On some points in the pathology, diagnosis, prognosis, and treatment of pneumonia / by C.H.F. Routh.

  • Routh, C. H. F. (Charles Henry Felix), 1822-1909.
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: On some points in the pathology, diagnosis, prognosis, and treatment of pneumonia / by C.H.F. Routh. 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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    which cases, owing to a chemical change of a similar kind induced in the blood, the pneumonia passes seldom beyond the first stage into the second, but into a half gangrenous, half purulent destruction of the lung. (a) 2. The hyperinosis which follows is due to hyper- oxygenation of the blood. Dr. B. W. Richardson, a fellow of our Society, has proved that if an animal be placed in an atmosphere of oxygen, intense hyperinosis follows; and, ac- cording to his views, this is one of the reasons which leads to the death of the animal by obstructions of the heart through fibrinous coagula. In pneumonia, too, circum- stances contribute to the same result, viz., the increased ^ number of respirations, and the increased activity of the capillary cutaneous function. The number of respirations in a minute in this disease is frequently very great. Instead of 16 in a minute, the usual extremes are from 30 to 50, sometimes as high as 70 or 80, when sufibcation seems threatened; but 30 or 40 respirations per minute may exist without the patient being conscious of particular dyspnoea. (Walshe.) The rapidity of the respiratory func- tion thus more than compensates for any obstruction in the lungs, a greater quantity of oxygen is absorbed in a given time, and hyperinosis results. But the increased activity of the cutaneous function assists to bring on the same result. The skin, as is now invariably admitted, contributes to the maintenance of animal heat, and, as such, acts like a respiratory organ to consume the oxygen absorbed. The experiments of Becquerel and Breschet on rabbits, have proved this. When the skin was covered by an imperme- able varnish, the temperature of the body fell, although, d priori, the evaporation of the sweat being also thereby impeded, an opposite effect might have been expected. It is also remarkable, that in pneumonia the extreme heat of skin is a characteristic of the disease. Indeed, this increased heat of the surface is by some physicians considered as pathognomonic of the disease, reaching to 105° and even higher ; the normal temperature being 98°. It is a curious fact, and one which I may observe en passant, that this in- creased heat of skin is usually and chiefly observed in diseases where the blood is poisoned, as in scarlatina, typhus, remittent, and intermittent fevers, yellow fever, puerperal fever, etc.; and thus it may, perhaps, be considered as evidence of a similar state of blood in pneumonia. Most probably this increased oxygenation of the blood is an abortive attempt made by the vis medicatrioc