Miscellany

1880 Boston Medical and Surgical Journal  
In a late number of this journal was a note from Dr. 0. F. Ham, of North Barnstead, N. H., intimating that true croup and the croup which sometimes occurs in cases of diphtheria are essentially the same thing.! Now, for about nine years after I began practice I saw, on an average, one case of croup a year, without seeing any case of diphtheria. The cases were, as usual, mostly boys, between two and ten years of age. I never saw two cases in the same family of children ; never knew of one child
more » ... knew of one child taking it from another. The local and constitutional symptoms in the two diseases are different ; and if a child was saved from croup, which was rarely the case, he always more readily recovered strength than from diphtheria as ordinarily treated. Since I came in contact with diphtheria, nearly twenty years ago, I have occasionally seen cases of the true non-contagious croup, but many cases of diphtheria, and several of them with the croupy complication. I have not seen any cases of croup which were of true diphtheritic origin where there was any difficulty in making out their true nature, though I imagine such isolated cases may occur. But that true croup and true diphtheria are essentially the same disease it is impossible for me, with what I have seen, to believe. It has not happened to me to see a case which began as a croup which afterwards took on the characters of a diphtheria. All the cases with both croupy and diphtheritic symptoms have had the croupy symptoms succeed the diphtheritic, though in some of them these croupy symptoms were close behind the others. With only one exception, all the cases of croupy complications in diphtheria I have seen have happened in patients who, during the early periods of the disease, were attended by other physicians. Not a single case of croup in diphtheria has occurred in my practice where I have had an early opportunity to treat the case. By early directing my efforts to destroying of the poison, through constitutional means, I have hitherto succeeded in not only arresting the spread of the membranous exudation to the larynx or trachea, but in preventing the usual sequelae of the disease. During the last four years and a half I have found abundant cause to stand by the statements I made in this journal, June 8, 1876, -to rely very fully on the free exhibition of the hyposulphite of soda in the early stage of diphtheria. Indeed, I am now administering it oftener and in larger doses the first few hours, bringing in the stimulants and tonics afterwards. I am fully convinced of the power of the hyposulphite of soda over the poison of diphtheria, and also over the poison of scarlet fever. It will fail if not early and freely administered. If early and freely administered, these diseases are modified, and recovery is brought about earlier and surer than under any other treatment which I know.
doi:10.1056/nejm188012161032513 fatcat:vq7ylupip5bfvdwwc35uxjpuxi