Further report on the treatment of phthisis by iodoform infusion / by Thomas W. Dewar.

  • Dewar, Thomas W.
Date:
[1905]
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Licence: In copyright

Credit: Further report on the treatment of phthisis by iodoform infusion / by Thomas W. Dewar. 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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    G solution through the cricothyroid membrane. When injecting here the head must be thrown well back and fixed, and the patient told on no account to swallow or move the larynx during the operation, otherwise one could anticipate fracture of the veiy delicate needles (Schimmel’s) employed. When she left, the left lung was normal in every respect, save that expiration was rather prolonged at the apex and there was hollowing under the clavicle. The right lung was much shrunk on inspection, percussion over the upper lobe impaired, and breathing bronchial; otherwise it seemed normal. Breath sounds had returned at the base anterior and no crepitations were heard at the base post. Three months after treatment was stopped I had the sputum examined; no tubercle bacilli (Royal College of Physicians’ Laboratory). This patient has now been at work a year and has kept well. Weight, 9 st. 7 lb.—[Dr. E. S. Jackson and Dr. B. Cl. Morison.] CASE No. 3. [Sir Thomas Fraser.] F., age 20; weight, 9 stone; probable tubercular history; two brothers died in infancy, one had to winter at Cannes with pleurisy, marked tubercular history in ancestors. Present illness is referred back to a severe attack of scarlet fever seven years ago, since when there have been alternating periods of good and bad health. Attacks of anaemia, diarrhoea, unexplained prostrations, rises of temperature her physicians could not account for, etc. After one of these rigors she was taken to Dr. Goodhart, who detected lung mischief. In these feverish conditions her temperature had risen to 102°, but during the time she was under my care it never rose above 100°. (Once when she had a pleuritic attack, and again during laryngitis.) The sputum contained large numbers of tubercle bacilli, cocci, and elastic tissue (Royal College of Physicians’ Laboratory). The skin was gi-eenish-yellow, but the blood count was normal, and haemoglobin 110. Temperature was never a conspicuous feature in the case, and the antipyretic effect of the injections was not so marked as in other patients. The pulse never rose above 100. Despite these favourable features the condition of the lungs \vas very serious. There was extensive pleurisy on the left side anteriorly over both lobes down to the costal margin. No action over the upper left lobe, which was con- solidated with medium moist sounds. There was dulness over the upper portion of the lower lobe and wliispering pectriloquy to the left of the mamma at the axillary border with large crepitations. The right apex was dull, and fine crepitations