The age-herald. [volume] (Birmingham, Ala.) 1897-1902, 1899-04-12
The Origin of Ineumonia

From the Medical Record.
In pneumonia the Importance of the role
played by heterogeneous is now gener-
ally acknowledged. Dr. Andrew II. Smith,
in his article on "Croupous Pneumonia
in Forthcoming volume Of the Twentieth
Century Practice OF Medicine, has done
much to elucldate these mooted points and
to remove the difficulties in the way of d
more intelligent understanding of tho
causation of the disease. He takes tho
ground that pneumonia is not an inAam-
nation of the lung, but that it is simply Il
process OF germ culture going on in the air
cells, the culture medium being supplied
from the functional vessels. DIR. Smith is
OF the opinion that the key to the whole
problem is in the double circulation in the
lungs, thing known to every one, but
the bearing of which upon the pathology
OF pneumonia has been hitherto overlooked.
Attention is drawn to the fact thar in no
other organ of the body but the lung could
structural health and diseased action go on
side by side, for it is the only one-altnough
somewhat analogous condition is met
with in the heart-in which the blood sup
ply for nutrition and function are se2alate-
~ provided for.
AS might be expected, so radical a change
OF view as to the pathology of the disease
carries in its train numerous new views in
respect to treatment. More than one-third
OF the article is devoted to a consideration
of this branch of the subject, in marked
contrast to the usual custom of writer's.
We have seen that DIR. Smith asserts that
pneumonia is not an inflammai ion of the
lung, for the reason that in his opinion it
does not affect the nutrition of the orsaii
but is process of germ culture in which
the pneumococcuS grows in a culture mo
dunn supplied by the functional capl!lar.es
OF the lung. Hence, his argument runs
that therapeutic Efforts should be directed
toward the arrest or inhibition of this germ
culture Inasmuch as this culture medium
Is derived from the blood, any substance
added to the latter will also be found in
the former, and If that substance is mimi
cal to the growth of the coocus it will i'll
so far act in the direction sought For
tunately the pneumococcus is the most vul-
inerable of all the germs and possessed OF
the least vitality. We have, therefore, ac-
ccrding to Professor Smith, prior prob
ability that its career in the lung can be
modified by drugs. The one from which
the most satisfactory results in this direc-
ton have been obtained is the salicylate of
sodium. Creosote is also valuable, as are
likewise large doses of quinine, which have
been credited with an abortive effect long
before the existence of any kind of mcro-
organism was recognized.
In regard to the treatment OF pneumo-
MIA by means of antitoKin, Professor Smith
believes, with most scientific men, that
while there may and probably will be a
great future for orrnotherapy, at present
the results have been too indecisive to be
relied upon as curative or remedial in this
disease. However, the news has recently
come from Berlin that Professor WasseT-
mann, of that city, a pupil OF Professor
Koch, hopes that he has discovered q
serum cure for pneumonia.
There are many more features of inter-
est in Professor Smiths work which we
should like to notice, but it would be i'm
possible within the limits of an article to
do moro than give the chief points. How
ever, this much may be said, that the NEW
views on pneumonia are likely to prove
a most valuable addition to medical knowl-
edge.