a serious illness.
Such cases as these in a school, or even in the street, are capable of
infecting all they come in contact with.
Still more likely to escape recognition by parents, are cases of
Nasal Diphtheria, in which patches of Membrane develop in the nose,
and may not spread from there, and can only be detected by a careful
examination of that organ.