Pneumothorax in tuberculous subjects / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
[1905]
Catalogue details

Licence: In copyright

Credit: Pneumothorax in tuberculous subjects / by F. Parkes Weber. 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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    plete healing, except for an aerial fistula, through which air could be expired. In the discussion at the Clinical Society when the case was shown, W. G. Spencer stated that he had operated on a case of pyopneumothorax and had removed a lot of caseous material from the lower lobe of the lung, and that apparently the disease had not advanced for three years following the operation. In conclusion, I would remark that cases of tuberculous pyopneumothorax in which anything like an Estliinder’s operation can be recommended must be very rare indeed. Whatever local treatment be adopted every endeavour must be made to improve the patient’s general condition,'** for, even if he recover from the local condition of pneumo- thorax, it is upon his general state of health (connected with his occupation, food, and general mode of life) that his power of resisting the advance of the tuberculosis mainly depends. In the chronic cases of hydropneumo- thorax and pyopneumothorax the patient should have a generous diet, plenty of fresh air, and all the advantages of the modern treatment of pulmonary tuberculosis. In this connexion certain writings of F. Penzoldt* and L. Spengler^* are very instructive. Penzoldt’s patient was a medical man, aged 30 years, who in April, 1900, presented physical signs of tuberculosis in the lower posterior part of the left lung ; tubercle bacilli were detected in the sputum. At the commencement of June, 1900, pneumothorax of the left side developed and after two months became converted into a pyopneumothorax, the pus being apparently of the “ empyeme graisseux ” kind. By the end of August the air in the pleural cavity was completely replaced by the fluid effusion. The treatment adopted consisted in repeated tappings and iodoform injections, together with rest in the open air and good feeding. To the strict observance of modern open-air principles Penzoldt in great part attributes the successful result. After July, 1900, there was no fever. During 1901 and 1902 the signs of empyema slowly cleared up and the heart gradually returned to its normal position. The cough and expectoration diminished and Anally altogether ceased and the patient’s weight steadily increased. Finally, he was able to return to work, •*'» Leyden in 1890 at the Berlin Verein fiir Innere Mediein drew attention to the great importance of combining general hygienic treatment with local treatment in such eases. *1 Deutsches Archiv fiir Klinische Mediein, 1905, vol. Ixxxiv., p. 57. Zeitschrift fiir Tuberkulose, Leipsic, 1901, vol. ii., pp. 27, 105.