Produced by Bryan Ness, Dianna Adair and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive/American Libraries.) Diphtheria HOW TO RECOGNIZE THE DISEASE HOW TO KEEP FROM CATCHING IT HOW TO TREAT THOSE WHO DO CATCH IT KEEP WELL SERIES No. 4 [Illustration: logo] TREASURY DEPARTMENT UNITED STATES PUBLIC HEALTH SERVICE 1919 GOVERNMENT PRINTING OFFICE Diphtheria After babyhood has passed, beware of diphtheria. Of all the deaths of children 3 and 4 years of age, more than one-seventh are caused by diphtheria. Diphtheria is preventable and, when properly treated with antitoxin, is curable. Most of the children who die from diphtheria really lose their lives because of the ignorance and carelessness of their parents. Diphtheria is a disease most often occurring in children and resembling a sore throat or tonsillitis. It is caused by a small germ called the diphtheria bacillus. The disease may resemble: _A very mild sore throat_, the tonsils and back of the mouth being redder than usual, and the person not feeling ill. It may look like a _more severe sore throat_ or tonsillitis with a white or grayish patch, called a membrane, on the tonsils. There may be only one or a few small distinct patches, and the throat may feel somewhat sore. The glands in the neck, below the tonsils, may be slightly enlarged and may feel about the size of small peas. The patient may feel rather ill. Or the disease may be like a _very severe sore throat_, with small or large gray or white patches. Not only the tonsils but also the uvula, the small rounded end of the palate which hangs down between the tonsils, may have on it white or gray patches. (If there is a membrane on the uvula, the disease is almost certainly diphtheria.) With such a throat the person feels very sick. Not only does the throat hurt, but there are usually aches in the back of the neck and in the muscles generally. The glands in the neck may be quite large and feel painful when touched. The soreness in the throat may extend down the windpipe, and membranes may form there. The patient is feverish and often is delirious. The fever, however, is not necessarily high. In some cases the membranes may form in the larynx (Adam's apple). When this is the case the patient's voice sounds hoarse and croupy, and the child may breathe with difficulty. In small children it is not uncommon, if such cases remain untreated, for this membrane to choke the patient. Therefore, in all cases of croup, send for a doctor immediately. THROAT CULTURES.