THE TREATMENT OF PNEUMONIA


Infections is favored by cold; therefore, the patient should be well protected at all times even when changing the bed linen, but, of course, do not go to the other extreme and have patient too warm. Clothing, light but sufficient, through ventilation and a temperature of about 68 degrees should be carefully arranged. Bathing is necessary for cleanliness but as a rule it is not needed as an aid in reducing temperature.


The earlier treatment is instituted in the course of the disease pneumonia, the better will it be for the patient and I believe this cannot be disputed. Pneumonia, though, is such a treacherous disease that seemingly, when everything appears in the patients favor, he frequently will die, and adversely, so often when it seems there can be no hope, conditions will suddenly change and patient will get well. However, it does seem that the earlier a patient can be gotten to bed the better the result should be.

Physical and mental rest is most important and here the doctor is usually as much at fault for irritations to the patient as anyone else. Too frequent physical examinations are unnecessary. An early and complete examination is usually sufficient and unless serious changes take place, why subject the patient to more discomfort. Avoid making the patient exert himself; for instance, when using the bed-pan, or urinating, or changing the linen, much help can be given by nurse or attendant. Avoid discussing the case either with the patient or with others in the presence of patient. Pay close attention to condition of heart and pulse, and here, also, this can be done in such a way as not to annoy.

Infections is favored by cold; therefore, the patient should be well protected at all times even when changing the bed linen, but, of course, do not go to the other extreme and have patient too warm. Clothing, light but sufficient, through ventilation and a temperature of about 68 degrees should be carefully arranged. Bathing is necessary for cleanliness but as a rule it is not needed as an aid in reducing temperature. The air should be kept somewhat moist. The easiest way to do this is by using a wet sheet hung in a door-way. It can be wetted down as it becomes dry.

Feeding should be given special attention, light but nourishing, usually milk and broths. In those patients who have indulged, or are alcoholics, alcohol should be administered in some manner; best, possibly, by mixing whisky or brandy with milk in the form of a punch. Many cases do well without alcoholic stimulants, but where there is increased prostration or collapse is imminent, it is absolutely essential to employ it. Also when cardiac weakness impends, alcohol also in some form is the better stimulant.

Local applications are greatly over-done. Usually as given by a light flannel jacket, regular use of the high frequency electric current in the form of diathermy or the use of the ultraviolet light is sufficient. The use of such weighty applications as the kaolin preparations is absolutely unnecessary.

Remedies found to be efficient both from the chest symptoms and pain are listed as follows:

Aconite. The fever is ushered in with a distinct chill and the history of an exposure to cold is clear. This remedy is particularly indicated if associated with the characteristic nervous and mental state. The pains of Aconite are violent stitches in the left side in the region of the breast; shooting pains in the intercostal region of the left side accompanied by a sensation of a weight in the chest. There is a hoarse, dry, croupy cough. The breathing is loud and labored and there is a hot feeling in the lungs.

Veratrum viride is indicated in the early stage with rapid pulse; rapid, strongly acting heart, dyspnoea and a sensation of heavy load on the chest as the most prominent symptoms. Usually cases which call for Aconite or Veratrum viride are seen too late to prescribe these drugs.

Ferrum phos. Here the chill is poorly defined. Blood- streaked sputum, hard, dry cough with a very sore chest, dyspnoea and fever are among the prominent symptoms.

Bryonia. This remedy is probably the most frequently indicated of all the remedies, but, not as some seem to think, the only one drug to use. The chief symptoms are a dry cough, dyspnoea and a great thirst. Pain is a prominent symptom, the type of which is a sharp, lancinating pain below the right nipple from within outward, felt during inspiration. Most of us consider this remedy as only right-sided but it also has a location on the left side and here pain is in the same region as on the right extending through to the scapula, also felt during inspiration. This symptom taken by itself does not, of course, mean Bryonia, but when associated with a characteristic right-sidedness, it is surely indicative of this drug.

Phosphorus is another very widely used remedy, and justly so. Pain is one of its prominent features. The pain is violent and stitching in character, under the left clavicle down the left side to the lower lobe of the lung, also a cutting pain from the sternum through to the right scapula. Other symptoms are, fever, chill and dyspnoea which is aggravated by motion and cough. The cough is hard, dry, tight and racking in character.

Cantharis has intense dyspnoea, palpitation, a frequent, dry cough which is short and hacking, with blood-streaked, tenacious mucus and severe stitches either on tone or the other side.

Conium. There is a dry cough which is almost continuous, and worse the latter part of the day. A small amount of mucus is raised only after prolonged coughing. The patient feels relief afterwards. There is dyspnoea on exertion with an oppression and constriction of the chest. The pains are violent stitches on the right side, as if a knife were being plunged into the side.

Causticum has hoarseness, with pain in the chest and soreness accompanied by palpitation, great anguish and uneasiness. He cannot lie down at night. The pain is on the left side, in the lower lobe and on both sides at the lower border of the upper lobes.

Rhus tox. Lancinating pain extends from the left side through and under the scapula, accompanied by a dry, ticking cough, worse after midnight, oppression of the chest with a sensation that he cannot breathe because of the sticking pains.

B B Penimore