CONSUMPTION.
Consumption mapped out.--The east winds.--Comparative
statistics.--Number of original cases of consumption in
Minnesota.--Consumption can be cured.--Rev. Jeremiah Day.--Fresh air the
best medicine.--The benefit of a dry atmosphere.--Equability of
temperature.--The power of the mind over disease.--Kinds of
consumption.--Danger in delays.
To all who are afflicted or threatened with pulmonic troubles the
climate of Minnesota becomes, in view of its reputed freedom from this
scourge, an interesting subject of inquiry.
For a long time it was maintained that this disease was not affected by
climate, but that it was the child of other causes, and that its cure
was impossible; and dread of its visitation became as great as at the
approach of any of the great maladies afflicting mankind.
Later and wiser investigation has proved it to be so much controlled by
climate that it may be practically located on a chart of the globe, if
all the climatic conditions are fully known. Of course, it is not
absolutely confined to any given limit, more than is the yellow fever,
which sometimes makes its appearance as high as the forty-second degree
of latitude, while its actual home, so to speak, is, on this continent,
below the thirty-fifth parallel.
In a medical chart of this country, which we had occasion to examine
many years since, the district where consumption attained its maximum
range was outlined along the coast, beginning with the State of Maine,
having a semi-circular sweep to Fortress Monroe in Virginia, with an
inland limit varying from one to two hundred miles. This is well known,
now, to all the medical profession, to be the territory where _phthisis
pulmonalis_ has greatest sweep, and this is conceded to be, for the most
part, caused by the marked peculiarities of climate existing over all
this area. These peculiarities have, in some of the immediately
preceding chapters, been duly though briefly set forth, and we now
proceed to the consideration of the sanitary value of the Minnesota air
and its effects on lung diseases as experienced by sufferers and
observed by others, together with some of its leading characteristics.
If it has been sufficiently shown that the temperature of the district
in which consumption prevails most is a highly variable one, passing
almost daily from a low to a high point in the thermometric scale, with
the prevailing winds to be those in which east largely enters; and that
these winds come laden with a cold moisture, borne from off the surface
of the North Atlantic, which, when exposed to their sweep, chill the
person and pave the way to colds, catarrhs, rheumatism, pneumonia, and a
score of other ills scarcely less harassing and destructive, and all of
which give rise to the "great destroyer," as it has been sometimes
called. If, as we have said, these points have been proved to be the
leading ear-marks of this special locality, what, we may ask, are the
characteristics, briefly stated, of the climate of the State, which is
known to be comparatively free from, and, in very many instances, to
have wrought for the sufferer a complete restoration of health and
strength? They have been seen to be almost the exact antipodes of that
of the consumptive district before named. Instead of the northeast wind,
there is the northwest, or at least the prevailing winds from some point
into which _west_ enters; bringing, in place of the cold, humid
atmosphere of the North Atlantic, the dry continental winds from the
interior, which, in conjunction with the high altitude and peculiar
geographical position of the State, give, instead of the extreme
variable temperature, an equable and a relatively dry atmosphere, having
a bracing, tonic effect on the whole man, affording opportunity for
unrestrained exercise in the open air, causing good digestion to wait on
appetite, and with these the advent of fresh wholesome blood, which is
_the_ physician to heal the diseased portions of the lungs, and restore
healthful action to all of the inflamed parts.
In confirmation of the high value of this State as a residence for
invalids of the class to which special reference is made, we extract
from the last census report the following statistics, showing the
average number of deaths from consumption in the following States to be
One in 254 in Massachusetts,
One in 473 in New York,
One in 757 in Virginia,
One in 1139 in Minnesota.
This speaks for the climate more of praise than it is possible for any
scientific speculation to do, since it is the practical and final test
as well as the most satisfactory.
Undoubtedly, the relative disproportion would be very much greater if
the number of deaths of those who go from other States, after it is too
late for them to receive any benefit, could be eliminated from the
actual number that die from among the inhabitants themselves. The
question may arise right here among some of the more skeptical, how it
is that any of the population are afflicted with this disease, if the
climate is such an enemy to it? We answer--that full half of the deaths
reported from phthisis are of those who come too late--as before
stated--and a fourth of the whole number we know to be from among those
who are not natives, but yet are of the _regular_ inhabitants, whose
lives have been prolonged here, and who from improper exposure or
neglect of wholesome rules (which they at first rigidly followed, but
growing better, neglected to maintain), have paid the penalty. Not over
one-third of the entire list of inhabitants of the State, up to the
present time, are natives; hence deaths from consumption among the
remaining two-thirds cannot be attributed, by any fair inference, to the
direct influence of the climate. This still leaves a fourth of the whole
number of deaths from this scourge to fall on those who "are to the
manner born." This is a very trifling percentage, and might be waived as
not being a fraction sufficiently important to merit much attention; but
we may frankly admit that these cases appear here, and are the result of
a want of a _perfect_ equability in the climate, and to this extent it
must be held answerable. We might, however, conclude that even this
final fraction could be accounted for in the hereditary taint, but we
forbear, as we likewise do to claim entire exemption here from this
complaint. No climate, perhaps, in any portion of the whole habitable
earth, could be found to be utterly exempt. Then, too, consumption is to
general debility a natural sequence, almost as much as flame is to
powder when exploded; and as there are likely in all climates, however
favorable, to be found worn-out and exhausted humanity, why, there must
be expected untimely deaths culminating in this disease.
The curability of consumption is now a settled question. Every medical
student has either seen for himself or been assured by his professor
that post mortem examinations have disclosed this truth beyond all
cavil. Numerous cases might be cited where, at an early period in life,
tubercles had formed, and by-and-by, probably in consequence of a change
in the habits of life, these disappeared, leaving naught but old
cicatrices as evidence of their previous diseased condition. These
tubercular deposits must have disposed of themselves in one of three
ways: _first_, they might soften down and be expectorated; _second_,
they might soften and be absorbed; or, _thirdly_, they might become
calcined and remain as inert foreign material. In many cases all these
processes might unite in the removal, and a long life follow, as is well
known in some instances to be true.
An eminent instance in point occurs to us as we write, and which is
worthy of citation in these pages. The lamented Rev. Jeremiah Day, once
President of Yale College, when a young man, had "consumption," and was
expected to die, but by a rigid observance of the laws of health, and
self-imposition of stated exercise of a vigorous nature in the open air,
he, by these means and without much of travel, restored his debilitated
frame and healed the diseased lungs, and died at the rare age of
ninety-five, having lived a life of uncommon usefulness and activity. He
could not have accomplished his restoration without many and daily
sacrifices compared with the lot of his fellow-men. A post mortem showed
plainly that both apices of the lungs had been diseased.
There are many cases, of which no knowledge exists outside of a small
circle, of restored health, though with impaired power of respiration
and consequent endurance of great hardships, which latter, of course,
must be entirely avoided by those thus situated. There is, too, even
greater liability to a fresh attack than with persons who have never
been afflicted, but the vigilance necessary to maintain health fortifies
against its repetition.
One of the essentials in effecting a cure is FRESH AIR; and if this can
be had in such form as to give more of oxygen--the vital element--than
is usually found, the healing processes must be accelerated, beyond
doubt. The family physician will tell you this. Now, under what
circumstances is a larger amount of oxygen found? What climate affords
most, all other things being equal? It certainly is not a _hot_ climate,
nor a variable moist one such as prevails all over the consumptive
district which we have indicated at the beginning of this chapter. It is
found in a cool, dry climate, and this condition is had in Minnesota
with greater correlative advantages than in any other section of the
Union known up to this time. The atmosphere is composed of two gases,
oxygen and nitrogen, and in every one hundred parts of common air there
are about seventy-five parts of nitrogen and twenty-five of oxygen,
subject to expansion from heat and of contraction from cold. This
accounts in part for the general lassitude felt in a warm atmosphere,
while a corresponding degree of vigor obtains in a cold one. The
condensation, the result of a cool temperature, gives to the lungs a
much larger amount of oxygen at a single inspiration, and, of course,
for the day the difference is truly wonderful. The blood is borne by
each pulsation of the heart to the air-cells of the lungs for
vitalization by means of the oxygen inhaled--the only portion of the air
used by the lungs--giving it a constantly renewing power to energize the
whole man. If a cold climate is attended with great humidity, or raw,
chilling winds, the object is defeated and the diseased member
aggravated, as would also be the case even if the climate was not a
cold, raw one, but was a _variable_ cold one; as then the sudden changes
would induce colds, pneumonia, and all the train of ills which terminate
in this dire calamity we are so anxious to avoid.
_Equability_ and _dryness_ are the essentials of a climate in which
consumptives are to receive new or lengthened leases of life.
The following testimony is of such a high value that no apology need be
offered for its introduction here. It is, in the first case, from one
who was sick but is now well, and, in the other, from a party whose
observation and character give weight to opinions.
The able and celebrated divine, the Rev. Horace Bushnell, D.D., of
Hartford, Conn., in a letter to the _Independent_, says:--
"I went to Minnesota early in July, and remained there till the latter
part of the May following. I had spent a winter in Cuba without benefit.
I had spent also nearly a year in California, making a gain in the dry
season and a partial loss in the wet season; returning, however,
sufficiently improved to resume my labors. Breaking down again from this
only partial recovery, I made the experiment now of Minnesota; and
submitting myself, on returning, to a very rigid examination by a
physician who did not know at all what verdict had been passed by other
physicians before, he said, in accordance with their opinions, 'You have
had a difficulty in your right lung, but it is healed.' I had suspected
from my symptoms that it might be so, and the fact appears to be
confirmed by the further fact, that I have been slowly, though
regularly, gaining all summer.
"This improvement, or partial recovery, I attribute to the climate of
Minnesota. But not to this alone, other things have concurred.
"First, I had a naturally firm, enduring constitution, which had only
given way under excessive burdens of labor, and had no vestige of
hereditary disease upon it.
"Secondly, I had all my burdens thrown off, and a state of complete,
uncaring rest.
"Thirdly, I was in such vigor as to be out in the open air, on horseback
and otherwise, a good part of the time. It does not follow, by any
means, that one who is dying of hereditary consumption, or one who is
too far gone to have any powers of endurance, or spring of recuperative
energy left, will be recovered in the same way. A great many go there to
die, and some to be partially recovered and then die; for I knew two
young men, so far recovered as to think themselves well, or nearly so,
who by over-violent exertion brought on a recurrence of bleeding, and
died. * * * The general opinion seemed to be that the result was
attributable, in part, to the over tonic property of the atmosphere. And
I have known of very many remarkable cases of recovery there which had
seemed to be hopeless. One, of a gentleman who was carried there on a
litter, and became a hearty, robust man. Another, who told me that he
coughed up bits of his lungs of the size of a walnut, was there seven or
eight months after, a perfectly sound-looking, well-set man, with no
cough at all. I fell in with somebody every few days who had come there
and been restored; and with multitudes of others, whose disease had been
arrested so as to allow the prosecution of business, and whose lease of
life, as they had no doubt, was much lengthened by their migration to
that region of the country. Of course it will be understood that a great
many are sadly disappointed in going thither. * * *
"The peculiar benefit of the climate appears to be its dryness. There is
much rain in the summer months, as elsewhere, but it comes more
generally in the night, and the days that follow brighten out in a
fresh, tonic brilliancy, as dry, almost, as before. The winter climate
is intensely cold, and yet so dry and clear and still, for the most
part, as to create no very great degree of suffering. One who is
properly dressed, finds the climate much more agreeable than the
amphibious, half-fluid, half-solid, sloppy, gravelike chill of the East.
The snows are light--a kind of snow-dew, that makes about an inch, or
sometimes three, in a night. Real snowstorms are rare; there was none
the winter I spent there. A little more snow, to make better sleighing,
would have been an improvement. As to rain in winter it is almost
unknown. There was not a drop of it the season I was there, from the
latter part of October to the middle, or about the middle, of March,
except a slight drizzle on Thanksgiving Day. And there was not melting
snow enough, for more than eight or ten days, to wet a deerskin
moccasin, which many of the gentlemen wear all winter."
The Rev. H.A. Boardman, D.D., of Philadelphia, writes under date of
October, 1868, to a public journal, the following: "* * * The question
is often asked, 'how far is St. Paul to be recommended as a resort for
invalids?' If one may judge from indications on the spot, invalids
themselves have settled this question. I have never visited a town
where one encounters so many persons that bear the impress of delicate
health, present or past. In the stores and shops, in the street and by
the fireside, it is an every-day experience to meet with residents who
came to Minnesota, one, two, five, or ten years ago, for their health,
and having regained, decided to remain. I have talked with some who,
having recovered, went away twice over, and then made up their minds
that to live at all they must live here. * * * * *"
The statements of these observing and reflecting men are of the first
importance, and require no scientific deductions to prove the benefit
certain classes of consumptives may receive by a residence in Minnesota;
but if it is found that whatever of data in meteorology there is bearing
on the climate of this State, confirms the universal public judgment,
this then becomes a matter of most agreeable interest.
It seems that the _dryness_ and _equability_ are the important
features, as before observed. A gentleman, given somewhat to
investigation, made the statement to us, while in St. Paul, that he had
carefully watched the ice-pitcher on his table during the summers, and
that it was rare that any moisture accumulated upon the outside of the
same, as is commonly the case elsewhere. This is itself a most
interesting scientific fact, and completely demonstrates the great
dryness of the atmosphere during even the wet season of the year, as we
have found the rain-fall in summer to be about two-thirds of the whole
annual precipitation. Physicians have not generally thought that the
_summer_ atmosphere of this State was any improvement upon that of other
localities of like altitude, judging from the rain-fall, which, being up
to the average of this latitude elsewhere, left as much of moisture,
they have concluded, floating near the surface as at other points, and
they are led to send patients into less dry districts, or even, as is
sometimes the case, to the sea-shore. Graver mistakes could not well
occur than these, and it is to be ascribed to the little definite
knowledge we as a people have on medico-meteorology. Except for
debilitated constitutions, which, it is true, precede many cases of
consumption, the sea-shore is to be avoided, especially in every
instance of diseased lungs. Doubtless, the habit of advising a trip to
the sea-side for the relief and cure of whooping-cough in children has
led in great part to this error. The trip to the mountains, if a
location is well selected, is likely to be, and usually is, in summer a
real benefit. But then, the physician should know something of the
reputation of the particular locality to which he sends his patient. To
illustrate:--suppose a patient afflicted with phthisis is sent to the
White Mountains, and in company or alone, he reaches that region, and we
will assume that he settles down at the "Profile House," or at any
portion of the hills on their eastern slope, or immediate vicinity, and
the result is almost certain to be unfavorable, since constant showers
and violent changes of temperature are transpiring throughout the entire
summer. If, however, a moderate elevation, away from the immediate
influence of the mountains, out of the range of the frequent showers,
with a southwest exposure of landscape, where the cool westerly winds
have play, decided advantage will come to the sufferer. It would not
likely be at once perceptible, but a gradual toning up of the system
might be looked for, with an improvement of the general health. Indeed,
any change to either the sick or overworked, for that matter, who are
able to withstand the fatigue of a journey, is of benefit, even if the
climate and location are not improved, as it is well known that a change
of scene is a relief and recreation to the mind, which often plays an
important part in the recovery of invalids. We all remember the story
of the prisoner who had been condemned to suffer death, and at the
appointed hour was led blindfolded to the dissecting hall, where were
assembled the physicians who were to conduct the experiment. Being duly
disrobed and placed, he was informed that an artery was to be opened,
and left to bleed till life expired. An incision in the flesh at the
back of the neck was made, as a mere feint, and warm water allowed at
the same moment to trickle slowly down his shoulder and back, when, in a
brief time, spasms set in, and death ultimately followed.
This gives a clear view of the will power inhering in the mental man,
and its wonderful influence on the body. Sudden news of misfortune, or
great attacks of fear, have produced instant prostration and bodily
suffering, and these cases occur so frequent that all within the range
of an ordinary life are familiar with them.
An English author speaks of the potent power of the mind over the body,
and declares that the act of coughing can be, very often, wholly
restrained by mere force of will. This should not be lost sight of by
any who are attacked with colds or bronchial troubles, or even in the
incipient stages of lung difficulties; as thereby they may lessen the
inflammation, and defer the progress of the disease. We have seen
people, who, having some slight irritation in the larynx, have, instead
of smothering the reflex action, vigorously scraped their throats, and
coughed with a persistence entirely unwise, inducing inflammation, from
which they might date, perhaps, their subsequent bronchial troubles. It
is not in coughs alone that the will exerts a mastery. In a case of
fever, by which an elder brother was brought very low, scarce expected
by either his friends or physician to survive, a neighbor calling, was
allowed to enter the sick-room. The patient was too ill to take much
notice of the visitor, and the visitor likely felt that what he might
say would not effect the result, and, being rough in manners and coarse
of speech, bawled out, in a loud tone, that "he wouldn't give much for
his (the patient's) chances," and stalked out of the room. Happening to
be present, and fearing the effect of this ill-bred visitor's remark, we
drew near the bedside to hear the prostrate invalid whisper out that he
was determined to live, if only to spite the old fellow. His recovery
seemed to date from that event, and in a few weeks he was in possession
of good health.
Consumption is divided into several classes; the more common forms are
the inflammatory, the hereditary, the dyspeptic, and the catarrhal.
There are others, but these suffice for purposes of brief mention of the
leading characteristics of all cases.
The inflammatory is often the more difficult of management than that of
the others, as its attack is violent and prostrating to such a degree as
to render the usual aids of exercise and diet out of the question, for
the most part. Long journeys, for any purpose, are to be avoided, though
removals from the immediate sea-coast, to some dry, sandy section in the
interior, within a hundred miles or so, is advisable. The robust and
strong are equally subject to this class of consumption. Contracting a
violent cold, such as might be taken when in a state of excitement and
great perspiration in a ball-room or at a fire, and without sufficient
protection pass out into the chilling air, inflammation of the lungs
immediately takes place, and the chances are great of either a fatal
termination of life or a shattered constitution.
The hereditary class are more frequent, and, by proper treatment of
themselves, many may attain to a comparatively long life, and be able to
do much of valuable service, if their employment takes them out in the
open air. Of course many, inheriting this disease and having enfeebled
constitutions, cannot be saved, let what will be done, and it is
probably a wise provision that they are not. Consumptives should be
careful to remember their great responsibility in forming alliances
whereby this terrible evil is perpetuated. There should be some law
enacted prohibiting the marriage of confirmed cases of scrofula,
consumption, and insanity, even though complete recovery be had, as
frequently happens in these difficulties.
The dyspeptic cases are numerous, and arise usually from general
debility, caused by insufficient or unwholesome diet, close apartments,
a too sedentary life, long depression of spirits, coupled with, perhaps,
uncleanliness and irregularities, all contributing to this result. These
can all be relieved, and many fully restored, if taken in season, by a
counter course of living.
The catarrhal forms of consumption are more difficult to treat, and, in
numberless instances, baffle all medical skill, and that is very
trifling, which can be applied directly to the seat of trouble. Repeated
"colds in the head," taken and neglected, become by-and-by confirmed,
and pass from the rank of common colds to that of chronic catarrh.
Indeed, catarrh is no more or less than a chronic cold in the head; but
after the lapse of time, and this may vary in different persons, from
one to a score or more of years, it assumes a more virulent character,
involving, perhaps, the whole of the breathing apparatus. Its
encroachments are insidious, and often are lightly considered, but the
general tendency of all cases of catarrhal affections is to the lungs.
Sometimes this approach is by a sudden leap, in consequence, probably,
of a fresh stock of "cold," from the mucous membranes of the nasal
organs to the lungs, and we have in such cases known one of the most
eminent physicians of the country to declare, when examinations were
made at this juncture, that "catarrh had nothing to do with it." This
but illustrates the fallibility of men, and we should never be surprised
when confronted with any fresh testimony tending to confirm this truth.
The dry catarrh, while more aggravating, is less fatal, and life is more
secure, and not as offensive either to friends or themselves, while
other classes of this disease are offensive and more malignant. It is
very obstinate, and yields to no treatment of a specific kind that we
know of. The same general course should be pursued, however, as with
dyspeptic consumptives. The entire medical fraternity are at their
absolute wits' ends, so far as any specific is concerned, for this
almost universal disease. We say universal, since it is within our
knowledge to be largely true, though, while in a mild form, little heed
is given it, and generally the party would deny its presence, even while
more than half conscious that it might exist. In addition to a generous
diet, fresh air, and other matters, of which we shall speak more in
detail as we proceed, a nasal _douche_ before retiring, of tepid water,
with salt enough added to make a weak brine, as half a teaspoonful to a
tumbler, will be in most instances of some benefit. Inhalation and nasal
baths must be the specific means of reaching and alleviating this
disease.
Thousands annually die of consumption springing out of this malady.
Time, it would seem, must discover to the race some more efficient
remedy than is now known.
Cold, humid, and variable climates give rise to and feed this disease,
and a change to an equable, warm, or a cool and dry temperature, is
essential.
Where heart disease is complicated with consumption, a warm, dry climate
is best; and in some cases, too, as where bronchitis exists in great
disproportion to the amount of tubercular deposit and inflammation of
the lungs, the climate of Florida during the winter would be more bland
and agreeable than that of Minnesota, but each individual varies so much
in constitutional character, that no positive rule can be laid down by
which any one case can be judged. This comes within the province of the
family physician.
We cannot too strongly urge upon the medical faculty, as well as the
friends of the afflicted of whom we have written, that delays are
dangerous. Early action on the first manifestations of lung troubles and
tendencies is necessary if lives are to be saved. It is hard to turn
from the beaten path and enter new, even when larger health is hoped for
and needed, yet that should be resolutely done, though it were far
better the confining and unhealthful course had not been originally
entered upon.