A further contribution to the local treatment of pulmonary cavities / by William Pepper.

  • Pepper, William, 1843-1898.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: A further contribution to the local treatment of pulmonary cavities / by William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    mental despondency. Careful treatment, including change of climate, having been faithfully tried for many months, without affording relief to the symptoms or checking the progress of the disease, it was decided to use injections into the diseased area. The general symptoms justified a grave prognosis, and especially the fear of constitutional infection and outbreak of the disease in other localities. The result confirmed this apprehension. Fifteen injections were made into the left apex; and the notes of the ease record marked relief to the cough, lessening of the expectoration, with evidences of arrested activity of the local disease, and tendency to contraction of the left apex. But ere long tuberculous formation made itself manifest at right apex, and extended rapidly through the lung. Intense cachexia was developed and death occurred. Here, as in Case XI., the local action of the injections was undoubtedly beneficial, but was ex- erted at too late a stage to secure as much good as might other- Avise have been derived. This comprises all the cases in which I have used injections into pulmonary cavities. Before attempting to sum up the re- sult of the twelve cases, in which a total of 210 injections were made, I will report a few cases where injections were made into areas of partial or complete consolidation, in order to test the applicability of such local treatment to such cases. Case I. (No. 1 in former communication.) John Dortt: pneu- monic phthisis, with caseous infiltration of entire left lung and secondary tuberculous formations in right upper lobe. The Symp- toms had lasted only nine months, but patient was sinking very lapidly. Five injections of dilute iodine solution were made in the course of sixteen days into the upper lobe of the consolidated left lung to the depth of one and a half inch. The punctures caused no symptoms whatever. Death occurred five days after last injection. Post-mortem examination showed no trace what- ever of passage of needle through the intercostal tissues, nor of the punctures of the lung substance. Case II. Charles Johnson, a Swede, set. 40, was admitted to I hiladelphia Hospital Sept. 10,1874. Symptoms of phthisis had existed for a year; cough, purulent sputa, numerous small he- morrhages: for six months there had been marked dyspnoea, and 2