An Account of the Sore Throat Attended With Ulcers: A Disease Which Hath of Late Years Appeared in This City, and in Several Parts of the NationFothergill, John
History
An Account of the Sore Throat Attended With Ulcers: A Disease Which Hath of Late Years Appeared in This City, and in Several Parts of the Nation
Fothergill, John
Diphtheria
From the preceding Account of the Sore Throat attended with Ulcers, it
will, I believe, appear, that this Disease is widely different from a
common Sore Throat, or simple Inflammation of any of the Parts about the
_Fauces_; both as to the Subject commonly affected by it, the Manner of
its Attack, the Progress of the Symptoms, and its Conclusion: For the
sore Throat with Ulcers generally attacks Children; and of these Girls
more frequently than Boys, as hath been observ'd: If Adults are seized
with it, they are commonly such as have been very much conversant with
the Sick, or else are weak and infirm: And it seems to affect those
Adults in the severest manner, who have been previously indisposed, or
whose Strength has been reduced by unseasonable or immoderate
Evacuations.
On the contrary, the common _Angina_, or an Inflammation of the Tonsils,
most frequently attacks the healthy, the vigorous, and robust; the weak,
the delicate, and infirm, are less exposed to it, at least suffer less
from it, than the former.
As both Diseases are attended with a Fever, and as most Fevers come on
with Shivering or Chilness, this Symptom may at least appear equivocal:
But if Sickness, or Vomiting, or Purging, or an acute Head-ach, towards
the back Parts or Top especially, or if all these, come on in the Space
of a very few Hours, which they generally do, where the Disease is
vehement, it may justly be esteem'd of the malignant or putrefactive
kind: But if an erysipelatous Redness discovers itself in the _Fauces_,
or if any Ulcerations or white Sloughs appear in them, the Disease is
evident.
In some Cases, the Symptoms have been so obscure, that it was difficult
to determine to which Class they properly belonged: But in these
Circumstances the Disorder was so favourable, that, supposing it not to
be of the ulcerated kind, no other Inconvenience seemed likely to ensue
from treating it as such, than a Suppuration; which is often an Event
rather to be chosen than avoided.
The Redness of the Skin in the Face, Neck, Breast, and Hands, is another
obvious and distinguishing Characteristic, which in Children and young
People especially, seldom fails to accompany this Disorder.
In the common sore Throat, a local Inflammation is the Disease: All the
Symptoms are derived from this Source: An acute throbbing Pain, greatly
increased upon swallowing even Liquids, is the principal Grievance. In
the other, the whole Habit suffers, as if by a _Stimulus_ of a peculiar
Nature and although the Throat is always more or less affected, yet it
is sometimes the least Part of the Patient's Complaint; and Instances
have occurr'd to me of considerable Sloughs being formed, before any
Soreness or Pain in the _Fauces_ hath been mention'd.
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