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.

    9/16 (page 7)
    preferable to use a water that is mildly diuretic, and for this reason I frequently prescribe Poland water, some good lithia water, or other water that contains a moderate amount of saline. Finally with increasing high temperature and progressive increase of the toxemia, we cannot do better than resort to additional hydrothera- peutic measures. Sponge baths, tub baths, ice packs, or douches, may be employed—the particular procedure depending upon the conveniences of the household, the degree of relief afforded, and the response secured. In some cases we find that the foregoing measures do not suffice, or, having been of avail in the early stages of the disease, later they lose their efficacy; the renal secretion lessens, vascular tension becomes reduced, and the pulse weak and dicrotic. The toxemia has increased, and its pernicious effects are more manifest. Under these circumstances the strychnin should be increased to 1/20 grain (0.003 gram) four times daily, and to this we may add a moderate dose of caffein, 1 to 2 grains (0.06 to 0.12 gram), three times a day, or cocain, £ grain (0.015 gram), three times a day. Under these circumstances, however, the best remedy is hypodermoclysis —the injecting of salt solution under the skin. In a case of pneu- mococcic infection, if the daily amount of urine falls below 40 or 30 ounces (1000 c.c.), I begin with the injection of salt solu- tion into the rectum, from 500 to 1000 c.c. (as may be well borne and retained by the patient), once or twice a day. In most cases there is an immediate increase in the amount of urine and a con- current lessening of the frequency of the heart-beat and an increase in the strength of the pulse; commonly, also, the delirium lessens, the temperature falls a little, and the respirations become less frequent and deeper. In most cases, however, it is necessary to go further. If the toxemia is not relieved, if the heart-beat becomes more rapid, and the respirations increased, I immediately resort to the injection of salt solution under the skin—once or twice in the 24 hours, sometimes every 8 hours. Although we may scarcely look upon hypodermoclysis as a specific in the treatment of pneumo- coccic and other infections, it is one of the most serviceable means of treatment at our command. A simple solution of ordinary salt (sodium chlorid), a teaspoonful to a pint of boiled water, may be used and injected at a temperature of 100° F. Or one may use certain of the tablets or concentrated fluids prepared by some of