Remarks on the frequency and character of the pneumonias of 1890 : an address delivered before the New York Academy of Medicine, April 17, 1890 / by William Pepper.

Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the frequency and character of the pneumonias of 1890 : an address delivered before the New York Academy of Medicine, April 17, 1890 / by William Pepper. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    unusual degree of gastro-intestinal irritability. Vomit- ing frequently occurred spontaneously at the onset and was readily caused by food or medicines during the course of the disease. Diarrhoea was also often easily caused. Both of these symptoms were highly unfavor- able. Haemorrhage from the bowels occurred in one case which came under my observation where there had been marked abdominal distress and fulness. A case is quoted here in full not only on this account but as illustrating peculiar physical signs and nervous symptoms. Case II.—Mr. X., aged forty-six, of excellent health, but probably somewhat overtaxed and depressed in vitality, having recently suffered from a very severe carbuncle, had a sharp attack of influenza. His whole family suffered at the same time. He went out and at- tended to business while still relaxed and with a hard, dry cough. He exposed himself on the evening of January 8th, going out in a damp, raw air and was at- tacked about midnight with chills, violent pains on the right side of chest, cough, and rapid development of fever. On physical examination there was found an ex- traordinary weakness of respiratory murmur over the right lung, especially over the two lower lobes. It was scarcely possible to hear the vesicular murmur, and crepitant rale was developed only after cough. Even on the left side there was no compensatory exaggeration of the respiratory murmur. The case developed into typical lobar pneumonia, involving the entire posterior part of the right lung and the anterior part of its lower lobe. There were a few rales at the base of the left lung, but no pneumonia developed there. The temperature never became very high (103°, maximum). The tongue was heavily coated and the stomach was very sensitive, but he was doing apparently well when there occurred sudden collapse with marked heart-failure and abdominal distress, which was explained soon after by several