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JAMA. 1927;89(12):982. doi:10.1001/jama.1927.02690120058027.
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Increase of Diphtheria  Since the introduction of diphtheria antitoxin in 1894, the morbidity and the mortality of diphtheria have decreased. In Berlin, since the beginning of 1926, the number and the character of diphtheria cases have undergone a change, and cases of malignant diphtheria have been observed, together with a rather high mortality. The special characteristics are foul smelling discharge from nose and mouth, marked glandular swellings, and all the symptoms of vascular disturbances, including numerous hemorrhages. In the majority of these cases, after a relatively short illness, death ensues from cardiac paralysis, supplemented by a grave kidney involvement. Last year, two members of the department of infectious diseases of the Rudolf-Virchow municipal hospital published a report on the cases occurring in that hospital. The percentage of fatal cases increased from 6 in 1923 to 17 in 1926, and in Old-Berlin the total number of diphtheria cases increased from 1,068


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