A girl nine years of age having been exposed, Nov. 13, to malignant diphtheria received Diphtherinum 1m. (Skinner) three times daily for eleven days, as a prophylactic, developing chilliness, high temperature, red face. She complained of being tired and cold, severe pain on swallowing and on the 12th day the tonsils and posterior walls of the pharynx were covered with dirty gray, yellowish membrane, corrugated vertically, like the surface of a washboard turned up.
- Thursday, Nov. 14, 1907, began powders three each day for eight days, then two daily for two days.
- Nov. 23, complained of being tired, sat down to rest three times.
- Nov. 24, would lie down because tired, but after a while felt playful.
- Nov. 25, temperature 103, pulse 148, full, with throbbing of carotids, eyes bright, face flushed, with centre of cheeks almost purple.
Throat dark red, no membrane ; but on posterior wall of throat, yellow, dirty cream color with dry membrane in folds, up and down.
Monday night talks in sleep, with eyes wide open.
Wanted imaginary objects taken from room, and to "make those people get away." Sat up and picked among bed-clothes for strap for her school books.
- Nov. 26, temperature 101.2°F, pulse, 116, membrane lighter and moist, thin in middle of throat.
- Nov. 27, temperature 99.2°F, pulse 100. Throat clearing from middle.
- Jerking of single limb, or shoulder, or finger.
- Nov. 28, temperature 101.2°F, pulse 116. Desired to have mother hold her hand. Tongue whitish, with exceedingly red tip (moist).
- Nov. 29, temperature 101.2°F, pulse 116, breath offensive.
- Nov. 30, temperature 99.4°F, pulse 100. Membrane white, and showing more to front. Clearing from centre of posterior wall of throat.
Tongue coated whitish, with red papillæ ; very red tip, with a dark red spot in centre of red tip. Slept well last night, until 4 A. M., then was restless and wakeful ; moved and changed position, moved arms and legs often, snored and fan-like motion of ala nasi, Skin seemed dry, forehead moist along edge of hair, when first falling asleep.
Fluctuating temperature, very little pain, membrane in vertical folds on posterior wall of throat, when the membrane first appeared, spreading forward as far as border of the tonsils, and also began to fade and disappear first from centre of posterior pharynx.
In centre of the tip of tongue was a very dark red spot, also very dark red or purple spot in centre of very red cheeks.
The membrane from a case of malignant diphtheria, triturated with milk sugar to the 6th centesimal, then potentized by Swan, the diphtheritic virus, or diphtheria toxin, from which the serum antitoxin is made.
These potencies have been very effective, not only in malignant diphtheria but in many cases of post-diphtheritic paralysis and kindred nervous affections following the use of antitoxin.
Diphtherinum has made many brilliant cures of diphtheria and post-diphtheritic affections to its credit, yet to receive its place among the remedies of the homœopathic Materia Medica it must pass the crucial test that all others have encountered, viz., a careful and thorough proving of the dynamic potency on the healthy. Thus far, like its great congener Antitoxin, its use has been clinical and empirical, the distinctive difference being that its action has been dynamic, while that of antitoxin is Chemico-catalytic.
Yet the empirical use of Von Behring's Antitoxin is a great advance on the former empirical methods of the profession and has proved a blessing to humanity.
The indications here given are chiefly clinical and are tentatively held until verified or disproved by provings.
Especially adapted to the strumous diathesis ; scrofulous, psoric or tuberculous persons, prone to catarrhal affections of throat and respiratory mucous membranes.
Patients with weak or exhausted vitality hence are extremely susceptible to the diphtheritic virus ; when the attack from the onset tends to malignancy (Lac c., Merc. cy.).
Painless diphtheria ; symptoms almost or entirely objective ; patient too weak, apathetic or too prostrated to complain ; sopor or stupor, but easily aroused when spoken to (Bap., Sulph.).
Dark red swelling of tonsils and palatine arches ; parotid and cervical glands greatly swollen ; breath and discharges from throat, nose and mouth very offensive ; tongue swollen, very red, little coating.
Diphtheritic membrane, thick, dark gray or brownish-black ; temperature low or subnormal, pulse weak and rapid, extremities cold and marked debility ; patient lies in a semi-stupid condition ; eyes dull, besotted (Apis, Bap.).
Epistaxis or profound prostration from very onset of attack (Ail., Apis, Carb. ac.) ; collapse almost at very beginning (Crot., Mer. cy.) ; pulse weak, rapid and vital reaction very low.
Swallows without pain, but fluids are vomited or returned by the nose ; breath horribly offensive.
When the patient from the first seems doomed, and the most carefully selected remedies fail to relieve or permanently improve.
Laryngeal diphtheria, after Chlor., Kali bi. or Lac c.
Post-diphtheritic paralysis - especially where Antitoxin has been used ; many cases cured - after Caust., Gels., Nux, Secale and the best selected remedies have failed.
In post-diphtheritic paralysis and spinal affections following diphtheria many brilliant cures have been effected by the potencies.
The same indications for its use in all forms of diphtheria that are used when Antitoxin is exhibited.