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January 1, 1927


Author Affiliations

New York. Assistant Professor of Hygiene and Preventive Medicine, New York University and Bellevue Hospital Medical College. 47 West Sixty-Ninth Street.

JAMA. 1927;88(1):49. doi:10.1001/jama.1927.02680270049025

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To the Editor:  —I was called in consultation by a physician to see a 3 year old child suffering from diphtheria. The physician himself had delivered the child and had taken care of it since birth. I saw the patient, noted the bull-shaped neck, the diphtheritic membrane appearing at the nostrils, covering the fauces, and making its way down to the larynx, and gave my opinion that it was too late. The child was sent to the Willard Parker Hospital and died the following day. The patient had received two days previously an insufficient dose of antitoxin, but evidently the disease had started at an earlier date than suspected as the hidden and most dangerous form of nasopharyngeal diphtheria—in the posterior nasopharyngeal fossa. A fatal dose of diphtheria toxin can easily be absorbed from this area before the physician may become aware with what he is dealing.I asked the

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