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Pneumonia in children (with special reference to the fibrosis following broncho- pneumonia): an analysis of 169 cases of pneumonia in children, and a histological examination of 78 lungs

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MooreAE_1913redux.pdf (31.35Mb)
Date
1913
Author
Moore, A. Eisdell
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Abstract
 
 
Considering that 30% of all deaths in England and Wales are in infants under the age of two years, and that in infancy the lungs are perhaps more frequently the seat of organic disease than are any other organs in the body, the importance of the subject, of this thesis can hardly be over-estimated. It is a subject upon which an immense amount of work has been done, yet the type of tine disease known as primary broncho-pneumonia has no recognised classification, some authors regarding it as a lobar pneumonia, most placing it with secondary bronchopneumonia, while only a few consider it as an individual disease. Again, though most writers refer to the possibility of fibrosis being a sequel of broncho-pneumonia, there has been but little histological work done upon the subject. In this paper my object is Firstly, to emphasise the differences between the various forms of pneumonia, and bring forward the reasons why primary broncho-pneumonia should be considered as an individual disease, and Secondly, to show that fibrosis is a very frequent occurrence in broncho -pneumonia, and that by thickening the alveolar and bronchiole walls even to a slight extent, the lung tissue is so devita- Used that a relapse or an exacerbation of the disease proves rapidly fatal. In order to gain information regarding the frequency of the various types of pneumonia in childhood, the clinical course of each, and the varying mortality, I have taken a series of 169 consecutive cases of pneumonia admitted to the East London Hospital for Children during a period of six months. Hospital statistics vary very much from the different classes of patients attending at different hospitals, from the inclusion or exclusion of infectious diseases, the prevalence of an epidemic,.etc. Thus it is necessary to mention that these cases were taken from a hospital where children from birth to the age of fourteen years are admitted, so that the age distribution is fair; where the patient is taken from the poorest slum class, so that the vitality is low and the mortality high, and where a limited number of cases of diphtheria, pertussis, and measles are treated in an infectious block. The cases of pneumonia were divided into three groups, lobar pneumonia, primary broncho-pneumonia, and secondary bronohc-pneumonia. This classification was made after viewing each case as a whole; history, physical signs, symptoms and course all being taken into account, and in the fatal cases, the pathological appearances as well. The main points in the differential diagnosis will be brought out in the clinical comparison of the diseases, but it may be wise to say that the diagnosis of primary broncho-pneumonia was made when a previously healthy child was attacked by a sudden severe pneumonic fever, with the physical signs of patchy consolidation.
 
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http://hdl.handle.net/1842/35395
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