Diagnosis and treatment of lobar pneumonia in the pre-antibiotic era Anton Chekhov's medical report (1883)

• Published in: Microbes and infection 2022-03, Vol.24 (2), p.104889-104889, Article 104889
• Main Authors: Steger, Florian, Kosenko, Oxana
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Anton Chekhov; Europe; Famous Persons; History of medicine; History, 19th Century; History, 20th Century; Humans; Lobar pneumonia; Pneumonia, Pneumococcal; Russia
• ISSN: 1286-4579; 1769-714X
• DOI: 10.1016/j.micinf.2021.104889

In the late 19th century, pneumonia was one of the leading causes of death in Europe and the USA. Although at this time doctors knew about the infectious cause of pneumonia, they were not able to offer patients specific antimicrobial therapy. In the current paper, we translated into English for the first time and analyzed the almost forgotten medical report of a pneumonic patient written by the famous Russian writer and physician Anton Chekhov (1860–1904), which describes the classic stages of lobar pneumonia, now no longer observed in clinical practice due to antibacterial treatment. Despite the limited capabilities of lung disease diagnosis compared to the possibilities of modern medicine, physicians were able to diagnose lobar pneumonia using techniques of percussion and auscultation. Therapy in this case was limited to diet and symptomatic treatment and could only relieve some of the symptoms. This case history shows that in the early 1880s, in the one of the leading university clinics in Russia, despite the transition from humoral theory and ideas of natural philosophy to the concept of cellular pathology, there were still contradictory trends in the treatment of diseases.