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Outside of laryngeal complications, the mortality in diphtheria is due to the toxin produced by the Klebs-Loeffler bacilli. No physician can successfully treat diphtheria unless he understands the nature of this toxin, how it is produced, and how the cells may be fortified against its destructive action. He must understand that the Klebs-Loeffler bacillus is a distinct living entity or vegetable organism; that one of the products of its existence is diphtheria toxin, just as the result of the life of the yeast plant in alcohol.
Other germs in anginas will cause inflammation, pain, temperature and membrane, but only the Klebs-Loeffler bacilli produce the deadly toxin which begins with their invasion and progresses to a fatal amount as swiftly as conditions permit.
To appreciate the danger of his patient, a physician must understand the rapidity with which these bacilli multiply under favorable conditions. The clinical symptoms manifesting their residence may
JAQUES WK. THE EARLY DIAGNOSIS OF DIPHTHERIA. JAMA. 1898;XXXI(18):1046–1047. doi:10.1001/jama.1898.92450180040001p
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