On some points in the pathology, diagnosis, prognosis and treatment of pneumonia / by C.H.F. Routh.

  • Routh, C. H. F. (Charles Henry Felix), 1822-1909.
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On some points in the pathology, diagnosis, prognosis and treatment of pneumonia / by C.H.F. Routh. Source: Wellcome Collection.

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    of crepitation still further. In these cases, the crepitation is moist, and accompanies the expiration ; whereas that of pneumonia is dry, and heard only at the end of f?ispiration, and is finer. Looking, however, to the nature of these dis¬ eases, and their concomitant symptoms, a mistake in the diagnosis can only be the result of inadvertency; yet I have seen the mistake made by an eminent stethoscopist, by whom a case of haemorrhage in the lungs was mistaken for one of pneumonia, and treated accordingly by tartar emetic, etc. Prognosis. If I am right in asserting that cases of simple pulmonary congestion, capillary bronchitis, pleurisy, etc., have been treated as cases of pneumonia, it is not to be wondered at that the experience of different practi¬ tioners should be very different. On one side, the eminent Dr. Williams asserts that pneumonia is at all times to be considered as a serious disease ; while, on the other, Chomel asserts that it is in most cases a benignant disease; and, when the individual attacked is of favourable age, he will almost invariably get well under any kind of treat¬ ment. Dr. Walshe, admitting the disease to be most se¬ rious within unfavourable ages, states that there are periods of life at which it is not easy, with common prudence, to lose a sufferer from idiopathic or sthenic pneumonia. I am myself inclined, after personal inquiry for some years, both in London and in the larger continental hospitals, especially Paris and Vienna, to believe that genuine uncomplicated pneumonia is a benignant disease. I am ready to admit that pneumonia is most fatal in England and Scotland ; but this chiefly arises because the proportion of complicated to uncomplicated cases is about fifty-three per cent., and be¬ cause the disease is generally too actively treated. I shall, however, again allude to the mortality in the sequel. Treatment. I cannot here enter at length into the va¬ rious methods of cure adopted in pneumonia—in other words, the experience of practice. I shall speak of three only—1, that by active blood-letting, local and general; 2, that by tartar emetic; 3, that by chloroform, emollients, and milder measures generally; and, lastly, I shall allude to that which I follow out myself, and which I would ven¬ ture humbly and respectfully to recommend. In speaking, however, of blood-letting as a remedy, it is necessary I should allude to some of the theories upon which it is based. By premising what I have to say on the experi¬ ence of that practice, by such an inquiry, I shall be in a bet-