Acute lobar pneumonia : a pathological and clinical study of 120 consecutive cases subjected to port-mortem examination / by John Lindsay Steven, M.D., Physician and Lecturer on Clinical Medicine, Glasgow Royal Infirmary.

  • Steven, John Lindsay, 1859-1909.
Date:
[1901]
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Licence: In copyright

Credit: Acute lobar pneumonia : a pathological and clinical study of 120 consecutive cases subjected to port-mortem examination / by John Lindsay Steven, M.D., Physician and Lecturer on Clinical Medicine, Glasgow Royal Infirmary. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    this regard. We have seen that in our cases pericarditis was most frequent in right-sided pneumonias, in three of them the lesion being situated in the upper lobe, a circumstance which points to general infection rather than to mere local extension. The association of lobar pneumonia with acute peritonitis points to the same thing, particularly if, as some- times happens, all the great serous cavities are more or less involved. The condition of the other organs, as demonstrated in the course of this analysis, is such as is usually met with in the specific fevers. We have seen that cloudy swelling of the liver, kidneys, and spleen are very frequent associated condi- tions. The constancy with which enlargement of the spleen is met with is perhaps worthy of special mention in this regard. My friend, I)r. David M'Crorie, assistant physician and bac- teriologist to the Glasgow Iioyal Infirmary, informs me that in a very large number of examinations he has never failed to obtain the pneumococcus in cultures from the spleen in cases of acute lobar pneumonia. On the whole, then, I think, it may be admitted that the facts as regards morbid anatomy brought together in this paper support the view that acute lobar pneumonia is a general and not a local disease. line of the strongest clinical arguments in favour of this view as to the nature of acute lobar pneumonia is the constancy with which the crisis of the disease occurs on the 7th or 8th day. A reference to the table showing the day of death in 74 of our cases makes it clear that by far the greatest number of cases die on and after the seventh day of the disease. The actual figures are these: On the 6th day and before it 21 cases died; from the 7th to the 11th day inclusive 48 cases died. These figures confirm the clinical argument based on the constancy of the critical day in pneumonia, and form a fitting conclusion to the foregoing remarks, in which I have endeavoured to give expres- sion to my opinion, based on six years’ observation and study in the post-mortem room (supplemented, as regards my personal experience, by six additional years of clinical study in the wards), that acute lobar pneumonia is a general febrile disease.
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