On vesicular emphysema of the lungs in early childhood : its origin, causes, and pathological importance, &c. / by Graily Hewitt.

  • Hewitt, Graily, 1828-1893.
Date:
1858
Catalogue details

Licence: Public Domain Mark

Credit: On vesicular emphysema of the lungs in early childhood : its origin, causes, and pathological importance, &c. / by Graily Hewitt. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of emphysema, but the general indication thus given of the part emphysema ordinarily plays in giving rise to symptoms usually referred to other conditions, has been thought sufficient for the present purpose. In conclusion, I would refer briefly to the kind of treatment which may be advantageously adopted in that form of emphy- sema most commonly witnessed during childhood, and which may be designated acute emphysema. The primary indication in such cases is to remove the cause of the emphysema,—viz., collapse of the pulmonary lobules. For this purpose counter- irritants possess a remarkable efficacy, inasmuch as the existing congestion of the lungs, especially localized in the collapsed lobules, tends to prevent both the ejection of the mucous secretion from the bronchi and the re-admission of air. The mustard bath or repeated application of mustard cataplasms to the thorax are to be preferred; frictions of the chest, with an oleaginous, slightly stimulant material, will be found of great service also. Internally, ipecacuanha wine, in slightly nauseant doses, promotes evacuation of the obstructing mucous secretion. I have rarely used tartar emetic, and am strongly opposed to its use in the bronchitic affections of young children, except in cases where the patient is very robust and over the age of two years. In cases of hooping-cough, in which it is desirable to mitigate the frequency of the violent expiratory efforts, I have found the hydrocyanic acid more useful than any other medicine. The diet should consist of milk, or milk and water and sugar, according to the age of the patient; and the state of the bowels must receive its due share of attention. It is impossible to lay down a treatment for every case, but the simple principles here indicated, it will rarely be found necessary to depart from. Depletion is hardly ever admissible in the case of patients belonging to the town population and of the lower classes. Under other circumstances it may be necessary, but I have not hitherto had occasion to find it so. The inspiratory act in the young child is, in cases of bronchitis, weakened by so many causes, that we should be careful how we add to the difficulties present, by depletory, which are depressing, measures.