Reprinted from the New York Medical Journal 
for June 5, 1897. 
MEASLES 
COMPLICATED BY LARYNGEAL DIPHTHERIA, 
ZW TUBA TION. RE CO VER Y. 
By BURT RUSSELL SHURLY, M. D., 
LARYNGOLOGIST TO THE DETROIT POOR COMMISSION AND BOARD OF HEALTH. 
The comparatively rare occurrence of authenticated 
cases of laryngeal diphtheria complicating measles, and 
the exceedingly grave prognosis of this condition, have 
prompted me to report the following result: 
A boy four years and eight months old was seen by 
me, in consultation with Dr. F. N. Henry and Dr. Toepel, 
December 17, 1896. The following history was then pre- 
sented: The child exhibited the usual prodromal symp- 
toms of measles. Acute coryza developed ten days ago. 
Exposure occurred ten or twelve days previous. There 
was a typical mottled rash four days after onset. The 
catarrhal symptoms had been greatly exaggerated. The 
cervical glands were enlarged. Examination of the phar- 
ynx revealed nothing more than an acute pharyngitis. 
Four days after the eruption appeared croup became 
manifest, and thirty-six hours later all the attending phe- 
nomena of a laryngeal stenosis-labored breathing, retrac- 
tion of the chest wall, restlessness, and cyanosis-devel- 
oped in a marked degree. Fifteen hundred units of Parke, 
Davis, & Co.'s antidiphtheritic serum were injected by 
Copyright, 1897. by D. Appleton and Company. 2 
MEASLES AND LARYNGEAL DIPHTHERIA. 
Dr. Henry, and I performed intubation, a three to four 
years' tube being placed in the larynx. This was im- 
mediately expelled, together with a piece of thick gray 
membrane three fourths of an inch in length. Rein- 
sertion gave perfect relief. The culture and exudate 
were carefully examined by the bacteriologist of the 
board of health and Klebs-Loeffler bacilli reported 
present, determining that this was a diphtheritic 
membrane engrafted upon the laryngitis of measles. 
Forty-eight hours after tubage a temperature of 105.4° 
developed, attended with increased bronchial irritation. 
No consolidated areas were found, however, and the fever 
gradually subsided. The tube was removed on the fourth 
day, ninety-two hours after operation, and considerable 
dysphonia promptly returned. This responded rapidly, 
however, to continuous steam inhalation, and the patient 
made a perfect recovery. 
In referring to the literature of measles, I am able 
to find but few authenticated cases with recovery. The 
complication is exceedingly grave.