The treatment of pneumococcic infection of the lung, or croupous pneumonia : a clinical lecture delivered at the Hospital of the University of Pennsylvania / by John H. Musser.

  • Musser, John Herr, 1856-1912.
Date:
1904
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Licence: In copyright

Credit: The treatment of pneumococcic infection of the lung, or croupous pneumonia : a clinical lecture delivered at the Hospital of the University of Pennsylvania / by John H. Musser. 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.

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    fact, Dover’s powder is frequently of excellent service, relieving the pain and promoting a mild diaphoresis. It may be given alone in doses of 2 grains (0.13 gram) every three or four hours, or it may be combined with certain other analgesics and stimulants. Should the pain be associated with severe coughing, so that it is to be presumed that violent muscular action contributes to its pro- duction, it may be controlled by the use of some of the milder derivatives of opium, such as codein in \ to £ grain (0.015 to 0.03 gram) doses, or heroin in 1/12 grain (0.005 gram) doses, every three or four hours. Of the symptoms on the part of the nervous that of themselves demand treatment, delirium is the most important; it is some- times severe and of a restless, exhausting character. It is usually an expression of the toxemia, and is usually to be combated by the remedies that we employ against the toxemia—antitoxin(?), and measures that promote elimination, diuretics, diaphoretics, and laxatives. It is often diminished when the pain is lessened, and sometimes in asthenic pneumonia it is improved by the administra- tion of cardiac stimulants. Of these, I have already mentioned several, especially strychnin, which in these cases should be admin- istered hypodermatically, and alcohol, which in these cases is often of service. Furthermore, the salts of ammonium are of value. Thus you may give the aromatic spirit in doses of 15 to 30 minims (1 to 2 c.c.) every hour or two; or ammonium carbonate (in some menstruum that diminishes its irritating effect upon the mucous membrane of the stomach, such as a little mucilage of acacia) in doses of 5 grains (0.3 gram) every two hours; or ammonium chlorid in 5 grain (0.3 gram) doses every two hours; or ammonium iodid in 2 to 3 grain (0.13 to 0.2 gram) doses every two hours, or somewhat larger doses at longer intervals. In some of these cases, camphor also will be found to be an excellent remedy, in doses of 1 to 2 grains (0.06 to 0.13 gram) by the mouth, or (the smaller dose) hypodermatically at one-hour intervals. In certain severe cases of pneumococcic infection of the lung a condition arises that is difficult to distinguish from true menin- gitis. The head is retracted, the muscles of the neck are stiff, and from time to time slight convulsions occur. If conscious, the patient complains of intense headache, and if unconscious, he makes various motions indicating that there is pain in the head. There