We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Other Articles |


Am J Dis Child. 1920;20(2):89-112. doi:10.1001/archpedi.1920.01910260015003.
Text Size: A A A
Published online


INTRODUCTION  During the course of the acute infectious diseases in childhood, certain changes in the heart muscle are prone to occur, due to the action of the specific toxins. In diphtheria these changes are more or less characteristic. It is my purpose to describe how these changes may give rise to clinical manifestations, and how diphtheria is related to the problem of chronic disease. The study is based on eighty cases that have been under observation in the St. Louis Children's Hospital. The electrocardiographic studies have been made in the Heart Station of the Washington University School of Medicine.

PATHOLOGY  In diphtheria pathologic changes occur throughout the body, particularly in the highly specialized tissues, such as cardiac muscle, nerve, kidney and liver. These changes have been described by Hayem,1 Babes,2 Romberg,3 Councilman, Mallory and Pearce,4 and others. The changes have been produced experimentally by Welch and


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.