An Address on PNEUMONIA: ITS NATURE AND TREATMENT: Delivered before the Glasgow Southern Medical Society
Authors: J. Barr
Journal: BMJ (1914)

TlEre suibject of pneuimonia, whlicll I lhave chosen for tllis ;ad(ldress, mnay appear to most of you threadbare, and it is one ol whicll I htave frequently lectured and written, but it is always possible to present an old subject in a noew lighlt.Moreover, a dlisease whiiich kills inore of His Majesty's lices in this cotunitry than aniy other, witl the singfle exception of ttuberculosis, mlust always cotinimanid thei attention of thloulghltful men.Tlo nigiht I slhall not weary youL witlh any hlistorical slketchl, diagnostic problemis, or syniptomatology, witli wlichl I shall assuimie that you a-C all famliliar; but I slhall limit otur attention to somlie poinits wlhichl I tlhink wortlhy of the consideratioln of an intellectual audienice.I lhave long lield that pneumonia is, to a great extent, a preventable disease, anid, in dealing ith this ubiqritous affectiomi, prevention niust more .l(rgelyi'est vitht the.general plractitioner than witlh the tledlical officer of healthl.For the prevenition and cutre of tlhis or ony otlher disease we miiust h1ave a good knowvle(dge of its inicidenice, etiology, and propel treatmuent.It is to tdicse topics tllat I shall devote your attention to-niglht.IN CIDENECE.In 1909 tlhe deatlhs fronm pneumhonia in England anid WVales considerably exceeded those fromii plthisis, tlhe mimiiiibers being pet 1,000 deatlhs, pnleumionia 89, plhtlhisis 74.6, anid tlhe 'rate per iimillion living, pneumonia 1,290, plitlIisis 1,080.IIn 1911 the deatlh-rate from pneumiiionia fiIbd falleni to 1,041 per lmillionl living, whlile the deatlhs ftPoimt plhtliisis (including 22 per lmlillionl of population from .Ictte in iliany tuberculosis) reaclhed 1,084.This dleatlh- miate fromii plithlisis of 1,084 per m-lillion personis amounted to 7.4 per cent.of-the total death-rate, and was coimnposed <f thle rate of 1,256 for miiales alnd 923 for females.It Woulld seem as3 if tlhe great fall in tlhe deatlh-rate fron ttibereculosis, whlichl was vrciy lmlarlked duLring the past fifty Y.ears, lhad been somewhlat clhecked since the great outcry about the con(luest of consunpl)tion began.In 1911 the (leatlhs from all formls of ttubercutlosis in England and \\ales were 53,120,-against 51,317 in 1910.Tllere is vidently still plenity of scope for tllose genitlemen wlho hlave done so muchl shlouting and miiade so little progress.rrhe total deaths in Englanid and Wales in 1911 from piieinlnloniia were. 21,582males and 16,060 femuales; total, 37,642, wlhiclh gives a deatlh-rate per million persons of 1,041.There xercr also 14,391 deatlhs from pneuimionia as acomplication of otlher diseases, such as mleasles, whoopingg- coiioh1j influenza, enteric fever, etc.[in theeRegistrar-General's report for 1911, Dr.,Stevenson reaiiarks on the miiortality fromii pneumonia that, " apart from Lonidon, wlere it is hliglh, there is a steady decrease from nortl to south in all classes of area and in botlh se:ses, the lposition of Wales beitng initermediate between tlle Nortl anid tlle Midlands.Thle range of mortality is extreme, beinig foutr times as great for males in tlle county borouglhs of the North as for females in the rural districts of the South, and not far from three times as great wllen persons of the same sex are compared.Even when comparison is restricted to the samlie class of area, in THE BRITIS X I EDICAL JOURNAL J PNEUMONIA: ITS NATURE AND TREATMENt.rJAN.TO, T9T4under 5 years of age, and 576 over 25 years.In Liverpool at these respective ages there were 738 and 629 deatlhs.In Glasgow during the same year and at the samiie ages there were 256 and 648 deatlhs from bron clhitis, while in Liverpool the respective niumiiber of deaths wvere 375 and 1,022.From these statistics it wouild appear to