Potassii Acetatis 3ij.
Aquae Cam/horn ad ,;viij. Misce.
Ft. ntistura. cpt. cock. snag. quartis horis.
Some physicians recommend Aconite in small doses in the early stage; it certainly acts promptly on the skin and kidneys, reducing the fever heat and the pulse-rate, but in a disease so likely to exhibit symptoms of cardiac asthenia and fall in blood-pressure this drug should be restricted to the early stage of the disease in sthenic individuals, and the same remark applies to Tartarated Antimony formerly employed as part of the routine in every case of pneumonia.
Quinine in moderate or full doses is another routine method of treatment recommended in the early stage and applicable in the later phases of the disease. Whilst the previously mentioned diuretics and diaphoretics rather aid than embarrass the expectoration, which is always adhesive in character. quinine tends on the other hand to render the expulsion of bronchial mucus more difficult, and therefore its routine administration may do more harm than good.
Nearly every drug possessing antiseptic properties has been tried, hut Salicylic Acid, Calomel, Chloroform inhalations, Phenol, Creosote, Guaiacol, Arsamin, Protargol, and a host of others have proved valueless.
Siebert gives hypodermic doses of 12 c.c. of a r in 5 oily solution of Camphor (this corresponds to the B.P. Liniment of Camphor), and he states that the drug destroys the pneumococcus, a fact which he has demonstrated by experiments on rabbits. The camphor also undoubtedly acts as a powerful stimulant to the heart.
Pneumococcine or Di-Iodide of Terpine has been vaunted as a specific destroyer of the pneumococcus when administered hypodermically in 3o-min. doses, hut no convincing data are as yet forthcoming.
Ethyl Hydrocupreine, known as Optochin, a quinine derivative, has been introduced by Morgenroth, and Sir A. Wright has demonstrated its germicidal power in the pneumonia of mice, though as yet its specific action in human pneumonia lacks confirmation. Chesney maintains if
given in one initial dose of 6 grs. and 2 grs. every 3 hours during the first 3 days a mortality of only 5 per cent. results.
Symptomatic Treatment.—Pain will be the first symptom calling for relief; as this is due usually to the accompanying pleuritis, the remedies detailed in the article on Pleuritis will be indicated.
A large hot Linseed poultice may be applied every three or four hours. It is best to redden the skin well at the start by Mustard, and to keep up the effect afterwards by plain linseed. The poultices should be spread upon flannel, and should extend from the spine to the sternum on the affected side.
Where poulticing fails to relieve the pain in the chest, a dose of Morphia may be given hypodermically, hut though this pain is probably owing to some pleuritis which is constantly present in pneumonia, the same freedom in the use of anodynes is not admissible, owing to the danger of interfering with the expectoration and its evacuation. With care, however, pain at this stage can generally be entirely relieved by opiates. Mitchell Bruce has drawn attention to the necessity of morphine for the relief of pain in pneumonia, and has shown that it often is of the greatest use and may save life. But it may be safely affirmed that opiates in any form should never be employed in the late stages of the disease.
ot fomentations are less satisfactory than cataplasmata, since the heat in the latter is more uniform. A rubber bottle partially filled with hot water so that it may fit in closely to the convexity of the chest often answers all purposes. As in the treatment of pleuritis, Cold Compresses, Ice and Leiter's tubes have been employed; they should only be applied when hot poulticing fails, though the practice of applying a large ice-bag to the thorax in order to produce an antipyretic as well as an analgesic effect may be tried.
In mild cases any of the local anodyne applications mentioned under Pleuritis may be effectual.