It is one of the great dangers of old age. If you care to look at the matter in a different way, you may, with Dr. William Osier, call it “the old man’s friend.”
It is particularly likely to occur if the patient is kept in bed for any length of time. For this reason a fractured bone in old people has far greater potentiality for harm than simply the consideration of the fracture itself would indicate.
The signs and symptoms of pneumonia are somewhat different in elderly people. The temperature usually is not high, and the dramatic onset which occurs in the pneumonia of younger people, as with a chill or pain, usually is absent. If the patient recovers, the mode of recovery is more gradual and prolonged than the classical crisis of pneumonia in more vigorous patients.
In treatment, the vigorous measures which are advisable in younger people should be withheld. Putting a patient outside on a screened porch, or in a room with all the windows open on a cold day, is entirely too severe. Any chilling of the body surface is extremely hazardous. In general, support of the heart and the use of liberal amounts of lukewarm water, and insistence upon the swallowing of easily assimilated and nutritious foods, are the only measures that need be used.
The high mortality from pneumonia in the aged accounts for the fact that a great majority of deaths among elderly people occur in the winter rather than in the summer.