Symptoms.—These differ, in the great majority of cases, from croupal pneumonia, in not being preceded by rigors. There is always fever and a rise of bodily temperature from 103° to 105°. There is often copious perspiration and increased pulse. As the disease progresses the breathing becomes more difficult and rapid, the cough changes its character, and “becomes short, harsh, hacking, and painful, the child endeavouring to repress it, and having an expression of pain or crying and diminished expectoration.”[115]
[115] Dr Roberts.
The treatment of this form of pneumonia consists in keeping up the strength of the patient by means of good nourishing food, and stimulants judiciously administered. Ammonia and senega should be given if the sufferer is very weak. In ordinary cases ipecacuanha wine will be found useful. Poultices of linseed or mustard to the chest are also prescribed. During convalescence the patient requires careful watching; his diet should be generous, and should include wine; cod-liver oil, quinine, and iron, or other tonics are additionally necessary.
3. Chronic pneumonia. This disease, in which the substance of the lung is in a more or less abnormal or altered condition, is mostly the result of some previous pulmonary affection. It frequently follows successive attacks of the catarrhal variety of pneumonia and the bronchial irritation arising from the inhalation of small particles of dust given off by substances employed in certain occupations or manufactures, such as coal, steel, granite, &c.
The symptoms are pains in the side, cough, sometimes occurring in severe paroxysms, shortness of breathing, the patient meantime gradually becoming thinner and weaker. Sometimes night sweats occur, but generally there is little or no fever.
The best treatment is nourishing diet, combined with tonics and cod-liver oil.
Of late years the doctrine of the contagious nature of some forms of acute pneumonia (whether complicated with pleurisy or not) seems to have been gaining ground amongst medical practitioners. The well-known fact that the pleuro-pneumonia of cattle is propagated by contagion, if it does not prove this contention, is at any rate “worthy,” as Dr Parkes remarks, “of all attention.”
The following cases, selected from amongst many others equally striking, would appear to lend considerable support to this view:
1. The ‘Lancet’ for January 9th, 1862, contains a communication from Dr Bryson, describing an epidemic of pleuro-pneumonia which occurred in 1860 amongst the Mediterranean fleet. The infectious character of the disease is stated to have been very marked; besides which there were several points of resemblance between it and the pleuro-pneumonia which attacks cattle.
2. Professor Bock of Christiana has recorded an outbreak of pneumonia which took place in the Akerhus prison of that city in 1866. Out of 360 prisoners 62 of them were attacked with pneumonia in six months. The prison, like the cattle sheds, ravaged by pleuro-pneumonia, was badly ventilated and overcrowded.