DIPHTHERIA. 
F. Hiller, Sr., M. D. 
G. H. Floto, Stationer and Printer, 222 Sansome Street. DIPHTHERIA. 
F. Hiller, Sr., M. D., San Francisco, Cal. 
[Bead before the Cal. State Med. Society of Homoeopathy ; reprinted from the California Medical Times.] 
The cause and development of diphtheria has 
been agitated in the medical literature of all civ- 
ilized nations during the past thirty years nearly 
to exhaustion. 
and that the atmosphere did not act as a me- 
dium for spreading the contagion. It was his 
opinion that croup and diphtheria were identi- 
cal, the latter being but a higher degree of the 
former. 
The propagation of diphtheria by spores and 
fungus parasites, as well as the miasmatic theory, 
have their defenders; and a variety of other 
speculations have been advanced, without estab- 
lishing any of these hypotheses satisfactorily. 
Thirty years later we find Virchow advancing 
his theory. He finds that the exudation follow- 
ing diphtheritic inflammation, depriving the mu- 
cous membranes and the underlying tissues of 
their supply of nutrition, is the cause of malig- 
nity and consequent mortification. 
Virchow asserts that diphtheria and croup are 
two entirely heterogeneous processes; but Wag- 
ner (an equally weighty authority) endeavored 
to prove that both were identical: that they only 
differed in the fact that the one was confined to 
the throat while the other involved the air pas- 
sages, and that the formation of the false mem- 
branes depended, not upon the throwing out of 
a fibrinous exudation over the surface, but upon 
a peculiar metamorphosis of the epithelium, 
which he describes as a fibrinous degeneration 
of these cells. 
We find in Ziemssen’s “ Medical Cyclopedia” 
that Homer and Hippocrates advanced views 
from which Bretonneau attempted to prove that 
diphtheria was known even at those times, and 
that since the disease has been at various periods 
destructive to human life. No exact knowledge 
can be gleaned from the authors of the past, be- 
cause the disease was frequently confounded 
with other affections, such as scarlet fever, etc. 
Bretonneau is the first who made accurate in- 
vestigations, and presented his views in two 
treatises to the French Academy of Medicine in 
1821. He named this form of disease angina 
diphtheritica, on account of its essential charac- 
teristic symptom, the exudation. He believed 
that an inflammation without an exudation is 
not diphtheritis, and that diphtheritis must be 
spread by contagion. 
Several hundred writers, from all countries, 
have recorded their views and experience in the 
medical annals without solving the perplexing 
question—what is diphtheria ? 
He attempted to prove that contagion occurred 
only when the diphtheritic secretion, in the form 
of fluid or dust-like atoms, came in contact with 
the soft mucous membrane, or with the skin de- 
prived of its epithelium. He believed the dis- 
ease could only be transferred by inoculation, 
The microscope at first seemed to shed light 
upon the subject. The discussion concerning 
the nature of diphtheria assumed a new phase 
when Oertel and others discovered that the diph- 
theric membranes, the subjacent tissues, and 
even the blood of diphtheric patients contained 4 
DIPHTHERIA. 
vegetable or bacteria in great numbers. This 
discovery created quite a revolution in medical 
matters. Scientists discovered at once vegeta- 
ble fungi in all pathological secretions ; wounds 
had to be hermetically closed ; antiseptics came 
into demand in the hospital and in the lying-in 
room, and men of high standing in the medical 
profession, recognizing these vegetable parasites, 
which they discovered under the microscope 
during their clinical observations, demonstrated, 
with a surprising constancy, the septic character 
of well nigh every form of disease. 
the tissues of the body or the blood until after 
this erosion has taken place and the tissue is de- 
stroyed by putrefaction : and it is only through 
these means that septicaemia and the presence 
of bacteria may be a consequence, but not a 
cause of the disease. 
Diphtheria is a sporadic form of disease, ap- 
pearing at times epidemically. Its ravages have 
been chiefly observed among those individuals 
who have a scrofulous diathesis complicated with 
a syphilitic taint; also strumous individuals who 
are subject to glandular swellings, enlarged ton- 
sils, and who suffer frequently from catarrhal or 
croupous affections. These, above all others, 
are the first to feel its destructive power. Nearly 
all who die from the effects of this disease are 
known to have had such predispositions. 
Oertel, who treated the subject most exhaust- 
ively, has evidently not been well understood by 
many recent writers, and particularly by the ad- 
vocates of the fungous theory. 
He says: “ The vegetations in the pathologi- 
cal products of diphtheria consist, as already 
stated, principally of spherical bacteria (the mi- 
crococcus), accompanied by a larger or smaller 
number of bac. ter., represented always by the 
smallest form known, and this occurs so con- 
stantly that in every part where a diphtheritic in- 
fection has appeared there the tissue and exuda- 
tions are filled with bacteria. They were discov- 
ered as far back as 1868, by Buhl, Hueter and 
myself, in false membranes, the blood and the 
tissues. In like manner they were demonstrated 
by Van Recklinghausen, Nassiloff, Waldeyer, 
Klebs, Eberth, Heiberg and others. I called 
them at the time micrococcus, in the same sense 
as Cohen used the term. It is not to be con- 
founded with the micrococcus of Hallier, who 
applied the term to one of the higher forms of 
yeast (ferment fungi).” 
Vaccination is also a fruitful source to develop 
this dreaded disease, particularly when the mat- 
ter is taken from a scab, as we have no means 
of knowing whether we have taken putrified 
matter or not. 
It is now a generally recognized fact that vac- 
cination has multiplied disease, and has in many 
cases contaminated individuals who would oth- 
erwise have escaped. The complaints following 
vaccination are either sudden and dangerous, or 
long, lasting and difficult to cure. 
Another cause for the frequency of diphtheria 
may be found in the fact that too little care is 
taken in the treatment of the diseases of early 
childhood. It is well known that suppressed 
disease of any form is followed by metastasis ; 
the seed of disease is only slumbering in the sys- 
tem, until it breaks forth in great violence when 
aroused during sickly seasons. 
Oertel shows further that diphtheria begins in 
the catarrhal form beneath the epithelium, in 
which no bacteria are formed, and that it may 
pass to the croupous variety, or laryngeal diph- 
theria, in which, as yet, no bacteria have been 
discovered until abrasion of the epithelium has 
taken place, and that this form may degenerate 
into the septic gangrenous variety, with large de- 
velopment of pus cells and masses of bacteria, 
which are transported, with the septic matter, 
into the blood and various organs and tissues of 
Diphtheria has been the scourge of humanity 
for the past thirty years, steadily increasing in 
all civilized countries : neither latitude nor lon- 
gitude, heat nor cold, as far as can be learned, 
have changed its ravages. 
In view of the variety of opinions advanced 
by professional men about the cause and devel- 
opment of diphtheritis, it is not surprising that 
there exists so great contusion in its description. 
Unimportant complications of this disease have 
been taken advantage of to establish new species, 
for which a variety of names have been ad- 
vanced, without deriving therefrom any practi- 
cal benefit. 
the body. 
He very clearly proves that the bacteria are 
not found in the diphtheritic deposit, unless an 
erosion and abrasion of the epithelium has been 
effected, and that they are not found in any of 
Well aware that any man who advances new DIPHTHERIA, 
5 
views or attempts to disprove existing error 
meets opposition, I am nevertheless prepared to 
prove that it is improbable and repugnant to 
common sense to assert that micrococci, or bac- 
teria, are the cause of diphtheria. The history 
of bacteria shows that they exist independent of 
diphtheria, and that they form no complication 
with the disease until after solution of the epi- 
thelium has been brought about by suppuration 
and excessive flow of saliva, which always attends 
this disease, or by roughly swabbing the throat 
and fauces, or by attempting to remove the ex- 
udation by cauterization. 
which, when brought under the microscope, ex- 
hibits sometimes fungous parasites (odeum albi- 
cans). The sporules and myselium of this fun- 
gus may invade the mucous membranes, the fau- 
ces, and even the alimentary canal; its irritation 
induces in the enfeebled membranes an increased 
secretion of epithelial scales and exudation cor- 
puscles. 
These fungous parasites are only at times, but 
not in all cases, discovered in specific exudation; 
theiefore these invaders are not the cause but 
the products of the disease, and are found to 
exist in all putrid secretions in other forms of 
disease. 
Diphtheria is, in its primary stages, nothing 
less than an inflammation of the lining mem- 
branes of the throat, which in many instances 
resembles membranous croup, with the differ- 
ence that diphtheria has a premonitory stage, 
while membranous croup commences sometimes 
very suddenly. The diphtheritic process is a 
membranous exudation. It is a common occur- 
rence upon the lining membrane of the mouth 
aud fauces. The formation of pseudo mem- 
branes even is not necessarily considered an im- 
portant complication, but when diphtheritis is 
the local expression of disease, it pursues a rapid 
course, and may terminate fatally in a very short 
time, particularly when favored by climatic or 
telluric influences. 
These microscopic parasitic organisms greatly 
aggravate diseases, but they never yet have been 
the cause thereof. They find only a suitable 
soil for their development, and -may aid in com- 
plicating and masking the original disease, and 
are the production of putrefactive fermentation. 
Another proof of my observation is, that par- 
asitic growths are only witnessed in cases where 
the putrefaction is well advanced, but never in 
the beginning. This accounts for the fact, that 
many observers were unable to discover these 
parasites at all times, even by the most minute 
examination. 
This parasitic theory has led to great errors in 
diagnosis and practice. It is, therefore, not sur- 
prising that so many individuals fall victims not 
of the disease, but of the treatment. The aim 
of the physician has been to kill the parasites, 
which has frequently been fatal to the patient; 
whereas, if we cure the disease, the parasites can 
neither develop nor exist. 
I have made, very carefully, numerous micro- 
scopic examinations of the secreta of diphthe- 
ritic patients, but have been unable to discover 
any of the various forms of parasites as reported 
to exist in diphtheritic exudation during the first 
stages of the disease ; but when the disease is 
not arrested in the primary stages, its progress is 
generally very rapid, hastening to decomposi- 
tion. 
We are daily breathing an atmosphere im- 
pregnated with myriads of microscopic cells. 
The air is also contaminated with effluvia from 
low or fresh-plowed lands, and from swampy, 
marshy countries. Without that, our health is 
not materially affected. 
The inflamed membranes are covered with 
patches, which consist of a pulpous, cheesy ex- 
udation of various thicknesses, which may be 
easily detached from the mucous membrane. 
Sometimes these pseudo-membranous patches 
are tinged with black blood, and resemble gan- 
grenous crusts, which are frequently expelled in 
fragments ; but they are reproduced with great 
rapidity. The resemblance of these whitish- 
gray formations to gangrenous scurfs, and the 
peculiar odor from the mouth have been fre- 
quently mistaken for genuine gangrene. 
This condition is worse during dry seasons, on 
account of the putrefactive decomposition of an- 
imal secreta which accumulate in the public 
streets, and which are by the winds whirled in 
all directions, and find their way into the remotest 
recesses of our dwellings. 
It is a well established fact that diphtheria is 
as readily manageable under homoeopathic treat- 
ment as any other form of disease. The expe- 
rienced practitioner should but seldom meet 
It is this grayish exudation of fibrinous matter 6 
DIPHTHERIA 
with a fatal case, because he has therapeutic 
means at his disposal which readily and surely 
control the primary inflammation as well as the 
conditions of the disease in the advanced stages. 
Even in badly mismanaged cases he is frequently 
successful, provided the patient is not under the 
influence of destructive drugs, which may pre- 
vent recovery. 
half ounces of the latter, used with a swab every 
three hours, always using this wash soon after 
the removal of the membranes. Internally, I use 
chlorate of potassa in large doses. A favorite 
prescription of mine is chlorate of potassa, three 
drachms; syrup of lemon and rose-water, each 
one ounce and a half; give one teaspoonful ev- 
ery two to three hours. This is for a child of 
three to five years. The amount is to be varied 
so as to meet each individual case. Externally, 
I use salt pork, well rubbed with capsicum (red 
pepper). This constitutes my principal treat- 
ment in these cases. ... I give this treat- 
ment with much confidence, having used it dur- 
ing the past winter. [Does not state with what 
results. How many recovered ?] 
There is perhaps no disease which has baffled 
the skill of the physician more than diphtheria. 
I have spent considerable time in examining 
the bulky literature on this subject. It is aston- 
ishing to find, in the nineteenth century, that there 
has not been one spirit to advance anything pos- 
itive, or to attempt to bring harmony into this 
lamentable chaos. As it is, we find page after 
page of contradictions in the allopathic works on 
practice. What one man recommends as a fact 
is denounced by another as false. There is 
nothing positive; all is conjecture. 
“ The treatment pursued by myself and many 
others (as per our text-books), with hypo-sul- 
phite of soda, internally, and liq. persulphate 
ferri, with carbolic acid and glycerine; hydrochlo- 
ric acid with iron, internally—each in their turn 
have all signally failed of good, as the great 
mortality will show.” 
The result of my investigations in this direc- 
tion may be summed up briefly in the words of 
one of their most illustrious teachers, George B. 
Woods, M. D., president of the American Phil- 
osophic Society and of the College of Physicians, 
of Philadelphia, etc. In his work on Practice 
of Medicine, edition 1866, vol. 1, page 520, he 
says : “ There is no certain or special remedy 
for diphtheria. Many have been claimed, but 
the partial estimate of their proposers has not 
been confirmed by the subsequent experience of 
others. ... By some distinguished practi- 
tioners, reliance is placed mainly on local meas- 
ures, almost to the exclusion of those addressed 
to the constitution, particularly of all those for 
which specific virtues have been claimed; whilst 
others, perhaps equally distinguished, trusting 
mainly to general remedies intended to alter the 
blood or change the systematic actions, attach 
but little importance to local applications, and es 
chew altogether those of an energetic character.’’ 
In view of such facts, and considering the 
enormous mortality these physicians meet with 
in cases of diphtheria, is it not reasonable to 
suppose that the interest of some conscientious 
practitioners would have been aroused, and led 
them to speculate in a direction where they 
easily could find the solution of their misfortune 
in the treatment of diphtheria. 
Whenever physicians, who administer crude 
drugs in quantities which are capable of produc- 
ing poisonous effects in the human system, would 
learn so ascertain what changes they will pro- 
duce upon themselves, they would no longer ad- 
minister them to the sick, nor would they ignore 
the law of similia similibus curantur. 
At the beginning of this century, the German 
Shakespeare, Goethe, recognized the uncertainty 
and deficiency of the art of healing. He satir- 
ized this lamentable condition in his “ Faust.” 
Notwithstanding that the studies of physiology, 
pathology, chemistry, and, since we are blessed 
with the microscope, histology, have made satis- 
factory advancements, the therapeutics of to-day 
are more obscure than ever. The venerable 
Doctor Faust, accompanied by his devoted 
Famulis Wagner, appears among the joyful 
people on a bright holiday. In vain is he trying 
to escape the homages of the people : 
Dr. Medbery has recorded in the Journal of 
Materia Medica, July, 1877, page 133, and in 
the Medical and Surgical Journal, a specimen of 
modern treatment for diphtheria. When first 
called to a patient with this disease, he says : 
“ I invariably prescribe some mild but active ca- 
thartic. Calcined magnesia 1 find is one of the 
best for this purpose. Locally, I use the persul- 
phate of iron (Monsel’s powder) and glycerine; 
one to two drachms of the former to one and a DIPHTHERIA 
7 
A Citizen—Doctor, it is really kind of you to con- 
descend to come this way, and not to shun us on this 
glad day. Your father and yourself always have been 
our friends, and on evil days, too. You were then 
young, and full of hope. You went in every house. 
Body after body was borne hence, but you came out 
safe. The Helper helped the helper. 
the whole bulk of medical literature. Besides 
this, there is a vast amount of very valuable in- 
formation scattered through the numerous hom- 
oeopathic journals printed in all languages. 
But younger members of our profession, de- 
sirous of gleaning from the experience of others, 
will find it, at times, a laborious task to do so, 
especially in the presence of a severe case, when 
time is precious; and as, in many instances, the 
recommendations of writers are not sufficiently 
supported by clinical facts, or they are not based 
upon experience. 
Faust (reverently)— Praise Him above who sends 
help in distress. 
Wagner—How happy must you feel, great man, who, 
as you well know, rightly deserves such honors, for the 
gifts which Heaven has bestowed upon you. 
Faust--A few steps further. On yonder rock let us 
rest. Here I have set alone many a time in the past, 
then rich in hope, possessed with sincere faith, pray- 
ing and fasting, with sighs and groans to Heaven, to 
have the sore plague stopped. Oh, could thou read in 
my very inner being how little sire and son merited 
these thanks ! We raved with our hellish mixtures in 
these valleys far more than the pestilence. I have ad- 
ministered myself the poison to thousands; they pined 
away—and died; no one inquired who recovered ; and 
I must live to hear the reckless murderers praised.* 
For instance, we find that Dr. Hughes recom- 
mends kali, per mang.; Dr. Minton, chlorate of 
lime ; Drs. Gigliovo and Davison, carbolic acid ; 
Dr. Billig, nitric acid : Dr. Fleischmann, kali, 
phos.; Dr. Schuessler, natr. mur.; Drs. Gullon, 
jr., and Gerhardt, mere, corn; Drs. Alph. Beck 
and Von Villers’jthe cyanuret of mere.; Dr.Trinks, 
phosph.; Dr. Hirsch, iodine; Dr. Williamson, 
crot. tig.; Dr. Lutze, chromic acid ; Dr. Logan, 
hydrastis, etc., etc. The busy practitioner has 
no time to consult all these authorities ; he must 
be prepared in advance. 
Hahnemann, with his sharp, critical eye, 
recognized the poverty and unreliability of medi- 
cine in his time, and his productive brain was 
capable of creating a rational and safe therapeu- 
tic system in medicine, As such it is not antag- 
onistic to medicine considered as a scientific 
whole. On the contrary, it constitutes a neces- 
sary completion of this science, inasmuch as the 
homoeopathic system establishes a part of scien- 
tific medicine, 
I must admit that it is difficult to obtain light 
out of such confusion. At the same time, it is 
not very important, because the physician who 
is familiar with the pathogenesis of the remedies 
which he employs, readily overcomes these ob- 
stacles. The fact is, cauterization is useless, 
and therefore an unnecessary torture to the 
patient. 
Homoeopathy is not merely an appendix to 
science and to scientific pathology, but it is inde- 
pendent in itself. It has created a materia med- 
ico which is destined to be the guiding star to 
physicians for ages. 
Diphtheria is not a local affection, but a consti- 
tutional disease, a characteristic symptom of 
which is the exudation in the fauces. Of what 
use can the destruction of the local symptoms 
possibly be, since the disease continues its de- 
structive course ? With the same propriety we 
may cauterize the variola pustules. 
Although we have not yet a complete thera- 
peutical treatise of diphtheria, and notwithstand- 
ing the clinical material is scattered through a 
vast amount of literature, we can boldly assert 
that the results obtained in the treatment of 
diphtheria under the homoeopathic law of cure 
are far more satisfactory than those obtained by 
allopathic practice. 
The practice of alternating several remedies 
is also a peculiarity of our English brethren, 
which is followed by some practitioners in the 
United States. The clinical results from such 
practice have no professional value, and is no 
reliable testimony. 
For the present, we find in the works of Drs. 
Hering, Hartmann, Boenninghausen, Raue, 
Baehr, Kafka, Hempel, Hughes, Ruckert, 
Grauvogl, Oehme, Ludlam, Dake, Guernsey, 
Neidhard, Dunham, Lippe, and many others, 
more practical information than can be found in 
The superiority of the treatment of disease 
according to tae law, similia similibus curantur, is 
now well established. The records of epidemics 
prove beyond a doubt that the mortality in chol- 
era, variola, scarlet-fever, measles, yellow-fever, 
diphtheria, etc., is less than one-half of that by 
* Free translation by the author. DIPHTHERIA, 
any other mode of treatment, especially in diph- 
theria. A thorough acquaintance with the 
pathogenesis of our remedies, a correct diagno- 
sis, and careful individualization will enable the 
practitioner to save lives, frequently under very 
adverse circumstances. 
teria medica, will be productive of far better re- 
sults in the future. 
The telegraph and the press have brought us 
in closer relation with the master minds of all 
nations. Through the medium of our numerous 
journals we become acquainted with their expe- 
rience. Every number adds some grains of gold 
to the storehouse of our knowledge. Every day 
brings forth new features. Every case which is 
presented for treatment exhibits some new con- 
ditions, which require special study. 
Having applied the precepts of Hahnemann’s 
teachings, in a very extensive practice, for nearly 
thirty years to every form of disease with satis- 
factory results, I am confident that earnest 
study of our text-books, and particularly of ma-