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Title: Pulmonary fibrosis : with special reference to its occurrence in stone-masons : a clinical and therapeutic study
Author: Burnet, James
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1905
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The term pulmonary fibrosis should be confined to cases which arise apart altogether from the action of the tubercle bacillus. This disease may be due to a variety of causes, but the one special - ly considered is that form which occurs in stonehewers. It is due to the inhalation of dust particles, and its onset is often aided by improper diet, alcoholic habits, and unhygienic home surroundings. As a rule the patient has been pre - viously healthy, while the family history is uaually free from any tendency to pulmonary disease. The critical epoch in the life of a stone -hewer is between the ages of 35 and 40, and no workman should continue at this trade after the age of 35. Pulmonary symptoms are not always observed at the onset of the disease. Dyspepsia and general cebility are often more prominent than cough and dyspnoea. There are three stages, that of onset in which the patient can continue at work with comparative ease, that of progress in which he works under difficulty, and that of complete breakdown in which he is compelled to leave off work entirely. The patient rarely lives beyond the age of 40, and probably most deaths occur between the ages of 39 and 42 years. Death is often the result of secondary tuberculous infection, of heart failure, or of some other complication such as bronchiectasis. Death may either occur suddenly or the patient may be confined to bed for some days or weeks before the end. The pro gnosis.depends to a large extent on the ability of the patient to leave off work before the disease has become too far advanced. In any particular case the prognosis will be influenced by the extent of the fibrosis, by the nature and severity of the complications, by the intensity of the dyspnoea, and by the general environment of the patient. The diagnosis depends partly on physical signs and partly on symptoms which are more or less definite and characteristic. In every case the urine and sputum should be carefully examined and a blood count made. The invasion of the lung by tuberculous disease should be recognised as early as possible and this may be done by examination of the sputum and larynx, as well as by the Rontgen rays and by the use of tuberculin. The differential. diagnosis of pulmonary fibrosis as it occurs in stone -masons is not usually difficult, but certain other conditions may resemble it very closely, and accordingly care must be exercised in weighing the results of the physical examination of the patient and in interpreting the general symptoms in any particular case. Treatment may be prophylactic; otherwise measures must be adopted which will relieve the symptoms and tend to prolong the life of the patient. General hygiene, good food, fresh air, moderate exercise, judicious rest, and certain drugs, especially strychnine, ichthyol and iodides, are all calculated to meet the exigencies of the case. Complications must be treated as they arise, and attention ought specially to be given to the heart which should be carefully examined from time to time.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available