Essays In Pastoral MedicineWalsh, James J. (James Joseph)
Religion
Essays In Pastoral Medicine
Walsh, James J. (James Joseph)
First aid in illness and injury; Medicine
Besides the general systemic conditions in which sudden death may
occur without anticipation, there are certain specific diseases of
which unexpected death is sometimes a feature. For the clergyman to
know the condition in which the sudden fatal termination is liable to
occur is to be forearmed against the possibility of death without the
Sacraments, or their enforced administration in haste, when the
recipient is in a very unsatisfactory condition of mind and body. It
has been said that if a normally healthy individual reaches the age of
twenty-five he is reasonably sure to live to a good old age, provided
he does not meet with an accident or catch typhoid fever or pneumonia.
Pneumonia is an extremely important affection as regards its
prognosis. From 15 to 20 per centum of sufferers from the disease die;
that is to say, about one in six of those attacked by the disease will
not recover. It is a little more fatal in women than in men. It is
especially serious for the very young and the old.
Healthy adults in middle life very rarely die from the disease. The
prognosis of any individual case, it has been well said, depends on
what the patient takes with him into the pneumonia. Serious affections
of important organs nearly always cause fatal complications. If the
heart is affected before the pneumonia is acquired, then the prognosis
is very unfavourable, and a fatal termination is almost inevitable. If
the kidneys are seriously diseased beforehand, death is almost the
rule. Pneumonia developing during the course of pregnancy is fatal in
more than one-half of the cases. At one time it was suggested that
premature delivery of pregnant {151} pneumonia patients might save at
least the mother's life. Experience in Germany, however, has shown
that, far from making the prognosis more favourable, the induction of
premature labour makes the outlook a little worse for the patient.
Previous affections of the lungs, emphysema, or tuberculosis, are
prone to make the prognosis of pneumonia much more unfavourable than
under ordinary circumstances.
Deteriorated conditions of the blood, anaemia, chlorosis--such as
occurs so commonly in young women--is prone to make the outlook in
pneumonia more serious. Pneumonia of the upper lobes of the lungs is
more apt to be followed by complications, and is therefore more
serious than pneumonia of the lower lobes. Secondary pneumonia--that
is, inflammation of the lungs which develops as a complication of some
other disease--is much more unfavourable than primary pneumonia which
develops in the midst of health. The amount of lung involved is of
course a serious factor in the prognosis. If the whole of one lung is
consolidated, or if considerable portions of both lungs are thus
affected, the prognosis becomes extremely unfavourable.
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