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
Catalogue details

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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    of congestion in the lung by diverting the blood elsewhere in the body. The most serviceable way to lower the blood-presure in these circumstances is by means of laxatives, of which calomel and the salines are the best. In most cases I am in the habit of using calomel for two reasons—because of its well-known laxative effect and because it is a local antiseptic. The pneumococcus, the cause of the infection, as is generally known, is found in the mouth of even healthy individuals; in those ill with pneumonia it is found in the mouth and the upper air passages in increased numbers, and it is truly pathogenic. If, then, we administer calomel in such a manner that it may exert its local antiseptic action, we take steps toward preventing the spread of the local inflammation and toward reducing the degree of the toxemia. Ten grains (0.6 gram) of calomel should be given dry on the tongue. The patient should be asked not to swallow it, but to allow it to mix with the juices of the mouth so that it may come in intimate contact with the mucous membrane of the mouth, fauces, and upper air passages, whereupon it may be swallowed. This is good, sensible thera- peutics, based upon sound principles. It furnishes us with a scien- tific explanation of the empirical success attending the use of calo- mel in the treatment, a form of treatment in especial favor among the older physicians, particularly in the South. There many cases of pneumococcic infection are called bilious pneumonia, and the patients are treated with enormous doses of calomel—20 to 30 grains (1.3 to 2 gram), sometimes repeated. There is no occasion for repeating the dose (and 10 grains suffice), but the use of the remedy is unquestionably of service. In addition to exerting a local antiseptic action in the mouth, by reason of its laxative action it serves to lower the blood-pressure and to reduce the frequency of the heart’s action and the respiration rate. Furthermore, we may control the inflammatory lesions in the lung by means of certain local applications. Of these, dry cups are the best. In the early stages we may be uncertain which lung is affected; put the cups on both sides, and put on not one cup or two cups, but 20 or 30 cups. I have the greatest confidence in the use of dry cups applied over the chest—first generally, and later locally, over the seat of lung involvement. Cup when you are called to see the patient; and if, when you call later in the day or even- ing, improvement is not marked, cup again. Repeat the cupping