THE CLINICAL ASSESSMENT of DISPROPORTION' by WILLIAM HUNTER, M.D., F.R.C.O.G
494 POSTGRADUATE MEDICAL JOURNAL October 1951 Postgrad Med J: first published as 10.1136/pgmj.27.312.494 on 1 October 1951. Downloaded from infection is the precipitating factor. Intramuscular sidering the use of antibiotics in non-tuberculous penicillin, combined where indicated, with inhala- disease of the chest. tion therapy should be commenced at once if chest 2. Bacteriological investigation and sensitivity infection is felt to be a contributory factor in tests of organisms obtained are essential. cardiac breakdown. Meanwhile investigations 3. Blunderbuss therapy must not be used. should be started and modification of treatment 4. Newly discovered and comparativelyuntested may be made as indicated. The effective treat- antibiotics must not easily replace tried remedies. ment of the lung lesion associated with the correct 5. The wider aspects of aetiology such as social approach to the heart condition may lead to factors must be evaluated. dramatic improvement in what may otherwise 6. The important part that lung infection plays seem to be a hopeless problem. in heart failure has been touched upon. I should like to thank my colleagues, and many Conclusions others in the hospital for their constant cooperation I. Dogmatism must be avoided when con- and help with these problems. BIBLIOGRAPHY GUNNISON, J. B., COLEMAN, V. R., and JAWITZ, E. (I95oa), FATTI, L., FLOREY, M. E., JOULES, H., HUMPHREY, Proc. Soc. exp. Biol. N.Y., 75, 549; (I95ob), J. lab. Clin. J. H., and SAKULA, J. (1946), Lancet, i, 295. Med., 36, 900oo. DAVIES, D., and ASHER, R. A. J. (I951), Lancet, i, 924. LEHR, D. (195ob), Brit.
[Show full text]