A treatise on the pneumonia of children / by Rilliet et Barthez ; translated from the French by S. Parkman.

  • Rilliet, F. (Frédéric), 1814-1861.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the pneumonia of children / by Rilliet et Barthez ; translated from the French by S. Parkman. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    For example, what are the differences between pneumonia and pleurisy, bronchitis and phthisis. Simple pleurisy is a very rare disease in children from two to five years ; for our part, we have never met it, for whenever we have found a liquid in the pleural cavity, there has always existed an hepatisatinn of the lung, thus usually confounding the symptoms of the pneumonia with those of the pleurisy. In one case the absence of all respiratory sound, where a bronchial respiration had been heard, immediately niter the declaration of a pleuritic pain, enabled us to recognise an effu- sion complicating the hepatisation. We may also remark, that the access of suffocation, mentioned in two of our observations, ap- peared of some value as diagnostic of an effusion into the pleura. cavity. But we must not assign too much importance to this symptom, as we are not certain that a rapid hepatisation may not give rise to the same phenomenon. Among the observations of MM. Constant and de la Berge, we find two of a pleuritic effusion diagnosticated by percussion and change of position. In the older children, simple pleurisy is still a rare affection, dif- fering however in nothing from the same disease in the adult. A bronchitis severe enough to produce constitutional symptoms is certainly very rare in children from two to five years. In the immense majority of cases, when it puts on this form, it is compli- cated with lobular pneumonia, and we have, in speaking of the diagnosis of this latter, alluded to the great difficulty of distinguish- ing these two affections, especially where the bronchial element is predominant. A catarrh in the younger children not determining any symptoms of reaction is characterised by cough, sonorous and sibilant rales, mucous cracklings or even the subcrepitous rale, but this latter is in general of short duration and its bubbles are very unequal. As we have often heard a subcrepitous rale in cases where we have afterwards found pneumonia, we would guard against being understood to assert, a subcrepitous rale heard on both sides of the back to be a pathognomonic sign of bronchitis, such an assertion would be in flagrant contradiction to facts, which we have detailed above. In children from five to fifteen years, a pulmonary catarrh fre- quently complicates other affections, measles, hooping-cough, typhoid fever, &c, but it is also observed idiopathieaiiy, and then it presents no difference in its symptoms with that oi the adult. The tuberculous affection of the lung ; can this simulate a pneu- monia? In speaking of vesicular pneumonia we had occasion to remark that a superficial examination might mistake the granula- tions of inflammation for those of tubercles, and we have thus pointed out their characteristic differences. Inattentive observers also might regard the small abscesses of the lung as tubercular excavations, but in those latter when existing in the parenchyma, the surrounding tissue and the age at which they occur prevent all mistakes of this nature. In fact we all know that in children, of 16—d ril 4