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.

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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    It will be remarked, that the number of females in the whole 232 cases is too small by 8 per cent., being 23 per cent, instead of 31; and the proportion of complicated cases is not stated. In 69 of the recoveries from among the 182 cases last re- corded, blood-letting was employed, together with mild laxatives only; but in the 81 remaining, antimonials were freely conjoined. The number of deaths which occurred among all those treated on the former plan, as compared with all those treated on the latter plan, is not stated; and this omission in some degree, therefore, vitiates the result as a measure of the value of treatment by blood- letting singly. Grisolle’s remarks, however, on these cases are instruc- tive. Taking, he says, all these cases (232), 101 only were successfully treated by blood-letting. In the remaining cases it did not stop the disease ; and it is, when reasoning on these cases, that he makes the admission, before quoted, on the incurability of pneumonia, of a certain intensity, by blood-letting alone. As, moreover, in the above number of cases there is not the normal complement of females, this circumstance alone would necessarily diminish the cypher of mortality. So far, then, we have evidence of the occasional ineffi- ciency of blood-letting as a means of cure, in the proportion of at least in 131 cases out of 232, or 56 per cent. I cannot now dwell upon this part of our subject, but I shall conclude by the addition of Dr. Dietl’s cases. That physician treated also 85 cases on the blood-letting system, and he lost 17, or 20 per cent. To recapitulate, therefore,— Per cent. Grisolle obtained (1st stage) a mortality of.... Bouillaud, 1st series selected cases „ 2nd ditto Dietl 20 14 12 20 Mean. 16*5 II. Treatment hy Blood-Letting^ combined with Tartar Emetic. ' This, I believe, is the ordinary treatment of most modern practitioners, and is probably the most dangerous. The great Laennec was perhaps the first physician who com- bined these two therapeutical agents. After bleeding a patient to sixteen ounces, he used to give tartar emetic in grain doses every two hours, sometimes, if the case were severe, increasing it to two grains, but he never exceeded thirty grains in twenty-four hours. His success was most marked. Before 1824 he says he did not keep any exact
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