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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    the right axillary border in the fourth and fifth interspaces. Where and how this abscess originated can now only be matters of conjecture. It was of importance, however, to decide whether the lobes of the left lung were actually involved or only crushed solid and collapsed. The only way to ascertain this was by an anatomical examination of the discharge. A large quantity of sputum was diluted with an equal quantity of Aq. chloroformi, well shaken, and centri- fuged. After much search small fragments of elastic tissue and a few epithelial cells were discovered. He used to ex- pectorate a pint of sanious foetid pus in twenty-four hours, and had occasional rigors and hoemorrhage; enormous numbers of tubercle bacilli and cocci. He has been under treatment three winters. He now expectorates 9 oz. It is no longer foetid, and few organisms besides the tubercle are found, but these still exist in considerable numbers. The area of absolute dul- ness is not so extensive, and faint respiratory sounds are returning at its periphery. The apex beat is coming nearer the right mammary line. Had the condition not been estab- lished for three years before I saw him, he might have been assisted by surgery, but the permanent displacement of his heart, embarrassment of breathing, and the danger of adminis- tering anfesthetic, contra-indicated this. He would probably have died on the table or soon after. He takes the ethereal solution in liquid paraffin easily, but five minims of the pure ethereal solution occasions breathlessness for hours. His utmost possible is a quiet, uneventful life; he can walk several miles, shoots and fishes, his appetite is good, and he has no temperature.—[Professor Arthur Gamgee.] CASE No. 9. [Dr. Livingston-Loudon.] M., age 28; height, 6 ft. 2 in.; weight, 9 stone; very pronounced tubercular history; duration of illness, before iodoform treatment, six years. So soon as it was detected sanatorium treatment in Switzerland and at home was carried out, with guaiacol, cod-liver oil, etc. Steady advance occurred in spite of every effort. There were cavities in both upper lobes, larger in the right, involvement in both lower lobes, bilateral pleurisy, very resti'icted action, and great flattening of chest. Over the lower lobes posteriorly the muscular effort of inspiration is visible for quite a measurable interval of time before the very short respiratory sounds are audible. Patient could only sleep on his back. He had slight fever, consider- able cough and expectoration, large mimbers of tubercle