New Zealand Times (PUBLISHED DAILY.) THURSDAY, JANUARY 4, 1877.

New Zealand Times, Volume XXXII, Issue 4924, 4 January 1877, Page 2

New Zealand Times (PUBLISHED DAILY.) THURSDAY, JANUARY 4, 1877.

The report of the Royal Commission appointed in Victoria in 1872 to inquire into the origin of diphtheria in that colony, and the best mode of treating the disease, is a most valuable and instructive document; and a reference to some of its most important features may not be out of place at the present time. Cases of diphtheria are authentically reported so early as the years 1854-5; and it would also appear that the disease was in Tasmania at an earlier date than it appeared in Victoria. From these premisses the Commissioners drew the inference that the disease was most probably introduced from Tasmania into their own colony. The symptoms -of the complaint vary considerably, according to the evidence; it being ushered in sometimes with high fever and hot skin, and at other times the skin being cool, and the fever not perceptible. Great prostration is generally an accompanying sign; and stiffness and swelling of the throat, accompanied by a difficulty in swallowing, and sometimes pain in the ears, are _ the general local symptoms. The pulse is quick, but weak, the tongue moist, large, and whitish ; the appetite bad, thirst being generally present, and a cough, sometimes croupal in its nature, almost always comes on. The exudation is generally first observed on the tonsils in small points, which speedily coalesce, and extend in all directions over the soft palate and other regions of the throat. The 00107 of this exudation is of all shades, from white to grey and yellow, often presenting an appearance similar to wash-leather, and there is usually a fetid odor arising from it, and often a fetid mucopurulent or sanious discharge from the nose. The question of predisposing causes is gone into at length by the Commissioners; but as we have the disease in our midst, it is needless now to allude to them. The evidence clearly shows'that diphtheria is both contagious and infectious; the contagion of the disease may be retained for a considerable period on the clothes of a person who has been attending on, or in contact with, diphtheritic patients, and may, through the medium of such a person, be communicated to a third person, without the medium having suffered from the disease. As illustrating this char'ac teristic of the disease, Dr. Foster reports a case of a lady who carried the disease to a distant locality where diphtheria did not at the time exist. It does, not appear, however, to be so virulently contagious as scarlatina; and cases are recorded in which the disease was confined to one member of a- family, and others in which children slept in the same bed with a child suffering from diphtheria, but who did not contract the disease. The diagnosis and prognosis of the disease are gone into most fully; but those are matters more appropriate for medical men than for the bulk of our readers. In cases likely to termiiKite favorably the symptoms abate gradually, the exudation becomes sharply defined at its edges, and gradually drops off without being reformed, the appetite and strength return, and the patient becomes convalescent in periods varying from seven to fifteen days. In other cases the symptoms for the time being are favorable, and there is an apparent tendency towards recovery, when a relapse sets in, and graver symptoms show themselves. In bad cases the disease increases from the first, the dangerous symptoms set in rapidly, the membrane forms and re-forms, and the patient either dies in a short period from asphyxia, or the struggle is prolonged to twelve or fourteen days, and death occurs from exhaustion and blood poisoning ; however, speaking generally, convalescence or death occurs in about seven days. Although even its mildest form it is a most dangerous and treacherous disease, yet the majority of cases when brought under early medical treatment recover. This is a fact which can- ■ not be too well understood by parents, and under our present circumstances there should be no resort whatever to home quackeries and popular panaceas for colds and sore throats, but a prompt summoning of a duly qualified practitioner in every such case. Diphtheria appears in its nature to be most nearly allied to scarlatina, as both diseases have often been observed to exist together in the same house and in the same district, as is at present the case in Wellington. The majority of the evidence shows a very close relation though not an identity between diphtheria, and scarlatina, the former very often following the latter, the members of a family getting one after another, scarlatina first and diphtheria afterwards. The remainder of tho report deals with the treatment of .the disease in all its phases, and does not call for especial comment by us. There is, however, a short paragraph at the end worthy of notice, and which runs as follows:—“Beyond immediate separation from the infected we have no evidence of any effective prophylactics . . . fresh air and whatever tends to strengthen vitality are probably tho best.” The keeping of a supply of sulphur is recommended as a remedy which can be used with the utmost benefit until medical aid is called in. The use of ice is also advised. However, in a city like Wellington, where the best medical aid can bo procured in a few minutes, these safeguards are not of particular moment, as in every case wo have no doubt medical aid will be resorted to. In conclusion, it may not bo amiss to call

attention to the fact that diphtheria lias been gazetted a dangerous, contagious, and infectious disease under the Public Health Act, 1876, and that the City Corporation is the Local Board of Health entrusted with the duty of . carrying out the provisions of that statute.