A case of tuberculous excavation of the left lung, treated by perforation of the cavity through the walls of the chest / by John Hastings, M.D. and Robert Storks, Esq.
- Hastings, John, M.D.
- Date:
- 1844
Licence: Public Domain Mark
Credit: A case of tuberculous excavation of the left lung, treated by perforation of the cavity through the walls of the chest / by John Hastings, M.D. and Robert Storks, Esq. Source: Wellcome Collection.
Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.
8/16 (page 6)
![his head having slipped off the pillow during the night. 9 P.M.—He had about half-past one, after a long nap with his head verv low, a severe attack of cough and difficulty of breathing, with great pain in and around the wound. As Dr. Hocken lived much nearer the residence of the invalid than myself, and had very kindly promised to supply my place in the event of emergency, he was imme- diately sent for. On arriving he with- drew the tube, which was followed by the escape of about a tea-spoonful of healthy-looking pus; this afforded great relief to the dyspnoea. The irri- tating cough had been nearly subdued by an anodyne, and expectorating mix- ture, prescribed by Dr. Hocken, which was ordered to be continued. Whilst the cough continued, frothy sputa to the amount of an ounce was expecto- rated. The headache was severe; the pulse 100. The naphtha mixture and wine were withheld, and his head and chest maintained in a raised position. Cold lotions were ordered to the head. 25th, 8 A.M.-—The pulse were 88 ; the respirations 28. He had passed a to- lerable night, with slight cough, and trifling expectoration of frothy mucus. 2Bth, 8 A.M.—The cough and expec- toration had diminished. He had slept at intervals during the night. The pulse were 100. 9 P.M.—He was generally more com- fortable than in the morning; he attri- buted this to his being able to keep an erect position by the aid of one of Daw's patent chairs. The pulse were 112; skin hot; tongue moist, 27th, 8 A.M.—The pulse were 96. He was very languid; had passed a tolera- ble night, with slight cough, and ex- pectoration of a brown tenacious mucus, blended with sputa of a purulent cha- racter. The appetite was deficient, and he complained of pain in and around the wound. The tube was re- moved, as it was suspected it might be the cause of the pain. 4 P.M.—The cough was troublesome, accompanied with difficulty of breath- ing and great languor ; the pulse were 100 ; the skin hot; with a total loss of appetite. 28th, 8 A.M.—The pulse were 84; the cough and expectoration were less ; the purulent character of the latter had almost disappeared; the bowels were open. Ten minims of Nap. Rect. were added to each dose of the mixture, and wine, beef-tea, and animal jelly, were directed to be given. 29th, 8 A.M.—The pulse were 92; the respirations 28 ; the tongue clean, and the skin moist. He complained of headache, which he had sufl'L-red from more or less since the 24lh, nausea, and occasional shooting pains. He had had snatches of sleep during the night, his spirits were good, and he felt stronger than he did the day before ; the expec- toration, which amounted to about an ounce, was chiefly of a mucous charac- ter, and of a brown flesh colour. He had taken nourishment two or three times during the night. [For the report of the condition of the patient during the next two days, and also Dec. the 3d and 4th, I am in- debted to my friend Dr. Hocken, in consequence of my unavoidable ab- sence from town, to whom both Mr. Storks and myself feel highly indebted for his kind assistance, and entire con- currence in the treatment which has been adopted in this case.] SOth, 9 P.M.—Appearance much im- proved; feels much better and stronger; is quite free from headache, except from exertion, or from moving sud- denly. Chest and wound comfortable, and free from pain ; pulse stronger than in the morning, 92—soft; respirations 24. Has had little difficulty of breath- ing or cough all day, and did not ex- pectorate anything till one o'clock p.m. Since then has spat up about half an ounce of a transparent, tenacious, frothy mucus, mixed with saliva; some few sputa, very slightly streaked with scarlet blood. Has eaten some animal food (rabbit), &c. with appetite. No fever. Dec. 1st.—Had passed on the whole a good night; sleep having been seve- ral times disturbed by dreams, and pain in the back of the head. On first v\ ak- ing suffered much from headache; but it has gradually decreased, and is at present trifling. Had no ex})ect.oration till about two o'clock a.m., since which he has spit up about one ounce of te- nacious rusty-looking mucus; some sputa streaked with florid blood. The tongue clean and moist. Bowels moved; stool liquid, healthy coloured. No un- due heat of skin- pulse 74; respira- tions 26. The tube has given no un- easiness, and air escapes with a whist-](https://iiif.wellcomecollection.org/image/b21476111_0008.jp2/full/800%2C/0/default.jpg)
