Why Pneumonia is so Often Fatal

New Zealand Herald, Volume LXXVI, Issue 23339, 6 May 1939, Page 7 (Supplement)

Why Pneumonia is so Often Fatal

pNEUMONIA is one of the most dreaded of all diseases, striking equally at old and young, the healthy and the infirm. Its onset is rapid and dramatic. Within 48 hours a strong, healthy/person may be fighting for life. This dramatic attack has always held the popular imagination; under various misnomers that form of pneumonia known to physicians as "acute lobar pneumonia" has formed the theme of many tragedies in popular novels. Again there is that dramatic termination to an acute attack —the crisis. At this critical point life hangs in the balance. There is usually either a dramatic turn for the better, or death. .y,* Aftermath of Influenza Pneumonia, in its widest sense, means /inflammation of tho lungs.'' The term is, how generally confined to lung-in-flammation due to infection by germs. These again are subdivided into lobar pneumonia (beginning in the substance of a lobe of a Jung) and broncho pneumonia / (beginning in the bronchial tubes). Acute lobar pneumonia is the form, usually called "pneumonia" in popular parlance. This acute type attacks persona of all ages, though men are more susceptible than women. Certain races, such as negrbes, appear to be especially liable; and certain physical conditions, such as weakness following an acute infection like influenza,, predispose to an attack. Exposure to extremes of temperature appears to bo another cause, also alcoholism; but it must bo confessed that in many cases no excitfactor is to be found. The germ which causes the disease, the diplococcus of pneumonia, has been known since tho close of last century. But it exists in a harmless as well OS a ''Virulent form. These pneumonia germs dwell in the throats of healthy peoplo and cause no ill effect; yet if conditions become ,suitablo the germs develop virulence, attack their host, and cause an acute attack of pneumonia. Development of Crisis The average case of acute pnoumonia Jjhowß definte clear-cut symptoms. *here is a sudden onset. This is marked |>y a rigor (shivering fit), and tho temperature immediately soars. Intense headache and an attack of vomiting often accompany tho rigor. After the second day, a typical attack of pneumonia proceeds rapidly 10 the "crisis." This usually occurs at * week or 10 clays' time from the first r, Eor. It is a most dramatic event. The patient has been getting.. steadily *orse; the cough is constant, there is a Perpetual struggle for breath; the temP®ratnre runs up to 104 degrees or pore, the heart races (but with a feeble beat); the patient is weak, _ reitjSes food, and at night is delirious and cannot sleep, s , Then suddenly a profuse perspiration - f r n a^R °, n t, the temperature rapidly *alls, the'patient feels better, ceases to struggle for breath, the pulse improves, goes, the cough loosens. Often the patient falls into a deep, rcfre.*ltlng Bleep, and wakes up asking for to eat. When the crisis is safely over, howthe patient is by no means out . danger. Tho chief dread at this stage heart failure. Right from tha time

of their invasion of the lung, the pneumonia germs have been pouring toxins (poisons) into the general circuaThese poisons destroy the efficiency of all the muscles of the body, particularly those of the heart. So that it often happens that a patient safely weathers the crisis, only to succumb to heart failure; the heart, weakened by toxins, is unable to stand up to tin* strain imposed on it by the fever. Heart failure is especially liable in old persons and those weakened by previous disease. Pneumonia is not only dangerous m the early stages, but right on into the period of convalescence. "It is a disease that calls upon all the resources of medical skill; and even then there is an element of chance or luck, for one can never surely whht natural resistance the patient may possess. Need of Oxygen

Naturally, good nursing is an essential, as in the early stages of the complaint constant attention is needed night and day. Perfoct rest, comfort (as far as can be secured), and endeavour to keep up the patient s "pecker," and to keep up the strength by getting food taken, even if only tho lightest kind and smallest amount, are necessary. _ . Oxygen is the great standby. Otving to the blocking of the lungs and the poisoning of the heart muscle the body is starved of oxygen, and # this must be supplied till after the crisis is over.