Clinical observations on pneumonia in children / by William Stephenson.

  • Stephenson, William, 1837-1919.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: Clinical observations on pneumonia in children / by William Stephenson. Source: Wellcome Collection.

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    since. The case, when seen out of doors, was supposed to be typhus fever. Day oi Illness. T. P. J une 3 V. — E. 106° 124 On admission, the skin is felt to be hot and dry, the tongue moist and thinly furred, the face dark and typhus-like in expression; examination of the chest showed nothing abnormal, except just a suspicion of pneumonia at the apex, but no distinct physical signs can be made out. „ 4 VI.—M. E. 103-8 101-8 124 124 During last night child has been very delirious ; he is very thirsty, and drinks freely of milk and beef-tea. Chest.—Respiration rapid and shallow, almost en¬ tirely abdominal; tremulous pulsation visible over the large vessels in the neck; anteriorly, a shade of dulness on right side in the acromial half of the sub- clavicular region; occasional fine crepitation, with sibilant rales over the whole right front; over the upper lobe the respiratory murmur is deficient, with conveyed bronchial sound; in the lower lobe, breathing is exaggerated; posteriorly, percussion natural; exaggerated vesicular breathing; no rales. „ 5 VII—ai. E. 102 101-8 112 120 Still delirious ; lips and teeth coated with sordes ; res¬ piration less abdominal, still shallow, quick and uneasy; marked dulness in right subclavicular region; respiratory murmur faint; subcrepitant rales; towards base, exaggerated breathing ; scanty rSIes. „ 6 VIII.—M. E. 97 95-8 85 68 Physical signs much the same; rales less abundant, heard occasionally at back. » 7 IX.—M. E. 96 97-5 65 88 Still improving; appetite good; chest the same. „ 9 X.—M. E. 98-7 98 65 88 Dulness diminished; no rales. From this date chest symptoms steadily cleared off. Patient dismissed 19th June. The next case was sent to the hospital as a case of fever • an opinion which the apparent gradual rising of temperature during the second and third day of illness, and the absence of all chest symptoms, confirmed until the sixth day, when the pneumonic ex¬ pression, quickened breathing, and cough, drew attention to the chest. On entering the ward the house-surgeon remarked—u Does not that child look as if she had pneumonia? ” He had examined the chest, but having only directed his attention to the lower lobes, had failed to detect the physical signs. Case IY.—Pneumonia of right apex—Mistaken for fever—Crisis at the encl of the eighth day. (See Chart.) Mary Jane Cochrane, get. 10, admitted 6th June; taken ill the day before. Days, ii. ii r. IV. V. VI. VII. VIII. IX. X. XI. E. M. E. M. M. E. M. E. M. E. T. 100-8 102-4 103 102-9 103 103-1 103-1 103-5 103-1 103-6 103 103 97-2 99 98 P. 110 120 128 130 124 132 136 138 124 128 132 138 98 95 72