Sec. 30. This is a very increasing malady in the present day. It is no
longer limited to the middle part of life: children at five years of
age die of it, and old people at sixty or seventy. It is not confined
to the flat-chested, the fair-skinned, the blue eyed, the
light-haired, or the scrophulous: it often attacks people with full
chests, brown skins, dark hair and eyes, and those in whose family no
scrophulous taint can be traced. It is certainly infectious. The very
strict laws still existing in Italy to prevent the infection from
consumptive patients, were probably not enacted originally without a
sufficient cause. We seem to be approaching to that state which first
made such restrictions necessary, and in the further course of time,
the disease will probably fall off again, both in virulency and
frequency.
Sec. 31. The younger part of the female sex are liable to a disease very
much resembling a true consumption, and from which it is difficult to
distinguish it; but this disease is curable by steel and bitters. A
criterion of true phthisis has been sought for in the state of the
teeth; but the exceptions to that rule are numerous. An unusual
dilatation of the pupil of the eye, is the most certain
characteristic.[13]
[Footnote 13: Many years ago I communicated to my friend, Dr.
Percival, an account of some trials of breathing fixed air in
consumptive cases. The results were published by him in the
second Vol. of his very useful Essays Medical and
Experimental, and have since been copied into other
publications. I take this opportunity of acknowledging that I
suspect myself to have been mistaken in the nature of the
disease there mentioned to have been cured. I believe it was
a case of _Vomica_, and not a true _Phthisis_ that was cured.
The Vomica is almost always curable. The fixed air corrects
the smell of the matter, and very shortly removes the hectic
fever. My patients not only inspire it, but I keep large jars
of the effervescing mixture constantly at work in their
chambers.]
Sec. 32. Sydenham asserts, that the bark did not more certainly cure an
intermittent, than riding did a consumption. We must not deny the
truth of an assertion, from such authority, but we must conclude that
the disease was more easily curable a century ago than it is at
present.
Sec. 33. If the Digitalis is no longer useful in consumptive cases, it
must be that I know not how to manage it, or that the disease is more
fatal than formerly; for it would be hard to deny the testimony cited
at page 9. I wish others would undertake the enquiry.
Sec. 34. When phthisis is accompanied with anasarca, or when there is
reason to suspect hydrothorax, the Digitalis will often relieve the
sufferings, and prolong the life of the patient.
Sec. 35. Many years ago, during an attendance upon Mr. B----, of a
consumptive family, and himself in the last stage of a phthisis; after
he was so ill as to be confined to his chamber, his breathing became
so extremely difficult and distressing, that he wished rather to die
than to live, and urged me warmly to devise some mode to relieve him.
Suspecting serous effusion to be the cause of this symptom, and he
being a man of sense and resolution, I fully explained my ideas to
him, and told him what kind of operation might afford him a chance of
relief; for I was then but little acquainted with the Digitalis. He
was earnest for the operation to be tried, and with the assistance of
Mr. Parrott, a very respectable surgeon of this place, I got an
opening made between the ribs upon the lower and hinder part of the
thorax. About a pint of fluid was immediately discharged, and his
breath became easy. This fluid coagulated by heat.
After some days a copious purulent discharge issued from the opening,
his cough became less troublesome, his expectoration less copious, his
appetite and strength returned, he got abroad, and the wound, which
became very troublesome, was allowed to heal.
He then undertook a journey to London; whilst there he became worse:
returned home, and died consumptive some weeks afterwards.