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.

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    consideration into two parts. The first, that of this evening, will include some points in connexion with its pathology, diagnosis, prognosis, and, as a consequence, the unphiloso- phical nature of that theory which recommends blood-letting as a useful therapeutic measure. The second part, which I hope to be fortunate enough to bring forward before this Society on a future occasion, will relate to the experience of various plans of treatment, especially those of blood-letting, tartar emetic with and without blood-letting, the chloro¬ form treatment, and the milder plans of practice, generally and statistically considered; to conclude with the plan of treatment which I would humbly and respectfully recom¬ mend. In this inquiry, I feel I shall need your indulgence, and would ask you to bear kindly with me if, in the course of this paper, I venture to oppose the views of many of the most eminent of our profession. I court philosophical in¬ quiry : I seek only the elucidation of truth. Pathology. It is not my intention to follow out the pathology, diagnosis, or treatment of pneumonia, in its second and third stages, except where incidentally necessary to illustrate a point under consideration; the more so as I believe that, in these two last stages, the diagnosis is com¬ paratively easy, and all are agreed that general blood-letting is then comparatively noxious; to discountenance which is the chief object of this paper. It may, however, be right to premise by stating what I conceive to be, first, the patholo¬ gical appearances of pneumonia in the first stage; and secondly, what are the principal morbid changes in the blood. In regard to the first of these points, I may generally quote Dr. C.J.B. Williams’s words as the exponents of my opinions, namely, that in the first stage there is not necessarily ex¬ travasation of blood in the air cells, but that the vessels around these are engorged, dilated, and generally congested, in actual specific gravity heavier than healthy lung, but still floating in water. The mucous membrane of the smaller bronchi and air-cells may be redder than usual, but not re¬ markably so. When a portion of the lung is cut and com¬ pressed. a frothy, rusty, or bloody serum exudes. The whole tissue is much reddened, and less elastic to the feel. This appearance is wholly clue to congestion of the lungs. The occasional extravasation of blood in the bronchi is ca¬ daveric, and analogous to what we observe in other hollow organs of the body, as in the intestines after peritonitis. (Library of Medicine.)