“General symptoms.—These may be summed up generally as severe fever with great depression and prostration. The skin is hot, dry, and burning. The temperature rises with great rapidity to 102°, 103°, 105°, or sometimes higher. It has been known to reach 107° in cases which recovered, and in fatal cases it has attained to 109·4°. In a large number of instances it does not exceed 104°. There is usually considerable flushing of the cheeks. The pulse ranges generally from 90 to 120, or may be much above this.”
In the majority of cases this variety of pneumonia has a favorable termination, but however slight the form in which it shows itself, or the mildness of its attack, the properly qualified practitioner should be called in to combat it. We have described the nature and cause of the disease and given the course to be followed in treating it, for the benefit only of the emigrant and others similarly situated. The above comments are meant to apply to the other descriptions of pneumonia, which will be adverted to in the course of the present article.
Treatment to be followed in croupous pneumonia.—Bleeding was formerly had recourse to, but this treatment has either been abandoned of late years, or very rarely practised, the only case in which its moderate employment is recommended being that in which the patient is threatened with death from partial privation or suspension of breath.
Leeches may be applied to the spot in pain, and a large blister near it, but it is preferable to first try the effect of hot fomentations and poultices containing laudanum; or turpentine sprinkled on a warm damp flannel may be tried. A third of a grain of tartarised antimony, with a few drops of laudanum, or a third of a grain of hydrochlorate of morphia may be given every four hours.
“In all low forms of the disease the only chance is in free stimulation. At the same times full doses of carbonate of ammonia, with bark, spirits of chloroform, ether, camphor, and such remedies, must be administered. In some cases quinine with iron is useful.”[114]
[114] Dr Roberts.
The best diet consists of milk and beef tea. The patient, it is needless to say, should be kept in bed, and the temperature of his chamber should be maintained at about 60° F. It is also most essential that the room should be thoroughly ventilated, and all the expectorated matter, stools, &c., thoroughly disinfected before removal.
2. Catarrhal pneumonia. The acute variety of this form of pneumonia is that which principally attacks infants and children, and
frequently complicates diphtheria, hooping-cough, measles, and influenza; although it may occasionally occur when not associated with these diseases.
In the other variety—chronic catarrhal pneumonia—the greater number of cases arise from bronchitis. Many authorities look upon the last variety of pneumonia as the cause of a great proportion of the cases of pulmonary phthisis.