The curability and treatment of pulmonary phthisis / Tr. and ed. by Montagu Lubbock.

  • Jaccoud, S. (Sigismond), 1830-1913.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The curability and treatment of pulmonary phthisis / Tr. and ed. by Montagu Lubbock. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    chronic miliary tuberculosis, or the ordinary form of the disease, and the pneumonic form. Notwithstanding its more gradual development, and that its progress is at first less rapid, the miliary offers in typical cases a condition which is decidedly less favourable to recovery than the pneumonic form. This statement, already made in my Clinical Lectures, is deduced solely from the results of my own observation. It might be supposed in consequence that it was the effect of a casual sequence of cases ; this opinion, however, can scarcely be held, since the sequence would have to be of too great length. The facts which I have studied since the publication of my lectures confirm the assertion, while I also find, upon comparing these two forms, sufficient reasons for the difference which they present as to curability. These reasons are certainly of an indirect kind, and not connected with the special form of the lesion; but, as far as the final and practical conclusion is concerned, this is, judging from all that I have seen, such as was just asserted. We will now survey the indirect or direct causes of the difference which exists between the two principal anatomical forms of tuberculosis, and this consideration will remove all that might appear para- doxical in my assertion. The miliary is connected, so to speak, with the highest form of the diathesis; the hereditary and innate diseases are usually expressed in it, and this would be the cause of its greater resistance to the healing process. In this form the lesions are almost invariably bilateral, either from the first, or before the disease has been long in existence, which is another unfavourable circumstance owing to the influence exercised by the large extent of the lesions. In this form the lesions are more disposed to increase by successive miliary de- velopment as usually occurs in the disease, while one rarely observes that tendency which, on the contrary, is so frequent in the pneumonic form—I mean, to the formation of foci