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January 1935


Author Affiliations

From the Department of Pediatrics of the Yale University School of Medicine and the Pediatric Service of the New Haven Hospital and Dispensary.

Am J Dis Child. 1935;49(1):60-68. doi:10.1001/archpedi.1935.01970010069006

In the past ten years malignant diphtheria has increased alarmingly in Europe and has occasionally assumed epidemic proportions, with a mortality rate of from 30 to 60 per cent, in spite of the administration of large doses of antitoxin. Attempts to explain the high death rate by identifying a new strain of the diphtheria bacillus have been unsuccessful. Furthermore, accompanying infections with other organisms do not seem to play a deciding rôle in the development of malignant diphtheria.1 The suggestion that the high rate of mortality was due, in great part, to the physiologic disturbances produced by the diphtheria toxin before the neutralizing effect of antitoxin was obtained, and that therapeutic success required the adequate symptomatic treatment of these disturbances was responsible for the studies reported in the earlier papers of this series.2 In the present article the treatment of malignant diphtheria from the physiologic point of view

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