personal experience. In reference to the local applications to the interior of the throat, the same observations hold good as in the exhibition of medicines internally. It is easier to order than to execute. No false tenderness, however, must be allowed to intrude itself where so much depends upon energy and promptitude. Neither should the applications be entrusted to parents or nurse; the medical attendant alone is competent to carry them out effectually.
Of external applications to the throat, no form should in my opinion be employed except emollient applications, as bran poultices or the more cleanly hot-water compresses. Leeches are inadmissible, and blisters only increase the danger, by putting on a diphtheritic and, in very adynamic cases, a sloughy condition, thus adding materially to the danger of the patient. Should the infiltration of the cellular tissue be very considerable and fluctuation be plainly perceptible, the ordinary principles of surgery would inculcate the evacuation of the pus, rather than risk its further diffusion.
This concludes what I have to say respecting the treatment of diphtheria. It must not, however, be imagined that all cases present the fearful features I have endeavoured to describe, or require the energetic treatment mentioned. Whether from original robustness on the part of the individual, or from the favorable circumstances under which he is placed, or whether, as sooner or later appears to be the case in all epidemics, the poison loses its intensity, a certain number of patients will present themselves in which the general symptoms are mild, and the diphtheritic exudation is limited in extent and is slow in increase.
