A treatise on the pneumonia of children / by M.M. Rilliet and Barthez. Translated from the French by S. Parkman.

  • Rilliet, Louis-Frédéric-Théodore-Albert, 1814-1861.
Date:
1839
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the pneumonia of children / by M.M. Rilliet and Barthez. Translated from the French by S. Parkman. Source: Wellcome Collection.

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    eased tissue becomes grayish, and presents very little difference from the surrounding portions. The reader will therefore easily con¬ ceive, that if it requires a careful attention to establish the exist¬ ence of a lobular pneumonia at the second degree, how much more is necessary to recognise it when arrived at the third stage, where the peculiar colour, the most common of the marks, has disap¬ peared. But if we pay proper attention, we cannot fail of remarking, that in the track of the incision certain lobules are projecting, the vesi¬ cles not collapsing as in the surrounding portions, and that pressure in these lobules gives issue to a liquid, rather purulent than serous? after which we may easily establish the existence of the other cha¬ racteristic signs. This description of the three stages of pneumonia, written with the preparations before our eyes, and which is very nearly a compend of the opinions of all the authors upon the subject, does not appear to ns, however, to give a perfect idea of the pathological anatomy and the progress of the disease. We have thought that we have observed two forms of the lobular pneumonia, the one perfectly circumscribed, which we would call mamellonated, the other not so clearly limited, to which we would give the name of partial. In giving these names we would not be understood as thinking to describe two distinct diseases ; we consider them only as two forms of an identical affection, having a common origin, but a different progress; finishing by presenting some modifications of the symp¬ toms, and of which the partial is an intervening stage between the lobular and the lobar pneumonia. The mamellonated pneumonia forms a nodule of inflammation, the colour and appearance of which contrasts strongly with the sur¬ rounding tissue. It is a point of pneumonia perfectly limited, thrown into the midst of a tissue nearly or quite healthy, and its boundaries are clearly defined, even when the surrounding tex¬ tures are engorged. It may even happen, as we have seen in one subject presenting about a dozen of these nodules, that the boundary is marked by a circle, or rather by a white resistant spherical cap¬ sule, of about an eighth of a line in thickness, and presenting a fibrous aspect. Usually, the line of demarcation, besides the change of colour, is indicated by the collapse after an incision of all the surrounding parts. The size of these nodules varies from a hemp-seed to a pigeon’s egg ; their border is generally regular, representing a sphere, or some analogous figure, and their number varies from one in a lung to twenty, thirty, or even more. The partial pneumonia, on the contrary, is less well defined than the mamellonated ; its circumference is insensibly confounded with the surroun ling textures, without any distinct demarcation, either by change of colour or protuberance of the diseased part ; its vo¬ lume, often greater than in the mnmellonated form, is, however, sometimes the same : its form is not always regular, the inflainma-