In persons having a low vitality, purulent infiltration may occur, which consists of diffused suppuration of the lung tissue. In rare cases a circumscribed Abscess forms. The occurrence of copious expectoration of whitish or yellowish mucus, general perspiration, a sudden abundant discharge of urine with copious sediment, Diarrhoea, or even bleeding of the nose, may be regarded as signs of a crisis, encouraging the hope of a favourable termination, but the true crisis is shown by the thermometer, which will indicated a sudden fall of temperature at the critical period.
Occasionally, in old or enfeebled constitutions, Gangrene of a portion of the lung may occur. This conditions is easily recognized by a most intolerable odour of the patient’s breath, resembling that proceeding from mortification of external parts. Unless the gangrenous portion is extremely limited, the case is almost certain to terminate fatally.
CAUSES. Pneumonia is due to the invasion of the lung by a bacillus, which in the great majority of cases is the pneumococcus, but severe of long continued exertion, or over fatigue, either alone or combined with cold, may act as a predisposing cause by lowering bodily resistance. Brief exposure to cold, however intense, is rarely sufficient to excite this Inflammation; it is rather a prolonged and deep reaching cause of cold that can produce this effect. This, write Dr. C.J.B. Williams, if a person gets thoroughly wet, and remains long in wet clothes, or lies out on damp ground, or a sentinel standing or slowly pacing for hours in a cold wind, Pneumonia is likely to be the result. Boys who get heated at football, or some other violent exercise, throw themselves on the damp grass, or remove clothing to cool themselves, or stand about; the chill operation on the exhausted body, causes extreme Congestion in the lungs, the circulation of which has been weakened by the previous respiratory efforts.
The result is Pneumonia, generally asthenic, commonly double, and attended with much prostration.
EPITOME OF TREATMENT.
1. At the onset. Aconite, then Phosphorus In previously healthy patients, and in uncomplicated cases, these two medicines are generally sufficient.
2. Pleuritic complication. Bryonia T., Phosphorus
3. Bronchial complication. Ant. T., Phosphorus
4. Other conditions. Chelidonium (liver complications); Arsenicum or Ac. Nit.(aged persons or feeble constitutions); Iodium (scrofulous patients); Sulph. (tedious or sub acute); Rhus. Arsenicum, or Baptisia (enteric symptoms); Carbo V. Arsenicum, or Lachesis (foul breath, Gangrene, et.); Cact. (Congestion in the chest); Verbascum Vir. (also cerebro spinal irritation), (Verbascum Vir. is praised by some as almost specific in the early stages if there is marked vascular excitement); Arnica (from injury, or over exertion); Lycopodium (deep seated pain, or bronchial irritation left after Pneumonia). Ferrum phos.
ACCESSORY MEANS. The patient should be warmly but lightly covered; the temperature of the apartment 60 degree to 65 degree. A large, thick linseed meal poultice to fit thee chest in front and back, or Antiphlogistine may be used. A continuous poultice is one of the best methods of providing for the local loss of vitality in Pneumonia and similar disease. Niemeyer says, In all cases I cover the chest of the patient, and the affected side in particular, with cloths which have been dipped in cold water and well wrung out. The compresses must be removed every five minutes, unpleasant as this procedure is in all cases, yet even after a few hours the patients assure me they feel a material relief. The pain, dyspnoea, and often the frequency of the pulse, is reduced. Sometimes the temperature goes down an entire degree. It must be remembered, however, that if a poultice is to do any good the patient ought to feel the benefit of it in relief of symptoms at one. If a poultice is not felt to be a relief and comfort by the patient it should be discontinued. The patient must be kept very quiet, have mucilaginous drinks and farinaceous diet, and be treated generally as directed under Enteric Fever.
112. Pleurisy.
DEFINITION. Acute Inflammation of the pleura (the serous membrane which invests the lungs and lines the thorax).
In health, the pleura has a smooth, lubricated surface, to permit the free motion of the viscera it encloses; inflammation destroys this polished surface, so that movement of the membranes, or of the lunges, is rendered difficult and painful.
PLEURODYNIA (False Pleurisy) is pain in the chest walls, and does not belong to the pleura, or lungs. See Section of Neuralgia…
SYMPTOMS. The decease comes on suddenly and violently, with rigors, fevers, and lancinating, stabbing pains, often called stitches in the side, commonly felt below the nipple, and usually affecting only one side; the pains are actually increased by coughing, by pressure, or by the least attempt at a deeper inspiration, which the patient soon refuses to take. There is tenderness at the intercostal spaces, and the breathing is diaphragmatic, the movements of the ribs being restrained, and the lungs only partially filled with air. There are also a short, frequent, dry cough; parched tongue; flushed face; hard, wiry, quick pulse (about 100 in the minute); scanty, high coloured urine; and the patient constantly desires to lie on the affected side, or on the back. Should the lung also be involved, the expectoration will be very copious, and streaked with blood.
The Inflammation, however, soon terminated either in resolution, when the two surfaces of the pleura regain their smooth moist character; or the roughened and inflamed surfaces become more or less adherent; or effusion takes place, and a dropsical fluid separates the surfaces, a condition known as hydrothorax. In several cases the effusion may be so excessive as to compress the lungs and the heart, and to suspend their functions. Sometimes there is a large collection of true pus, which fills the pleuritic cavity, when it is termed Empyema. This condition is likely to arise in bad constitutions, and also when the Inflammation has resulted from injury, or the presence of foreign matter in the cavity. The quantity of effusion may be estimated by the dyspnoea with which the patient suffers being greater in proportion as the lung is more completely compressed, as also by the extent of the dullness on percussion.
PHYSICAL SIGNS. On applying the stethoscope to the affected part of the chest at an early period, the dry inflamed surfaces may be heard rubbing against each other and producing a friction sound; this rubbing may also be felt by placing the hand on the corresponding part of the chest. This sound is only to be heard for a short time, because the apposite surfaces become glued together, or, more probably, separated by serous effusion; in this there is dullness on percussion at the lower part of the chest as high as the level of the fluid. To the same extent the respiratory murmur is also lost. Eegophony may also be heard occasionally, above the dull area. This a peculiar high pitched quality of the speaking voice. At the same time the patient, though at first he preferred to lie on the sound aide, is compelled to turn to that which is affected, so that the movements of the healthy lung may not be impeded by the superincumbent weight of the dropsical pleura.
CAUSES. Infection with some germ. Tubercle is often responsible for Pleurisy. Predisposing causes exposure to atmospheric vicissitudes and sudden checking of the perspiration, are the most frequent causes, especially in persons of unhealthy constitutions; surgical operations and mechanical injuries are frequently exciting causes; thus the rough ends of fractured rib may set up Inflammation of the pleura. It may also be excited by extension of other diseases. The cause of the disease may materially alter the treatment.
TREATMENT. Aconitum. In the early stage of the disease. After two or three doses, its beneficial effects are often marked by perspiration, which contrasts most favourably with the hot dry skin, urgent thirst, quick pulse, and general suspension of the secretory functions which previously existed.
Bryonia. This is remedy of great power in Pleurisy ( as in all other Inflammations of serous membranes), even in its most violent forms. Its special indications are stinging, shooting, or burning pains in the side, aggravated by breathing or movement; painful, dry Cough, or Cough with expectoration of glairy sputa; laboured, short, anxious, and rapid respirations, performed almost entirely by the abdominal muscles; weariness, disposition to retain the recumbent posture’ irritability, restlessness, etc. A dose every one to three hours. It follows Aconite Well.
Arsenicum. Tedious cases; when much effusion has taken place, evidenced by painful, oppressed breathing, occasional attacks of suffocation, etc.; coldness of the body, exhaustion.
Iodium. Weakly patients, in whom the disease is protracted. Even when effusion has occurred, Iodium, in alternation with Aconite or Bryonia, is still the best remedy for the tubercular.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."