In asthenic pneumonia, in addition to the nutritious diet, burgundy, port wine, or brandy should be used, and stimulant embrocations should be applied to the chest. In children the state of the bowels must be most carefully watched. Stimulating expectorants are more frequently necessary than at any other period of life.
In conclusion, I would urge that all remedial measures which tend to paralyze the heart should be excluded from the treatment of pneumonia, and great care should be exercised not to over-stimulate the heart, for over-stimulation often results in paralysis. It must always be remembered that in the milder cases there is necessity for no treatment except a regulated diet and attention to those general hygienic measures which have already been referred to.
I shall not attempt to discuss the treatment of the complications which may occur in the course of a pneumonia, for it is impossible to even mention every contingency that may arise. The rule is to treat the pneumonia so long as it is the controlling disease, and the complication when it shall have become the most prominent and dangerous element in any given case. In prolonged convalescence it is of the utmost advantage that the pneumonic patient shall have a change of scene and climate.
Antiseptics.—The use of antiseptics in the treatment of pneumonia has as yet given no definite results. I have employed hypodermically phenic acid after Declat's method in several well-marked cases of simple pneumonia, without being able to determine that the temperature or course of the disease was at all influenced by its use.
F. Schwarz53 states that the very favorable results which he has obtained in croupous pneumonia can only be due to one thing—i.e. the specific action of iodine, which renders inert the exciting cause of the disease, which he regards as an organism, and that its efficacy is limited exclusively to the very early stage of the pneumonia. He believes that its action in acute lobar pneumonia is the same as Von Willebrandt claimed for it in typhus, typhoid, and in malarial fevers. He even states that he regards iodine as a genuine specific in pure uncomplicated croupous pneumonia if employed within twenty-four or thirty-six hours after the ushering-in chill, that hinders its development and arrests its progress.
53 Deutsche medicinische Wochenschrift, January, 1881, No. 2.
After using benzoate of soda in diphtheria, scarlet and puerperal fever—drachm ij in the twenty-four hours—E. B. Cady54 states that when an epidemic of pneumonia visited his town in Wisconsin he had equally good results from the similar use of this salt in pneumonia, cases recovering which had a temperature of 106° F. and 107° F.
54 N.Y. Med. Record, 1880, July, 3, "Benzoate of Soda in Pneumonia."
Orth55 has recently written an interesting account of the treatment of pneumonia (lobar) with iodine.
55 Allg. med. Centr. Zeitschr., Berlin, 1881, i. p. 181.