8. The true disease, that is, the exudation which has infiltrated itself
through the pulmonary tissues and been coagulated, constituting
hepatization, can only be removed, first, by its transformation into pus
cells; second, by the molecular degeneration and liquefaction of these;
third, by absorption into the blood; and fourth, by excretion of the
exuded matter in a chemically altered form through the evacuations.
9. These processes are favoured by supporting the vital powers: first,
by rest in bed immediately after the attack; second, by beef-tea and
milk during the febrile period, with a moderate amount of wine, if the
pulse be feeble; third, by beefsteaks and solid food as soon as they can
be taken, with more wine or a little spirits, if the pulse falter;
fourth, by mild diuretics on the seventh or eighth day, to favour
excretion by the kidneys.
10. The same pathology and principles of treatment apply to all simple
cases of pneumonia, whether single or double—the latter being only
modified by the weakness of the patient, when more restoratives and
stimulants are required.
11. In complicated cases other treatment may be required, according to
the circumstances of the case; the pneumonia, however, being always
influenced in the manner previously detailed.
12. Since I commenced the treatment of pneumonia by restoratives on the
principles just detailed, in 1848, 153 cases of the acute form of the
disease have entered my clinical wards in the Royal Infirmary. Of these
129 were simple, and 24 complicated cases. They have been recorded by my
clinical clerks, and the progress of each case superintended by my house
physician. The whole investigation and the results have been arrived at
in public, before successive large clinical classes. Of the 129 simple
or uncomplicated cases, of which 35 were double, all recovered,
notwithstanding many of them presented the most apparently alarming
symptoms. Among the 24 complicated cases were five deaths—1 from
ulcerated intestines, 2 from cerebral meningitis, and 2 from uræmia
following Bright’s disease. Of the whole series, the deaths were 1 in
30⅗ cases. Among the simple cases, single or double, the mortality was
_nil_.