Arizona republican. [volume] (Phoenix, Ariz.) 1890-1930, 1893-02-12
Pneumonia.
BY WIN. W. mBBARD, MIDI
IL.

Gases OF pneumonia having a rapid
course and tending toward recovery do
not usually involve more than one lung.
When both lungs are involved one part
is attacked previously to the other.
The right lung is more commonly az
fected than the left and the base Of the
organ rather than the apex. When
both lungs are involved it is probably
due in most cases to some impaired
physical condition which has Influenced
the whole system and thereby left it in
a condition in which the disease more
readily invades the lungs. Statistics
indicate that old people and children
are more liable to have double pneu-
monia. This form of the disease is al.
ways to be viewed with much appre-
hension. In the aged it is quite danger
Gus. Pneumonia is double in about one
case in eight. The symptoms when
uncomplicated are clear and not easily
mistaken. 1t is one Of those diseases
that runs definite course and is ushered
in with severe chill, and from this
symptom we may date its beginning.
The chill does not alternate with fever
as in intermittent fever, but almost in
variably is OF considerable duration and
Immediately followed by fever with
much loss OF muscular strength and
willingness on the part OF the patient
TO take to the bed.
The chill, as has been remarked, is OF
q severe type and usually not re-
peated. In old persons this Symptom
may be slight or entirely absent, and in
children its place is taken by conyul-
sions or vomiting. With the develop
ment Of fever other symptoms rapidly
follow, the earliest are pain in the side,
difficult breathing and cough, increased
pulse, considerable thirst and prostra-
ton, The face becomes flushed and
dusky, there is an anxious expression
and hot skin. The pain in the side
usually corresponds with the part at
tackled and is much increased in breath
ing as we'll as coughing. The increased
frequency OF breathing may be quite
marked, ranging from thirty to fifty
times minute and is much higher in
children. The pulse is somewhat
variable. 1t is more rapid in
early than in late life. Owing to d. !
minished power OF the heart old peo- |
pie have much less rapid pulse. The |
temperature usually mas a rapid rise at |
the beginning of the disease ard is |
frequently maintained until the crisis |
has been reached. The maximum is !
reached either in two or three days |
after the onset or Immediately be- !
fore the crisis. 1t is lowest |
from 6 to s O'Clock in the !
morning and highest in the
early part Of the evening, though .
sometimes there is much fever about .
midnight. After passing the crisis the
temperature rapidly declines. During
the height of the fever there is frequen-
tly a severe headache, great restless
ness and inability to sleep. There may
be incoherency OF thought delerlum,
in bad cases delerium is more marked
and may become violent in character.
Cough Is usually present with greater or
less degree OF prominence. Occasional
ly it is very slight. 1t is generally ac-
companIed by expectOration, at first
scanty transparent and irothy. About
the third day il becomes less trans
parent, very tenacious and has an iron
rusk like tint, it contains blood cor.
puscles, and may vary in colorng iron a
light brick red to brownish black and
be go tenacious that it will stick to
vessel when it is turned over. 1t has
the general appearance OF thick jelly
as to its consistency. Occasionally the
expectoration is very small and the
coloring slight.
The symptoms that have been re-
ferred to as characteristic are the more
important ones, particularly as applying
TO the first stage. Later certain changes
occur in rapid succession. The pain
grows less. Coughing and expectora-
ton becomes easier, the matter expec-
torated loses its rusty appearance. The
fever diminishes and the respiration,
though more frequent, rapidly i'm
proves. Ii the history Of the disease be
unfavorable and there is increased in
Vasion Of the substance of the lung, the
fever persists and the breathing grows
more difficult later on according to the
favorable or uniavorable history OF the
affection the symptoms increase or de-
crease in severity somewhat, similarly
to what has been referred to when only
one lobe of the lung has been attacked.
The end OF infiammatory iniiltration
designates the time at which
changes occur. This may be anywhere
from the fourth to the tenth day; then
a rapid decline OF the symptoms in gen.
eral takes place. In uncomplicated
cases the disease rapidly declines some
times in few hours. There seems to
be set up q process OF re-absorption by
which the exuded material is quickly
removed and convalescence is FASTENED
to that degree that in less than three
weeks the disease has almost wholly
CONTINUED February 10thl