Diagnosis. — A  definite  attack  of  diphtheria,  and  the  characteristic  onset
of  the  subsequent  paralysis,  render  the  diagnosis,  as  a  rule,  a  simple  matter.
It  is  only  when  the  nature  of  the  preceding  disease  has  escaped  recognition
that  any  real  difficulty  occurs.  It  must  be  remembered  that  an  offensive  dis-
charge from  the  nose  is  sometimes  the  chief  indication,  of  diphtheria.  But
the  onset  by  the  affection  of  the  throat  and  eye,  and  the  subsequent  progres-
sive paralysis  in  the  limbs,  are  so  distinctive  as  to  indicate  at  once  the  nature
of  the  symptoms,  and  also  that  of  the  preceding  sore  throat,  of  which  there


*  Gaz.  Hebd.,  i$8z,  Nos.  20  and  21.
77


1234  DIPHTHERITIC    PARALYSIS.
