Cooley's Cyclopaedia of Practical Receipts Volume Ii Part 159

_Treatment to be followed in croupous pneumonia._--Bleeding was formerly had recourse to, but this treatment has either been abandoned of late years, or very rarely practised, the only case in which its moderate employment is recommended being that in which the patient is threatened with death from partial privation or suspension of breath.

Leeches may be applied to the spot in pain, and a large blister near it, but it is preferable to first try the effect of hot fomentations and poultices containing laudanum; or turpentine sprinkled on a warm damp flannel may be tried. A third of a grain of tartarised antimony, with a few drops of laudanum, or a third of a grain of hydrochlorate of morphia may be given every four hours.

"In all _low_ forms of the disease the only chance is in _free stimulation_. At the same times full doses of carbonate of ammonia, with bark, spirits of chloroform, ether, camphor, and such remedies, must be administered. In some cases quinine with iron is useful."[114]

[Footnote 114: Dr Roberts.]

The best diet consists of milk and beef tea. The patient, it is needless to say, should be kept in bed, and the temperature of his chamber should be maintained at about 60 F. It is also most essential that the room should be thoroughly ventilated, and all the expectorated matter, stools, &c., thoroughly disinfected before removal.

2. CATARRHAL PNEUMONIA. The acute variety of this form of pneumonia is that which princ.i.p.ally attacks infants and children, and frequently complicates diphtheria, hooping-cough, measles, and influenza; although it may occasionally occur when not a.s.sociated with these diseases.

In the other variety--chronic catarrhal pneumonia--the greater number of cases arise from bronchitis. Many authorities look upon the last variety of pneumonia as the cause of a great proportion of the cases of pulmonary phthisis.

_Symptoms._--These differ, in the great majority of cases, from croupal pneumonia, in not being preceded by rigors. There is always fever and a rise of bodily temperature from 103 to 105. There is often copious perspiration and increased pulse. As the disease progresses the breathing becomes more difficult and rapid, the cough changes its character, and "becomes short, harsh, hacking, and painful, the child endeavouring to repress it, and having an expression of pain or crying and diminished expectoration."[115]

[Footnote 115: Dr Roberts.]

The treatment of this form of pneumonia consists in keeping up the strength of the patient by means of good nourishing food, and stimulants judiciously administered. Ammonia and senega should be given if the sufferer is very weak. In ordinary cases ipecacuanha wine will be found useful. Poultices of linseed or mustard to the chest are also prescribed.

During convalescence the patient requires careful watching; his diet should be generous, and should include wine; cod-liver oil, quinine, and iron, or other tonics are additionally necessary.

3. CHRONIC PNEUMONIA. This disease, in which the substance of the lung is in a more or less abnormal or altered condition, is mostly the result of some previous pulmonary affection. It frequently follows successive attacks of the catarrhal variety of pneumonia and the bronchial irritation arising from the inhalation of small particles of dust given off by substances employed in certain occupations or manufactures, such as coal, steel, granite, &c.

The symptoms are pains in the side, cough, sometimes occurring in severe paroxysms, shortness of breathing, the patient meantime gradually becoming thinner and weaker. Sometimes night sweats occur, but generally there is little or no fever.

The best treatment is nourishing diet, combined with tonics and cod-liver oil.

Of late years the doctrine of the contagious nature of some forms of acute pneumonia (whether complicated with pleurisy or not) seems to have been gaining ground amongst medical pract.i.tioners. The well-known fact that the pleuro-pneumonia of cattle is propagated by contagion, if it does not prove this contention, is at any rate "worthy," as Dr Parkes remarks, "of all attention."

The following cases, selected from amongst many others equally striking, would appear to lend considerable support to this view:

1. The 'Lancet' for January 9th, 1862, contains a communication from Dr Bryson, describing an epidemic of pleuro-pneumonia which occurred in 1860 amongst the Mediterranean fleet. The infectious character of the disease is stated to have been very marked; besides which there were several points of resemblance between it and the pleuro-pneumonia which attacks cattle.

2. Professor Bock of Christiana has recorded an outbreak of pneumonia which took place in the Akerhus prison of that city in 1866. Out of 360 prisoners 62 of them were attacked with pneumonia in six months. The prison, like the cattle sheds, ravaged by pleuro-pneumonia, was badly ventilated and overcrowded.

The following ill.u.s.trations are extracted from Dr Wynter Blyth's valuable 'Dictionary of Hygiene and Public Health.'

1. "Mr Alfred Mayo, Mildenhall, Suffolk, in a private letter to the author, gives a series of cases in which the infectious character of the malady was well marked. The first case was that of a bricklayer, about thirty-five years of age, who was taken ill with pleuro-pneumonia. His mother, who nursed him, very shortly afterwards took the same disease and died. A neighbour, a healthy young woman over thirty, who came in to nurse the last patient, was also taken similarly ill, and died with all the physical and other signs and symptoms well developed; and lastly, her child contracted the disease, but eventually recovered. There were other cases in the neighbourhood at the same time, and all of them were remarkable for their fatality."

2. "Dr Richard Budd, of Barnstaple, has communicated to the author the following remarkable cases:--1. A clergyman, after attending a public meeting, became affected with acute pneumonia. 2. The nurse in attendance became ill of the same disease about a week afterwards. 3. The clergyman's sister, taking the place of the nurse, was in her turn also seized with pneumonia. 4. A brother of the clergyman, who now undertook the duty of nurse, was in a very short time laid up with the same malady. The nurse and sister died, the two brothers recovered. Dr Budd concludes his communications as follows: 'Since that time I have witnessed innumerable instances of the occurrence of this disorder in several members of the same family in succession, and I am thoroughly convinced that it spreads by infection, as the facts I have observed admit of no other explanation.'"

The following table, from the Registrar-General's Report for 1875, gives the yearly number of deaths from pneumonia in England from 1848 to 1875:--

1848 21,868 1849 21,194 1850 20,303 1851 22,001 1852 21,421 1853 24,098 1854 23,523 1855 26,052 1856 22,653 1857 23,452 1858 26,486 1859 24,514 1860 25,264 1861 22,914 1862 23,713 1863 24,181 1864 24,470 1865 22,489 1866 25,155 1867 21,118 1868 19,908 1869 25,246 1870 23,729 1871 22,768 1872 20,282 1873 22,904 1874 25,927 1875 27,161

As a commentary upon the high death-rate from pneumonia for 1875, we may quote the Report for 1877 of the Registrar-General to the President of the Local Government Board. He writes, "The winter of 1875 was unusually severe; extremes of temperature, with a long continuance of east winds, were fatal to infants and to elderly people, and no less than 162,156 deaths were registered in England for the first quarter of the year; the mortality was at the annual rate of 275 per 1000, or 26 per 1000 above the average of the thirty-eight years--1838-75."

_In animals._ For pneumonia and ordinary pleuro-pneumonia, the treatment prescribed for pleurisy may be followed.

EPIDEMIC PLEURO-PNEUMONIA OF CATTLE. It is now universally admitted that this disease is very often traceable to contagion, and hence that its propagation has been largely due to the practice of purchasing infected animals in open market, and afterwards allowing them to herd with healthy ones. When a cow is attacked with this epizootic disease, the first noticeable symptoms are generally tenderness and flabbiness of the udder, and a frothy condition of the milk.

These symptoms are accompanied with a dry cough and irregularity of appet.i.te; at the same time the mouth, horns, and legs become hot, the pulse becomes more rapid, and the breathing also. When on its feet the animal arches its back, and when lying down rests itself upon its breast bone. Generally, however, when in the rec.u.mbent posture, it lies on that side where the affected lung is.

The treatment, omitting the bleeding, is very similar to that recommended for pleurisy, except that it should be supplemented by the application to the sides of fomentations of hot water, followed by the rubbing in of mustard or of some vesicant. "If no improvement occur after the third or fourth day, give three times daily an ounce each of ginger and gentian, with four drachms of sulphate of iron. Where there is debility, arrested secretion, and cold extremities, give several times a day a quart of warm ale, with an ounce each of ginger, cardamoms, fenugreek, or other aromatics."[116]

[Footnote 116: Finlay Dun.]

=POACH'ING.= Amongst cooks, a peculiar method of cooking small articles by a slight boiling or stewing process.

POACHED EGGS are prepared by breaking them into a small saucepan or stewpan containing about 1/2 a pint of boiling water, to which a teaspoonful of common salt, and, occasionally, a little vinegar, is added, and gently simmering them for 3 or 4 minutes, or until sufficiently firm to bear removal with a spoon or 'slice.' Another method is to employ melted b.u.t.ter instead of water, and to dress them either with or without stirring.

Poached eggs are commonly served on toast, or with fried ham or bacon, with spice or vegetable seasoning at will. They form an excellent breakfast, or 'make-shift dinner.'

=PODOPH'YLLIN.= _Syn._ RESIN OF PODOPHYLLUM; RESINA PODOPHYLLI (B. P.).

Obtained from the root of the _Podophyllum peltatum_ (Linn.), or may-apple, a substance officinal in the Ph. U. S.

_Prep._ 1. The alcoholic extract of may-apple is digested in cold ether to remove fatty matter, and is then dissolved in rectified spirit; the solution is decoloured with a little animal charcoal, and filtered; it is, lastly, allowed to evaporate spontaneously.

2. (B. P.) Podophyllum, in coa.r.s.e powder, 1; rectified spirit, 3-3/4, or a sufficiency; distilled water and hydrochloric acid, of each a sufficiency; exhaust the podophyllum by percolation with the spirit; distil over the spirit; slowly pour the liquid remaining after the distillation of the tincture into three times its volume of water acidulated with 1/24th part of its weight of hydrochloric acid, constantly stirring; let it stand 24 hours; collect the resin which falls, wash on a filter with distilled water, and dry in a stove. Cholagogue purgative; used as a subst.i.tute for calomel.--_Dose_, 1/6 to 1/2 gr., or even 2 gr. It is best to begin with 1/8 gr. (Squire.)

_Prop., &c._ An amorphous, greyish-white ma.s.s, soluble in alcohol, and slightly soluble in water. It is a safe and certain cathartic, superior in activity to resin of jalap.--_Dose_, 1/2 to 3 gr. See EXTRACT OF MAY-APPLE.

=PODOPHYLLUM ROOT.= _Syn._ PODOPHYLLI RADIX (B. P.) The dried rhizome of the _Podophyllum peltatum_; imported from North America. Active and certain cathartic.--_Dose_, 10 to 20 gr.

=POIS'ON.= _Syn._ TOXIc.u.m, VENENUM, L. Any substance which, when swallowed or applied in any particular way to the living body, disturbs, suspends, or destroys one or more of the vital functions. In sufficient quant.i.ty, or in small doses long continued, the common result of the administration of deleterious substances is either impaired vitality or death.

Poisons are cla.s.sified by Orfila under four heads:--

1. IRRITANT POISONS, or such as inflame or corrode the parts with which they come in contact. Their chief effects are upon the alimentary ca.n.a.l, with, sometimes, ulceration of the tongue, fauces, and sophagus. Nausea, vomiting, stomachic and intestinal pains, extreme anxiety and anguish, quick and feeble pulse, cold and clammy skin, and mucous, bilious, or b.l.o.o.d.y diarrha, are among the common leading symptoms. a.r.s.enic, blue vitriol, verdigris, strong acids and alkalies, drastic purgatives, and numerous other substances, belong to this cla.s.s.

2. NARCOTIC OR STUPEFYING POISONS, or such as paralyse the functions of the nervous system, and produce headache, vertigo, confused vision, delirium, stupor, convulsions, coma, &c. It includes morphia, opium, henbane, oil of bitter almonds, prussic acid, &c.

3. NARCOTICO-ACRID POISONS, which produce at the same time narcotism and irritation of the parts which they touch. Alcohol, belladonna, cocculus indicus, colchic.u.m, foxglove, hemlock, poisonous fungi, strychnine, tobacco, veratrine, &c., are of this kind.

4. SEPTIC OR PUTREFIANT POISONS, including all those which alter, liquefy, or cause the putrescence of the fluids of the body; as sulphuretted hydrogen, the gas from sewers and cesspools, putrefying organic matter, miasmata, &c.

The treatment of cases of poisoning varies with the substance occasioning it; the proper antidotes will be found noticed under the names of the various substances that exert a deleterious action on the animal body. It may here, however, be useful to remark that, in almost all cases of poisoning, copious vomiting should be excited as soon as possible by the administration of a powerful emetic; its action being promoted by copious draughts of lukewarm water, tickling the throat with the finger, &c.

Should this fail, but not otherwise, the stomach-pump should be had recourse to. The vomiting should be kept up and the stomach well washed out with bland alb.u.minous or mucilaginous liquids, such as milk-and-water, barley water, sweetened water, flour-and-water, or any similar matters, as circ.u.mstances may afford. After the vomiting a brisk aperient draught, or clyster, may be administered, and nervous irritability or exhaustion allayed by means of ether, opium, wine, or warm spirit-and-water, as the case may require. Even in a suspected case of poisoning, when proper medical advice is not at hand, an emetic should be immediately administered. Vomiting may be, in general, produced very promptly by merely swallowing a cupful of warm water mixed with a teaspoonful of flour of mustard. If no dry mustard is at hand, a portion of the contents of a mustard-pot, put into the water, will answer nearly as well. As mustard may thus prove of so much use, it should never be wanting in any house; but even should there be no mustard at hand, warm water by itself, freely taken, forms a tolerably efficacious emetic.

=POLARISA'TION (of Light).= A change produced upon light by the action of certain media and surfaces, by which it ceases to present the ordinary phenomena of reflection and transmission. Instruments or apparatus employed to effect this change are called 'polariscopes.' Although the polarisation of light is frequently employed as a means of chemical investigation, and is of the utmost interest to the philosophical inquirer, its consideration scarcely comes within the province of this work. See 'Watt's Dict. of Chemistry,' 'Ganot's Physics,' &c.

=POL'ISH.= Various substances, differing widely from each other, are popularly known under this name. See POWDERS, VARNISH, &c., and _below_.

=Polish, French.= See FRENCH POLISH.

=Polish, French Reviver.= _Prep._ 1. Linseed oil, 1/2 pint; pale lac varnish and wood naphtha, of each 1/4 pint; well shaken together, and again every time before use.

2. Methylated rectified spirit, 3 pints; linseed oil and French polish, of each 1 pint; as the last.