Respiratory System Disorders and Therapy From a New - Louis Bolk ...

3.2.4. Changed Awareness
Sleepiness
A patient with pneumonia and fever is less alert and concentrated and has a lowered
awareness. There is a tendency to dose off. During the day, the patient often takes short
or longer naps. Moreover, the attention span and the time span during which the patient
can tolerate conscious contact with his surroundings are reduced. The patient easily tires,
carrying a ‘good conversation’ is an impossibility, and the patient prefers to keep contacts
to a minimum.
The decreased ability to concentrate is indicative of a diminished formative capacity in
the patient's mind (compare fig.2.4.).
Need to Rest
Sensory stimuli such as smell, light, or sound are experienced as disturbing. The patient
tries, therefore, to protect himself from the outside world.
The patient does not tolerate sensory stimuli very well and has a need to rest.
Deliriousness
In addition to the lowered awareness, an abnormal, generally incoherent type of awareness
may occur with fever. The patient can become delirious, a situation in which strange,
frightening, or even absurd scenes manifest themselves in the mind. In contrast to the
anxiety of the asthmatic patient in which all awareness appears to concentrate on one
thing, the inner scenes in a delirium are dynamic, often colorful, hyperactive, and quick to
change. The richness of images and the dynamic quality of the scenes are similar to what
we know from our dreams.
In contrast to what we saw with asthma, the awareness of the pneumonia patient is
insufficiently formed and the quickly changing images exhibit a form-dissolving tendency
(fig.2.4.).