Two hundred cases of acute lobar pneumonia / by John Hay.

  • Hay, John, 1873-1959.
Date:
[1904]
Catalogue details

Licence: In copyright

Credit: Two hundred cases of acute lobar pneumonia / by John Hay. 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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    toxaemia or the onset of cardiac failure. Toxaemia and cardiac failure being the two most common actual causes of death a discussion on treatment really resolves itself into the consideration of these conditions. So long as there are no signs of severe toxaemia and no indications of cardiac weakness, general treatment, careful dieting, and good nursing are all that are required. In such cases the medicinal treatment makes very little difference so far as the ultimate result is concerned, though the comfort of the patient may be greatly influenced by appropriate means which, however, do not fall to be considered here. Before dealing with the question of the treatment of cardiac failure it will be advisable to discuss the means of preventing its appearance. This must be accomplished by peaceful and quiet surroundings, a good supply of fresh air, no unnecessary movements, the relief of pain, and the pre- vention of any interference with the action of the diaphragm. Sleeplessness, struggling associated with delirium, and flatu- lent distension of the abdomen are, in my opinion, three of the gravest conditions to be dealt with. The first pro- duces general nervous and physical exhaustion and may end in the production of an asthenic or typhoid state. The second may rapidly induce grave cardiac failure. The third adds considerably to the work of the heart. Continued insomnia is almost fatal and much may be done in the early days of the disease to comfort and to ease the patient and so induce refreshing slumber. Cold or tepid sponging is especially soothing and at the same time tends to lower the temperature. A. poultice of linseed and mustard applied to the side may induce sleep by relieving the pain of pleurisy ; this pain is generally sharp and stabbing and is increased by breathing, in contradistinction to the dull, con- tinuous, aching pain felt during the first few dajs either alone or contemporaneously with the pleuritic pain. This dull pain is due to the distension of the visceral pleura and capsule of the lung and is frequently relieved by the appli- cation of ice bags placed over the engorged and distended lobes. Paraldehyde in doses of two or three drachms was occasionally useful in the alcoholic cases. It is somewhat objectionable to take and can be given either in mucilage with syrup of orange and peppermint or with a small quantity of brandy. It does not depress the heart. I did not find the chloral and digitalis mixture efficient unless given in such large doses that one feared for the depressing