Paralysis following relapses and second attacks of diphtheria / by J.D. Rolleston.

  • Rolleston, John Davy, 1873-1946.
Date:
1910
Catalogue details

Licence: In copyright

Credit: Paralysis following relapses and second attacks of diphtheria / by J.D. Rolleston. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted front I PARALYSIS ATTACKS OF DIPHTHERIA By J. D. Rolleston, M.D. ASSISTANT MEDICAL OFFICER, GROVE FEVER HOSPITAL, LONDON, ENGLAND The following communication has been prompted by the perusal of the remarkable case, published by Dr. F. E. Coulter in this Journal, of a second attack of general diphtheritic paralysis occurring after an interval of two years. In the present paper, which is based on personal observations made on 1,600 completed cases of diphtheria at the Grove Hospital, an artificial distinction has been made between relapses and second attacks. By a “relapse ” is meant the re-appearance of the disease after recovery from the initial attack, but before the discharge of the patient from hospital. The term “ second attack ” is applied to cases in which the two illnesses did not occur during a single period of detention in hospital. In all the relapses and second attacks as well as in the primary disease, the clinical diagnosis received bacteriological confirmation, so as to exclude those cases of non-specific tonsillitis, which, as I have shown elsewhere, are not infrequent in convalescence from diphtheria. In the 1,600 cases 27, or 1.6 per cent., had relapses, which were separated from the initial angina by intervals ranging from three to four- teen weeks. The average date for their occurrence was about the middle of the sixth week. Two of the 27 had palatal and ocular palsies after the primary attack, but none showed any signs of paralysis after the relapse. Thirty-six, or 2.2 per cent., had second attacks, between which and the first there were intervals ranging from three months to fourteen years. The period of predilection was the first three years, during which 22 of the 36 took place. In 18 the first attack had occurred in the same hospital, so that their records were available. One of the cases had paralysis during the first attack only, and three had paralysis during the second illness who had previously escaped any nervous sequelae. In only one case were both attacks followed by paralysis. This patient was a woman, aged