Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays.

  • Thomas Jefferson Mays
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    vital resistance on the part of ihe patient's constitution. This seems to be true when it is excessively high, as well as when it is too low; and it appears that the safety point lies be- tween these two extremes. A pneumonic adult, with an average temperature of 100° F., or less, has a less hopeful outlook than another with the same amount of pulmonary disturbance and with a tem]x-rature of 104° F. A low tem- perature in acute pneumonia indicates serious exhaustion of the nervous system, and this is found in the pneumonia of alcoholics, that of the insane, and in that of others whose nerve integrity is greatly impaired. This deduction in regarfi to the prognostic influence of fever in this disease is practically corroborated by Dr. Wil- son Fox's statistics.* He shows that out of a total of 353 cases of acute pneumonia that the mortality from 107° to 110° was 100 per cent., from 106° to 107'', 42.8 per cent., from 105 to 106°, 18 per cent., from 104° to 105°, 7.4 per cent., from 103 to 104°, 17.6 per cent., and under 103, 36.9 per cent. A pulse-rate of 120 in the adult is to be regarded as a danger sign, especially if the fever is moderate. In children in whom the pulse is very impressible no special an.xiet\- need exist unless it reaches a rate of 150 or 160 in the minute. Tntermittency and irregularity of the pulse are serious signals, although they are not infrequently found in the aged. A frequent respiration-rate is not such an unfavorable indication as is a laborious dyspncea, in which each in- spiration is accompanied by pain and distress in the epigastrium. When the expectoration is wanting from the beginning, excepting in children, who frequently swallow it, and es- pecially when at the same time there are beard moist rales in the lungs, or when this is of a prune-juice color, a grave * '■ Diseases of the Lungs and Pleura,'' p. 352.