On some points in the pathology, diagnosis, prognosis, and treatment of pneumonia / by C.H.F. Routh.

  • Routh, C. H. F. (Charles Henry Felix), 1822-1909.
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On some points in the pathology, diagnosis, prognosis, and treatment of pneumonia / by C.H.F. Routh. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    24/46 (page 22)
    under this head involves the question of experience, viz., the results of the treatment hy blood-letting—its influence on mortality. I purposely, therefore, refrained from entering upon its discussion on the last occasion; but its considera- tion necessarily opens the subject of the paper, to which I venture this evening to solicit your attention. I. Treatment hy Blood-Letting. It is alleged that, by carrying out blood-letting freely, the mortality is dimin- ished. But who is there amongst us who will undertake to state what is the normal mortality of pneumonia, affected as it is by sex, age, habits of life, seasons, seat, complication with other diseases, and treatment % Take for instance the following table:— Cases. Deaths. Per cent. Trousseau (1831-32) 58 2 , .. 3.4 British Army (Colonies) 12271 .. 413 . .. 3-3 Bang (Copenhagen) 54 2 . .. 3-6 Navy (Home and Colonies) 3099 .. 136 , .. 4.3 Varentrapp (chloroform) ...... 23 1 . .. 4-3 Cases treated by Baumgartner, Wacherer, Helbing, & Schmidt 193 9 .. 4*5 Husson 43 3 .. 6-9 English and Scotch Hospitals .. 59 7 .. 11-8 Liverpool Southern Hospital .... 10 1 .. 10* Laennec (1824-5) 62 4 .. 6-6 Varentrapp (usual treatment) .. 206 .. 49 .. 18-4 Dietl (Vienna) 380 53 .. 131 Bouillaud (Paris) . 75 13 .. 17*3 Grisolle (Paris) 391 71 .. 181 General Hospital, Vienna 1134 .. 200 .. 12-9 Glasgow Infirmary (1844-8) .... 248 .. 69 .. 27-7 Drs. Walshe, Taylor, and Peacock 140 .. 44 .. 31-4 Total 18,506 1,137 61 I cannot here enter upon all the different causes which influence the mortality of pneumonia; such a course would involve far too lengthy a paper. I must, however, say a word about the influence of age, sex, and complication. (a) Age, At the two extremes of life, the mortality is great. It is stated by Dr. Walshe to be, from 6 to 12, scarcely exceeding 2^ per cent.; from 15 to 30, 6 per cent.; from 30 to 40, suddenly rising to 14 per cent.; and in- creasing thenceforth steadily for each succeeding decade. The following table, from Grisolle, founded on some 900 cases, carries this ratio higher.