Remarks on the frequency and character of the pneumonias of 1890 : an address delivered before the New York Academy of Medicine, April 17, 1890 / by William Pepper.

Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the frequency and character of the pneumonias of 1890 : an address delivered before the New York Academy of Medicine, April 17, 1890 / by William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    10/18 (page 10)
    IO PEPPER, rise equal to the initial temperature. Temperatures of 105° and 106°, and in two cases of 107°, have been re- ported, the latter occurring toward the fatal close of the cases, one of whom was quite clear in his mind and the other fairly rational. On the other hand, in a few cases strikingly low temperatures were noted throughout the course of the extension of croupous pneumonia. In a case involving all of the left lung except the tip of the apex, and terminating in abscess, the initial temperature reached 102° for a brief period, but at no subsequent time was it above ioi§° until hectic fever set in. It is proper here to call attention strongly to the fact that the vast majority of pneumonias occurred as a sequel, rather than a complication, and that they were clearly traceable to exposure to damp and raw weather while the patient had a relaxed system and while slight pyrexia persisted after the subsidence of the more marked symptoms of his influenza. Experience furnishes many instances of this fact. Both the cases above quoted are striking exam- ples. It was not even necessary that the patient should leave the house to meet with this fate. In a marked case which I saw, a man aged thirty-five, heavily taxed with important professional work and depressed by the loss of a favorite child of three with apex pneumonia of a cerebral type, had an ordinary influenza, from which he improved so greatly by the fourth day that, in opposi- tion to his physician’s orders, he rose, dressed, and went to his library at some distance from his bed chamber. He soon had a chill, followed by temperatures of 105° and 1060, with right-sided pneumonia, rapidly develop- ing delirium and deepening stupor, and with rapid and furious convulsions before death, which occurred on the fourth day. The practical lesson taught to all of us by this case must be embodied impressively in the records of this epidemic, and in all future cases of influenza must serve as a most important guide in the management ot this disease, especially in this state of convalescence.