March 12, 1892


JAMA. 1892;XVIII(11):331. doi:10.1001/jama.1892.02411150021006

A few weeks ago we called attention to the diagnosis of diphtheria, and to the meaning of the term, and urged that it should be used only in a clinical sense, and to indicate the formation of a false membrane.

Quite recently, Jules Simon,1 in a clinical lecture upon the diagnosis of the anginas in children, has treated this subject in a masterly way. He classifies exudative anginas as follows:

  1. Pultaceous exudation.

  2. Membranous exudation.

    • Diphtheritic.

    • Non-diphtheritic.

The pultaceous exudate is whitish, but slightly adherent, readily removed with the end of the tongue depressor, and is rapidly broken up in a little water. The membranous exudate, on the other hand, is thicker, tougher, fibrinous, cohesive, elastic, and does not dissolve in water. As examples of the pultaceous form of exudate he mentions that found in the beginning of scarlatina, the exudation of thrush which has extended to the tonsils,

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