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Diphtheria most often leads to death if left untreated because of obstruction of the upper airways by an adherent membrane. Pierre-Fidele Bretonneau – who introduced the term diphtheria in 1817 – is usually credited with having documented the first successful use of tracheotomy to relieve laryngeal obstruction caused by the disease. After two unsuccessful operations in 1818 and 1820, his third (done in 1825) was successful. Bretonneau’s pupil, Emile Trousseau, also had two failed operations (in 1826 and 1828) before succeeding in 1831. In 1855, Trousseau reported on the fate of 216 children in whom he had used tracheotomy at the Hopital des EnfantsMalades in Paris. Forty-seven children (22%) had survived, a result that he rated as remarkable given the dire natural history of laryngeal obstruction caused by diphtheria:

French 19th century contributions to the development of treatments for diphtheria