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Pneumonia

Bryan Applications, P

Two morbid conditions in the lungs are described as pneumonia. In one there is an involvement of the smaller subdivisions of lung tissue, the lobules, and this is called bronco-pneumonia. In the other, one or more entire lobes of one or both lungs is concerned, and this is called lobar pneumonia; when the word pneumonia is used without qualification it is generally this type that is meant.

Lobar pneumonia is properly regarded as a general disease, a specific fever, with a special involvement of the lungs. It is caused by germs circulating in the blood, the most usual one being the pneumococcus, though the typhoid bacillus, the plague bacillus, the influenza bacillus, and other organisms, when they cause a general infection of the body, may also cause changes in the lung similar to those occurring in pneumonia. In this disorder the infection is generally acquired from the breath of a person suffering from the disease or from that of a carrier.

The incubation period is from one to seven days and the onset is sudden, generally with a chill, perhaps in the severe form called a rigor, especially in children, in whom also convulsions might occur. The temperature rises quickly, and soon there is a short cough, which, however, the patient may try to suppress because it causes a sharp, cutting pain in the side; for the same reason the breathing may be shallow. The pulse is rapid, but the respiratory rate is more so in proportion. The normal ratio of the pulse and respiratory rates is 72 to 18, or 4 to 1, but in pneumonia, it may only be 3 or even 2 to 1. The patient looks ill. The sputum brought up by coughing is very sticky and brownish in color. It is referred as a rusty sputum. Sometimes, however, it is blood-red.

The cheeks are flushed, perhaps one more than the other, and frequently there are crops of blisters, or herpes, round the mouth. The tongue is furred, and as the disease goes on may become dry and brown. Sleeplessness is apt to be troublesome, and delirium is common and may be violent; unless he is watched, the patient may get out of bed and hurt himself by falling. After some days the fever begins to abate, and usually terminates by crisis, that is to say, the temperature falls within a few hours to normal, or subnormal. The patient commonly falls into a deep sleep while this is taking place, from which he awakes feeling very much better. The crisis often occurs on the odd-numbered days: say, the fifth, seventh, or ninth.

In adults the disease usually affects the base of the lung, but it may be at the apex, when it is called atypical pneumonia. This is the commonest site in children. It may extend to other lobes and possibly to the other lung, when one speaks of double pneumonia.

Changes in the lung tissue:

The changes in the lungs constitute acute congestion, followed by filling up of the air cells with fibrin and red cells, a state of affairs described as consolidation. Later this red substance is invaded by a host of white blood cells, and becomes grayish in color. The contents of the air cells are also softer, and soon become liquefied and are discharged through the air tubes, or absorbed; this is the stage of resolution.

There is usually an extension of the inflammation to the adjoining pleura, and it is the accompanying pleurisy that accounts for the sharp pain. The pleurisy usually clears up when resolution takes place, but it may not do so, and a collection of purulent fluid, or empyema, may occur in the pleural cavity. Again, resolution may be delayed, and sometimes it is incomplete so that a chronic inflammatory process goes on which leads to fibrosis of the lung. Sometimes, instead of resolution, an abscess of the lung occurs, or even gangrene. Complications affecting other organs may occur, as, for example, meningitis, nephritis, and so on.

The general treatment of pneumonia is that of fever, but as it is infectious the provisions for isolation described under the heading Infectious disease should be carried out. It is the duty of the physician in attendance to notify the Department of Health of the existence of the disease. Recently, the six major causes of death in New York State were heart disease, cancer, nephritis, cerebral hemorrhage, accidents, and pneumonia.

In no disease is good nursing of more importance, and as the patient may need to be constantly under observation both a day and a night. Pain is usually relieved by a poultice, but an injection of morphia may be necessary. Often the patient is put into a pneumonia jacket. He should be propped up in a sitting position to aid circulation through the lung. Stimulation of the heart by alcohol, digitalis, etc., may become necessary. Sometimes a sleeping draught must be given, and paraldehyde is commonly selected. If the patient tends to become livid, the inhalation of oxygen is of value. If the type of organism responsible has been discovered by bacteriological examination, a serum prepared for this type may be injected with advantage. To aid in the expulsion of the sputum, a cough mixture containing ammonium carbonate and other drugs are often given.

Those in attendance on the patient should bear in mind the possibility of infection, and should gargle the throat several times with some antiseptic, say, a weak solution of permanganate of potassium. A gauge respirator may usefully be worn, especially when it is necessary to come close to the patient.

The sputum should be received in a jar containing Lysol solution, a teaspoonful to the pint, and should not be allowed to adhere to the sides of the jar. The mouth should be wiped with paper hand-kerchiefs, which should be burned at once. See: Bronco-pneumonia.. Lung..

Application and treatment:

Shortness of breath is serious: It may be related to heart disease, being overweight from carrying an extra load of fat, or it may be due to nervous exhaustion and or respiratory diseases.Oxygen is a major key to health and healing the body. Deep breathing for 1 to 2 hours daily can work tremendous healing fast in body tissues. This is taught in yoga. Pneumonia and tuberculosis with fever to 106 degrees F is common and can be readily eliminated with 727, 787, and 880 Hz at low output for 3-5 minutes every three days. Drink electrolytes first. If breathing is difficult use positive to left lung area for 30 minutes: negative toward chest under armpit on left side and positive toward chest under armpit on right side for thirty minutes at the same time.

Treat fever separately. Very rapid recoveries are reported. See: Breathing..