,diphtheria   ,,how ,,to ,,recognize    
,,the ,,disease   ,,how ,,to ,,keep     
,,from ,,catching ,,it     ,,how ,,to   
,,treat ,,those ,,who ,,do ,,catch ,,it 
,,keep ,,well ,,series ,no4 #d          
,illustration3 logo          ,,treasury 
,,department ,,united ,,states ,,public 
,,health ,,service              #aiai   
,,government ,,printing ,,office        
,diphtheria   ,after babyhood has       
passed1 beware of diphtheria4 ,of all   
the deaths of children #c and #d years  
of age1 more than one-seventh are caused
 by diphtheria4  ,diphtheria is         
preventable and1 when properly treated  
with antitoxin1 is curable4 ,most of the
 children who die from diphtheria really
 lose their lives because of the        
ignorance and carelessness of their     
parents4  ,diphtheria is a disease most 
often occurring in children and         
resembling a sore throat or tonsillitis4
 ,it is caused by a small germ called   
the diphtheria bacillus4 ,the disease   
may resemble3  ,a very mild sore throat1

 the tonsils and back of the mouth being
 redder than usual1 and the person not  
feeling ill4  ,it may look like a more  
severe sore throat or tonsillitis with a
 white or grayish patch1 called a       
membrane1 on the tonsils4 ,there may be 
only one or a few small distinct        
patches1 and the throat may feel        
somewhat sore4 ,the glands in the neck1 
below the tonsils1 may be slightly      
enlarged and may feel about the size of 
small peas4 ,the patient may feel rather
 ill4  ,or the disease may be like a    
very severe sore throat1 with small or  
large gray or white patches4 ,not only  
the tonsils but also the uvula1 the     
small rounded end of the palate which   
hangs down between the tonsils1 may have
 on it white or gray patches4 7,if there
 is a membrane on the uvula1 the disease
 is almost certainly diphtheria47 ,with 
such a throat the person feels very     
sick4 ,not only does the throat hurt1   
but there are usually aches in the back 
of the neck and in the muscles          

generally4 ,the glands in the neck may  
be quite large and feel painful when    
touched4 ,the soreness in the throat may
 extend down the windpipe1 and membranes
 may form there4 ,the patient is        
feverish and often is delirious4 ,the   
fever1 however1 is not necessarily high4
  ,in some cases the membranes may form 
in the larynx 7,adam's apple74 ,when    
this is the case the patient's voice    
sounds hoarse and croupy1 and the child 
may breathe with difficulty4 ,in small  
children it is not uncommon1 if such    
cases remain untreated1 for this        
membrane to choke the patient4          
,therefore1 in all cases of croup1 send 
for a doctor immediately4   ,,throat    
,,cultures4  ,in order to prevent the   
spread of diphtheria to others it is    
important always to recognize the       
presence of the disease1 even in mild   
cases4 ,in order to do this the doctor  
makes a culture from the throat and nose
 of the suspected individual4 ,he takes 
a piece of sterile cotton wrapped around

 the end of a thin stick of wire and    
touches this to the throat and tonsils1 
especially where there are patches or   
membranes4 ,then he sends this swab to a
 laboratory1 where cultures are planted 
from it4 ,the next day these cultures   
are examined with a microscope to see if
 diphtheria bacilli1 the germs which    
cause diphtheria1 are present4  ,since  
the diphtheria germs or bacilli grow on 
the lining of the throat and air        
passages1 they are easily thrown out    
from the mouth and nose of the patient  
with particles of mucus or spit when the
 patient coughs1 spits1 or sneezes4 ,but
 even when the patient talks1 especially
 when he talks loudly1 tiny droplets of 
mucus or spit are given off4 ,these     
droplets may have diphtheria bacilli on 
them4 ,the same is true of particles of 
food1 no matter how small1 falling from 
the patient's lips4 ,eating utensils    
such as cups1 glasses1 forks1 and spoons
 that have touched the lips of the      
patient may likewise have saliva on     

them4 ,when the patient has diphtheria  
all these droplets of saliva and of     
mucus may1 and usually do1 contain many 
diphtheria bacilli4 ,curiously1 some    
persons may have diphtheria bacilli in  
the nose and throat and yet remain      
entirely well4 ,such persons are called 
healthy carriers4 ,they are especially  
dangerous1 because there is no outward  
sign which will tell them or others that
 they are carrying deadly disease germs 
around4  ,all who attend the patient    
must be very careful not to get any of  
the dangerous discharges from the       
patient's mouth or nose on the hands4   
,in fact1 it is important for the       
attendant always to wash her hands      
promptly after waiting on the patient4  
,besides this1 care should be taken that
 the germs are not carried to others by 
the use of eating utensils1 such as     
cups1 glasses1 spoons1 forks1 or plates4
 ,all of these should be sterilized with
 boiling water after each meal4         
,,antitoxin ,,treatment4  ,depending on 

the way it is treated1 diphtheria is one
 of the least dangerous or one of the   
most dangerous diseases4 ,it is one of  
the least dangerous when promptly       
treated with antitoxin2 it is one of the
 most dangerous when the antitoxin      
treatment is not given1 or is delayed or
 insufficient4 ,in the days before we   
had antitoxin one out of every three    
children who had diphtheria died4 ,now1 
if antitoxin is used on the first or    
second day of the disease ninety-eight  
out of every hundred children recover4  
,the sooner diphtheria is attended to   
the more certain is a cure4  ,in severe 
cases suspected to be diphtheria the    
doctor always gives diphtheria antitoxin
 at once4 ,this is a wise thing to do1  
because the disease goes on rapidly and 
a delay of #ab or #bd hours may be      
fatal4 ,besides1 no harm is done1 even  
if the disease proves not to be         
diphtheria4 ,the antitoxin1 although    
making some people uncomfortable for a  
day or two1 never does any real harm4   

,whenever antitoxin is given to a person
 ill with diphtheria it should be given 
in one dose1 large enough and early     
enough4   ,,temporary ,,protection      
,,with ,,antitoxin4  ,diphtheria is very
 contagious1 and many people1 especially
 children1 can catch it4 ,for this      
reason1 whenever a case of diphtheria is
 discovered1 the doctor injects the     
antitoxin not only into the patient1 but
 also1 as a protective against the      
disease1 into those who have come into  
contact with the patient4 ,this is      
spoken of as immunizing these           
individuals4 ,the immunizing dose is not
 so large as the curative dose given to 
the patient1 but it is usually          
sufficient to protect those exposed to  
diphtheria for a month from the time of 
injection4 ,at the end of that time the 
protection disappears4   ,,the ,,schick 
,,test4  ,a few years ago a very simple 
test was discovered to tell whether a   
person could or could not catch         
diphtheria4 ,this is known as the       

,schick test4 ,it consists in injecting 
a few drops of a prepared diphtheria    
toxin into the skin and then watching   
whether a characteristic red spot       
appears where the injection was made4   
,if such a spot does not appear within  
two or three days it shows that the     
person can not catch diphtheria4        
,,lasting ,,protection ,,by ,,diphtheria
 ,,vaccination4  ,for those in whom the 
characteristic redness appears1 and who 
are therefore known to be liable to     
catch diphtheria1 doctors now advise a  
course of protective injections similar 
to those which have proven so successful
 against typhoid fever4 ,this protective
 treatment consists of three small      
injections1 a week apart4 ,there is no  
sore1 as there is in smallpox           
vaccination1 and the injections are     
harmless4 ,the protection lasts for     
years1 and perhaps even for life4  ,why 
not have the doctor make a ,schick test 
on your child1 and if this shows the    
lack of protection against diphtheria   

have him give the three protective      
injections8   ,,personal ,,and ,,bedside
 ,,hygiene4  #a4 7a7 ,all discharges    
from the nose and mouth should be       
gathered in soft1 clean cloths or rags  
or papers and destroyed by burning4 7b7 
,the patient should cover the mouth and 
nose when coughing or sneezing1 for a   
cough or sneeze will throw droplets of  
mucus to a distance of #aj or #ab feet4 
#b4 ,the attendant should wear a        
washable gown that completely covers her
 clothing4 ,it should be put on when    
entering the room of the patient and    
taken off immediately on leaving it4    
#c4 ,a basin of water1 together with a  
cake of castile soap 7or where possible 
an antiseptic solution71 should be      
placed in a convenient place1 so that   
the doctor and nurse attending the      
patient may wash their hands whenever   
leaving the room1 and even before       
touching the door handle4  #d4 ,all     
eating utensils that the patient uses   
should be washed in boiling hot water   

separately from other dishes and used   
exclusively by the patient4  #e4 ,all   
bedclothes and bedding should be boiled 
in soap and water1 or they should be    
exposed to the sunshine4 ,direct        
sunshine kills disease germs4  #f4 ,the 
person attending the patient should wear
 a double layer of gauze or other soft  
thin cloth across the mouth and nose as 
a face mask whenever near the patient so
 as to prevent the droplets containing  
the germs coming from the patient's     
mouth from entering and lodging on the  
lining of the mouth or throat of the    
attendant4 ,always remember that even   
though you may not get the disease if   
the germs lodge in your throat they may 
grow there and you may carry the disease
 to another person who may catch it4    
#g4 ,there should be but one attendant  
wherever possible4  #h4 ,no visitors    
should be permitted in the sick         
room--not even during convalescence4    
#i4 ,the one who attends the sick should
 not prepare or handle the food of      

others4 ,sometimes it is impossible to  
take this precaution1 as very often it  
is the mother who must take care of the 
patient1 cook1 and do all the housework4
 ,in such cases the one attending the   
sick must never neglect whenever near   
the patient--        7#a7 ,to wear a    
face mask4        7#b7 ,to wear a       
washable gown 7which is to be taken off 
on leaving       the room74        7#c7 
,to wash her hands when leaving the sick
 room4  ,every attendant on the sick    
should know how disease germs are       
carried from the sick to the well4 ,this
 knowledge should make her more careful1
 and thus help to prevent the spread of 
the disease4  ,illustration3 logo       
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,,states               ,,public ,,health
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