!'il!S BRONCHITIS AND KINDRED DISEASES, IN LANGUAGE ADAPTED TO COMMON READERS. W. W. HALL, A. M., M. D., NEW YORK. REDFIELD, CLINTON HALL, NEW YORK. 1852. [seventh edition.] WF 185:. pUvr, TVB, /Otf-blj y i(%^, i Entered, according to Act of Congress, In the Year One Thousand Eight Hundred and Fifty-two, by J. S. REDFIELD, In the Clerk's Office of the District Court of the United States, for the Southern District of New York. TO PUBLIC SPEAKERS, CLERGYMEN, AND OTHERS, THESE PAGES ARE RESPECTFULLY MintMt: Being the result of many years observation and experience, in this and European countries, on a class of diseases, which has hitherto baf- fled the most skilful, and has hurried to a premature grave, one person for every six, throughout the civilized world; and believing as he does, that the system of practice which he has adopted, has been attended with encouraging success, the Author submits it with con- fidence to public consideration. 5 THROAT-AIL-BRONCHITIS-CONSUMPTION." WHAT IS THROAT-AIL1? Its medical name is Chronic Laryngitis, pronounced Lare-in-jEE-tis, called by some, Clergyman's Sore Throat, from the fact that so many of them have been observed to be troubled with it of late years. It is an affection of the voice-making organs, which are at the top or begin- ning of the windpipe, answering to Adam's Apple; and when these are impaired in any way, the voice itself must inevitably be changed; hence, the great distin- guishing, all-controlling symptom, is an alteration of the voice, or an inability to speak without an effort or some previous preparation; the tones of the voice are more or less clear or husky, unless speaking a word is preceded by an instinctive hawk or hem; this is the far-off, the great premonitory symptom, removable in a few days or weeks at most, if at once attended to, but if neglected terminating uniformly in a fatal consump- tion. Of this disease, ending in consumption, the great clerical orator, Edward Irving, died. * See page 337. 6 BRONCHITIS AND KINDRED DISEASES. WHAT IS BRONCHITIS 1 It is an affection of the branches of the windpipe—a simple, common cold at first. These branches are hol- low, like their parent stem, the windpipe itself; but they become filled with a glairy, sticky, tough, pearly-like substance, which not only causes the person to cough a great deal, night and day, but prevents the air from passing into or out of the lungs as fully as it should. Hence the prevailing complaint in Bronchitis, (pro- nounced bron-KEE-tis) is a feeling of " fullness," an " op- pression," a " difficulty of breathing." When the symp- toms are urgent, it appears as if a cord were drawn tightly across the breast. WHAT IS CONSUMPTION 1 Consumption, commonly called a " Decline," and by physicians " Phthisis," is a gradual wasting away of the lungs, by which they become disorganized, or rotten, and are spit out of the mouth in the shape of yellow matter, which, as the disease advances, usually sinks in water, and in three cases out of four, is, or has been, more or less tinged with blood at various intervals. COMPARISONS. It is thus seen that Throat-Ail is a disease of the top of the windpipe, Bronchitis a disease of the branches of the windpipe, and Consumption a disease of the little air cells, which are situated at the extreme ends of the branches of the windpipe, as leaves are at the extremity of the branches of a tree. These cells or bladders are of all sizes, from that of a pea, downwards. SYMPTOMS OF THROAT-AIL. 7 CAUSES. Throat-Ail is generally the result of accidental and temporary causes, such as indigestion, over-exertion of the voice, suppressions, sitting or standing on damp places. Rronchitis is brought on by the application of, or taking cold, in some way or other. Consumption is most generally an inherited disease, and it is sufficient for one of the parents only to have had a weakly or diseased constitution; but in the pre- sent day it is constantly becoming more common, in consequence of its being generated in persons whose parents, grand-parents, and in many instances, they themselves, had a strong robust constitution, by irregu- lar habits of life, indulgence of the passions and appe- tites, by over-efforts of body or mind, by corroding care, by deep grief, by protracted sufferings, by late hours, damp clothing, damp sheets, damp rooms, and very often by unwise efforts to " harden the constitution" by need- less exposures to heat and cold, and over-exertion—for- getting that a man's constitution is like a good garment, which lasts the longer for being the better taken care of, and is no more improved by hard treatment, than a new hat is made better by being banged about. SYMPTOMS. Throat-Ail is a disease of the voice-making organs at the top of the windpipe; its distinguishing symptom, an impairment of the voice. Rronchitis is an ailment of the branches of the wind- pipe ; its prominent indication being a difficulty of breathing, and harassing cough at any and all times. Consumption is an affection of the lungs themselves, 8 BRONCHITIS AND KINDRED DISEASES. at the ends of the branches of the windpipe; its univer- sal symptom, a wasting of flesh and strength and breath. TREATMENT. Throat-Ail requires mainly external applications, washes, gargles, fomentations, and the like. Rronchitis is cured by internal remedies. Consumption itself, the great giant of Death, calls for none of these things necessarily, unless complicated with other ailments. WHAT ARE THE SYMPTOMS OF THROAT-AIL 1 The most universal symptom is an impairment of the voice, which is more or less hoarse or weak. If there is no actual want of clearness of the sounds, there is an instinctive clearing of the throat, by swallowing, hawk- ing, or hemming; or a summoning up of strength to enunciate words. When this is continued for some time, there is a sensation of tiredness about the throat, a dull heavy aching, or general feeling of discomfort or uneasiness, coming on in the afternoon or evening. In the early part of the day, there is nothing of the kind perceptible, as the voice muscles have had time for rest and the recovery of their powers during the night. In the beginning of the disease, no inconvenience of this kind is felt, except some unusual effort has been made, such as speaking or singing in public; but as it pro- gresses, these symptoms manifest themselves every eve- ning ; then earlier and earlier in the day, until the voice is clear only for a short time soon in the morning; next, there is a constant hoarseness or huskiness from week to month, when the case is most generally incurable, and the patient dies of the common symptoms of Consump- tive disease. SYMPTOMS OF BRONCHITIS. 9 In some cases, the patient expresses himself as having a sensation as if a piece of wool or blanket were in the throat, or an aching or sore feeling, running up the sides of the neck towards the ears. Some have a burning or raw sensation at the little hollow at the bottom of the neck; others, about Adam's Apple; while a third class speak of such a feeling or a prickling at some spot along the sides of the neck. Among others, the first symptoms are a dryness in the throat after speaking or singing, or while in a crowded room, or when waking up in the morning, or after unusual exertion. Some feel as if there were an unusual thickness or a lumpy sensation in the throat, at the upper part, removed at once by swallowing it away; but soon it comes back again, giving precisely the feelings which some persons have after swallowing a pill. Sometimes, this frequent swal- lowing is most troublesome after meals. Throat-Ail is not like many other diseases, often get- ting well of itself by being let alone. I do not believe that one case in ten ever does so, but on the contrary, gradually grows worse, until the voice is permanently husky or subdued; and soon the swallowing of solids or fluids becomes difficult, food or drink returns through the nose, causing a feeling of strangulation or great pain. When Throat-Ail symptoms have been allowed to pro- gress to this stage, death is almost inevitable in a very few weeks. Now and then a case may be saved, but restoration here is in the nature of a miracle. WHAT ARE THE SYMPTOMS OF BRONCHITIS? Bronchitis is a bad cold, and the experience of every one teaches what its symptoms are. The medical name for a cold is Acute Rronchitis; called acute, because it comes on at once, and lasts but a short time—a week or 9* 10 BRONCHITIS AND KINDRED DISEASES. two generally. The ailment that is commonly denomi- nated Rronchitis, is what physicians term Chronic Rron- chitis ; called chronic, because it is a long time in coming on, and lasts for months and years instead of days and weeks. It is not like Throat-Ail, or Consumption, which have a great many symptoms, almost any one of which may be absent, and still the case be one of Throat-Ail, or Consumption; but Bronchitis has three symptoms, every one of which are present every day, and together, and all the time, in all ages, sexes, constitutions, and temperaments. These three universal and essential symptoms are— 1st. A feeling of fullness, or binding, or cord-like sen- sation about the breast. 2d. A most harassing cough, liable to come on at any hour of the day or night. 3d. A large expectoration. This expectoration is of a tough, stringy, tenacious, sticky, pearly or greyish-like substance, from a table- spoon to a pint or more a day. As the disease pro- gresses, this becomes darkish, greenish, or yellowish in appearance; sometimes all three colors may be seen together, until at last it is uniformly yellow, and comes up without much effort, in mouthfuls, that fall heavily, without saliva or mucus. When this is the case, death comes in a very few weeks or—days. WHAT ARE THE SYMPTOMS OF CONSUMPTION % A gradual wasting of breath, flesh, and strength are the three symptoms, progressing steadily through days and weeks and months, which are never absent in any case of true, active, confirmed Consumptive disease that I have ever seen. A man may have a daily cough for fifty years, and not have Consumption. A woman may SYMPTOMS OF CONSUMPTION. 11 spit blood for a quarter of a century, and not have Con- sumption. A young lady may breathe forty times a minute, and have a pulse of a hundred and forty beats a minute, day after day, for weeks and months together, and not have Consumption ; and men and women and young ladies may have pains in the breast, and sides, and shoulders, and flushes in the cheeks, and night sweats, and swollen ankles, and yet have not an atom of Consumptive decay in the lungs. But where there is a slow, steady, painless decline of flesh and strength and breath, extending through weeks and months of time, Consumption exists in all persons, ages, and climes, although at the same time sleep, bowels, appetite, spirits, may be represented as good. Such, at least, are the re- sults of my own observation. The great, general, common symptoms of Consump- tion of the Lungs are night and morning cough, pains about the breast, easily tired in walking, except on level ground, shortness of breath on slight exercise, and general weakness. These are the symptoms of which Consumptive persons complain, and as they approach the grave, these symptoms gradually increase. HOW DO PERSONS GET THROAT-AIL ] C. M. " noticed that public speaking was followed by some soreness in the throat, which usually wore off in a day or two; in a year or two it was painful to make a speech, and he was compelled to desist altogether from making public addresses. In time, every attempt to speak a word required an effort followed by weari- ness ; there is a constant disposition to swallow or clear the throat, increased by taking cold — appetite good—sleep sounds-general health uninjured. If there is several days rest, begins to feel well, but if any at- 12 BRONCHITIS AND KINDRED DISEASES. tempt is made to speak for fifteen minutes, the soreness in the throat returns." A woman, while sitting on a stone bench in Feb- ruary, was attacked with sudden hoarseness, this conti- nued, grew worse until the voice was lost altogether; a little pain in the throat, shortness of breath on the least exercise ; was three months getting well. Mrs. P. took cold by being exposed in the Park in Versailles, in August, followed by a hoarseness which nothing could control. In two years her voice was alto- gether extinct. In two months more there was oppres- sion and shortness of breath if she walked fast; in two weeks more this oppression became constant during the night, often threatening suffocation; and death took place in two years and a half from the first hoarseness. A tall man, strong constitution, good figure, aged thirty-three, had hoarseness every winter for five years, then there was cough, irregular chills, clear expectora- tion, very sensitive to cold, copious night-sweats, daily fever, voice then changed some, throat became painful, then drinks began to return by the nose, appetite bad, digestion imperfect, casting up after meals, gradual falling away, heat in the throat, loss of voice, thick greenish expectoration, diarrhoea, and death. A man thirty years old, delicate, subject to frequent colds for eighteen months past; with pains in the throat and hoarseness; voice hoarse and broken; expectora- tion thick and tough; often put his hands to his throat as if there were some obstruction there; had fits of coughing which were stifling, this grew painfully severe, and finally died from suffocation. A gentleman, aged forty-two, was attacked in the street one morning in August, with a fit of suffocation ; HOW PERSONS GET THROAT-AIL. 13 he could not proceed ; a dry, rough, hoarse cough came on, with shortness of breath. In two weeks had another attack and died. A vigorous Dutch courier, was subject to cold every winter for eight years, but last winter it was worse, with sore throat, and obstinate hoarseness; emaciated very rapidly, with complete loss of voice; acute pain in the throat when he swallows either liquid or solid food; a tender spot on the side of Adam's apple when pressed with the finger; expectoration streaked with yellow at times, at others, it is viscid, small, opaque, and swim- ming in a sort of mucilage; night sweats on face and chest; general debility and death. A gentleman, aged fifty, had an eruption over the body ; it disappeared, but a pain in the throat came on immediately, with a feeling of oppression; expectora- tion smelt badly. In a year or two there was a cough, hoarse voice, with a tough, sticky expectoration; acute pain in the throat, especially on swallowing—and even of liquids; falling away; loss of voice and death. A large, spare man, of fifty-two, a porter, noticed his voice changing for thirteen months, becoming hoarser for the last six weeks, until the voice was almost lost; difficult breathing ; painful swallowing; wakes in starts from sleep, and died of suffocation. B. W. felt uneasy about the throat frequently, inclin- ing him to swallow or to clear the throat, as something appeared to be sticking there ; now and then there was a little hoarseness, especially towards evening, or after speaking or reading; occasional dryness of the throat; some burning feeling at the side of the neck; unnatural sensation at top of breast bone; sometimes a feeling of tightness there; in the course of the year he found it re- 14 BRONCHITIS AND KINDRED DISEASES. quired some little effort, when after silence, he began to talk, a kind of instinctive summoning of strength about the breast, in order to enable him to speak clearly and distinctly; after awhile, whenever spoken to, he would be compelled to give a hem or two before attempting to reply, as if conscious that something must be cleared away first. A clergyman says: " I had spoken a great deal for six weeks, which left some hoarseness, otherwise quite well. Soon the hoarseness was such as to reduce me to a whisper if I conversed only a few minutes ; the throat inside looked very red, with large blotches or hillocks on the back part of it, and a slimy stuff was always col- lecting there, and when I would hawk it away, there would sometimes be streaks of blood in it; occasionally a little pain there. I quit preaching, and kept the house for several months, and nothing does me any good." A physician was called to ride on a January night, and contracted a hoarseness, which continued with very little cough and no expectoration ; his general health continued excellent; no one could have supposed any- thing the matter with him. His voice became more and more hoarse, until it was entirely lost, and in a few months afterwards he died. A lady was attacked with fits of dry cough, and sub- sequently lost her voice; there was a sense of scraping in the throat; sometimes obstinate sneezing; the cough was a little soothed by drinking water; the breathing gradually became difficult, swallowing- painful, and she died. A gentleman observed for a year past, that his voice was occasionally a little cracked, and soon became per- manently hoarse, and at last it was entirely lost. There HOW PERSONS GET THROAT-AIL. 15 was no pain, no swelling, no spitting of blood; he seemed to enjoy the fullest health; yet the symptoms gradually grew worse until he died. P. T. " slept on an ice-box one summer's day two years ago, and waked up with a sore throat, it has never since ceased to hurt me, and has been steadily getting worse." 835. " I worked in a damp cellar in winter, two years ago, in striking off a newspaper; a short, dry cough ap- peared, which has steadily got worse; the voice became hoarse and husky, until I cannot speak above a whisper without considerable effort. I now cough night and morning, an hour at a time often, and am weak and emaciated, chills, fevers, and night-sweats." He soon died. A man had suffered a great deal from sick headache; he was advised to have cold water poured on the top of his head; he did so; he had headache no more. The throat became affected ; had frequent swallowing, clear- ing of throat, falling of palate, voice soon failed in sing- ing, large red splotches on the back part of the throat, and white lumps at either side; but the falling of the palate and interminable swallowing were the great symptoms, making and keeping him nervous, irritable, debilitated, and wretched. He was advised to take off the uvula, but would not do it. Had the nitrate of silver applied constantly for three months. Tried homoeopathy. After suffering thus two years, he came to me, and on a subsequent visit, said, " It is wonderful, that for two years I have been troubled with this throat, and nothing would relieve it, and now it is disappearing in a few days." That was four months ago. I saw him in the street yesterday. He said his throat gave 10 BRONCHITIS AND KINDRED DISEASES. him no more trouble; that he had no more chilliness, and had never taken a cold since he came under my care, although formerly " it was the easiest thing in the world to take cold." A merchant (1002) slept in a steamboat state-room in December, with a glass broken out; woke up next morning with a hoarseness and sore throat; for several months did nothing, then applied to a physician. Counter-irritants were employed without any perma- nent effect. At the end of four years, he came to me with " a sort of uneasy feeling about the throat, more at times than others; not painful; sometimes a little hoarseness, with frequent inclination to swallow, or clear the throat. At the little hollow at the bottom of the neck, just above the top of the breast-bone, there was a feel- ing of pressure, stricture, or enlargement—no pain, but an unpleasant sensation, sometimes worse than at others. It is absent for days at a time, and then lasts for several hours a day." A clergyman (1012) has a hoarse, cracked, weak voice, easily tired in speaking; a raw sensation in the throat; and in swallowing has "a fish-bony feeling." He had become over-heated in a public address, and immediately after its close started to ride across a prairie in a damp, cold wind in February. Had to abandon preaching altogether, and become a school teacher." This gentleman wrote to me for advice, and having fol- lowed it closely for eighteen days, reported himself as almost entirely well. I greatly desire it to be remembered here, that in this, as in other cases of Throat-Ail, however perfectly a person may be cured, the disease will return as often as exposure to the causes of it in the first place is per- HOW PERSONS GET THROAT-AIL. 17 mitted to occur. No cure, however perfect, will allow a man to commit with impunity such a thoughtless and inexcusable act as above named, that of riding across a prairie in February, in a damp, cold wind, within a few minutes after having delivered an excited address in a warm room. None of us are made out of India rubber or iron, but of flesh and blood with a reasonable soul, subject to wise and benevolent conditions and restric- tions ; and it is not to the discredit of physic or physi- cians, that being once cured, the disease should return as often as the indiscretion that originated it in the first in- stance is re-committed. Three weeks ago, one of our merchants came to me with a troublesome tickling in the throat. At first it was only a tickling; but for some weeks the tickling compels a frequent clearing of the throat; and without a cough, each clearing or hemming brings up half a tea- spoonful of yellow matter, with some saliva. On look- ing into his throat, the whole back part of it was red, with still redder splotches here and there—epiglottis almost scarlet. On inquiry, I found he had for years been a chewer of tobacco; then began to smoke; would day after day smoke after each meal, but especially after tea would consume half a dozen cigars. In time, the other naturally consequent steps would have been taken—to consumption and the grave. Among other things, I advised him to abandon tobacco absolutely and at once. In two weeks he came again. Throat de- cidedly better; in every respect better, except that he, in his own opinion, " had taken a little cold," and had a constant slight cough—not by any means a trifling symp- tom. Let the reader learn a valuable lesson from this case. This gentleman had the causes of cough before; 18 BRONCHITIS AND KINDRED DISEASES. he found that smoking modified the tickling, and taking this as an indication of cure, he smoked more vigorously, and thus suppressed the cough, while the cause of it was still burrowing in the system and widening its ravages. It will require months of steady effort to arrest the pro- gress of the disease, and he may consider himself for tunate—more so than in any mercantile speculation he ever made—if he gets well at all. If he does get well, and returns to the use of tobacco, the disease will cer- tainly return, for the following reason.—Throat-Ail is inflammation; that is, too much heat in the parts. Tobacco smoke being warm, or even hot, is drawn di- rectly back against the parts already too much heated, and very naturally increasing the heat, aggravates the disease. Again, any kind of smoke—that of common wood—is irritating, much more that of such a powerful poison as tobacco—soothing, indeed, in its first transient effects, like many other poisons, but leaving behind it consequences more remote, but more destructive and enduring. A gentleman, just married, clerk in a Southern house, applied to me to be cured of a sore throat. He was per- manently hoarse: swallowing food was often unendur- ably painful, besides causing violent paroxysms of cough. He said he knew no cause for his complaint, except that he had smoked very freely. On inquiry, I found that for the last two years he had used, on an average, about " a dozen cigars every day; perhaps more." He died in six weeks. In several instances, persons have applied to me who had been advised to take brandy freely for a throat affection. Such advice is warranted by no one princi- ple in medicine, reason, or common sense. Were I to HOW PERSONS GET THROAT-AIL. 19 give it, I should feel myself justly liable to the charge of being an ignorant man or a drunkard. The throat is inflamed ; inflammation is excitement; brandy and to bacco both excite, inflame the whole body ; that is why they are used at all. The throat partakes of its portion of the excitement, when the throat, body, and the man, all the more speedily go to ruin together. I have in my mind, while writing these lines, the melancholy history of two young men—one from Kentucky, the other from Missouri—who were advised " to drink brandy freely, three times a day, for throat complaint." One of these became a drunkard, and lost his property, and within another year he will leave an interesting family in penury, disgrace, and want. The other was one of the most high-minded, honorable young men I have lately known. He was the only son of a widow, and she was rich. He came to see me three or four times, and then stated that he had concluded to try the effects of a little brandy at each meal. A few weeks afterwards he in- formed me, that as he was constantly improving, he thought that the brandy would certainly effect a cure. Within seven months after his application to me, he had become a regular toper; that is, he had increased the original quantity allowed, of a tablespoon at each meal, to such an amount, that he was all the time under the influence of liquor. His business declined; he spent all his money ; secretly left for California, many thou- sand dollars in debt, and soon after died. The per- son who advised him is also now a confirmed drunkard; but in his wreck and ruin, still a great man. A gentleman from a distant State wrote to me some months ago for advice as to a throat affection. He is a lawyer of note already, and of still higher promise, not 20 BRONCHITIS AND KINDRED DISEASES. yet having reached the prime of life. By earnest efforts as a temperance advocate, in addition to being a popular pleader at the bar, his voice became impaired, with cough, spitting of blood, matter expectoration, diarrhoea, debility, and general wasting. He was induced to drink brandy with iron, but soon left off the iron and took the brandy pure. The habit grew upon him ; he sometimes stimulated to excess, according to his own acknowledg- ment; his friends thought there was no interval, and gave him up as a lost man to themselves, his family, and his country ; but in time, the virulence of the disease rose above the stimulus of the brandy, and in occasional desperation he resorted to opium. He subsequently visited the water cure, gained in flesh and strength, and was hopeful of a speedy restoration ; but he took " an occasional cigar"—the dryness in the throat, hoarseness, pain on pressure, and soreness still remained! He left the water cure, and in a few months wrote to me, having, in addition to the above throat symptoms, a recent haemorrhage, constipation, pains in the breast, nervous- ness, debility, variable appetite, and daily cough. Within two months, he has become an almost entirely new man, requiring no further advice. Further illustration of the manner in which persons get Throat-Ail, may be more conveniently given in the letters of some who have applied to me, with the addi- tional advantage of having the symptoms described in language not professional, consequently more generally understood. A PRESBYTERIAN CLERGYMAN. (1059.) " I have had for three years past a trouble- some affection of the thorax, which manifests itself by A CLERGYMAN--A LAWYER. 21 frequent and prolonged hemming or clearing the throat, and swallowing: both more frequent in damp weather, or after slight cold. General health very feeble, sleepless- ness, waste of flesh, low spirits. Visited a water cure, remained two months, but my hemming and swallowing were not a whit improved. Touching with the nitrate of silver slightly makes the larynx sore. I have been always able to preach. It has never affected my voice until very recently. Two weeks ago I preached two long sermons, in a loud and excited voice, in one day. During the last discourse my voice became hoarse, and my hemming lias become very bad; and there has been a slight break in my voice ever since. Hem, hem, hem, is the order of the day; clearing the throat is incessant, swallowing often, and a slight soreness of the larynx, particularly after a slight cold, or after several days' use of nitrate of silver, with a scarce perceptible break in the voice. These are my principal symptoms." A LAWYER. (1016.) "Aged thirty-seven. Have been liable, for several years past, in the fall, winter, and spring, to severe attacks of fever, accompanied with great debility, loss of flesh, appearing to myself and friends to be in the last stages of Consumption; in fact, the dread of it has been an incubus on me, paralyzing my energies and weighing down my spirits. In the summers, too, I have been subject to attacks of bilious fever and bilious colic. A year ago, I attended court soon after one of these at- tacks, and exerted myself a great deal. My throat be- came very sore, and I had haemorrhage—two teaspoons of blood and matter. My health continued feeble. I went last summer to a water cure, and regained my 22 BRONCHITIS AND KINDRED DISEASES. flesh and strength, but the weakness in my throat and occasional hoarseness continued all the time. After- wards, by cold and exposure, I became worse, conti- nued to have chills and fever and night sweats, accom- panied by violent cough and soreness of the throat. I got worse; was reduced to a perfect skeleton, and had another haemorrhage. Mucus would collect in the top of the throat, and was expectorated freely. I am still liable to colds. The seat of the disease seems to be at the little hollow in front at the bottom of the neck, just above the top of the breast-bone. At my last bleeding, the pain seemed to be in the region of Adam's-Apple. The principal present symptoms are soreness in throat, dryness, pain on pressing it, and hoarseness; pulse from eighty to ninety in a minute; irregular appetite. These symptoms, together with my fear of Consumption, serve to keep me unhappy. I find myself constantly liable to attacks of cold, sneezing, running at the nose even in the summer time. My mother and sister have died of Consumption, as also two of my mother's sis- ters. Feet always cold ; daily cough." OPINION OF THE CASE. There is no Consumptive disease: it is impossible. No personal examination is needed to tell that. The foundation of all your ailments is a torpid liver and a weak stomach. If you are not cured, it will be your own fault. The treatment of this case was conducted by corres- pondence, as he lived six hundred miles away, and therefore I had not the opportunity of a personal exami- nation. Within a month he writes :—" I am gradually improving; feet warm; all pain has disappeared from A CLERGYMAN. 23 the breast; appetite strong, regular, and good; pulse seventy-two; breathing eighteen; all cough has dis- appeared." At the end of two and a half months, no further advice was needed, as he wrote—"I have not written to you for a month, being absent on the circuit. I have not enjoyed better health for years than I have for the month. Weight increasing; no uneasiness or pain about my breast; pulse, se venty-five; less in the morning. The only trouble I have is costiveness, from being so confined in court, and being away from home deprived of my regular diet. We were two weeks holding court, last of November, in a miserable room, the court-house having been recently burned; kept over-heated all the time. I made four or five speeches, and suffered no inconvenience whatever. I have no cough. I now weigh about as much as I ever did, and my average health was never better, I have no ailment whatever except slight constipation." A CLERGYMAN (1024) called over two months ago, having had at first an ailment at the top of the throat, apparently above or near the palate. It soon descended to the region of Adam's-apple, and within a month it seemed to have located itself lower down the neck, giving a feeling as if there were an ulcer there, with a sense of fullness about the throat, hoarse after public speaking, lasting a day or two, with attacks every few weeks of distressing sick headache. As the disease seemed to be rapidly descending towards the lungs, a rigid, energetic treat- ment was proposed, and at the end of ten weeks he writes—»I take pleasure in introducing my friend----, to you. He has suffered many things, from many 24 BRONCHITIS AND KINDRED DISEASES. advisers, with small benefit. I have desired him to consult with you, hoping that he may have the same occasion to be grateful for the providence which leads him to you, which I feel that I myself have for that which guided me to your counsels. I suffer but little, very little from my throat, and confidently anticipate entire relief at no distant day, for all which I feel myself under great obligation both to your skill and to your kindness," &c. SICK HEADACHE is a distressing malady, as those who are subject to it know full well, by sad experience. In this case, this troublesome affection had to be permanently removed before the throat ailment could be properly treated; when that was done, the throat itself was comparatively of easy management. A MERCHANT' (947) wrote to me from the South, complaining chiefly of Bad cough, sometimes giving a croupy sound ; Throat has a raw, choking, dry, rasping feeling; Soon as he goes to sleep, there is a noise or motion, as if he were going to cough ; Startled in sleep, by mouth filling with phlegm ; Expectoration tough, white, and sticky; darkish parti- cles sometimes; Flashes or flushes pass over him sometimes ; Sick stomach sometimes, acid often, wind on stomach oppresses him greatly; A lumpy feeling in the throat; On entering his house, sometimes falls asleep in his chair, almost instantly; A MERCHANT'S CASE. 25 In walking home, at sundown, half a mile from his store, is completely exhausted; Slightest thing brings on a cough; never eats without coughing ; If he swallows honey, it stings the throat; Got a cold a month ago, which left the palate and throat very much inflamed; Throat and tongue both sore; A hooping, suffocative cough; can hear the phlegm rattle just before the cough begins; A dry, rough feeling from the little hollow at the bottom of the neck up to the top of the throat. One night after going to bed, began to cough, choke, suffocate; could not get breath, jumped out of bed, ran across the room, struggled, and at length got breath, but was perfectly exhausted ; could not speak for half an hour, without great difficulty. In addition to his own description of the case, his wife writes—" Ten o'clock at Night.—I am no physi- cian, nor physician's wife, but am his wife and nurse, and an anxious observer of his symptoms, and can see his throat inflamed behind the uvula. He says there is a lump somewhere, but he cannot tell where. Some- times he thinks it is in the little Hollow at the bottom of the neck, sometimes just above, and sometimes in or about the swallow. A recent cold has aggravated his symptoms. His cough to-day has been very fre- quent and loose. He has emaciated rapidly within a month, and is now a good deal despondent. As for myself, 1 feel as one who sees some fair prospect sud- denly fading away. I had fondly hoped—oh! how ardently !—that he might be restored. If a knowledge of the fact would give any additional interest to the 26 BRONCHITIS AND KINDRED DISEASES. case, I will only say, he is one of the loveliest charac- ters on earth. None in this community has a larger share of the respect and confidence of their acquaint- ance." The opinion sent, for I have not seen the case, was as follows :—" The whole breathing apparatus, from the top of the windpipe to the extremity of its branches, is diseased; the lungs themselves are not at all affected by decay. Your whole constitution is diseased; and yet there is good ground for hope of life and reasonable health." In three months this patient writes—" I am glad to inform you that I think I am still improving in health and strength. My bowels are sometimes disordered by eating melons and fruits; but I felt so much better that I thought I might indulge. Pulse sixty-five to seventy ; an almost ravenous appetite." A month later he writes ■—" My health and strength are still improving; cough not very troublesome; increasing in flesh," &c. I believe this gentleman now enjoys good health. A LADY, (948) teacher of vocal music, writes—" There is a pecu- liar sensation in my throat for the last two months. Whenever I attempt to swallow, it feels as if some- thing were in the way; a swelling under the jaws, a soreness on the sides of the throat, extending to the ears and occasioning throbbing painfully. I have a dull aching at the top of my collar-bone, and an unpleasant sensation of weakness and heaviness in my chest • a bad taste in my mouth frequently. Have been regular, but have been afflicted for a few years past with sickness at the stomach and vomiting, attended occasionally with TEACHER OF VOCAL MUSIC. 27 great pain for a few hours. During these attacks, the complexion changes to a livid hue. I have been very much troubled with dyspepsia. On recovering from the attacks above mentioned, I have experienced a feeling of weakness almost insupportable. Am very costive ; and my spirits are greatly depressed. Within a day or two I have taken a violent cold, which has affected me with sneezing, running from the eyes and nose, together with a slight hoarseness. I was advised to apply caustic to the throat, and Croton oil to my neck, chest, and throat. I have since discontinued these, not having received any permanent benefit from them. On two occasions, from over-exertion at concerts and examinations, I was unable to speak a loud word, from hoarseness, for several days. I am extremely anxious to learn your opinion. In about two months my public concerts take place, and it is absolutely necessary that something should be done for me." OPINION. Yours is general constitutional disease. There is no special cause of alarm. A weakened stomach, a torpid liver, a want of sufficient air and exercise, are the foun- dations of all your ailments, and by the proper regula- tion of these, you may expect to have good health and a stronger voice. You must have energy and patient per- severance in carrying out the prescriptions sent to you. In one month this lady writes, and the letter is given to encourage others who may come under my care, to engage with determination and energy in carrying out the directions which may be given them. The reader may also see what great good a little medicine may do when combined with the judicious employment of rational 28 BRONCHITIS AXD KINDRED DISEASES. means, which do not involve the taking of medicine or the use of painful and scarifying agencies and patent contrivances :— " I began your prescriptions at once. Having followed them for some time, I was obliged to intermit them for a few days, in consequence of having to conduct a con- cert, besides having to travel by stage and railroad seventy or eighty miles. During this time I was up every night until twelve o'clock, and was much exposed to the night air. On returning home, I re-commenced your directions, have made it a point to attend to them strictly, and have very seldom failed of doing so. In consequence of two omissions in diet, I suffered from headache, which disappeared when I observed your direc- tions. My appetite is good; my food agrees with me. I sometimes feel dull and sleepy after dinner. I drop to sleep immediately. Seldom wake in the night. Sleep about seven hours, and generally feel bright and strong in the morning, when I take a brisk walk of two miles and a half; the same after six, p.m. My walks at first fatigued me considerably; generally, however, I have felt better and better from their commencement to their end, and have perspired very freely. The exercise I take seems rather to increase than diminish my strength. I have not been prevented from taking exercise from any dampness in the atmosphere. I have sometimes been exposed to the night air in going to church and other places, but without any perceptible injury. The means you advised produce a general glow, and invaria- bly remove headache, which I sometimes have to a slight degree after dinner. I think my throat is better. There is no unpleasant feeling about it at present, except the DANGEROUS EXPOSURES. 29 difficulty in swallowing, and even that is better. Pulse sixty-seven." I had for some time ceased to regard this energetic young lady as a patient, when she announced a new ail- ment, a difficulty at periodic times:—" I walked two miles every day, and every thing was going on well, until one evening after walking very fast, I sat awhile with a friend, in a room without fire, in November. The weather was chilly and damp; was unwell, sup- pressed : had a chill and incessant cough for several hours, finding in something like inflammation of the lungs." These things were remedied, she now enjoys good health and is engaged in the active discharge of her duties. This last incident is introduced here to warn every reader, especially women, against all such ex- posures at all times, most especially during particular seasons. Such exposures, as sitting in rooms without fire, in the fall and spring, after active walking, have thrown stout strong men into a fatal consumption ; and it is not at all to be wondered at that delicate women should lay the foundation of incurable disease in the same manner. I will feel well repaid for writing these lines, if but here and there a reader may be found to guard against such exposures. Our parlors and draw- ing-rooms are kept closed to the air and light for a great portion of the twenty-four hours, and unless the weather is quite cool there is no fire in them. Thus they neces- sarily acquire a cold, clammy dampness, very percept- ible on first entering. A fire is not thought necessary, as visitors usually remain but a few minutes; but when the blood is warmed by walking in the pure air and the clear sunshine, it is chilled in a very short space of time, / 30 BRONCHITIS AND KINDRED DISEASES. if the person is at rest, in the cold and gloom of a mo- dern parlor, especially as a contemplated call of a minute is often unconsciously extended to half an hour, under the excitement of friendly greetings and neigh- borly gossip. There can be no doubt that thousands every year catch their death of cold, to use a homely but expressive phrase, in the manner above named. Young women, especially, cannot act thus with impunity. Men perish by multitudes every year by exposures of a similar character; walking or working until they be- come warm, then sitting in a hall or entry dr a cold counting-room; or standing still at the wharf or at a street corner; or running to reach a ferry-boat until they begin to perspire, and then sitting still in the wind while the boat is crossing. It is by inattention to what may be considered such trifling little things that thousands of valuable lives are sacrificed every year. A YOUNG GENTLEMAN, (950) from Washington City, complained of Uneasiness at throat, caused by repeated colds; late hours, hot rooms; Cough most of mornings—dry, tickling, hollow ; Expectoration a little yellow; Bloody, streaked expectoration, six months ago; Breathing oppressed, if sit or stoop long; Take cold easy, in every way; Throat has various feelings, tickling, heavy aching, raw, dry, from palate to depression ; Swallowing a little difficult at times; Voice not much affected; Headache, costive bowels, piles occasionally; Pain about shoulder-blades and at their points • OPINIONS OF CASES. 31 Soreness under both ribs sometimes ; Pains in the breast—more of a soreness from the top of the breast-bone to the pit of the stomach ; Have been ailing fifteen months ; Father, mother, sister, uncle, aunt died of Consump- tion. OPINION. You cannot have Consumption now: you are de- cidedly threatened with it. With proper attention, persevering and prompt, you may ward it off effectually, and live to the ordinary term of human life to those of your occupation. It is my opinion, that without this care, you will fall into settled disease within a year. In two months, this gentleman called to see me for the first time. His lungs were working freely and fully, over the natural standard; pulse seventy-two; appetite good ; bowels regular. I did not think he required any particular medical advice ; and it is my present belief, that with proper attention to diet, exercise, and regular habits of life, his health will become permanently good. (952.) Took a severe cold last winter, which left a severe cough. Every morning the breast feels sore, until stirs about some. Pain in the left side, running through to the left shoulder blade, and between the shoulders; pain in the breast-bone, and in the centre of the left breast. Chief complaint is pain in the chest, left side, and a constant raising of frothy, thick, tough, and yellow matter, with frequent hawking, hemming, and clearing of the throat. Age 22. OPINION. Your ailments are all removable by diligent atten- tion to the directions I may give you. I very much 32 BRONCHITIS AND KINDRED DISEASES. hope you will spare no pains in carrying them out most thoroughly. You certainly have not Consumptive dis- ease. He called upon me some months afterwards, when I saw him for the first time. He had nothing to com- plain of; pulse sixty ; his lungs working freely and fully, being considerably above the natural standard; and as far as I know, he continues well to this day. (973.) " Am officer in a bank. Was at a fire during Christmas, seven months ago. Used my voice a great deal; began to be hoarse; very much so by morning. This lasted a week, and went off; but in three weeks there appeared to be something about the palate which wanted to come away. Throat seemed inflamed, and ever since then have had a clogging feeling in the throat, that does not affect my voice, unless I read aloud, when I soon become hoarse. Two days ago, spit up a spoonful of dark blood ; never before or since. I have a binding sensation across the top of the breast, and three months since had a pain up and down the breast-bone. Have used iodide of potash; have had the throat pencilled, and then sponged with nitrate of silver, without benefit — pulse, one hundred and ten.'' OPINION. Yours is a throat ailment, at the entrance of the wind- pipe, not as low down as the voice organs. There is very considerable active inflammation there. Your lungs are a little weakened, nothing more; the pains in the breast are not serious at all, and I see no obstacle to your entire recovery. I received letter after letter from this young gentle- man, statin? that no perceptible benefit seemed to fob A CLERGYMAN. 33 low what I advised. He was encouraged to persevere, and finally his symptoms began to change, and then disappeared; and in two months from his first consul- tation, he wrote me to say that he had steadily improved; pulse, permanently at sixty-five; expressing his obliga- tions, &c. This case shows strikingly the advantage of perseverance. A CLERGYMAN (844.) Wrote to me for advice in reference to a throat complaint. I prescribed, and had entirely for- gotten the circumstance, when the following letter was received:— " I began to follow your directions on the 4th day of May, not quite three months ago, and have adhered to them strictly ever since. I am evidently a great deal better. I have lost no flesh; although it is summer, my weight has not varied three pounds since I wrote to you ; it is now one hundred and forty-nine pounds. My tonsils are diminished, and give me no uneasiness, ex- cept in damp weather. From my throat, which is now generally perfectly comfortable, I am continually bring- ing up a pearly substance. Sometimes it is perfectly clear, and like the pure white of an egg. But this is a mighty change. At first, 1 could not talk five minutes in the family circle. My throat was constantly tickling and burning; so that a mustard plaster, which took all the skin off my neck in front, was a comfort; but now I can talk as much as I wish, read a page or so aloud, and am almost tempted to sing a little." On the 9th of March, a distinguished clergyman, young, and of great promise, made to me the following statement: " Unusual circumstances compelled me to perform an immense amount of clerical labor, the work o* 34 BRONCHITIS AND KINDRED DISEASES. of three men; but it seemed unavoidable. I broke down, and was attacked seven months ago, in apparent health, with a sudden fit of coughing, which lasted three hours. I lost my voice; went to New York for medical advice; thence to Jamaica, in the West Indies; re- turned to the United States still an invalid, not having dared to preach since my first attack." He had night and morning cough, and the usual aus- cultatory signs of the loss of the upper portion of one lung. He was spitting up daily, quantities of thick, heavy, yellow matter. He said he was engaged to be married to a lovely woman, but that if his was a hope- less case, he could not reconcile it to his conscience to marry. He had great personal popularity, was almost idolized by his people, and a large circle of family con- nections. Here was a case well calculated to excite the highest interest of a physician. He wrote April 3d, " My voice and throat are as clear as they ever were in my life." Some months after- wards he called to see me, to say that he was well and was married. Two years later I heard that he conti- nued well. In many of the above cases, it may be seen how often a permanent hoarseness or huskiness, or loss of voice • or soreness in the throat, or painful pricking sensation in swallowing; or a gradual change of voice, end in death, sooner or later, if neglected; and the hope is, that the reader will take warning by these, and by timely application, save himself from a death at once painful and often extremely sudden, coming on in the dead hour of night, when there is no unusual or alarm- ing symptom the preceding day. HOW PERSONS GET BRONCHITIS. 35 It was of the acute form of this disease General Washington died after an ilness of about 24 hours. HOW DO PERSONS GET BRONCHITIS'? In the same manner as a common cold, for Bronchitis is a common cold protracted, settling not on the lungs, but on the branches of the windpipe, clogging them up with a secretion thicker than is natural ; this adheres to the inside of the tube-like branches, and to a certain extent closes them: hence, but a small portion of air gets into the lungs. Nature soon begins to feel the de- ficiency, and instinctively makes extra effort to obtain the necessary quantity, in causing the patient to draw in air forcibly instead of doing it naturally and without an effort. This forcible inspiration of external air drives before it the accumulating phlegm, and wedges it more compactly in a constantly-diminishing tube, until the passage is entirely plugged up. The patient makes greater efforts to draw in the air, but these plugs of mucus arrest it, and there is a feeling as if the air did not get down to its proper place, or as if it were stopped short, causing a painful stricture, or cord-like sensation, or as some express it, a stoppage of breath. If relief is not given in such cases, either by medicine judiciously administered, or by a convulsive effort of nature at a cough, which is a sudden and forcible expulsion of such air as happened to be on the other side of the plug, the patient would die; and they often do feel as if they could not possibly live an hour. This is more particu- larly a description of an attack of Acute Bronchitis. Chronic Bronchitis is but a milder form of the same thing, very closely allied in the sensations produced, if 36 BRONCHITIS AND KINDRED DISEASES. not indeed in the very nature of the thing, to what may be considered a kind of PERPETUAL ASTHMA, which may in most cases be removed and warded off for an indefinite time by the use of very little medicine, if the patient could be induced to have a reasonable de- gree of self-denial and careful perseverance. HOW DO PERSONS BECOME CONSUMPTIVE1? It is in many cases inherited from parents or grand- parents ; but as countless thousands bring it on them- selves, it may be more instructive to know how it was done, in some of the cases coming under the Author's notice. S. T. " Healthy until thirty months ago, when a slight cough was first noticed, often returning at shortening intervals, and continuing longer, until eighteen months since, when I spat a teacup of clear blood. Soon after, a continued cough came on. Seven months later had another spitting of blood." Has now a fixed cough, and is in the advanced stages of consumption. J. J. S. " Three years ago rode to church, in Septem- ber; sat by an open window, took a bad cold, neglected it; chills came on, followed by fever and night sweats ; in a month had a first spitting of blood, a pint at once; in a year had a settled cough, another haemorrhage and wasting of flesh." J. M. " Was perfectly healthy until two and a half years ago, when had frequent attacks of chill and fever • has fallen off a great deal; thin face, flabby muscles dark hair, freckled skin, great weakness, distressing cough; lungs half gone." Death inevitable. HOW PERSONS BECOME CONSUMPTIVE. 37 J. R. M. "Was perfectly healthy until eighteen months ago. After being very much fatigued and over- heated, in summer, laid down on a sofa, in a passage, both doors open, a considerable draught of air, no cover- ing, fell asleep, waked up in a chill, got up, became temporarily blind, and have had a cough from that day to this. In six months after that first chill, spat blood, a pint, and once since, a little. First wife died of con- sumption. We had five children; all died before her." This case utterly hopeless. H. F. R. " Had robust healt/h until three years ago, when travelling in mid-winter, took a bad cold, which made me feel as sore as if I had been beaten all over. This wore off, but cough came on, gradually increasing, until it became so violent that a blood-vessel was rup- tured, causing profuse bleeding, followed by great weak- ness." His lungs have decayed away until more than one half of them are useless to him. W. A. B. " Went a hunting; it rained in the morn- ing, wet all my clothing; still hunted on till night; was then taken with a terrible chill and hoarseness ; did not speak above a whisper for a week ; was confined to bed several weeks, with a very sore throat, headache; grad- ually got about, but a settled cough was left behind, which has constantly grown worse." This patient has now all the worst symptoms of advanced consumption. D. B. " Worked hard all day ; came home, laid down on a settee in an open porch, and slept until ten o'clock; waked up, felt chilly and bad; cough came on, most troublesome on getting up and on lying down ; now expectorate large quantities of yellow matter, extreme prostration, strength and flesh nearly all gone." No hope of cure. 38 BRONCHITIS AND KINDRED DISEASES. N. K. " Took cold a year ago, from walking in the rain ; this was repeated several times ; a cough came on, scarcely noticeable at first, but has steadily increased, until it now troubles me night and day, attended with night sweats, large, yellow expectoration, great debility, almost out of breath if I walk up a few stairs." On examination, half the lungs were gone. C. H. " While heated from exertion, made a mis-step in crossing water, and fell in ; neglected to change the clothing, felt chilly, cough came on next day, and con- stantly increased," with 'the ordinary symptoms of con- sumption, of which she died a short time after I saw her. E. H., the daughter of a Southern Planter, at the age of seventeen, was riding on horseback to a fourth of July celebration, at a oritical time ; a shower came on, the ride was continued, the clothing unchanged ; cessation came, cough, wasting, weakness, and death in eighteen months. M. H, aged eighteen, sitting in a porch at Long Branch until ten o'clock or later, of a summer evening, became chilly; continued the practice; a slight cough came on; then a small expectoration of blood, cessation followed, no alarm ; the sea breeze appeared perfectly delightful; the practice was continued, followed by death in fourteen months. J. A. " Worked hard for several days in a mill-race, with lower limbs in the water from morning until night; took cold, cough followed," and died in two years. P. G. " Was engaged in drawing plank from a raft, at Pittsburgh, in November; feet were in water nearly all day for weeks together; took cold, left a cough, night sweats came on," and died in eighteen months. S. R. " Was a stout, healthy farmer; went to the HOW PERSONS BECOME CONSUMPTIVE. 39 Legislature in mid-winter; was confined a great deal in small heated rooms; going out often, day and night, into the cold, piercing, damp air; took a bad cold, which left a settled cough; spitting of blood and general decay followed." B. S. started to a party in a carriage, in winter, hav- ing on a warm pair of woollen stockings, put on in her mother's presence and by her requirements, but changed them for a silken pair at the door of the ball-room ; feet became very cold before leaving the room; waked up next morning with a sore throat; a slight cough followed in a few days ; parents became alarmed. She was sent abroad ; no improvement; and as the vessel entered the bay of New York she died—in sight of home. And thus perished one of the loveliest women the writer ever knew, in her nineteenth year. C. M. A young man of great promise and worldly expectations, became possessed of the idea, that by accustoming himself to hardships, he would establish his constitution ; therefore, whenever he rode, he would ride in a gallop—if it were in heat, or rain, or snow, all the better. Often, while bathed in perspiration, and weakened by long rides and fasting, he would, on coming to a creek or bayou, swollen by recent rains, plunge in —horse, clothing, and all—and then ride five, ten, or twenty miles, home. He died of confirmed, unmistaken consumption, in my presence, having just looked over his merchant's account rendered, of the sales of a large crop of cotton. All the above cases were fatal from undisputed con- sumptive diseases. They were selected purposely to show that such causes, trivial as they may appear, do lead to a malady which baffles all human skill; and they 40 BRONCHITIS AND KINDRED DISEASES. are wisest, who take most pains to avoid them, and to impress upon the minds of their children, as a part of their education, the importance of taking care of their health; and not only this, but how to do it; for the heritage of millions of money does not weigh a feather in the scale, against a young body full of health and manly vigor. Very many persons trace their Consumption to a slight cough, which followed an attack of Fever, or Pleurisy, long continued Chills and Fever, Measles disappearing too soon; and very few ever recover who have Con- sumption from this last named cause. THE PHILOSOPHY OF THROAT-AIL. In other words, how do the circumstances which have been named as the causes of this malady, operate so as to develope it 1 Pain, sickness, and disease, arise from a faulty circu- lation of the blood, fast or slow. A needle cannot be pressed on any spot in the body, without drawing blood, showing that blood vessels are everywhere, that these vessels are too small to be seen by the naked eye, and that the blood must be confined to them, and not flow- ing about in the system. As the sap of a tree flows from the trunk through every spreading branch to the farthest extremity of the smallest twig, so the blood gushes out from the heart, running through all the branching arteries, growing continually smaller, and spreading wider, until they are too minute to be seen by the naked eye; but when this blood has reached the ends of the arteries, it does not stop, but passes on a space, and enters the veins, which gradually become larger and fewer, until they form one trunk, which PHILOSOPHY OF THROAT-AIL. 41 empties all its blood into the heart again, as the great Mississippi is formed by innumerable smaller streams, growing larger, fewer, concentering, finally making one great flood, opening into the boundless sea. But each minute artery does not empty itself directly into some viewless vein : a smaller tube than either, connects the two ; these tubes are called Capillaries, from their fine- ness, being hair-like, as the Latin word Capilla means a hair; and as the finest hair of the Caucassian race, is a hollow tube, so are these connecting capillaries hollow, and in the transit of the blood through them are all the issues of life and death to men. When these hair-like tubes are in natural, healthful working order, they are strong enough to pass the blood from the arteries to the veins in natural quantity and proportion, but if they are weakened, or too much blood is presented for transmis- sion, that instant disease begins, for not being passed off soon enough, that is, not as fast as it comes in, an accumulation is inevitable, the capillary becomes clog- ged up, distended with blood, and is soon large enough to be seen, just as when the eye is injured, red streaks appear on the white of the eye, which were not observ- ed in health; becoming distended, these capillaries take up more room than is natural, and must inevi- tably crowd upon some other part; and as nerves are everywhere, it crowds, presses on them, and gives pain, more or less, according to the amount of pressure, that is, of room taken up by the swoln capillary ; every one knows that the slightest pressure of a needle on the skin gives pain, because it touches a nerve, and where there is no nerve, there is no pain. Now these little capilla- ries, when thus clogged up, must get rid of the extra blood, or they will burst. Nature first endeavors to re- 42 BRONCHITIS AND KINDRED DISEASES. move the accumulation, and the thin substance of which these capillaries are made, is distended, and the thinnest part of the blood oozes through the sides, and stands on the outside, in the shape of a distinct globule, small as the tiniest dew drop upon the leaf of spring; any one may observe the like process in a leathern hose pipe at a fire; it soon becomes wet on the outside from the' great pressure from "within, and however muddy may be the water in the hose, that on the outside is clear; but if the pressure were to be continually increased, the less purer portions of the water would begin to exude, until act- ually muddy water would be seen, or the pipe burst: now for the application of this to the explanation of the phenomena of Throat-Ail, Bronchitis, and Consumption. In Throat-Ail, the voice making organs are first af- fected, and then the voice itself: these organs are four little muscles, or tendons, or strings at the upper end of the windpipe, at Adam's Apple, two on each side, one above the other, some quarter of an inch apart, running front and rear ; the blood vessels of the system spread out over every part of the body, as a vine spreads itself over the side of a wall, and just so are they spread over the voice strings, and when, by any means, they become weakened, the blood accumulates, distends them, and the clogging up still going on, the thinner portions escape, or ooze through the sides, and become a little thickened, that instant the voice strings do not vibrate freely, do not give a natural sound, any more than a violin string would give a clear sound, if any gluey sub- stance were put on it; hence, hoarseness and huskiness, the great, the distinguishing, universal symptom of Throat-Ail. But as soon as the thinner portion of the blood becomes separated from the blood itself, and gets PHILOSOPHY OF BRONCHITIS. 43 on the outside of the capillary, instead of the inside, it becomes a foreign body ; nature gets weary, and seeks to cast it out; hence the instinctive hawking, hemming, or endeavoring to swallow it away, just as many persons endeavor to swallow a pill away, for some minutes after it is taken ; and no one ever has Throat-Ail who is not troubled, more or less, with this incessant hawking, hemming, or fruitless swallowing. At this stage of dis- ease, a perfect cure is easily performed in a few days, simply by using "rational means to aid nature in getting rid of the accumulation of blood in the capillaries of the part; on the other hand, if neglected, it goes on uniform- ly to a fatal Consumption, as follows: After the thinner portions of the blood have escaped, the clogging still going on, a thicker substance exudes, and the patient expectorates a great deal; it does not necessarily produce a cough, it is not far enough down to require that: a hawk or hem, or violent clearing of the throat is all that is requisite to get it away, but the cause remaining, it begins at once to gather again; if no relief is now afforded, the blood vessels, by the continued strain, lose all their power, the blood bursts out, a sore is formed, this becomes an ulcer, the chords are eaten away, and the voice is gone forever ! Ulceration now progresses rapidly, the windpipe is eaten through, or it runs down to the lungs, and all is over. THE PHILOSOPHY OF BRONCHITIS. When more blood is.in an artery than there ought to be, it is called " inflammation ;" if more in a vein, it is called " congestion ;" there is no special name for there being more blood than is natural in a capillary ; but the word congestion answers well for all three. The little 44 BRONCHITIS AND KINDRED DISEASES. word of four letters, itis, pronounced always etis, means flame-like, or reddish, and when any part of the body is permanently redder than it ought to be, in consequence of too much blood being in the arteries of that part, as in the white of the eye, when injured, that part is said to be inflamed, and it is not only flame-like in appear- ance, but is also warmer than natural : the word itis, then, invariably means, when attached to the name of any particular part of the body, that such a part has more blood in its small blood-vessels «than is natural. Thus, the word Bronchitis, means simply more blood in the small blood-vessels which spread themselves over r the inside walls of the branches of the windpipe, than there ought to be. These branches of the windpipe are called Bronchi, or bronchial tubes, from a Greek word Rrecho, which means to moisten, because the ancients thought, as solid food was conveyed into the stomach by the gullet, which is behind the windpipe, so fluids were conveyed into the system by means of the windpipe and its branches, thus, itis added to Rronchi, means more blood than is natural in the small blood-vessels which spread out over the inner walls of the branches of the windpipe, being an admirable illustration of the beautiful correctness, succinctness, and expressiveness of medical terms, "hard" as they are generally thought to be, ten letters being made to express what would otherwise require twenty-five words. The philosophy, then, of Bronchitis is, the smaller blood-vessels spread out over the inner walls of the branches of the windpipe being so congested, clogged up with blood, that the thinner watery portions of the blood are made to ooze through the pores into the bronchi; hence, in the first stages of bronchitis, there is a water- PHILOSOPHY OF BRONCHITIS. 45 ing of the nose, which is a part of the air-passages ; as the clogging goes on, it begins to ooze out more, accu- mulation takes place, the bronchial tubes begin to be filled, the air cannot pass freely through them, into and out of the Lungs, and the patient complains grievously of "fullness," of " oppression," of a " cord-like feeling across his breast," of a" want ofbreath," and, without relief he would soon die, but Nature comes to his aid by an instinctive cough, which is nothing more than a sud- den forcing of air through a bronchi, for the purpose of loosening and carrying before it, the obstruction, that is, the oozed-out substance just spoken of, just as boys at school, by a sudden and forcible breath, cause a feathered arrow to be ejected through a long reed; hence, the three inevitable and universal symptoms of Bronchitis, difficult breathing, violent coughing, and large expectora- tion of a most gluey, tenacious, sticky, pearly-like sub- stance, sometimes half a pint or more in a day, for days and weeks in succession. It is often so sticky, adheres so closely to the insides of the Bronchi, that the efforts of Nature, to dislodge it by cough become so violent and exhausting, that the patient feels that if he had to cough a single time more, he would die, and falls back on his bed, perfectly exhausted and helpless, and wringing wet with perspiration, only to be renewed again in a short half hour or less, day and night, for weeks together, unless relieved. At this stage of the malady, relief and cure are prompt, uniform, and permanent, by simply giving such mild medicines as will dilute this tough, adhering substance, and thus make its detachment from the sides of the Bronchi easy; the next step is to give other remedies which will afford additional strength to the capillaries, by which they will be able to transmit 46 BRONCHITIS AND KINDRED DISEASES. larger quantities of blood, until equilibrium is restored ; this is to be done by thinning the blood, diminishing its quantity, and improving its quality, thus strengthening the whole system, and in proportion, every part of it. But if neglected, instead of being cured at this point, the clogging goes on, as in Throat-Ail—the blood-vessels burst, ulceration begins, the parts are eaten away, large quantities, not of a glairy, pearly look, are spit up, but of a heavy, yellow, darkish, greenish, or rusty-color—a tea-cup full or more in a day, the drains of the system tend that way, as drift-wood tends to a broken part of a mill-dam, and the patient, imagining that he is spitting away his lungs, concludes that they must be almost entirely gone, and gives up all hope of life, yet he can be cured at this point, and in a fortnight be walk- ing the streets, because the lungs themselves were not touched by disease, it had not reached that far; but now, if there is further delay, ulceration rapidly pro- gresses, and Bronchi, Lungs and all, break down toge- ther in death. THE PHILOSOPHY OF CONSUMPTION. Consumption is a disease of the lungs themselves, which are little cells or bladders at the extremity of the branches of the windpipe, are of all sizes, from that of a pea, downwards; and millions in number; when the blood-vessels which spread out on the inside of these little cells, as a vine spreads over a wall, become too full of blood, the thinner portion oozes out, as before described in Throat-Ail and Bronchitis, and stands at first, a clear little drop, then thickens, increases, hardens, and becomes a hateful tubercle ! and two results follow. It has become a foreign body, small as a crumb of bread PHILOSOPHY OF CONSUMPTION. 47 though each tubercle be, yet like a crumb of bread which has " gone the wrong way," it excites a tickling cough, trifling at first, but constantly increasing in violence to the end of life ; thus cough is the general attendant of consumption, from its stealthy access, to its dreadful end. A second result of the presence of tubercle is, that each one takes up a little room, no larger perhaps than the head of a pin, yet when these amount to thousands, the room for air in the lungs is materially diminished; hence consumptives not being able to take in air enough, always complain of so easily "getting out of breath" of being " 50 easily tired." And here let the reader's attention be drawn to what the Author considers the happiest thought of modern times, the most magnificent application of a scientific principle ever made, as to medicine, dimly outlined by Abernethy, but not matured and made practical until within a very few years, that of determining the begin- ning of Consumption, to be at a point when the lungs first begin to consume the first cubic inch less of air than they ought to do, which is generally long before the slightest cough has ever been observed. To do this, two things are necessary. 1st. To know how much air any given man's lungs hold when in full and health- ful operation. 2d. To be able to measure the amount accurately, infallibly, mathematically, down to a single cubic inch. It is sufficient to say here, that the first is certainly known, and that the second is as certainly and demonstrably done. Each person requires a given amount of air, in proportion to age, size, sex, &c, but every person of given physical requirements must con- sume the same minimum amount of air, or disease is 48 BRONCHITIS AND KINDRED DISEASES. inevitable. It is easy'then to perceive, that if a man should measure two hundred cubic inches of air in health, he would, if half his lungs had consumed away, measure only one hundred inches; and so of any other proportion, larger or smaller. And as the lungs begin to be filled up with tubercles, long, long, before they begin to consume away; and, as previous to the con- suming process, every body knowing anything at all medically, knows that consumptive disease is perma- nently removable, it follows demonstrably, that if pro- per means were used when the breath first begins to fail, that consumption is, at that stage, as certainly curable as certainty can be affirmed of any therapeutic agency on record. And if the public could be induced to take up this fact, and act upon it rationally and practically, and could prevent its being turned into ridicule by ig- norant and unprincipled peripatetic lecturers, not one need die of consumption, where thousands now do. The Author dislikes hobbies, and will not here fur- ther insist upon the application of the principle in cer- tainly determining the first, faint, far-off approaches of consumptive disease, but will state that to the judi- cious application of this principle, with the aids of auscultation and general medical experience, he owes the ability to give the plain, and specific written opinions of a previous page, every one of vjhich time has con- firmed. GENERAL HISTORY OF THROAT-AIL. The general history of the beginning, progress, and end of a case, is as follows :— An uneasy feeling is present in the upper part of the throat, causing a frequent tendency to swallow, as if GENERAL HISTORY OF THROAT-AIL. 49 some obstruction might be removed thereby. In other cases, there is a constant hemming or hawking, in order to clear the throat of some sticky or glutinous stuff, ad- hering to the back part of it; then the voice is not of that clear, ringing sound as formerly : or if it is made clear, it requires an effort, which shows that something is wrong; for nature works without an effort; after a while the effort becomes such as to cause fatigue. The voice has to be pushed out as it were; at length it be- comes hoarse or cracked, after unusual speaking or read- ing; this is more perceptible after meals, or towards evening: some soreness begins now to be felt in the region of Adam's-Apple. There may be as yet no cough; and for weeks and months it may make no per- ceptible progress, even getting better; but sooner or later it becomes worse again from exposure to changes of weather and other causes; and thus it alternates, until the patient becomes exhausted in his efforts to get rid of it; the strength declines ; the cough appears ; the constitution yields, and death closes the scene. It must be remembered that, sometimes, no cough makes its appearance until within a few weeks of death, but the voice becomes more and more cracked, dis- cordant and husky; it requires the utmost effort to enounce a word above a whisper; the whole body seems to exert itself in the pronunciation of every syllable, and not only the throat, but the whole system is wearied with the effort; yet generally unattended with extreme pain, in or about the throat. Sometimes the voice be- comes utterly extinct previous to dissolution. In the progress of the disease, ulcers form in the throat, so far down as not to be visible to the common eye, and these ulcers pour out. day by day, enormous quantities 50 BRONCHITIS AND KINDRED DISEASES. of the most offensive stuff, matter, blood, mucus, pure or mixed, a great deal of which is got rid of by expecto- ration, a whole pint of it in a day sometimes; another part goes by way of the stomach, destroying its tone and power of digestion, and the patient wonders " where so much corruption comes from !" and assures the physi- cian that he " must have spit up all the lungs before now;" and yet, on a proper examination, the lungs will be found unbroken and undecayed. While this affords encouragement to persons who appear to have consump- tion, to have their cases properly examined, perchance the lungs may happily be sound, notwithstanding the threatening nature of appearances; it at the same time points out the necessity of prompt attention in all cases where there is any ailment about the throat, or any alteration of the voice whatever. Many distinguished names, such as Piorry, Chomel, Louis, Belloc, Andral, Columbat De L'Isere, Sir Charles Bell, Stokes, Horace Green, and others, bear the most unhesitating testimony to this important and interesting truth : " There can be no doubt that a person may have all the apparent signs of consumption of the lungs, in consequence of the throat affection, and the lungs them- selves be free from disease." In view of this, how strongly does the irresistible con- viction fasten itself upon the mind of every reflecting reader, that many have been hastily abandoned, as being in the last stages of Consumption, because they had cough, emaciation, night sweats, and difficult breathing, when a skilful physician would have detected in the throat alone, a sufficient cause for these alarming symp- toms, and, by a short course of judicious treatment, have rescued them from an untimely grave. • * ** .• TWO CLERGYMEN. 51 A clergyman called upon me, in New Orleans last winter, for an examination and opinion of his case, which his friends had supposed hopeless consumption. I con- sidered it one of throat disease in the main, and treated it accordingly. In two months he writes to me: " Dear Sir : Your prescriptions began in a few days to act like a charm. My cough is more than half abated—digestion improved fifty per cent., strength and spirits in like proportion—nothing seemed against me but too frequent pulse. My throat and voice improved wonderfully, and my respiration very much helped," &c. The rapid improvement in this case could only have taken place on the ground of my opinion being correct as to the character of his ailment—and yet he had been sent an interminable journey south, from Kentucky through Florida, and, as he informed me, " got worse all the time." What a world of distress and anxiety, and what a large expenditure of time and money might have been saved to this gentleman, had a more truthful opin- ion been formed of his case before he left home. Another clergyman, after having been under treatment for 6ome time, writes me, and after relating the favor- able changes which had taken place, says: "And, permit me to say, Doctor, that I shall ever cherish, with grateful remembrance, the day I first visit- ed your office for advice and prescription, and that you may long live to relieve the sufferings of the human family, and enjoy that happiness which a consciousness of doing good gives its possessor, is the prayer of your obedient servant." A gentleman, whose life was of considerable Import- ance to.the community, called at niy office wishing to 52 BRONCHITIS AND KINDRED DISEASES. know my opinion of his case. On a careful examina- tion, I told him he was suffering more from a throat disease than anything else, and that there was no effi- cient remedy. As I could do him no material good, I dismissed him, expecting to see him no more. Early next morning he returned, and said, " you must do some- thing for my throat," I prescribed, and he got better rapidly, very rapidly. Knowing, however, that he could not recover, and seeing that every day he was cherishing new hopes of life, I thought it best to acquaint his wife, to whom he had not long been married, that I considered him in a dangerous condition, and advised an immediate return to his friends, assuring her, at the same time, in the most positive terms, that he was liable to die within any hour. He could not be induced to assent to my views, and I advised him to call in another physician. He did so, and I withdrew. Within ten days, though apparently better, his wife heard a singular noise while her husband was sleeping, and before she could go to the family apartment, to give the alarm and return, he was dead. This sudden death sometimes arises from ulcers forming in the windpipe or its branches, and closing up the passages so that no air can pass; or an ulcer bursts and fills up the passages with matter, so as to suffocate. Sometimes the ulcers eat through the sides of the air passages, and making communications with adjoining parts, produce irritation, inflammation, and death. A gentleman called at my office with a distressing hoarseness of voice, but no soreness; it required a great effort for him to speak distinctly. He had just placed himself under the care of a physician, who was said to have had some success in curing throat diseases ; but GENERAL HISTORY OF BRONCHITIS. 53 hearing that I was in town, he called on me to know what I thought of his condition. I was obliged to say that he would die in a few days, and declined prescrib- ing ; first, because I knew that I could do him no mate- rial good; and second, I considered it would not be just toward his physician, to abandon his treatment without giving it a fair trial. I saw him on the street several times afterwards, but within ten days I was hastily sum- moned to see him, and found him dead from suffocation. It ought to be extensively known that there are seve- ral forms of throat disease, which render those who have them liable to sudden death ; this is especially true of acute and chronic Laryngitis, from swelling, in- flammation, or exudation about the upper part of the Larynx, which close the sides, and prevent breathing. This is very liable to come on in the night, during sleep; the breath is gradually stopped, the person becomes un- conscious; instinctive struggles may give the alarm, but death usually ensues, before any person can be called; of this Washington died, after an illness of a few hours. GENERAL HISTORY OF BRONCHITIS. It begins as a common " bad cold," the eyes are weak and watery; there is a running from the nose, chilliness, appetite fails, general weakness; there is a feeling of fullness all over the breast, of being stuffed up, great difficulty in drawing in the breath; cough commences, spiteful, quick and dry at first, then more loose, and ex- pectoration begins, of a tough, tenacious, gluey, pearly substance, a cup full in a day. These coughing spells are usually most severe of mornings on first waking up; at length, as the patient gets weaker and worse, the ex- pectoration becomes yellow, greenish, black, bloody or 54 BRONCHITIS AND KINDRED DISEASES. rusty colored—sometimes of a bad smell, indescribable. The cough, which at first was curative, is now tearing, exhausting, and almost insupportable—aggravating every symptom, and wearing the patient to a welcome grave. GENERAL HISTORY OF CONSUMPTION. No two cases of this disease are precisely alike in every particular; yet, in general, the feelings and symp- toms in its beginning, progress, and end, are as follows: In nearly every case, Consumption begins with a slight, short, tickling cough in the morning; but as it occurs only now and then, and is so very slight, that only one or two efforts at coughing are made on getting up, it is not noticed at this stage; after a while, this cough occurs occasionally during the day ; it may be next ob- served on lying down at night, or some minutes after being in bed; a single cough or two; coming on quite suddenly, as if produced by a particle of dust in the throat, from the pillow or bedding. Soon the morning cough increases, and the night cough comes on regular- ly ; damp weather, or a sudden spell of cold weather, increases it, and the person says he has " caught a cold, some how or other;" but it does not go off of itself, like a cold used to do ; it " hangs on," and is increased by every slight change in the moisture or temperature of the. atmosphere. The patient now begins to think he had " better take something" for his cold. He might discover, however, by this time, that it does not affect him as a cold used to do; for several years ago, when he took a cold, he remembered that it made him " feel bad all over;" his appetite decreased; his nose would run almost constantly; occasioning a snuffling every few minutes, with a stopping up in the head ; and he would GENERAL HISTORY OF CONSUMPTION. 55 cough, and cough hard, any time during the day, spit- ting up more or less of heavy yellow matter; and he describes himself as being " out of sorts ;" but the cold he now has is quite a different thing; his head is not stopped up ; his nose does not run ; his appetite is quite good; he does not feel bad at all; he spits up no yellow matter during the day or night either; but he has sim- ply a dry, short, tickling cough, which keeps him from going to sleep when he first gets into bed at night; and which comes on in the morning as soon as he gets up, and begins to stir about; and with the exception of this, when he goes to bed, and when he gets up, he says he " feels well enough," having no headache, no fever, no burning feeling about the nostrils, and repeats for the hundredth time, "if I could only get rid of this cough, I would be as well as I ever was in my life." He then determines to " take something." Every body has a prescription that cured such and such a one, who " had just such a cough, only worse and of a longer duration, and it is so simple that it could not possibly hurt any one." Some of these do no good whatever; others give relief, but soon appear not to have the desired effect, and something else is resorted to, with similar results. But long before this time, a practiced observer will have no- ticed that other changes have been taking place ; because, every hour, the disease has been digging its way deep down into the vitals. The pulse is more rapid than natural, has more of a quick, thread-like, spiteful beat; and too weak, besides; the patient is more easily tired than for- merly, especially in going up stairs, or walking up a hill or gentle ascent; when he attempts to do any thing, he " (dves out" sooner than he used to, causing him to have an occasional shortness of breath; about this time, 56 BRONCHITIS AND KINDRED DISEASES. he finds occasionally that he cannot take a full long breath as formerly; something seems to cut it short, leaving an unsatisfied feeling; his friends observe that he is as lively as usual, and indeed more so; he feels, and appears cheerful; and is quick in his movements; but before he does much, or walks far, he becomes very weak about the legs and knees ; and there is a great craving for a place to sit down upon, and rest awhile; and if a sofa or bed is near, it feels at first so comfort- able that he is inclined to stay there ; now and then there is a feeling of weight in the breast, dull, heavy, or cold-like; if he leans forward much, his breast gives way; pains, more or less transient, or permanent, are felt in some part of the chest; often these are at the lower edge of the ribs; there is now an occasional fever- ishness ; the bowels become costive and loose alternate- ly ; sometimes the feet or hands, or both, burn very much; at others, they are uncomfortably cold; the pa- tient begins to think that he is " falling off" some; and turns to weighing himself with very unsatisfactory re- sults ; he perceives that although his appetite is quite good, his food does not seem to do him as much good as formerly ; there is unusual thirstiness during some part of the day; if the weather is but a little cool, he gets very chilly; after a while, chills frequently run all over the body, and along the spine, without any apparent cause; an emotion of the mind, a drink of cold water, is sufficient to send a succession of chilly sensations all through the system; while these symptoms are present- ing themselves, the original cough, although sometimes better, has, in the main, become decidedly worse, and continues from ten or fifteen minutes to two hours, ac- cording to circumstances; throwing the system into a GENERAL HISTORY OF CONSUMPTION. 57 nervous irritable condition; effectually preventing sleep for half the night, perhaps, when he falls into a doze from mere exhaustion; and in the morning he wakes up, pale and wan and haggard, without seeming to have derived any benefit whatever from his repose; and weak and wretched as he feels, the morning cough now attacks him, hard and dry at first, but in a few minutes he is relieved, by bringing up more or less of yellow matter, mixed with something of a whitish, frothy, bub- bly character. Coughing comes on after meals, with heaving, and in some cases vomiting, although not spe- cially attended with sickness at the stomach. As the disease progresses, he emaciates more and more, the weakness of the lower limbs increases, the amount of yellow matter expectorated becomes greater from day to day, while the frothy substance is less; there is more or less of thirst or chilliness between breakfast and din- ner, with decided fever in the afternoon, which subsides during the fore part of the night, and goes off' towards morning with a copious, exhausting, and death-like sweat, carrying damps and chilliness to the very heart. These sweats are accompanied or alternated, with fre- quent and thin, watery, light colored passages from the bowels, from two or three to a dozen or more in the twenty-four hours, attended sometimes with horrible griping pains in the bowels; at other times, there are dull pains in the muscles and bones of the limbs, occa- sionally almost insupportable. Even yet the patient may keep about, and appear quite cheerful; but his steps are slow, measured, and careful; his body bent forward; his shoulders inclining upon the breast, and towards one another; if he sits down a moment or two, his legs are crossed, his arms laid across his thighs, 58 BRONCHITIS AND KINDRED DISEASES. presses on his breast by leaning forward, and thus throws the whole strain and weight of the body upon it, hastening his death by imposing an unnatural and unnecessary weight on the struggling lungs, already en- feebled and wasted by disease ; he begins now to feel best in bed, where he spends the greater portion of the twenty-four hours; his ankles swell, generally the left first, often extending to the feet and legs, sometimes painfully ; he cannot walk with comfort; and soon his mother earth receives him to her bosom, where myriads of her weary children have already gone, to be wasted with sickness no more. The Author has now given a parallel history of the three diseases, in the regular order of Throat-Ail, at the top of the windpipe, Rronchitis in the branches of the wdndpipe, and Consumption in the air cells at the ex- tremity of the branches of the windpipe; and for thj interest the fact will excite in all who have little chil- dren, he here states, that Croup, of which so many die in spring and fall, is a disease of the windpipe itself; as soon as the small blood vessels on its inner walls be- come clogged up, they begin to exude through their sides, the thinner, the more watery portion of the blood, this begins to harden and toughen at once, as the gum does, that oozes out on the bark of a tree, that is wounded or injured; and the windpipe of a child being small, it does not require much to fill it up, and the little suf- ferer dies of suffocation; and when the windpipe is cut open after death, its inside is found lined all around (as the spout of a tea kettle, in limestone districts, is with lime) with a leathery substance, which, to use a strong expression, is almost as " tough as a hide." The reader may now see the beautiful order, clearness and arrange- DEFINITION OF THROAT-AIL, BRONCHITIS, ETC. 59 ment of these most fearful and fatal diseases of the air passages ; and can also so clearly understand their na- ture as never to forget. Hitherto, the terms employed have not conveyed to common minds any clear, defi- nite, distinctive idea; but have left an impression, ill- defined, mysterious, unsatisfactory and obscure. Throat-yAil, (Chronic Laryngitis, Clergyman's Sore Throat, all mean the same thing,) is a disease at the top of the windpipe, where the voice organs are. Croup or Tracheitis, (because trachea is the Latin name for windpipe) is a disease of the windpipe itself. Rronchitis is a disease of the branches of the wind- pipe. Consumption is a disease of the air cells or lungs them- selves, which are at the ends of the branches of the windpipe, as leaves are at the ends of the branches of a tree. This appears to the Author, to be the plainest and most satisfactory, as well as the most rational theory of these diseases; he has entertained them for twenty years; when a better one is presented, he will change. Young physicians, and some older ones, may not ac- cord with these views, but when these older ones have fallen into the slumber that wakes no more, and the juniors have had a quarter of a century's more ex- perience and observation, the Author believes that the above theory will be generally entertained ; most cer- tainly, the extraordinary physiological-developments of Carpenter and Liebig, and others, within five years, are strongly confirmatory of these views. 60 BRONCHITIS AND KINDRED DISEASES. PARALLELS. Throat-Ail is characterized by hawking, hemming, frequent swallowing away of something that appears to stick in the throat, and when swallowed away, rises back again ; by inconvenience, if not actual pain in swal- lowing, by pain sometimes running up to the ear; by hoarseness or huskiness of voice, without cough neces- sarily, at first, or much expectoration. Rronchitis never exists without distressing, exhaust- ing cough, and with copious and weakening expectora- tion. Consumption is a gradual wasting of breath, flesh and strength, sometimes without any cough or expectora- tion, until within two or three weeks of death. Throat-Ail has the uniform symptom of impaired voice, or some unnatural, troublesome sensation about the " swallow." Rronchitis is always attended with watering of the eyes or nose, or both, a binding sensation across the breast, a stuffed up feeling, large expectoration. Consumption has a short, dry, hacking, tickling cough at first of mornings on getting out of bed, then on going to bed, quick pulse, short breath, easily fatigued in as- cending a pair of stairs, or wralking up a hill or even gently rising ground. Throat-Ail is at one end of the breathing organs. Consumption is at the other end. Rronchitis is between the two. In Throat-Ail, there is constant forebodings and ap- prehension of ill; the patient lounges and mopes about, PHTHISIS--SCIENTIFIC DEFINITION. 61 and when he sits down, feels as if he would never want to get up again. In Rronchitis, the cough is so exhausting and distres- sing, the invalid often feels as if death would be a wel- come event. ' In Consumption, the spirits are usually good ; the pa- tient is full of hope, busy in laying out plans for the future; how he is going to manage his business, and take care of his health hereafter, whatever else may suffer; and to every inquiry as to the state of his health, the ready answer is, " I'm better." phthisis--scientific definition. Consumption is the Oxydation of the Exudation Corpuscle.—This corpuscle, this little body, this tuber- cle, this seed of consumption, is an albuminous exuda- tion, as minutely described on a preceding page, and being deficient in fatty matter, its elementary molecules cannot constitute nuclei, capable of cell development; therefore, these nuclei remain abortive, are foreign bodies in the lungs, and like all other foreign bodies there, cause irritation, tickling. This tickling is a cause of cough, as itching is a cause of scratching, both being in- stinctive efforts of nature to remove the cause of the difficulty. The oxydation, that is, the burning, the soft- ening of this corpuscle or tubercle, gives yellow matter as a product, just as the burning, that is, the oxydation of wood, gives ashes as a product. Thus the yellow matter expectorated in consumption is a sign infallible, that a destructive, consuming process is going on in the lungs, just as the sight of ashes is an infallible sign that wood or some other solid substance has been burned, that is. destroyed. 62 bronchitis and kindred diseases. But why is it that this albuminous exudation, this tubercle, this exudation corpuscle, should lack this fatty matter, this oil, this carbon, which, did it have, would make it a healthy product, instead of being a foreign body and a seed of death 1 Consumption is an error of nutrition. The patient has soliloquized a thousand times, " I sleep pretty well, bowels regular, and I relish my food, but somehow or other it does not seem to do me the good it used to. I do not get strong." The reason of this is, that the food is imperfectly digested, and when that is the case, acidity is the result, which is the distinguishing feature of con- sumptive disease. This excess of acid in the alimentary canal dissolves the albumen of the food, and carries it off into the blood in its dissolved state, making the whole mass of blood imperfect, impure, thick, sluggish, damming up in the lungs, that is, congesting them, in- stead of flowing out to the surface, and keeping the skin of a soft feel and a healthful warmth. Thus it is that the skin of all consumptives has either a dry, hot feel, or a cold, clammy dampness; at one time having cold chills creeping over them, causing them to shiver in the sun or hover over the fire; at another time, by the reaction, burning hot, the cheek a glowing red, the mouth parched with thirst. Another effect of the excess of acidity dissolving the albumen and carry- ing it into the blood is, that the blood is deficient in the fat, or oil, or carbon, which would have been made by the union of this albumen with alkaline secretions ; the blood then wanting the fat or fuel which is necessary to keep the body warm, that which was already in the body, in the shape of what we call flesh, is used instead, and the man wastes away, just as when steamboat men, CONSUMPTION AN ERROR OF NUTRITION. 63 when out of wood, split up the doors, partitions, and other parts of the boat, to keep her going; she moves by consuming herself. So the consumptive lives on, is kept warm by the burning up, the oxydation of his own flesh every day and every hour; this same wasting away being the invariable, the inseparable attendant of every case of true consumption. He lives upon himself until there is no more fuel to burn, no more fat or flesh, and he dies—" nothing but skin and bone." What, then, must be done to cure a man of consumptive disease1? He must be made more, as it is called, "fleshy;" that is, he must have more fuel, fat, to keep him warm. The acidity of the alimentary canal must be removed, in order that the food may be perfectly digested, so as to make pure blood, such as will flow healthfully and actively through every part of the system, and become congested, sluggish, stagnant nowhere. To remove this acidity, the stomach must be made strong, and healthfully active; but no more than health- fully active, so as to convert the food into a substance fit for the manufacture of pure blood. To make the stomach thus capable of forming a good blood material from the aliment introduced into it, as a perfect mill converts the grain into good flour or meal, there is behind the mill a power to turn it, there are be- hind the stomach powers to be exerted. These are those of the glandular system, the liver being the main one of all. This must be kept in healthful, operating order; if it acts too much or too little, the food is badly manufac- tured, and the blood, which is made out of the food, and of the food alone, is imperfect and impure. After all this is done, there is one more operation, which is the finishing touch, and the one by which pure life- 64 BRONCHITIS AND KINDRED DISEASES. giving blood is made; (J^gf* a sufficient amount of pure air must come in contact with it before blood is consti- tuted. This contact takes place in the lungs ; not such a contact as the actual commingling of wine and water, for the air and what is soon to become blood are not mixed together; they are kept separate in different ves- sels. The air is in the lungs ; that is, in the little blad- ders or cells, and this fluid, which is to be converted into blood, is in the little veins or tubes, which are spread around over the sides of the air-cells, as a vine is spread over a wall; but these little vessels have sides so very thin, that the life-giving material of the air passes through into the blood, just as the warmth of the sun passes through glass; but while this life-giving quality of the air passes into the blood, making it per- fect, the impure and deathly ingredients of the blood pass out of it, into the air, which has just been deprived of its life. Thus it is, that while the air we draw in at a single breath is cool and pure and full of life, that which is expired is so hurtful, so poisonous, at least so desti- tute of life, that were it re-breathed, instantly, uncom- bined with other air, by a perfectly healthy person, he would instantaneously die. So that pure air in breath- ing is most essentially indispensable; first, to impart perfection, life, to the blood; and also to withdraw from it its death. No wonder, then, that a plentiful supply of pure air is so essential to the maintenance of health, so doubly essential to the removal of disease and resto- ration to a natural condition. No wonder, then, that when a man's lungs are decaying, and thus depriving him of the requisite amount of air, he so certainly fades away, unless the decay is first arrested, and the lung power or capacity restored. NECESSITY OF PROPER FOOD--PURE AIR. 65 The great principles, then, involved in the cure of Consumptive disease, or, professionally speaking, the great indications, are— . To cause the consumption and healthful digestion of the largest amount possible of substantial, nutritious, plain food. To cause the patient to consume more pure air. To bring about the first condition, requires the exer- cise of extensive medical knowledge, combined with a wide experience and close and constant observation. To regulate healthfully the digestive apparatus—that is, to keep the whole glandular system of the human body in healthfully-working order—requires remedies and treatment as varied in their combinations almost as the varied features of the human face. Scarcely any two persons in a hundred are to be treated in the same way, unless you can find them of the same size, age, sex, constitution, temperament, country, climate, occupation, habits of life, and manner of inducing the disease. Here are ten characteristics, which are capable, as every arith- metician knows, of a thousand different combinations; so that any person proposing any one thing as a remedy, a cure for Consumption, applicable to all cases and stages, must be ignorant or infamous beyond expression. The two things above named will be always curative in proportion to their timely accomplishment. The ways of bringing these about must be varied according to constitution, temperament, and condition. The mode of doing the thing is not the essential, but the thing done. Beyond all question, the thing can be done; Consump- tion can be cured, and is cured in various ways. The scientific practitioner varies his means according to the existing state of the case. The name of the disease is 66 BRONCHITIS AND KINDRED DISEASES.' nothing to him : he attacks the symptoms as they are at the time of prescribing; and if he be an experienced practitioner, he will know what ought to be done, and how it should be attempted, just as a classical scholar knows the meaning of a classical phrase or word the first time he ever sees' it, as perfectly as if he had seen it a thousand times before. And without setting myself up as an instructor to my medical brethren, I may here in- timate my conviction, that the cure of Consumption would be a matter of every day occurrence, if they would simply study the nature of the disease, read not a word of how it had been treated by others, but observe closely every case, and treat its symptoms by general principles, as old as the hills, and follow up the treat- ment perseveringly, prescribe for the symptoms, and let the name and disease go. But, then, they must first understand perfectly the whole pathology of the disease —its whole nature. That, however, requires years of laborious study and patient observation. The above things being true, as perhaps none will deny, it is worse than idle to be catching up every year some new medicine for the cure of Consumption. The readiness with which every new remedy is grasped at, shows beyond all question that the predecessors have been failures. Scores of cures have been eagerly ex- perimented upon;—naptha, cod-liver oil, phosphate of lime, each will have its day, and each its speedy night, simply because no one thing can by any possibility be generally applicable, when solely relied upon. The physician must keep his eye steadily upon the thing to be done, varying the means infinitely, according to the case in hand. Therefore, the treatment of every indi- vidual case of Consumption should be placed in the CELL DEVELOPMENT. 67 hands of a scientific and experienced physician, and in time, and not wait, as is usually the case, until every balsam and syrup ever heard of has been tasted, tried, and experimented upon, giving the practitioner nothing to work upon but a rotten, ruined hulk, leaving scarcely anything to do but to write out a certificate of burial, and receive as compensation all the discredit of the death. The necessity of keeping the whole digestive appara- tus in high and healthful operation in the successful treat- ment of Consumptive disease, is illustrated by a descrip- tion of the mode of nutrition, as connected with CELL DEVELOPMENT. The human body is in constant transition. The par- ticles of which its structure is constituted are not the same in position and relation for any two minutes in succession. Thousands of atoms which compose it the present instant, are separated from it the next, to make a part of it no more ; and other thousands, which are a portion of the reader's living self while scanning this line will have been rendered useless and dead on read- ing the next. There are two different armies of workers, whose occupations cease not from the cradle to the grave. One army, composed of its countless millions, is building up the body; the other removes its waste; one party brings in the wood and the coal for the fire- place and the grate, the other carries away the ashes and the cinders :—the builders and the cleansers When the builders work faster than the cleansers, a man becomes fat and over-fat is a disease. When the cleansers are too active, the man becomes lean, and wastes away to a 68 BRONCHITIS AND KINDRED DISEASES. skeleton, as in Consumption. Health consists in the proper equilibrium of these workers. Every movement of the body, every thought of the mind, is at the expense of a portion of the material frame ; that is to say, certain atoms of the living body are killed by every action of the mind, by every motion of the body, and being dead, are useless. But they must be removed from the body, or these " heaps of slain " would fill up the workshop of life, and the whole machinery would stand still; the fire-place would be filled with ashes, the furnace clogged with cinders, and the grate be useless. Vast masses of these dead atoms are pushed, worked out, or thrown from the body at the surface. At any night, on undressing, the cleanliest person may rub from the body countless numbers of these dead atoms, a teaspoon-ful of them may be gathered from the feet at a single washing, if long neglected. Hence the value of thorough daily frictions to the skin, as promotive of health, because, on an average, we all eat about one-third more than is needed ; thus throw- ing on the cleansers a third more labor every twenty- four hours than they were designed to perform. By the frictions we come to their aid artificially. They are wise who perform these frictions daily and well ; but wiser they by far who do not eat the extra one-third, and consequently do not need to be scrubbed and bathed and washed every day of their existence, to save them from the effects of over-feeding. Better eat less and save trouble. The surplus third would feed half the poor of the land. But a larger portion of these dead atoms are scattered in the more interior parts of the body, and the cleansers remove them by first rendering them fluid, as solid ice SUPPLY AND WASTE OF THE BODY. 69 or snow is made fluid by heat. It is then, as it were, sucked up by these cleansers, and conveyed finally to the blood, just at the heart, where they are mingled toge- ther and sent direct to the lungs, where they meet with the pure air that is breathed. Here an exchange takes place between the air and the blood. The air gives to the blood its oxygen, its life, while the blood gives its death to the air. i fence it is that the air gives life as it goes into the lungs, but gives death if breathed unmixed as it comes from the lungs; that is, if a healthy person were to breathe for three minutes, no other air than that which has just come off the lungs of another man, in three minutes he would die. Hence the double reason for my insisting so much on causing consumptive persons to breathe the largest possible amount of pure air; it unloads the blood more perfectly of its dead atoms, and also gives life to the essence of food which it also meets in the lungs ; that is, puts the finishing work to its becom- ing living blood. Let us notice next the builders, whose work is to sup- ply new and living particles as fast as the old ones fall off and die. These new particles are in the blood, which delivers its living freight as it flows through the body, as a steamer delivers its freight to the thousand different ports as it ploughs along the majestic Mississippi. Whenever a living particle comes to the point where it is needed to supply the place of one just fallen or dead, by some inscrutable, inexplicable agency, as quick as electricity itself, a vesicle, a cell, a little boat, as it were, is formed,-which floats it to the spot, delivers its charge, and bursts and dies, its duty done, the objects of its crea- tion having been performed :—an apt type of the whole and living man, who, when the great object of his crea- 70 BRONCHITIS AND KINDRED DISEASES. tion is performed on earth, himself passes away in death; and happy Indeed would he be, were that work so fully, so well, and so invariably performed. These little wrecked, these bursted boats, have been collected, and ascertained to be made invariably and almost wholly of two materials—phosphorus and lime, which also are con- stituents of the brain itself. This phosphorus and lime are supplied by what we eat and drink. If we do not eat and drink enough, or if what we do eat and drink has not enough of these constituents ; or if, again, it is not perfectly digested, then there is not enough of these constituents to make the necessary boats to freight the living particles to their destination; hence, the man wastes away to skin and bone, and dies—not because he does not eat, but because what he does eat, does him little or no good. Especially thus is it in Consumption; a man dies of inanition, or, as physicians say, an error of nutrition. Consumptive people die for want of strength, want of flesh, want of nutriment; not for want of lung sub- stance, as is almost universally supposed. They die, in almost every instance, long before the lungs are con- sumed, so far as to be incapable of sustaining life. Numerous cases are given where men have lived for years with an amount of available lungs not equal to one-fourth of the whole. They were there, perhaps, but not available, not efficient. The majority of persons who die of Consumption, perish before a third of the lungs have consumed away, in consequence of loose bowels, torpid liver, indigestion, night sweats, want of sleep, clogging up of the lungs with matter and mucus by the daily use of cough drops, balsams, tonics, or other destructive agents. These symptoms need but be con- DI8C0VERY OF OXYGEN. 71 trolled to protect life, indefinitely ; that is to say, if the symptoms were prescribed for according to general prin- ciples, and properly nursed, letting the consumptive portion of the disease alone, it would sometimes cure itself, or at least allow the patient to live in reasonable comfort for a number of years. The reader may almost imagine that he has a clue to the cure of Consumption, if he could but give the patient phosphorus and lime, or phosphate of lime—that is, burnt bones—eight or ten grains, with the first mouthful of each meal, so as to let it be mixed with the food and carried with it into the blood ; from twenty to thirty grains being daily needed in health. The scientific world were charmed less than a hundred years ago by the dis- covery of oxygen. It was supposed that as oxygen was the constituent of the air which imparted vitality to the blood, gave it its purity, its activity, and filled the man with life and animation, nothing was needed but to take enough oxygen to purify the blood, and thus strike at the root of all disease. Accordingly, the oxygen was prepared and administered. The recipient revived, was transported, was fleet as the antelope, could run with the wind. He smiled, he fairly yelled for joy, and—died, laughing, or from over excitement. The machine worked too fast; it could not be stopped, and pure oxygen has never been taken for health since. Thus it will, perhaps, always be with artificial reme- dies ; they cannot equal those which are prepared in Nature's manufactory. The phosphate of lime, in order to answer the purposes of nature, must be elim- inated from the healthful digestion of substantial food in the stomach, and the only natural and efficient means of obtaining the requisite amount is, to regulate the 72 BRONCHITIS AND KINDRED DISEASES. great glands of the system in such a manner as to cause the perfect digestion of a sufficient amount of suit- able food, and this is within the power of the scientific practitioner, in the great majority of cases of consump- tion, when attempted in its early stages; but for con- firmed Consumption—that is, when the lungs have be- gun to decay away, it is criminal to hold out any pro- mises of cure, or even of essential relief, in any given instance. In illustration of the subject of a perfect digestion in its relation to food and fresh air, the following incidents are here given: "SUICIDE BY STARVATION. " A very curious example of suicide by means of starvation occurred some years ago in Corsica. During the elections, the Sieur V. rushed into the electoral college armed with a dagger, which he plunged into the breast of a man who had done him some injury. The man fell dead at his feet. The assassination was committed in the full light of day, and in the presence of an assembled multitude. " V. was tried, found guilty, and condemned to death. His high spirit and resolute character were well known, and it was suspected that he would seek, by a volun- tary death, to evade the disgrace of perishing on the scaffold. He was therefore vigilantly watched, and every precaution taken to deprive him of the means of putting an end to his existence. " He resolved to starve himself to death during the interval which elapsed between the sentence of the Court or Assizes, and the reply which the Court of Cassation would make to the appeal he had addressed to it. SUICIDE BY STARVATION. 73 " He had succeeded in concealing from the observa- tion of his jailers a portion of the food with which they supplied him, so as to make it be believed that he re- gularly took his meals. After three days' abstinence, the pangs of hunger became insupportable. It then sudden- ly occurred to him that he might the more speedily ac- complish the object he had in view by eating with avidity. He thought that the state of exhaustion to which he was reduced would unfit him to bear the sudden excess, and that it would inevitably occasion the death he so ardently desired. He accordingly sat down to the food which he had laid aside, and ate voraciously, choosing in preference* the heaviest things. The consequence was that he was seized with a violent fit of indigestion, of which, contrary to his expectation, the prison doctor speedily cured him. " He then resumed his fatal design. He suffered again what he had undergone before. The torture was almost beyond his strength. His thirst, too, was in- tolerable. It overcame his resolution. He extended his hand towards the jug of water which had been placed in his cell. He drank with avidity, and, to use his own expression, was restored to life. " To avoid yielding again to a similar temptation, he daily took the precaution of overturning the jug of water which was brought to him. Lest he should be induced to raise it to his lips, he threw it down with his foot, not venturing to touch it with his hand. In this manner he passed eighteen days. " Every day, at different intervals, he noted down in his album, a minute account of his sensations. He counted the beatings of his pulse, and marked their number from hour to hour, measuring with the most 4 74 BRONCHITIS AND KINDRED DISEASES. scrupulous attention, the gradual wasting of his strength. In several parts of-his melancholy memento, he declares that he felt it harder to bear the agonies of thirst than those of hunger. He confesses that he was frequently on the point of yielding to the desire of drinking. He nevertheless resisted. " He was surprised to find his sight become more and more clear, strong and accurate; it appeared to him like the development of a new sense. The nearer he approached his latter moments, the more his power of vision seemed to increase. On this subject he thus ex- presses himself: 'It appears as though I could see through the thickest walls.' His sense of feeling like- wise attained the most exquisite sensibility. His hear- ing and smelling improved in a similar degree. His album contains many curious statements on these sub- jects. " The Sieur V. had devoted some attention to anatomy and physiology; and he attributes the increased acute- ness of his senses to the way in which the intestinal irri- tation acted on the nervous system. " His ideas, he says, were numerous and clear, and very different from anything he had experienced in moments of excitement or intoxication. They were all directed to logical investigation, whether he applied them to an analysis of material objects, or to philosophic contemplation. He also felt himself inspired with a singular aptitude for mathematical calculation, a study for which he had previously felt very little inclination. In short, he declares that he never derived so much gra- tification from his intellectual condition, as throughout the whole duration of his physical torture. " He made notes in his album to the last moments of SUICIDE BY STARVATION. 75 his existence. He had scarcely strength sufficient to hold the pencil with which he traced the following words: ' My pulse has nearly ceased to beat—but my brain retains a degree of vigor which, in my sad con- dition, is the greatest solace Providence could bestow on me. It is impossible that I can live out this day. My jailers watch me, and fancy they have adopted every precaution. They little think that I have outwitted them. Death annuls the sentence which has been pro- nounced on me. In another hour, perhaps, they will find nothing but a cold corpse.' "V. expired as he foretold. His album has been carefully preserved. It is a record replete with interest to medical professors. The slow torture, endured with so much courage, and described with such remarkable clearness, renders it one of the most curious documents in the annals of medical science." Illustrating the same point, a gentleman, Mr. I. F. II. stated to the Author that he was once under medical treatment for some affection of the eyes, requiring a very scanty diet. His general health was excellent, but he was always hungry; yet so far from having any sense of debility, he had, when he went out into the street, an elasticity of mind and body, an instinctive desire of lo- comotion, which caused him to feel as if he could almost fly, and a joyousness of spirit, which was perfectly de- lightful. These two cases strikingly show, that with a smaller amount of food, and consequently of blood, men are cheerful in mind and active in body; £3P therefore, a small amount of food, perfectly digested, gives more health and strength than a larger, if not so. It is better, 76 BRONCHITIS AND KINDRED DISEASES. incomparably better, to feel a little hungry all the time, than to feel full, oppressed, heavy, with over eating. Every patient of mine, who ever expects to get well, must keep this fact constantly and practically in view. It is too much the custom to measure one's health by the avidity of his appetite and his increase in flesh, as if he were a pig; forgetting that a voracious appetite and fat, are always indications of a diseased body. A uni- form, moderate appetite, is the attendant of good health. A racer's ribs must be seen before he is fit for the track, because then he is most capable of endurance. The next incident shows, that with a moderate amount of substantial food and cold water, such being prisoner's fare, men may live for many years, with but little ex- ercise, in the dark vaults of a prison, breathing all the time an atmosphere not very pure, as may be readily supposed. And it is earnestly hoped that the incidents narrated will leave upon the mind of every reader a life- long impression as to the value, both to the sick and the healthy, of living habitually on a moderate allowance of plain, substantial, nourishing food. It may be well to recollect here, that it is not the quality, so much as the quantity of food, which lays the foundation every year of innumerable diseases and deaths. Let it be remem- bered, also, that men need a variety of food ; living on only one kind for a length of time will always under- mine a healthy constitution. Milk only, has all the ele- ments of life; and any other one kind of aliment, used indefinitely as to time, will as certainly deteriorate the constitution, bodily and mental, as anything that is planted will deteriorate, if kept for successive years in the same field, unrenewed. The popular notion that one or two kinds of food at a meal is most whole- COUNT CONFALIONERI. 77 some, is wholly untrue. On the contrary, several kinds at a meal, other things being equal, are more conducive to our well-being. Quantity, and not quality, is the measure of health. COUNT CONFALIONERI wrote from the great jail of Vienna as follows:— " I am an old man now, yet by fifteen years, my soul is younger than my body: fifteen years I existed, for I did not live. It was not life in the self-same dungeon, ten feet square. During six years I had a companion; nine years I was alone. I never could rightly distin- guish the face of him who shared my captivity in the eternal twilight of our cell. " The first year we talked incessantly together. We related our past lives, our joys forever gone, over and over again. " The next year we communicated to each other our ideas on all subjects. " The third year we had no ideas to communicate; we were beginning to lose the power of reflection. " The fourth, at intervals of a month or so we would open our lips, to ask each other if it were indeed pos- sible that the world was as gay and bustling as it was when we formed a portion of mankind. " The fifth year we were silent. " The sixth, he was taken away, I never knew where, to execution or to liberty. But I was glad when he was gone: even solitude was better than that pale and va- cant face. After that, I was alone. " Only one event broke in upon my nine years' vacancy. One day, it must have been a year or two after my companion left me, my dungeon door was 78 BRONCHITIS AND KINDRED DISEASES. opened, and a voice, I knew not whence, uttered these words: 'By order of his Imperial Majesty, I intimate to you, that one year ago, your wife died.' Then the door was shut. 1 heard no more. They had but flung this great agony in upon me, and left me alone with it again." Having shown the bearing which food has on health, I desire to make some statements as to the value of air and exercise in the same direction. These will be given succinctly, in the hope that the intelligent reader will study them and apply them at length, especially if he should come to me for medical advice. My habit is not merely to cure, when I can, the patient who comes to me, but to induce him to study and understand his own case and constitution, so that by the application of general principles, he may afterwards be able to regulate his health under all ordinary circumstances, as far as it can be done by diet, air, exercise, and regularity of per- sonal habits: but never venturing to take an atom of medicine, however simple, except by the special advice of an educated, experienced physician. IMPORTANCE OF PURE AIR TO HEALTH. Men are reported to have lived three weeks without food, but without air we cannot live three minutes. The lungs of a full-sized man weigh about three pounds, and will hold twelve pints of air; but nine pints are as much as can be inhaled at one full breath, there being always a residuum in the lungs; that is, all the air that is within them can never be expelled at once. In com- mon, easy breathing, in repose, we inhale one pint. Singers take in from five to seven pints at a single breath. We breathe, in health, about eighteen times in IMPORTANCE OF PURE AIR TO HEALTH. 79 a minute; that is, take in eighteen pints of air in one minute of time, or three thousand gallons in twenty-four hours. On the other hand, the quantity of blood in a common- sized man is twenty pints. The heart beats seventy times in a minute, and at each beat throws out four tablespoons ; that is, two ounces of blood ; • therefore, there passes through the heart, and from it through the lungs, an amount of blood every twenty-four hours equal to two thousand gallons. The process of human life, therefore, consists in there meeting together in the lungs, every tweuty-four hours, two thousand gallons of blood and three thousand gal- lons of air. Good health requires this absolutely, and cannot be long maintained with less than the full amount of each ; for such are the proportions which nature has ordained and called for. It is easy, therefore, to perceive, that in proportion as a person is consuming daily less air than is natural, in such proportion is a decline of health rapid and inevitable. To know, then, how much air a man does habitually consume, is second in import- ance, in determining his true condition, to no other fact; is a symptom to be noticed and measured in every case of disease, most especially of disease of the lungs; and no man can safely say that the lungs are sound and well and working fully, until he has ascertained, by actual mathematical measurement, their capacity of action at the time of the examination. All else is indefinite, dark conjecture. And I claim for myself to have been the first physician in America who made the measured amount of consumed air, an essential element, as to symp- toms, in ascertaining the condition of persons in refer- ence to the existence of consumptive disease, and made 80 BRONCHITIS AND KINDRED DISEASES. a publication thereupon. The great and most satisfac- tory deduction in all cases being this, that if, upon a proper examination, the lungs of any given person are working freely and fully, according to the figures of the case, one thing is incontrovertibly true, demonstrably true, that whatever thousand other things may be the matter with the man, he certainly has nothing like Con- sumption. And Consumption being considered a fatal disease by most persons, there is quite a willingness to have anything else: and the announcement and certainty that it is not Consumption, brings with it a satisfaction, a gladness of relief, which cannot be measured. On the other hand, just in proportion as a person is habitually breathing less air than he ought to do, in such proportion he is falling fast and surely into a fatal disease. This tendency to Consumption can be usually discovered years in advance of the actual occurrence of the disease; and wrere it possible to induce the parents of children over fifteen years of age, to have an investigation as to this point in the first place, and then to take active, prompt, and persevering measures to correct the difficulty, and not one case in a thousand need fail of such correction, with but little, if any medicine, in most instances none, many children would be prevented from falling into a premature grave, and would live to be a happiness and honor to the old age of those who bore them. Persons who live in cities and large towns think, and wisely so, that the teeth of their children should be carefully exam- ined by a good dentist once or twice a year; but to have the condition of the lungs examined, and, if need be, rec- tified, few, if any, ever think of such a thing. And yet, as to practical importance, it immeasurably exceeds that of attention to the teeth. The latter are cared for as a IMPORTANCE OF PURE AIR TO HEALTH. 81 matter of personal appearance and comfort; the lungs are a matter of life and death. We can live and be happy without a tooth, but without lungs we must prematurely die. Were the condition of the lungs, after such an examination as I have suggested, a matter of opinion or conjecture only, I would not propose it; but it is not: it is a thing of numerical measurement, of mathematical demonstration, as to the one point, Do the lungs work freely and fully or not % If they do not, declining health is inevitable, sooner or later, unless their activity is restored, which, however, can be done in the vast majo- rity of cases. The actual practical results correspond with the above statements. A man came into my office who had lost half his measurement. I told his brother that although appearances were against the opinion I was going to give, and he had walked to my office from his own apart- ments, several squares off, without much fatigue, yet I felt bound to say he could not survive three weeks. Within that time he died with unmistakable consump- tion. Another gentleman came to me from North Alabama, attended by his brother, who was extremely anxious to know his condition, but desired me to withhold my opin- ion from the invalid. He told me his brother had been improving of late, was greatly better, and stronger, and livelier than he had been for some time past. On exam- ination, I found he had lost two-fifths of his measure- ment ; and felt compelled to say, that he could not under any conceivable circumstances live six weeks, and that he ought to be taken to his family without the least pos- sible delay. He died in about five weeks from that time. These are given as examples from many others. 4* 82 BRONCHITIS AND KINDRED DISEASES. In short, the use which I make of these things is simply this,—if a man is deficient in measurement, and under my treatment,. lessens that deficiency every week, I encourage him to persevere, for he is evidently and sub- stantially improving. If, unfortunately, on the other hand, the deficiency increases every week, notwithstand- ing all I can do, I send him home, because he is declining every day, and must inevitably die; and I desire no man's money, unless I believe that I am doing him a commensurate good. A highly respectable physician of extensive practice, from Kentucky, called to see me. I explained every thing to him as fully as I could, and on submitting himself to examination, he said at once, in a manner and tone so despairing I can never forget it, " I see it—it is of no use to try anything ; I may as well go home and die." He started on his return the next morning, and died not long after his arrival. With facts like these constantly occurring, I look upon this new diagnostic with increasing admiration. A deficiency of measurement arises from two principal causes. An actual loss of the substance of the lungs; or an infiltration, or inaction or solidification. Auscultation must decide which of these it is. A young gentleman came to me from one of the western counties of Mis- souri. He was sent by an elder brother who had been cured by me of cough, pain in the breast, &c, several years before. His principal symptoms were distressing pains about the breast, no appetite, sleepless nights, and such an inveterate spitting of blood, that walking two or three squares would cause him to bring it up by mouth- fuls. His deficiency of lung measurement was nearly one-third ; but auscultation showed that it came from the VALUE OF LUNG MEASUREMENT. 83 air cells of the lungs being filled up with collections that did not properly belong there. His brother was greatly alarmed : his family physician said it was useless for him to come to me, as it was a clear case of tubercular con- sumption. I at once informed his brother that I thought he could be cured, that so far from its being a dangerous case, he could safely and profitably leave for home in a week. I gave him some vegetable pills, administered quinine and elixir of vitriol three time a day, and required him to walk about the city from morning till night; never carrying his exercise to fatigue or exhaus- tion. Within a week he ceased to spit blood altogether ; his appetite returned, his sleep became sound, unbroken and refreshing; his bowrels regular daily, without medi- cine for that purpose; whereas, before, they had kept obstinately costive ; his strength returned so that he could walk for hours at a time without special fatigue ; and on the eighth day when he left, his lungs measured to the full healthy standard. With results like these, I should be excused if I speak enthusiastically in these pages. These are facts, and I consider them triumphant, and in recording them, enjoy the pleasurable feeling which a man possesses when he knows he is right, and sees that the multitude, now incredulous, will sooner or later agree with him. In confirmation of my views in relation to the impor- tance and value of this new method of determining the actual condition of the lungs, what proportion of them are in healthful and efficient operation, I will give the testimony of two of the most respectable and extensive periodicals in the world. The London Lancet, one of whose Editors has been for some years a member of the British Parliament, and who is honored every session by 84 BRONCHITIS AND KINDRED DISEASES. appointments on committees, among the most impor- tant to a nation's interest, says: " This mode of distin- guishing Consumption at an earlier period than by any other means, has been actually proved." The British and Foreign Medical Review, while edited by Dr. Forbes ; and which has been conducted with such signal ability for the last quarter of a century, that it is now circulated in every part of the globe, says: "We have no hesitation in recording our deliberate opinion that this is one of the most valuable contribu- tions to physiological science that we have met with for some time." I consider the stethescope and percussion as mere toys, which do well enough to excite the wonder of the credulous. I must confess they never gave me any sat- isfaction, I never could learn anything by them. It may be different with others, but I believe that the ear laid upon the patient's breast, with nothing intervening but a single thickness of the inner garment, stretched with- out a wrinkle and laid smoothly on the skin, is immea surably preferable to any stethescope ever invented, it tells us more certainly and in louder tones by far, all that stethescopy and percussion pretend to, and in a more simple and natural manner. In all cases I use the ear directly, to ascertain the more prominent sounds, but the stethescope and percussion never; nor do I place any dependence on the eye, nor the moving of the extended hand over the chest. In forming an opinion in a case of Consumption, the main foundations are, 1st, The condition of the pulse. 2d, The degree of the emaciation. 3rd, The measurement of the lungs. VALUE OF LUNG MEASUREMENT. 85 4th, The sounds given to the ear when it is laid on the patient's breast, while standing ; or back when stooping forward ; a single thickness only intervening of the inner garment stretched smoothly over the skin. Cough, spitting of blood, and expectoration, I consider, of themselves, of little consequence, for the simple reason that they cannot be relied upon, until too late a stage in the progress of the disease. No one pretends that either of them has an invariable cause, an invariable effect, or an invariable tendency, therefore, by them- selves, they are symptoms of little value. In reference to this new method of determining the early existence of Consumptive disease, the London Lancet says: " It is proven by actual experiment, that a man's lungs, found after death to have been tuberculated to the extent of one cubic inch, had been by that amount of tubercu- larization controlled in their action to the extent of more than forty inches." It is very apparent then, that this mode of examination detects the presence of tubercles in their earliest formation, which is in fact the only time to attack Consumption successfully and surely ; and when attempted at the early stage, before it is at all fixed in the system, the certainty of success in warding off the danger, of curing the disease, is as great as that of warding off the cholera or perfectly curing it, if at- tempted at the first appearance of the premonitory symp- toms ; and as when cholera is present in a community, every person who has three or more passages from the bowels within twenty-four hours, ought to be considered as attacked with cholera, and should act accordingly, so when a man has tubercles in his lungs to the extent of impairing their functions for a dozen inches, that is, when his lungs do not (with other symptoms) hold enough air 86 BRONCHITIS AND KINDRED DISEASES. by a dozen inches, he should consider himself as having Consumption, and should act accordingly and with the assurance that in four cases out of five, human life would be saved by it. And as thousands have died with cholera by hoping they did not have it, or denying they had it, although warned by the usual symptoms of its commencement, until its existence was so apparent to the commonest observer as to render a hope of cure im- possible, so precisely is it in Consumption : people will not take warning by the symptoms in their own persons, which have in thousands of others terminated in certain death, but go on day after day without reason, hoping that the symptoms will go away of themselves, and stead- ily deny that they have the disease, until remedy is hopeless. If, then, a man should take the alarm, as soon as he perceives that he is habitually consuming a less amount of air at each act of breathing than he ought to do, whatever may be the cause of it, so on the other hand, if he finds, on examination, that his lungs contain fully as much air as the system requires, then is it be- yond all question, that all his lungs are within him, in healthful action, and therefore must be perfectly free from Consumptive disease; that whatever else may be the matter with him, it most evidently is not Consump- tion. THE MANNER OF DYING. It has been elsewhere remarked, that when persons die of consumption, it is not from the amount of lung substance actually destroyed, because many persons have been known to live for years with an amount of lungs only equal to one-third of the whole, while from actual inspection of the lungs after death from phthisis, seldom as much as one-third of them have decayed MANNER OF DYING. 87 away. The more immediate cause of death therefore in consumption is inanition, wasting away, inability of the glandular system to derive sufficient nourishment from the food eaten, or from the want of a more direct con- trol over the disorder of some more critical part or function of the system. Every thing, every part wastes away but the brain, that maintains its integrity, with but few exceptions to the very last effort of expiring nature. Hence, however much the consumptive may suffer in other respects, he has at least this satisfaction, that in the last earthly conflict, he will have his senses fully about him. When persons die from other dis- eases, the senses die one by one, the sight first, then the smell, the taste, the speech, the touch, and last of all the hearing, hence no whisper should ever be uttered in the chamber of death, except it is intended for the dying, for the softest voice in the most distant corner is con- veyed in loudening tones to the departing, and for an equally good reason, should all loud words be avoided, because they grate painfully on the increased sensibility of the ear. While in other diseases, the senses die one by one, in consumption they all pass away together, (except the sight, which goes first) and at the last mo- ment. The reason that consumptives maintain their senses to the last is, that the brain is the last part of the human body that feels the effect of inanition, of starva- tion. The incident given on page 72, illustrates this fact; there are, it is true, circumstances which may modify this explanation, as there are but few statements which apply universally. In the following list of the dying words of the distin- guished dead, are confirmations of the general principle laid down. 98 BRONCHITIS AND KINDRED DISEASES. " Head of the army."—Napoleon. " L'Isle D'elbe, Napoleon."—Josephine. " I must sleep now."—Ryron. " It matters little how the head lieth."—Sir W. Raleigh. " Kiss me, Hardy."—Lord Nelson. " Don't give up the ship."—Lawrence. " I'm shot if I don't believe I'm dying."—Chancellor Thurlow. " Is this your fidelity V—Nero. " Clasp my hand, my dear friend, I die."—Alfleri. " Give Dayroles a chair."—Lord Chesterfield. " God preserve the Emperor."—Hayden. " The artery ceases to heat."-^Haller. " Let the light enter."—Goethe. " All my possessions for a moment of time."— Queen Elizabeth. "What! is there no bribing death."—Cardinal Reau- fort. " I have loved God, my father, and liberty."—Madam De Stael. " Be serious."—Grotius. " Into thy hands, O Lord."—Tasso. " It is small, very small indeed," (clasping her neck). —Anne Roleyn. " I pray you, see me safe up, and for my coming down, let me shift for myself," (ascending the scaffold). —Sir Thomas Moore. " Don't let that awkward squad fire over my grave." —Robt. Rums. " I feel as if I were to be myself again."—Sir Walter Scott. " I resign my soul to God, and my daughter to my country."—Jefferson. DYING WORDS. 89 "It is well."—Washington. " Independence for ever."—Adams. " It is the last of earth."—,/. Q. Adams. " L,wish you to understand the true principles of the government. I wish them carried out. I ask nothing more."—Harrison. " I have endeavored to do my duty."—Taylor. " There is not a drop of blood on my hands."—Fred. V., of Denmark. " You spoke of refreshment, my Emelie; take my last notes; sit down to my piano here ; sing them with the hymn of your sainted mother; let me hear once more those notes which have so long been my solacement and delight."—Mozart. " A dying man can do nothing easy."—Franklin. " Let not poor Nelly starve."—Charles II. " Let me die to the sounds of delicious music."— Mirabeau. " Remorse."—John Randolph of Roanoke. " The Lord reigns, let the earth rejoice."—Rev. Dr. E. Cornelius. " Doctor, I think I am getting weaker, feel my pulse." —John New/and Maffit. " Adieu my beloved Cuba; adieu my brethren," (the instant before his execution.)—General Lopez. " Sister, I am weary, let us go home."—Neander. "But even the log on the Delaware, has its care taker."—Dr. Joseph Parish. " How violent is this disorder, how very extraordi- nary it is !-1—Stephen Girard. " I forgive the authors of my death, and I pray that my blood may not fall upon France," (the moment be- fore he was guillotined).—Louis XVI. 90 BRONCHITIS AND KINDRED DISEASES. COUGH is an instinctive spasmodic effort of the lungs to expel the air which they contain, through their " pipes," or their bronchial branches, for the purpose of carrying before it, and out through the mouth, any thing which is in the lungs or air passages, and which ought not to be there. It is a law of the animal economy to relieve itself; not the least of all the wonderful adaptations which Infinite wisdom and benevolence has ordained for our preserva- tion. The eye begins to water and wash out with tears the particle of dust or sand which offends it. The stomach revolts instantaneously at the presence of poi- son, and ejects it. The tongue repels any thing placed upon it, that is not adapted to the well being of the system. And if the lungs were less vigilant, accumula- tions would take place from time to time, and they would eventually fill with solid substances, air could not enter, and we would die. Cough is excited by putting a straw or feather or other offending substance in the ear, thus if a person is asleep, and an insect were crawling in, the cough would arouse him. Cough is the common attendant of Consumptive dis- ease. Although it does not imply that because a man has a cough he must necessarily have Consumption, yet no one can have Consumption without a cough sooner or later, with extremely rare exceptions. This cough is an effort of nature to remove from the lungs that which ought not to be there, that which is causing mischief, just as vomiting is an effort of nature to remove from the stomach that which, if permitted to remain longer would cause increasing mischief. There- fore to take medicine to repress cough is to counteract ILLUSTRATION. 91 nature, and if persevered in will always hasten death. Hence opium, paregoric, laudanum, morphine, or any other anodyne known to men, when taken day after day, will inevitably and under all circumstances make death the more certain in all forms of Consumptive disease, un- less there is a physician in attendance to counteract their mischievous effects. And as every intelligent druggist knows that of all the patent or secret medicines sold for coughs, colds and consumption, there is not a single one that does not contain an opiate or anodyne in some shape or form, so they all fight against nature, derange her machinery, lock up the glands of the system, disor- der the secretories, and therefore must prepare the way for a more certain decline and death. It is therefore suicidal to use them. ILLUSTRATION. An error which many persons fall into, in the treat- ment of Consumption, is in meddling with the cough. In standard medical works, cases are often given, to show that a troublesome and long continued cough may exist, and nothing be the matter with the lungs. In all such cases, all remedies addressed to the lungs must fail; and he who in a real case of Consumption, at once sets about to destroy the cough, destroys the patient. Many a person says, " If I could only get clear of this trou- blesome cough, I would be as well as I ever was in my life." Another will say, " there is nothing the matter with me but a little cough." A third will come in and say, "Doctor, I am not sick, and I don't want to go through a course of medicine, I only want to you to give me something to cure this cough. I have a good appetite, and sleep sound when I do get to sleep ; bowels 92 BRONCHITIS AND KINDRED DISEASES. regular, and I feel hearty and strong, but this cough is always pestering me; just give me some drops to take it away, and I will be as well as ever I was in my life." A case:—I was once called to see a very estimable lady, whose worst symptom was a distressing cough; she complained of pains about the breast and neck, and of several other things of minor importance. I told her the cough was deep seated, that it would require all her efforts to get rid of it, and that this would have to be done in a very gradual manner; that I would prevent her coughing at night, but that the cough during the day must be borne with, as it aided in bringing away the constant accumulations, otherwise her lungs would very soon fill up, and she would suffocate. She, however, be- came impatient, and being remiss in following some of my directions, I ceased to prescribe for her, after seeing her four or five times. Some one was called in who had " cured several cases worse than she was, in a few days." His medicine seemed to have a good effect; in a day or two the cough sensibly declined, and finally ceased alto- gether, and with it the expectoration, and about the same time she died. And it is thus that thousands are de- stroyed every year; they purchase various syrups and cough remedies, and because they moderate the cough, they think they are getting well; losing sight of the fact, that they are getting no stronger, or losing flesh, or that the dose has to be increased; and as soon as they cease taking it, the cough returns, proving conclusively that it is only a palliative, while the main disease is working its way deeper into the system. MORNING COUGH. 93 MORNING COUGH. It is not as extensively known as it ought to be, that, in the large majority of cases, Consumption begins with a slight cough in the morning on getting up. After a while it is perceived at night on going to bed; next, there is an occasional " coughing spell" sometime during the night; by this time there is a difficulty of breathing on any slightly unusual exercise, or in going up stairs, or ascending a hill; and the patient expresses himself, with some surprise, " Why, it never used to tire me so !" Next, there is occasional coughing after a full meal, and sometimes " casting up." Even before this, persons begin to feel weak, while there is an almost impercepti- ble thinning in flesh, and a gradual diminution in weight —harassing cough, loose bowels, difficult breathing, swollen extremities, daily fever, and a miserable death ! Miserable, because it is tedious, painful, and inevitable. How much it is to be wished that the symptoms of this hateful disease were more generally studied and under- stood, that it might be detected in its first insidious ap- proaches, and application be made at once for its arrest and total eradication ; for certain it is that, in very many instances, it could be accomplished. It must be remembered, that cough is not an invaria- ble attendant of Consumption of the lungs, inasmuch as persons have died, and on examination, a large portion of the lungs were found to have decayed away, and yet these same persons were never noticed to have had a cough, or observed it themselves, until within a few days of death. But such instances are rare, and a habitual cough on getting up, and on going to bed, may be safely set down as indicating Consumption begun. Cough as 94 BRONCHITIS AND KINDRED DISEASES. just stated, is originally a curative process, the means which nature uses to rid the body of that which offends, of that which is foreign to the system, and ought to be out of it; hence the folly of using medicines to keep down the cough, as all cough remedies sold in the shops merely do, without taking means at the same time for removing that state of things which makes cough neces- sary, that is, the congestions, the cloggings up, which oc- casion the exudations previously described. SPITTING BLOOD. All that the Author aims to do in these pages, is to speak his own sentiments, as formed from what he has seen; and it is perhaps the best method of preventing the perpetuation of error. Authority has most unfortu- nately too often rolled back the tide of true progress for ages. The Author has observed, that spitting of blood, in any manner or form, does, in an overwhelming majo- rity of cases, when neglected, terminate, sooner or later, in confirmed Consumption; hence the instinctive shudder or appallingness which dashes over a person, the first in- stant of his noticing that he has spit blood; in vain may the physician in his kindness and sympathy, talk about its coming from the throat, or the gums, or from con- gestion, it is but too often, as intelligent practitioners know full well, not a cause of Consumption, not a symp- tom of threatened Consumption, it is an effect of Con- sumption begun, of progressive lung decay : not always so, most assuredly, but it is so, in more than a large majority of cases, except in women. Some persons spit a little at a time, the expectoration is merely tinged with red, it ceases, and after various intervals, returns. SPITTING BLOOD. 95 Others bleed a pint or more at a time, coming on often without any appreciable or adequate cause, ceasing spon taneously almost, and the person fancies himself as well as he ever was in his life, and in a few months the fact of the haemorrhage has been forgotten; but sooner or later, another attack, and another, until a fatal issue. As a general rule, a man does not have more than three or four large haemorrhages before death steps in. In many cases, there is not the slightest cough noticed, until some months after the first or even second expec- toration of blood; it is the absence of cough that en- courages the patient to believe that it cannot possibly be Consumption. Consumptives who expectorate blood have usually less cough at first than those who have never had a haemorrhage, it is because the haemorrhage relieves the clogging up, which is the immediate cause of tubercles, which are again the more immediate cause of cough, hence small and frequent haemoptoes retard phthisis. In women, spitting blood is not a specially dangerous symptom, unless attended with one or two other symp- toms, which the watchful physician will readily detect. Sometimes haemorrhage from the lungs may occur in men without involving the existence of consumptive disease. See the case mentioned on page 82. In this and similar cases, it is of the highest import- ance to determine the nature of the haemorrhage, for upon that depends the subsequent treatment and result. Spitting of blood therefore, as it is so generally an indi- cation that a fatal disease is in progress in the system, should decide the person to call in a physician at once, for it is a symptom which should excite alarm mall cases whatever. 96 BRONCHITIS AND KINDRED DISEASES. EXPECTORATION. Its sinking in water is, of itself, no sign of Consump- tion, as all yellow expectoration will sink in time. Let the reader remember to spit out every atom possible, and never swallow it; better out than in ; otherwise it soon fills up the lungs, and there being no room for air, suffocation soon takes place, or being re-absorbed into the blood, it poisons and putrifies the very fountain of life. Usually, the expectoration of Consumption is of a heavy, yellow nature, that of Bronchitis is varied, yel- lowish, dark, greenish, stringy, tenacious. But it is a fact not to be disputed, that up to this time the expectoration gives no reliable indication as to the existence of Consumption, until the patient is in the very last stages of the disease, therefore a more definite description of it has not been given, especially as by it alone, the physician forms no opinion. But a daily expectoration, of any amount, of a yellowish nature, over a month or two, should excite attention, for it is an ominous symptom. CHILLS AND FEVERS. This is a frequent symptom in the graver forms and advanced stages of Consumption, and very many per- sons are hurried to the grave by treating them as a kind of Fever and Ague ; the already weak system is shocked by immense doses of quinine and other powerful tonics, which, while they sometimes only remove the chill for a day or two, very greatly aggravate the cough, and soon the symptom returns with greater violence, in a weaker body. Very many instances of this kind have come under the Author's notice; and the patients were de- LOOSE BOWELS. 97 stroyed, from a misconception of the nature of the symp- tom ; they are more of the nature of the rigors of disorganization and of absorbed matter, than of the chill •of Fever and Ague, but treated as this latter, every dose administered, only kills the surer and the sooner. LOOSE BOWELS, by which is meant, three or more stools in twenty-four hours, of a lightish color, and thin as common mortar or even whitewash; this is a symptom of the later stages, but if properly controlled, persons often live in comfort for months, and sometimes years, who otherwise would have perished in a few days. The condition of the bowels is a matter of the first importance in all stages of consumptive disease, more especially in the advanced stages, when they are inclined to be loose. If the passages are dark or greenish, they are favor- able, although they may be thin. In proportion as they are thin and of a lightish color, they are debilitating and dangerous, whether few or many. The first best advice is, send for a physician at once; in the meantime, be quiet, lie down on a bed or sofa, eat not an atom of any thing, except as much ice as may be desired, and drink nothing but thick flaxseed tea, or gum arabic, or slip- pery elm bark mucilage, that is, water thickened with these. Many a valuable life has been shortened, if not lost, by taking something for loose bowels, that is, diarrhoea, by following the over-confident advice of a well meaning neighbor or friend, who has no life to lose by the ineffi- cacy or over efficacy, or inappropriateness of the means which he himself recommends. Over confidence is 98 BRONCHITIS AND KINDRED DISEASES. always the result of ignorance, inexperience and reck- lessness. In all forms of loose bowels, it is as danger- ous to arrest it too soon, as it is to neglect it too long. When arrested too soon, the brain becomes affected, and* drowsiness, insensibility, and death soon follow. When the patient dies by being let alone, or by taking salts, castor oil, or other such things, which only aggravate the disease, he retains his senses to the very last, as is commonly observed in cholera, which is nothing more than a violent diarrhoea. IS CONSUMPTION COMMUNICABLE ? Some of the most eminent writers on the subject have died of Phthisis, Laennec, Hastings, Wooster and others, whether from thinking about it so much, or from being so frequently where it was, I cannot say; I only state a known fact. Again, most assuredly the large majority of widowers and widows who apply to me, have had their companions to die of Consumption. The use the reader should make of these facts is, to be care- ful not to eat, or drink, or sleep in a room where a con- sumptive person is confined. If called to sit up with them, eat some plain food every four hours during the night, in another room; and let a door, or window, or fire-place be partially open all the time. Impure air of any kind, if habitually breathed for along time, especially if the person be sitting about in comparative rest, is capable of generating consumption from the beginning; and much more, if a person be inclined that way, or have had near relations die with it. IS CONSUMPTION CURABLE ? 99 IS CONSUMPTION CURABLE? In its first stages, that is, previous to the commence- ment of any actual decay or destruction of the lungs, it is certainly, and often, and permanently cured. In its last stages, that is, when the lungs have begun to decay away, never ! The reader may consider this answer sufficiently definite, and to the point, but without an explanation, it will convey an erroneous idea, as to the second state- ment. No one will deny the full truth of the first. When a man's arm is cut off, and it heals up, he goes about his business, as if nothing had ever happened, and he is said to be a well man. In one sense of the word he is well; but he can never be a whole man again, can never be fully well, for the lost portion of the body cannot be restored ; therefore, he cannot be said to be a perfectly well man. So when a man is in the last stages of con- sumption, he has lost a portion of his lungs, the disease may be arrested, no more lungs may decay, all cough and expectoration may disappear with night sweats, and pain in the breast, or sides, and years afterwards, he may die of a disease whollv different, as in the case of Mr. Justice, and of Mr. Babbington in subsequent pases, cases occurring in the Author's practice. And as in the case of the celebrated medical writer and philoso- pher, Andrew Combe, of Edinburgh, and Dr. Joseph Parish, of Philadelphia, mentioned hereafter. But these men could never be said to be well, they had lost a portion of their lungs, and there can be no re-growth, no new creation of lung substance, hence they were deli- cate persons ever afterward, but enjoyed for many rears, after the lungs had begun to decay and healed up, a rea- 100 BRONCHITIS AND KINDRED DISEASES. sonable and comfortable degree of health. But the scienti- fic gentlemen making an examination of the lungs after death, saw with their eyes, in the broad light of day, first, that there was no disease in the lungs, and second, that death wras wholly the result of ailments in other portions of the body, in the nature of ship fever in Dr. Combe's case. They were weakly or frail ever after, because a part of their lungs were gone, and they had to live on a smaller amount of air from day to day, than was natural, and but from the accidental attacks of other diseases, they might have been alive and in com- fortable health to this day. Attention is requested again to the case of Mr. B—. At the outset I gave it as my opinion that so much of the lungs had decayed away, that he never would be wholly well again. But at the end of eighteen months, twelve months after he had ceased to be under my care, when he came to see me as a friend, I had the curiosity to weigh him, and to measure his lungs, when he weighed as much as at any previous period of his life, and his lungs reached the full healthful standard. I feel fully authorized to boast of this case, and give it as an encouragement to others to persevere in the ob- servance of the directions given them, as long as they appear to do them the slightest good; and to fight re- solutely and courageously against every rising symp- tom, until there is not an ache or ail, or pain in the whole body. Rut how is it, that after he had lost a part of his lungs by decay, he should recover his full healthful measure- ment ? A kind Providence never gives, but that he gives abundantly. All men in health have more lungs than IS CONSUMPTION CURABLE? 101 are actually necessary for the ordinary wants of the sys- tem, as something to fall back upon, in case extra efforts are needed, as often occurs in the emergencies of life. Again: in the by-gone days of wagon driving over mud roads in winter, just as the six horse team is al- most in sight of its night's resting place, one of the horses is taken sick and dies; it has often happened in the necessities of the case, that each of the five remain- ing, is made to perform an extra amount of labor, and by so doing, all reach their destination ; five horses doing the work of six. When one kidney is destroyed the other enlarges and will perform for life the work of two ; thus in the lungs, although a portion of them may have been destroyed, the remainder, by proper exercise and education, may be so strengthened and enlarged in their capacities and capabilities, as to be enabled to perform an amount of service equal to that wrhich the entire lungs did before. Such was the case with Mr. B. But while I speak of this as a matter of encouragement to all who read this book, I deem it due to truth and justice to say, that such a result is never to be attained, except by energetic at- tentions, long continued; and even with these, there are destined to occur, but too many failures, simply, be- cause there was too long a delay in the beginning. The opinions of great men on any point, are en- titled to our respectful consideration; but when men of distinction give their opinion on a subject which they have made their daily study for ten, twenty, thirty years or more, that opinion becomes in a certain sense, a fixed fact, and the denial of that fact, simply from a prejudice, or an impression to the contrary, without ever having made a single examination, or knowing anything as to the nature of the points to be investigated, a de- 102 BRONCHITIS AND KINDRED DISEASES. nial I say, under such circumstances, is not worth a thought, as it is worse than lost time to argue with ig- norance. I propose therefore to give some of the opinions of medical authors on the curability of consump- tion, men of eminence in their profession the world over, men who have made consumptive disease their constant and almost only study for the greater part of their lives, studying the cases while alive, and examining them after death, men, whose opinions on other medical subjects are considered as standard authority on both sides of the Atlantic, and having done so, I will leave the reader to form his own opinion, with this remark, viz., that I have always found those persons exhibit the most uncom- promising hostility to the idea that consumption is to be cured under any circumstances, who feel themselves to be in perfect health, and are pretty sure, that they have nothing like the disease in their own person ; they will really become even angry at the very expression of an opposite opinion, exhibiting an impatient intoler- ance, wholly inconsistent with a high degree of intelli- gence. This circumstance has given an eminent Eng- lish writer, Dr. Williams, Physician to the University College Hospital of London, occasion to observe in the "Medical Times," No. 230. "Many persons are set down as quacks, if they utter the words, ' cure of con- sumption,' and if a case does occur, it is said that it was not consumption." There is full reason in the United States, for the utterance of this sentiment, although de- signed for British ears. In the discussion of this question, there is a most un- fair and illogical commingling of ideas, by not acknow- ledging a case to be Consumption, until the person is dead or in a dying condition; and then, because there IS CONSUMPTION CURABLE? 103 are few, if any recoveries from this stage, the sweeping announcement is made, that Consumption cannot be cured, that it is inevitably a fatal disease. This is allow- ing Phthisis only a single stage, and that is the last stage; leaving the first half of the disease without a name or appropriation. On the same principle, any other disease is incurable. It would be just as insequent to say that a man has not cholera, unless he is in the last stage, that is, collapse, and then to argue that because f^w, if any, recovered from the collapsed stage, cholera was incurable, leaving all the premonitory symptoms nowhere, wholly unclassified. The truth is, all that is said about Consumption being curable or incurable, ex- cept by scientific men, is the merest jargon imagina- ble ; and the truly intelligent unprofessional reader will express his opinion on the subject hesitatingly and with modest moderation. But when an intelligent man has examined a subject, especially if it be in close connection with the main business of his life, he has a right to speak confidently and without equivocation. Such are the opinions which follow, and no wonder, because it is with them, not a thing to be reasoned about, whether, when the lungs have once begun to decay, they can heal up, and be sound again; it is a matter of ocular demon- stration; it is a thing to be seen, for the lungs, like any other part of the body, when wounded, divided by a knife or an ulceration, leave a scar in the healing, just as certainly as a gash in the arm or an ulcer in the flesh, will, when healed, leave a scar. If when a surgeon examines the bones of a dead man, he sees a certain mark, he knows that that bone has been broken, because the appear- ance could not present itself without a previous fracture, which fracture cannot occur, and unite, without such a 104 BRONCHITIS AND KINDRED DISEASES. mark being left. It is precisely so with the lungs, and from such evidence it is announced by the most skilful anatomists and surgeons the world ever saw, that there are few of all wrho die in civilized society, after forty years, who have not the unmistakable, ocular marks in the lungs, that at some previous time, they had begun to decay, that such decay had been arrested, in most cases spontaneously, without the use of any remedial means whatever, and the persons had died of wholly different diseases, without ever having had the slightest suspicion that any thing had been the matter with the lungs. It is true, these decays were slight, still they establish the great fact, that so far from its being a rare occur- rence, that the lungs heal, it is a thing which takes place every day of the world. Small scars are frequently seen, several in a single pair of lungs sometimes ; large ones very seldom, bringing us back to the point from which we started, that the cure of Consumption in its first stages, is of common occurrence, but in its last stages never to be promised. It was in reference to these after death, ocular signs of the cure of consumption, that the celebrated Aber- nethy exclaimed, " Can consumption be cured ? why that's a question which a man who has lived in a dis- secting room would laugh at." He considered it so evident, so demonstrable to the external senses, as to be beyond argument. It has been said that the lungs are never at rest, and therefore can never heal. But the heart has been wounded with bullets, bayonets and daggers, and the persons have recovered, and the heart moves twice, while the lungs move once. Many persons have been stabbed in the breast or side, or have been shot through TESTIMONY OF EMINENT PHYSICIANS. 105 and perfectly recovered; the gallant General Shields, a member of the United States Senate, is a living example of the fact, a ball from one of the enemy in the Mexican war, having passed entirely through the lungs. I would not have taken so much time on this subject, but from the wish that more truthful views should prevail, for until a more proper understanding of the nature of con- sumption becomes prevalent in the community, it must continue to be the scourge of humanity. As the general reader could not be expected to know the position wdiich the witnesses have occupied in the world, it will add to the weight and proper appreciation of their testimony, for me to state in what situations they were placed, and in what estimation they were held by the communities in which they lived. John Hunter, the Napoleon of medicine says, certain things " tend much to cure scrofula, and consequently to cure consumption, which is clearly scrofula, and ad- mits of CURE." Dr. Carswell, an English physician of great eminence, who spent many years in examining consumptive cases, while living, and the appearance of the lungs after death, uses this remarkably strong and decided language : " Pathological anatomy has perhaps never afforded more convincing evidence, in proof of the curability of disease, than it has in that of tubercular consumption." This same gentleman, who is one of the most elegant, and popular writers of modern times, says in another place : " The important fact of the curability of consumption has been satisfactorily established, and its perfect cure DEMONSTRATED BY SCARS IN THE LUNGS." Dr. Evans, another English author, who has had a 5* 106 BRONCHITIS AND KINDRED DISEASES. most extensive practice in lung affections, for many years, says, " I promise you, that by pursuing a proper line of treatment, you will be enabled to cure many cases of consumption in every stage." In reference to the above statement, the editors of the London Lancet, one of whom is a member of the British Parliament, and an educated physician, says, in a recent number of that work, which is, by the way, the first and best medical publication of the kind in the world : " On this point we entirely agree with the author, that recovery from phthisis pulmonalis, is much more frequent than is generally supposed, is an opinion daily gaining ground. The press at present, is teeming with works on this subject, and the numerous facts that are daily brought forward can no longer be met or put down by charging those who publish them with wrant of know- ledge. * * * We deprecate that condemnation which those receive who maintain its curability. * * * * There is necessarily nothing malignant or fatal in tuber- cle itself, and by treating the constitutional disease, its further deposition may be checked." Dr. Weatherhead, a veteran physician of London, says: " It is now too much the fashion with a certain class of our profession, when they find or fancy, that lesion of the lungs is present, to condemn the patient to inevit- able death, and thenceforth abandoning all active mea- sures for his recovery, adopt a mere palliative mode of treatment, under which, time never to be regained is lost, and the patient glides into that incurable stage, in which they had at first pronounced him to be." The following extract from a French author, who has had extensive opportunities of making observations in TESTIMONY OF EMINENT PHYSICIANS. 107 diseases of the lungs, and who for a number of years has given them special attention, is worthy of all consi- deration : Curability of Phthisis.—M. Fournet alludes to his having met with, in the course of one year, no fewer than 14 cases of confirmed phthisis that were cured; besides 10 other cases, in which dissection revealed the traces of caverns that had become perfectly healed. He goes on to remark, that "these 14 cases of phthisis cured in the living subject, have proved to me— "1. That certain persons who have exhibited the most decided symptoms of the disease, in its most ad- vanced stage, may yet be restored to excellent health. "3. That even hereditary phthisis, in its most ad- vanced stage, is susceptible of cure ; although such an occurrence is certainly much more rare than in cases of the accidental disease. " 5. The capital fact which seems to spring from these inquiries is, that tuberculous disease is not, like cancer, essentially incurable; on the contrary, that it is often curable, and that its extreme and most disheartening fatality is referable rather to the circumstances of its being seated in one of the vital organs of the system, and to its tendency to frequent relapses, than to its primary and essential nature." Dr. James Johnson, physician to King William IV. of England, quotes, in No. 82. of the Medico Chirurgi- cal Review, from Bulletin de Therapeutique, the follow- ing decided language in reference to Consumption—" by such means, we may reasonably hope to arrest the evil in not a few cases, which if improperly treated, will hurry on to a fatal termination." 108 BRONCHITIS AND KINDRED DISEASES. The Bulletin of Medicine, published in Philadelphia, by Dr. Bell, Professor in the Philadelphia Medical School, says, " Dr. Stokes speaks more especially of the curableness and cure of Consumption, in its earliest stages. Andral, Carswell, Williams, Morton and Ro- gee, assert, on evidence, its curableness and cure, in the most advanced stages. Dr. Rogee's essay, contains the result of observations made in a careful examination of more than two hundred subjects, in which the removal of tubercle by absorption, or cicatrices of pulmonary tissue, or the substitution of cretaceous or calcareous concretions for open tubercles, were manifest. The most eminent pathologists of the present day concur in the opinion, that Pulmonary Consumption is most certainly curable in the last and worst stages of the disease." Since the preceding pages were sent to the printer, I have derived sincere satisfaction in meeting with the strongest confirmation of some of the more important sentiments advanced. The following are quotations from a late number of the London Lancet, a "Journal which has long been celebrated as the most valuable periodical for medical practitioners ever published, while an uninterrupted existence of more than twenty years, has long produced for it a most elevated standard and character." The editor, Mr. Wakely, a member of the British Parliament, says in relation to Consumption, "We have NEVER HAD A DOUBT OF ITS CURABILITY. In a former volume, this important question was considered, and the experience which we have since had, fully confirms the truth then expressed, that " Physical diagnosis and pa- thological research show us that recovery takes place in many cases of true tubercular deposite in the lungs. TESTIMONY OF EMINENT PHYSICIANS. 109 One fact is worth a cart load of opinions. What then must be the value of the hundreds of accumulated facts which support this view ? Thus M. Boudet states, that in the post mortem examination of forty-five subjects, between three and fifteen years old, he had observed the cure of Consumption in twelve cases. " In one hundred and sixteen individuals, aged between fifteen and seventy-six years, tubercles in the lungs or bronchial glands had become innocuous in ninety-seven cases, and had wholly disappeared in sixty-one. " In one hundred and ninety-seven autopsies, promis- cuously taken, he found ten instances in which, at least, one cavern completely cicatrized, existed in the lung; and in eight cases one or more cavities were found in different stages of cicatrization. " There can be, therefore, no question as to the cura- bility of Consumption." The belief in the curability of phthisis is gaining ground every day, on both sides of the Atlantic, because the facts presented are absolutely incontrovertible; no sane man, (I mean medical man,) can resist them, who will acquaint himself with them. And I have great hopes, that, in a lew years, a disease which now destroys one in six of the inhabitants of New York, Philadelphia, Boston, Baltimore, Washington, and of other large cities, and perhaps not a less proportion in the country, will be as often and as perfectly cured, as bilious fever. It is true, that the mode and means of cure may be various in different hands, just as in any other disease; fever and ague, for example, is cured by different remedies, but the principles of cure must be forever the same. The populace generally, many common physicians, and even a few educated ones, believe it incurable. 110 BRONCHITIS AND KINDRED DISEASES. There are, however, many great names bearing unequi- vocal testimony that it can be perfectly cured, even in its last stages, by healing with a scar, just as a gaping cut finger will heal in a healthy person, if you press the sides together. That such scars are found in the lungs, and Consumption cured, the following testimonies are offered. Not the assertions of men, who have never examined the lungs in a dozen dead bodies, but of those who have examined many thousands, and have a right to know and to be relied on. I found an encased cavity, on an almost healthy lung tissue.—Louis. That a tubercular excavation is ever capable of a cure, is an important fact; and it is so, independently of all medical aid.— Cowan. " It is next to impossible to open a dozen bodies with- out meeting with positive proof of the curability of Con- sumption,"—in the presence of cicatrices, scars, in the lungs.-—Dr. Ramadge, of London. Dr. Clarke, of England, who wrote a book to prove that Consumption could not be cured, admits that " ca- vities in the lungs may remain a long while stationary, gradually contract, and become obliterated !" Dr. Latham, another English physician of distinction, who also endeavored to prove the same point, distinctly says, " we occasionally find traces of cavities, which have healed, in persons who have died of Consumption." The important fact of the curability of Consumption, has been satisfactorily established, and its perfect cure de- monstrated.— Cyc. Prac. Med. A French physician, who died a few years ago, and is believed to have taught the world more that was new on the subject of the same disease, than any one man TESTIMONY OF EMINENT PHYSICIANS. HI who had ever lived before him, and who spent many years among consumptive patients, inquiring into their symptoms, and feelings when alive ; and examining the lungs of those who died, writes in this manner, " When I first asserted the evidence of pulmonary cicatrices, it directed the attention of the hospital physicians to the subject, and so many of these evidences existed, they concluded it could not be that, but was something else! An ulcer in the lungs may be cured in two ways, by a scar, or by turning it into, a fistula; these scars and fis- tulas in the lungs, are extremely common; and con- sidering the great number of consumptive, and other subjects, in whom they are found, the cure of Consump- tion ought not to be considered impossible; for cavities in the lungs may be completely obliterated. It has been shown that its cure is not beyond the power of nature, it is possible for nature to cure it."—Laennec. " Heat is generated in proportion to the size and vigor of the lungs. Many persons with imperfectly developed lungs and a predisposition to Consumption, complain habitually of a coldness of the surface and feet. And many who were in previously good health, become more and more sensible to cold, in proportion as the approach of the disease, weakens the functions of the lungs. I have noticed this, both in myself and others, before any other evident symptom had appeared. And I have seen its further progress arrested, by a timely use of the proper means, where much greater difficulty would have been experienced, had the warning not been attended to."—Dr. Combe, of Scotland. Marshal Hall says, Obs. 2316, "The usual appear- ances of a cavity in phthisis and of the subsequent cica- trix," iVc, and then proceeds to give engravings to show 112 BRONCHITIS AND KINDRED DISEASES. how they look. " The utmost resources of our art often avail us nothing. But scars are seen in the lungs, estab- lishing the fact that a tuberculous cavity heals, after the matter is expectorated, and I will tell you how to re- move the tuberculous matter by absorption and prevent its formation."—Dr. Weatherhead. Tuberculous cavities are healed in three ways.—Dr. Hope. Dr. Weatherhead, one of the most honored of the London Faculty, writes : " With the superior advantages of treating Consumption on this plan, I was early im- pressed, from observing more recoveries under it, while employed during the late war at Hasler, one of the largest hospitals in England. And more lately, Dr. Giovanni di Vittis, physician of the Military Hospital at Capua, bears similar testimony to its efficacy in the Medical Annals of 1832, where he states that " between the 1st of May, 1828, and the 28th of January, 1832, forty-seven patients affected with Consumption in the first stage; one hundred and two in the second; and twenty-seven in the third or last stage, had left the hos- pital PERFECTLY CURED ! !" It is recorded in the " Transactions of the Path, &c, of Philadelphia," which society is composed of the most distinguished medical professors and physicians of that city, that " Dr. Parish, who during his life was the orna- ment and the honor of his profession, was, at the age of twenty-five years, attacked with Consumption in its hereditary form; having lost a brother and sister by that complaint. He finally died in his sixty-first year, thirty- six years after his attack of Consumption." His body was examined by eight physicians of standing, among whom were several professors, who reported that " there TESTIMONY OF EMINENT PHYSICIANS. 113 was no recent tubercular granulations or deposits, but there were numerous cicatrices, depressions, puckerings, &c, proving that his apprehensions in early life were well founded, and giving the strongest evidence of the efficacy of his prophylactic measures." Here is a case of Consumption arrested in its progress, and effectually and permanently cured; the patient, at the end of a third of a century, dying after a three weeks' illness of a complication of ailments, not specially referable to the lungs at all, as the seat of tubercular disease; a case of Consumption cured, known to every respectable medical man in Philadelphia; known too by evidence which no medical man can resist, for it is a demonstration! Dr. Carswell is one of the most eminent British phy- sicians living: he is referred to by medical writers both in Europe and America, and is considered as the highest authority in lung affections, because he has for many years made tubercular disease a special study, and few men stand higher in the profession than he does. In writing an article on the general subject for the Cyclo- paedia of Practical Medicine, one of the most extensive and useful medical publications of modern times, every article being written by men of established reputation, a book designed to be a standard work, and to be placed, as it deserves to be, on the shelf of every respectable physician in America and Europe, for daily reference; especially in this country, being adapted to the wants of the American practitioner, by Dr. Dunglison, himself perhaps the most popular medical writer in the United States—in a work of such a high character Dr. C. says : " Wo shall confine ourselves to a statement of those facts, more especially those of an anatomical character, which demonstrate the favorable termination or cure of 114 BRONCHITIS AND KINDRED DISEASES. tubercular disease. The cure of the disease is indicated, first, by the cessation of those symptoms which are peculiar to it; or the restoration of those modifications of function, to which its existence gives rise. Second, by the disappearance of the local cause of the disease, or by the presence of certain lesions, which are known to follow, as the consequence of such cause, and no other. Such indications of the cure of tuberculous dis- ease have been observed, even in those organs, the lungs, in which this disease was long considered, and still is by most (?) medical men, to prove inevitably fatal. Traces of cure have frequently been observed in the lungs of persons whose history left no doubt as to their having, at some former period of their lives, been affected with Consumption. The important fact of the curability of this disease has, in our opinion, been satisfactorily estab- lished by Laennec. All the physical signs of tubercular phthisis have been present, even those which indicate the existence of an excavation, yet the disease has ter- minated favorably, and its perfect cure has been demon- strated." Dr. C. here means to say to the common reader, " That Consumption can be perfectly cured, even after a part of the lungs have rotted away, is as plain to my mind as that two and two make four !" In another part of the same article, he enumerates certain visible signs of the perfect cure of Consumption, and says of them, " There must be few practical patho- logists, who will not consider these anatomical facts as evidence that Consumption is curable. No objection has been brought forward calculated in the slightest degree to invalidate the conclusion that they are positive indices of the removal of the material element of the disease, TESTIMONY OF EMINENT PHYSICIANS. 115 even at an advanced period of its progress. We cannot avoid repeating the fact, that pathological anatomy has perhaps never afforded more conclusive evidence in proof of the curability of a disease than it has in that of Con- sumption !!" Laennec, whose knowledge of the lungs, their diseases, &c, was more extensive than that of any half dozen physicians of modern times, and perhaps all of them, together, up to this day, was so entirely convinced that the cure of Consumption was of frequent occurrence, he says: " I think it is more than probable that hardly any person is carried off by a first attack of Consumption /" To the above, I may add the testimony of Sir James Clark, whose reputation is such, that he was employed to write the article on phthisis for the Encyclopaedia, as being, from his extensive experience and great learning, the most competent person in England to perform the duty in a manner worthy of the high character of the work. It is the more valuable, as Sir James is rather averse to considering the disease curable, except in its forming stages, even he acknowledges it is practicable "to prevent tuberculous disease if it has not already shown itself, or to check its progress if it has already taken place, as there are many instances where the fur- ther progress of the disease may be stayed. I am acquainted with some striking examples of persons now living, a considerable portion of whose lungs is incapa- ble of performing its functions, and yet, with care, they enjoy a reasonable share of health. Under such circum- stances, lives may be preserved that are of vast import- ance to their families and to society. Indeed we are satisfied that there are far more individuals in this state than is generally believed; and it is well known, that 116 BRONCHITIS AND KINDRED DISEASES. tubercles are frequently found after death in the lungs of persons, in whom their existence had not been even suspected. We have already stated our conviction, that the great cause of our want of success in the cure of tuber- cular disease, arises from the advanced stage at which its real nature is discovered, and from the late period at which the physician is consulted. If Laennec's opinion be true, that few die of a first attack of Consumption, we have still more reason to hope that the disease may be cured, that is, that a second attack may be prevented, by pre- venting a relapse into his former state." After having prepared the above for the printer, I found an interesting article in the third volume Nov. of the N. Y. Jour, of Med. and Col. Sciences, by Dr. Forry. It is a short review of a treatise on patholo- gical anatomy by Carl Rokitanski, Anatomical Pro- fessor in the University of Vienna, 1844. Of this work, Dr. Forry himself gives the following high praise, " We prize it as an acquisition to our medical literature; and will say without hesitation, that as a work on pure pathological anatomy, it has not been surpassed, by any that has yet appeared! And we will conclude this notice, by quoting the remarks on ' The curative pro- cesses in tubercles of the lungs' as one of the best por- tions of the book, and as illustrating the admirable man- ner in which the author unites clearness of description, with conciseness, the best internal evidence of accurate original observation." Professor R. observes—" Tubercular pulmonary Con- sumption is doubtless curable, as may be inferred from not unfrequent appearances -in the dead bodies of those who formerly had more or less suspicious affection of the chest, from which they recovered. We can only TESTIMONY OF EMINENT PHYSICIANS. 117 expect to arrive at a truly rational and certain method of treatment, by an investigation of the circumstances under w hich such spontaneous cures have taken place; and the consequences of such treatment will be the more beneficial, as it will be directed not merely against the tuberculous dyscrasia also. Pulmonary Consumption and tuberculous abscesses may be cured after the general disease, and hence that process which lies at the founda- tion of its local effects, viz.: the tubercles and abscesses, has been eradicated. Under such conditions it has been proven, by numerous incontrovertible facts, that tuber- culous abscesses may heal, and in fact in several dif- ferent ways. First. Reactive inflammation, deposites a gelatinous infiltration, which obliterates the air cells, converting the adjacent parenchyma into a dense, fibro-cellular tis- sue of varying thickness, lining the whole tuberculous abscess, which secretes through life, a serous, sticky, synovial fluid. Second. If the abscess be not too large, it may close by a gradual approximation of its walls, which finally touch and unite with one another. We then find a cellulo-fibrous stripe (a white scar) in the place of the former cavern ; the bronchii terminate in it, in a cul-de- sac. The approximation and agglutination of the walls of the abscess may be essentially aided by various occur- rences, among which belong the sinking in of the walls of the chest; the compression of the lungs by the dia- phragm ; by the enlargement of the abdomen, or some of its organs ; the emphysematous dilatation of the paren- chyma adjacent to the abscess; bronchial dilatation, eVe. If the curative process sets in, and proceeds very 118 BRONCHITIS AND KINDRED DISEASES. rapidly, the cicatrix may enclose chalky concretions of various sizes. Third. The abscess may be filled with a mass of fibro- cartilaginous tissue, in which case, only a slight con- traction of the lungs and breast ensues." Here is testimony of the highest kind; stronger, and more competent cannot be given ; and what is more, its truth is endorsed by one of the best medical journals published in this country. And the amount of this testimony, in more familiar language, is simply this, ,that "after a part of the lungs are lost, if it be but a small cavity, it may be perfectly healed by bringing the sides together, only leaving a long, whitish, fine scar, just such an one as is left from the healing of a gash on the finger, or on any other part of the body: but if a larger amount of lungs are gone, so much so, that the sides of the cavity cannot be made to meet, these sides are lined with a material of nature's own manufacture, • which prevents the progress of the decay." And this is precisely the principle advanced by me, in the first pub- lication I ever made on the subject, and which appeared in print long before the publication of Professor Roki- tanski's work. So far then from its being true that Consumption can-: not be cured, it is here proved that it is effectually cured, even in its last stages; that is, after the tubercles have softened down, and a portion of the lungs have decayed away. Attention is invited to a declaration of that great and remarkable man, Mr. Abernethy, " Can Con- sumption be cured? that's a question which a man who had lived in a dissecting room, would laugh at. How many people do you examine who have lungs tuber- cular which are. otherwise sound ? What i, General Washington, having been exposed to rain on the previous day, was attacked with an inflammatory affection of the upper part of the windpipe. The disease commenced with a violent ague, accompanied with some pain in the upper and lower part of the throat, a sense of stricture in the same part, a cough and a difficult rather than a painful breathing deglutition, which were soon succeeded by fever and a quick and laborious respiration. The necessity of blood-letting suggesting itself to the General, he procured a bleeder in the neigh- borhood, who took from his arm in the night twelve or fourteen ounces of blood. He could not, by any means, be prevailed on by the family physician to send for the attending physician till the following morning, who ar- rived at Mount Vernon about eleven o'clock on Satur- day. Discovering the case to be highly alarming, and foreseeing the fatal tendency of the disease, two consult- ing phvsicians were immediately sent for, who arrived, one at half after three, and the other at four o'clock in the afternoon. In the mean time were employed two pretty copious bleedings; a blister was applied to the part affected, two moderate doses of calomel were given, and an injection was administered, which operated on the lower intestines ; but all without any perceptible advan- tage, the respiration becoming still more difficult and distressing. Upon the arrival of the first of the consult- ing phvsicians, it was agreed, as there were yet no signs of accumulation in the bronchial vessels of the lungs, to 228 BRONCHITIS AND KINDRED DISEASES. try the result of another bleeding, when about thirty- two ounces of blood were drawn without the smallest apparent alleviation of the disease. Vapors of vinegar and water were frequently inhaled, ten grains of calomel were given, succeeded by repeated doses of tartar emetic, amounting in all to five or six grains, with no other effect than a copious discharge from the bowels. The powers of life seemed now manifestly yielding to the force of the disorder. Blisters were applied to the extremities, together with a cataplasm of bran and vinegar to the throat. Speaking, which was painful from the beginning, now became almost impracticable. Respiration grew more and more contracted and imper- fect, till half after eleven on Saturday night, when he expired without a struggle, retaining the full possession of his intellect. " He was fully impressed at the beginning of his com- plaint, as well as through every succeeding stage of it, that its conclusion would be mortal; submitting to the several exertions which were made for his recovery, rather as a duty, than from any expectation of their effi- ciency. He considered the operation of death, upon his system as coeval with the disease; and several hours before his death, after repeated efforts to be understood, succeeded in expressing his desire that he might be per- mitted to die without further interruption. " During the short period of his illness he economized his time in the arrangement of such few concerns as re- quired his attention, with the utmost serenity; and anti- cipated his approaching dissolution with every demon- stration of that equanimity for which his whole life had been so uniformly conspicuous. " This account is dated Alexandria, Virginia, Decern- DISEASES OF THE THROAT. 229 ber 21, 1799, and signed by Dr. James Craik, his at- tending physician, and Dr. Elisha Dick, his consulting physician. Thus died one of the greatest and most dis- tinguished men of any age or nation, in the last hour of the last day of the week, in the last month of the year in the last year of the last century, in his 68th year. The violent ague with which this commenced was doubt- less the rigor of incipient inflammation. " The pain and sense of stricture in the upper and fore part of the throat, and the labor of breathing, showed that the inflammation was seated in the larynx." The more immediate cause of the attack was stand- ing on the damp ground for some time, looking at some workmen. Inflammatory diseases are more vio- lent and fatal in large persons like Washington, who was six feet high ; his head measured seven and a half inches, and he weighed, in 1778, two hundred and nine pounds. And it is not uncommon for persons to feel a kind of burning or raw sensation in the throat when their feet have become damp or cold, and remained so for some time. In others it is the first warning that a cold has been taken, given sometimes at midnight when the per- son had retired in usual health; this was the case with Washington. In all such sudden attacks at night, a per- son should send for a physician at once, then have a mustard plaster put to the throat, a thin piece of wetted paper or muslin intervening between the mustard and the skin, to keep it from raising a blister and breaking the skin; let the plaster be made of vinegar and mus- tard only; then put the feet in hot water, with one or two, or three tablespoons of ground mustard stirred up in a gallon of the water, which should be in a wooden vessel, this will bring the water over half leg deep; 230 BRONCHITIS AND KINDRED DISEASES. keep adding more hot water from time to time for half an hour, so that the water shall be hotter when the feet are taken out than when put in ; at the end of the half hour, the patient being wrapped up well all the time in a good thick blanket, drinking as much cold water as he desires, wipe the feet dry, hold them by the fire, rubbing them with the hands until perfectly dry and warm, especially between the toes and at the heels, get into bed with bottles of hot water to the feet; these bottles should be only three-fourths filled with water, should be well stopped, and be wrapped up, each bottle in a small piece of woollen flannel, with the edges of the flannel turned in so as to be an additional aid in keep- ing the cork in; additional bed clothing should be placed from the upper part of the thighs downwards, and as little as consistent with preventing chilliness on the upper part of the person, the bed clothing to be well tucked in at the sides, until the arrival of the physician. These directions are given, not as a cure, except in mild cases, but in order to save time, for, as is seen above, it is, if at all violent, a rapidly progressing, and speedily fatal disease. The reason of its fatality is, that there is inflammation. The minute blood vessels are over distended with angry, inflammatory blood, and the chink of the glottis, that is, the entrance at the top of the windpipe, through which the air must pass to the lungs, and it can reach them in no other way, is very narrow, and is easily filled up by these blood vessels being so swollen with the un- usual amount of blood in them, that they more or less completely occupy the passage designed for the breath, and besides this, the more watery portion of the blood is exuded through the delicate sides of the little blood CROUP OF CHILDREN, ETC. 331 vessels into the interstices, and causes additional swell- ing of the parts. CROUP OF CHILDREN, is precisely the same thing, only occurring in the body of the windpipe instead of at the top, and as the wind- pipe is more roomy, and from its unyielding gristly nature, not inclined to swell, the more watery portions of the blood are differently disposed of: they harden and form a tough, leathery kind of substance like the exud- ing and hardening of gum on a tree, this thickens and thickens until the whole cavity is filled, is choked up, and the child dies from suffocation; an operation similar to that of the filling up of the boilers of steam-boats, or the spout of the tea-kettle where limestone water is used. And as many a lovely child is destroyed in a single night, and many young mothers are wholly ig- norant of the dangerous nature of the ailment, it may be useful to state here what should be done while the mes- senger has gone for a physician. SYMPTOMS OF CROUP. It almost always comes on at night, after the child has been some time in bed, and generally after having been out of doors of a damp, raw day. He is restless, and gives an unusual sounding cough, without its wakening him ; a cough so peculiar that a parent who has heard it once, will never fail to recognize it afterwards, a kind of ringing, husky, muffled cough, with something of a hoarse barking sound; it is from a Scotch "word, which means a croaky or husky sound; after a while the child coughs again, and is roused up, and after each cough the breath is drawn in with a hissing noise like a chicken with the pip, the breathing becomes slower as the open- 232 BRONCHITIS AND KINDRED DISEASES. ing becomes smaller by the gradual filling up as before described, the face is flushed, the eyes red, tearful, blood shot, skin dry and hot, or face bathed in perspiration, the hand is frequently carried to the throat, as if dis- tress were felt there, great thirst, urine high colored, great uneasiness, restlessness between the fits of cough- ing; a mother who has ever heard it once, needs no description to enable her to recognize it again. The first born are most likely to perish with it; simply be- cause the parent has no experience of its nature, and hence is not alarmed in time, or knowrs not what to do, while the physician is being sent for. In the hope of being instrumental in saving some little sufferer, whose life is inexpressibly dear, at least to one or two, I will make some suggestions, not for the cure of the patient, but to save time. The instant you perceive that the child has Croup, indicated by the barking Cough, uneasy breathing, restlessness, send for a physician, and as in- stantly wrap a hot flannel around each foot, to keep it warm; but while the flannels are being heated, dip another flannel, of two or more thicknesses, in spirits of turpentine, or spirits of hartshorn ; or have a large mus- tard plaster applied, one that will reach from the top of the throat down to some two inches below the collar bones, wide enough at top to reach half-way round the neck on either side, and nearly across the whole breast at bottom. But it will take time to send for a physi- cian, to prepare flannels, and to make the plaster or ob- tain the turpentined flannel, and in some cases fifteen minutes is an age—is death, if lost; therefore, while these things are preparing, give the child, if one year old or over (and half as much, if less), about half a teaspoon- ful of Hive Syrup, and double the dose every fifteen ATTEND TO FIRST SYMPTOMS. 233 minutes until vomiting is produced; and every half hour after vomiting, give half as much as caused the vomiting, until the physician comes, or the child ceases to cough, when he breathes free, and is safe. If you have no Hive Syrup, give a teaspoon-ful of Syrup of Ipecac, and double the dose every fifteen minutes until vomiting is pro- duced. If you have nothing at all, boil some water, keep it boiling, dip woollen flannels of several folds into it, squeeze it out moderately with your hand, and apply it as hot as the child can possibly bear it to the throat, and in from one to three minutes, according to the violence of the symptoms, have another to put on, the instant the first is removed, and keep this up until the breathing is easy and the cough is loose and the phlegm is freely dis- charged, or until the arrival of the physician. The second form of Throat-Ail is called Chronic La- ryngitis, from its long continuance, this is the real Throat-Ail, which for some years past has been becoming increasingly common, and which from neglect, is so fre- quently ending in a general decline and death, usually running its course to a fatal termination in a year or two, or three. The nature, causes, and symptoms of this disease have been described in previous pages. The object now is to attempt to induce persons to attend to the first symptoms, for the simple reason, that in perhaps a majority of cases, they are the symptoms of coming Con- sumption. Some physicians of great eminence, men of learning, and of patient, long continued research, have so generally seen the symptoms of throat-ail end in Consumption, as to have expressed their opinion, that the symptoms of chronic layringitis are the effect of Con- sumptive disease already present in the system; and I 234 BRONCHITIS AND KINDRED DISEASES. have reason to know, that it is in very—very many in- stances but too true. gST The tickling, which causes cough, seeming to be in the larynx, at the top of the windpipe, when in reality, it is in the depression, at the bottom of the windpipe, the irritation coming from the lungs close by, and not from the voice organs, which are from three to six inches above. A tickling in the throat of clergymen, in other words, throat-ail, in that class of persons, is not as commonly a symptom of Consumption in progress, or threatened, as in others, because the manner in which they use their voice, makes them liable to a local disease, confined to the voice making organs themselves; but in a large class of other cases, there can be no doubt, that throat-ail symptoms are nothing more nor less than accompani- ments of Consumptive disease, to say the least of it; leaving the question of the relations of cause and effect open. The amount of the whole matter is simply this, As a general rule, the fact of the existence of a throat affection for six or eight weeks, is presumptive evidence of a Consumptive constitution, public speakers excepted, and even many of them are in the same category. It is on this account that so many of these throat affections, unless taken in the beginning, are exceedingly intractable, requiring sometimes, months and months of tedious persevering effort to wholly eradicate the symptoms. For these two serious reasons am I at not less pains to designate the particular symptoms of Throat-Ail in the beginning, in the very first beginning, than those of Consumption. Nor do I think it possible to certainly designate between the two, without the aid of lung measurement; if they measure full, if they meet all the A CASE IN POINT. 235 requisitions, then is it certain that the Throat-Ail symp- toms are confined to the throat; but if with Throat-Ail symptoms, there be a decided defective lung measure- ment, then, beside the Throat-Ail treatment, I habitually manage the case as if it were one of evident Consump- tion ; this I do, to be on the safe side, and I think I have saved human life by it. I will here give a single case, proving conclusively the two points just stated. First, The difficulty, or rather the length of time re- quired to eradicate a slight form of the disease. Second, Where it was certain that no consumptive ailment was present. A merchant of this city, aged 38, applied Oct. 30th, having Tiredness in the throat. Weakness of the voice. I loarseness. Constant tendency to swallow. Burning feeling, at times, in the throat, Back part of the throat very much inflamed. Uncomfortable cough. Expectoration of unmixed yellow matter, readily brought up with a hem. His measurement reached the full standard, pulse 78, and weight 178, which was rather above what it was ordinarily. This was pronounced a clear case of uncomplicated Throat-Ail. On the 29th day of February following, just four months after, during which time he had most rigidly ob- served all the directions which had been given him, he had not the most remote remnant of any one symptom 236 BRONCHITIS AND KINDRED DISEASES. above named. While under my care, I gave this gentle- man no internal medicine, except perhaps one, or may be, two pills in the beginning; nor did I see him a dozen times perhaps; the directions were simple and safe, the main thing was, the persevering observance of them. On this point many persons fail of health and life. Because they do not get well in a week or two, they become tired, and want to try some thing or some- body else, or getting almost well, imagine that the danger is over, and that the rest will be accomplished of itself; in these ways relapses occur, the system is trifled with, time is lost, and the patient dies. I very greatly desire to excite no expectations which may not be realized, and therefore state to the reader very plainly, that unless this Throat-Ail, this Chronic Laryngitis is of a mild form, and of but a very few months standing, it is not probable that the symptoms can be removed, the disease eradicated and a habit of health restored, short of several months constant, thorough and persevering attention. I would be glad beyond expression to be able to propose a safe, a prompt and permanent cure, but I possess no such knowledge; and from the number of persons applying to me from various parts of the country, who have vainly tried every conceivable re- medy, I feel convinced, that there is no instantaneous cure, no rail-road route to the thorough eradication of Chronic Laryngitis; that nothing can accomplish it but a thorough, systematic effort, and generally long conti- nued. Usually but little internal medicine is required, unless there are complications, nor is frequent medical interference requisite, for in a comparatively short time, sometimes by a single set of prescriptions, the system is placed in a condition, which requires nothing thereafter NITRATE OF SILVER. 237 but a safe and simple treatment, but safe and simple as it is, it must be persevered in, often for months together. I trust that these sentiments will be thoroughly im- pressed upon the mind of the reader, and that he will make a wise and practical use of them. Illustrations have already been given on page 11, showing how certainly apparently slight symptoms of Throat-Ail end in death when neglected; on the other hand, it is seen in the case last given, and in others scat- tered through the book, with what regularity thorough cures take place, when the symptoms are attacked in the beginning, and persevering attention is given to them until every symptom of disease is not only eradicated, but even a little longer, so as not merely to get into health, but to establish a habit of health. To do this does not involve the taking of medicine, nor costly, nor painful observances, but it does involve the rational continued and systematic observance of safe and effec- tive practices. And when it is known that the conti- nued presence of Throat-Ail symptoms for months in succession, is presumptive evidence of a consumptive condition of the system, the reader is placed fully on his guard, health and life being the forfeit of inat- tention. NITRATE OF SILVER applied to the throat itself is now a common remedy, and has been favorably spoken of. From the year 1846, its employment has rapidly extended, until there is scarcely a town in the United States where it has not been tried. In many cases it affords immediate and grateful relief. I have never known a case where that relief was effectual and permanent. Persons have come 238 BRONCHITIS AND KINDRED DISEASES. to me, who have had it applied by the most skilful and experienced hands for days and weeks, and months without a cure. In some cases the ailment has been aggravated. It is not my business to decry any remedy, provided it is a remedy; but when it is sometimes an alleviant only, at others inert, occasionally an aggravant, and in no one known case effectual when alone used, it is per- haps a common due, to draw attention to the facts of the case. I have employed it in my own practice some years ago, and with results so unsatisfactory, that I have laid it aside, and only use it in rare instances. It has most notoriously disappointed the expectation of physicians all over the United States. It is' an old practice revived; not that there is no merit in what has become obsolete; but from the cir- cumstance that it was wholly lost sight of for a decade or more, it is reasonable to suppose that such a disuse arose from the fact of its general inefficiency. Trousseau and Belloc made a publication on the subject in Paris, May 15th, 1837; a translation appeared in Cincinnati, in September, 1839, by Dr. J. A. Warder; and yet, so completely had the practice passed from the medical public, that when it was revived in 1846, it was re- garded as a new discovery throughout the Union. Trous- seau is still living, and although he maintains a high re- putation, and has written much since he first proposed the topical application of nitrate of silver as a cure for several forms of throat disease in 1837, I am not aware that these sentiments were reiterated, or that the ori- ginal, or the translation, ever passed to a second edition. It is scarcely possible, therefore, if the topical application NITRATE OF SILVER. 239 of the nitrate of silver had been really a permanently efficient remedy, that it should have so soon fallen into desuetude. If the throat symptoms arise from the condition of the stomach, the application of the caustic to the throat cannot cure, since it does not remove the cause. If the symptoms originate from the condition of the lungs, there can be no cure, since the nitrate cannot reach them. If the throat feelings depend upon spinal derangement, as is not uncommon, an interesting case of which is now in my hands, no washes to the throat can avail. In these three kinds of cases, where the throat symp- toms, the tickling cough, more or less dry, arises from the condition of the stomach, the lungs, the spine; the application of the nitrate of silver not only does no good, but harm ; it merely smothers the complainings of na- ture; it deadens the sensibility of the throat, and thus muffles watchful Nature's voice, without removing the thing which caused her to cry out; stifling her com- plaints, while the cause of them remains in action. It is precisely like closing the hatches when the hold is on fire, and there resting! It is only covering with white wash the black spot on the wall; it is gone to all ap- pearance, but that black spot is there still. The fire is in the hold, and sooner or later will break forth with the more fury, and leave the noble vessel a ruin. I do not doubt that while using the nitrate of silver, the throat symptoms do sometimes disappear; I do not doubt that it sometimes, in the hands of a judicious phy- sician, may have a serviceable effect as a second or third rate aid; but that the nitrate of silver applied in solu- tion to the throat, has of itself, ever permanently cured 240 BRONCHITIS AND KINDRED DISEASES. one single case of serious chronic laryngitis, I do not believe. If other means were used in conjunction, then is the nitrate not the remedy. A CLERGYMAN having abandoned preaching from hoarseness and a feel- ing of rawness of the throat after speaking one year be- fore, had the nitrate of silver applied as well as it is pos- sible for a physician to apply it, he gave up public speaking altogether, and yet with this entire abandon- ment of his calling, and the use of the nitrate, he was not restored, and came to me for advice, complaining most of a weakness of voice which disabled him from reading aloud for five minutes at a time. In one month he could read thirty minutes at a time with ease, and in all respects felt well, with a clear, strong voice, system regular. I advised him to resume his duties, as I thought he could do so not only without harm, but with decided advantage. See his condition on the day he first came, and on his return one month after: Age. Date. Pulse. Breathing. "Weight. L. measure. 24 Feb. 2 100 20 110 200 " Mar. 4 72 16 114 220 SPINAL DISEASE. A young lady had been suffering two years with op- pression, cough, distressing irritation in the throat, shortness of breath, pains in the breast, suffering be- tween the shoulder blades. She had undergone a variety of treatment, had taken cod liver oil, and had used the nitrate of silver to the throat to remove the trouble- some irritation and tickling; every few minutes, some- times every minute there was a short hack, with every COD-LIVER OIL. 241 now and then a hoarse, deep, distressing hollow cough which jarred and pained the whole frame, pulse 130 a minute, and breathing thirty-six and over. Every thing done for her had not availed. On examining this deeply interesting case, it was found all the throat and lung symptoms arose from the condition of the spine, and the case was treated accordingly, and without re- garding the throat affection ; but directing attention to the spinal symptoms, the hacking cough was removed, the pulse fell a third, and the breathing likewise, and every symptom connected with the throat or lungs had a steady and encouraging abatement, promising now, an ultimate restoration. These cases are given as a warning to guard against loss of time in using the nitrate of silver to the throat, unless it is as certain as such a thing can be, that the ailment is confined to the upper part of the windpipe, ^PW in which case other things may be more successfully used, avoiding the discomfort of the nitrate applications, and the irreparable injury the teeth are liable to suffer, their certain and permanent discoloration, if the nitrate of silver forms any part of the gargle employed. The means referred to are the gargles, fomentations and con- stitutional remedies already known to educated physi- cians, as it is no part of the design of this book to aid the reader in ruining his constitution, his health, and his life, by teaching him to practice on himself. COD LIVER OIL has been given freely for affections of the throat as well as those of the lungs. I believe it to be the best known remedy for general scrofula of the system. It often 11 242 BRONCHITIS AND KINDRED DISEASES. gives flesh and strength to consumptive persons who take it; but, It has no direct effect upon the lungs in any way. It sometimes causes spitting of blood. It sometimes, nay, often, causes looseness of bowels. It often deranges the stomach. It is impossible for numbers to take it. It is, when applicable, adapted to two classes of per- sons mainly, if not exclusively; first, to the young; second, to those who, when in health, were inclined to be fleshy or fat. For these reasons it is not a reliable remedy, not generally applicable, and should not be taken except under the supervision of an experienced physician ; and by itself should never be relied on, for I have never seen a case of Consumption cured by it, and have never read of a case that was cured by the use of it alone. I know that cases have been reported in the public prints, and in medical journals, where persons taking it have ap- peared to do well. But to the best of my recollection one, if not both of the circumstances which I shall name, has attended its administration in every reported case. First, some one or more symptoms always remained; or, second, there is a failure to report the condition of the case a year or two or three after. I would not oppose its use in Consumptive disease, for it does, in quite a number of instances, impart flesh and strength to the patient, and thus far, it is well; and better still if these improvements are taken advantage of to employ them in proper out-door exercise, thus will it be a valuable aid, but if it fails To increase the flesh, To increase the strength, TO CLERGYMEN AND THEOLOGICAL STUDENTS. 243 Or, if on the other hand it tends To cause spitting of blood, To loosen the bowels, To derange the stomach, Then, by all means, should it be abandoned, because these occurrences are fatal in their tendencies, always weakening the general system. TO CLERGYMEN AND THEOLOGICAL STUDENTS. Ministers and mothers are our country's hope. As is the mother, so is the man. But in this happy land, where every one can worship as he chooses, the min- ister moulds the mother, and from his teachings do her principles take their coloring. Making it true "as is the priest, so are the people." Every good citizen will, therefore, naturally desire, that there should be a suffi- cient number of ministers of religion, to meet the wants of our growing country. It is however but too true, that the number of ministers for the last few years of all denominations, has relatively decreased, there are fewer clergymen in proportion to the population, than there were twenty years ago. One cause of this is, their early death, or their premature disabling, from loss of health. Every year that a faithful clergyman lives, that life becomes more valuable to the church, in consequence of his increased experience, prudence, forbearance and kindly feeling to his fellow race. The less he moves by terror, the more by love; the more valuable he is to the church to which he has dedicated himself and all he has, the greater is his obligation to take care of, and watch over that health, without which, his life is comparatively useless. 244 BRONCHITIS AND KINDRED DISEASES. A man who lives as he ought to, should be in his very prime at fifty years of age. But how many of our clergymen, some of the brightest among them, have passed away, long before that time. How many others incapacitated from efficient labor before they reach the age of fifty years! And how many too, in the vigor of manhood's physical power, and mental energy, have fainted under the burden and heat of the day ! To the little army of theological students, does the church look for recruits, to supply the places of the dis- abled and the dead. But in very many instances, these reasonable expectations have been disappointed; and in every direction are found young men, who have just left the seminary, wandering down to other occupations, from want of health, to become teachers in schools, in academies, in private families, to take agencies for books or religious newspapers, to assume the editorial pen, or having " married well" in the phrase of the times, settle quietly and conscientiously down, as invalids for life! To old fathers and mothers at home, whose whole lives are bound up in the advancement of religion, it is the sweetest and purest of all earthly pleasures, to look forward to the day, when their son, now at the seminary, shall have completed his studies, shall return to his native village, and among the neighbors and friends of his youth, shall stand up " a man of God," to deliver messages of high import to men. To maintain him at the seminary, how cheerfully do they labor by day on the farm, and by night at the needle or the wheel. With what willing frugality do they practice a thou- sand self-denials; and the brothers and loving sisters, how gladly do they lend a hand, to help him so far TO CLERGYMEN AND THEOLOGICAL STUDENTS. 245 away, and whom they already begin to regard as higher than they, mingling reverence with affection. In a thousand other cases, with what a sacred ambition does the childless widow in her age and poverty, strive to lay aside a penny now and then by extra labor or extra deprivation; but not alone, there are the maiden workers in the hard-lifed city, in the cheerless garret, in the damp basement, in the dingy rooms at the top of crazy stairways, or at the ends of dark passages; the poor mechanic, how do all these labor to save by the penny, that a little sum may be raised for an Education Society, to help such young men at the seminary to books and clothing, and board, as have no means of their own, so that they may the sooner enter upon their labors; we cannot otherwise than imagine that many a solitary hour is cheered by the reflection that they are thus doing something towards bettering the common cause of great humanity; and that for these little efforts, there is the sweet recompense of hope, that some one will be made better and happier for time and for aye. But when the student, for whose aid they have been struggling in these ways for long years, has almost completed his course, and the reward is just about to crown their willing efforts, what a blasting must there be of hope deferred, to know at such a time, that the health is gone; and the savings and denials, and labors of years irrecoverably lost, as far as all direct practical effect on society is concerned! Men and mothers of the church cannot but feel the truth of the statements made, and must regard with high interest, any proposition which looks to the abatement of a common calamity. The plan I propose is, that clergymen and theological students should consider it a 246 BRONCHITIS AND KINDRED DISEASES. sacred duty to be well. Certainly, the maintenance of health is a duty to all, but more sacredly so is it the duty of the two classes just named, and for the reasons stated. Health, a good constitution, is as much a " talent" entrusted to our care as any thing else. I know of no talent half so valuable; for without health—family, friends, wealth, the world and every thing in it and about it, is a comparative blank, and the invalid is a blank, and more than a blank, because he is not only of no account himself, but by compelling the care of others, hinders them that much. He is not only troubled him- self, but is a source of wasting solicitude to those who love him. Men are not naturally sick. Except in hereditary cases, they bring disease upon themselves. And even when diseased, these bodies of ours are made with such wonderful wisdom and kindness, that they have within them as a part of their being, a principle, recognized for centuries among medical men as the " vis medicatrix naturae," the power of nature of curing herself, if simply let alone, if her instinct dictates are wisely regarded. A man in ill health is very much like one who has failed in business. I never knew a person to attribute his failure to himself. It is always done by having endorsed the paper of others. Invalids are too prone to attribute their want of health to causes out of themselves. But it is a deception. There is perhaps not one case of disease in a hundred, in the ordinary walks of life, which does not owe its origin directly to the unwise conduct of the person himself. And one of the most valuable secrets of health is simple and emi- nently practical I£gFm when a man becomes unwell, let him rigidly, and at once, investigate the cause, and with conscientious care, ever after, make it his study to avoid TO CLERGYMEN AND THEOLOGICAL STUDENTS. 247 that cause. This is certainly not an unreasonable course, and if it be not wickedness to neglect it, then I do not know what sin against the Creator of our being is. And surely a stronger appeal than its sinfulness, cannot be made to the minister that is, or is to be. What I am most anxious to impress on the mind is "study to take CARE OF YOUR HEALTH WHILE YOU ARE WELL." If not well, instead of tampering with your constitution, seek advice promptly from your physician, and follow it, and do not by your example, teach your physician to be his own minister. Let then the minister now, or to be, study well the symptoms of that disease which has disabled so many eminent and useful men, and be prompt to check them in the budding. I will name here two causes, which perhaps, more than any others, lay the foundation for the ultimate abandonment of ministerial duties. First, Exposure to a colder air, too soon after speaking or singing. Second, Speaking or singing, when it requires an effort, or gives pain to do so, as in hoarseness from a cold. If every air cell of the lungs were spread out on a wall, a space would be covered several times larger than the surface of the body—thirty times larger. If the hand is dipped in cold water and suddenly placed on any part of the body which is usually covered, a most unpleasant shock is imparted to the whole system. If then, when the lungs have been preternaturally heated by speaking in a warm room, the person imme- diately goes out into a colder air, a dash of that cold air is made, not over a few square inches, but over a surface of many square feet; not over the comparatively 248 BRONCHITIS AND KINDRED DISEASE9. hardened skin, but over the delicate fibres of the internal throat and lungs. It is true, that the lungs do not make such a loud complaint, although the actual violence is very many times greater; still, it is a violence, and not the less injurious because it at first complains but little, for it is a law of the internal organs, that they suffer dis- organization to a wonderful extent without complaining, almost to within a few hours of death. AN ILLUSTRATION. The case is published in the New Orleans Medical and Surgical Journal for September, 1850, and was reported by Dr. J. C. Nott, of Mobile, to whom Dr. G. P. Gaines, who attended the patient without ever having seen him before, furnished the following notes: "Monday, May 27th, 1850, between 7 and 8 in the evening, I was called to see a gentleman aged fifty-six, who was staying with a friend, three miles from Mobile, where he had spent the previous two months under cir- cumstances of high mental excitement, in the discharge of the offices of his profession. Found him in great pain, which he referred to the lower portion of the breast. Suspecting immediately an affection of the heart, I questioned him if he had ever had any pain in his heart before; he answered that he had had, on seve- ral previous occasions, some slight pain in his left side, with slight palpitation, but not of much moment. Auscultation detected no abnormal sounds, no palpita- tion, but the heart beat regular and slow. He belched up great quantities of wind, but there was no distention of the epigastrium, or tenderness. He vomited occa- sionally undigested food, but said he had no nausea. He was perfectly cold all over, and bathed in a cold INSIDIOUS DISEASE ILLUSTRATED. 249 Bweat. I administered anodynes and carminatives, ap- plied a warm poultice with mustard to the seat of pain, endeavored to bring about reaction by wrarmth to the extremities, but nothing gave relief. He still com- plained of the pain, and would beat his breast with his clenched hands. At ten o'clock I gave him a large dose of calomel and morphine, also gave several enemas, under which, in the course of two hours, he seemed to react and get warm, and he remarked, ' Doctor, I feel better everywhere else, but that pain still remains ; it is a persistent and abiding pain, that seems to press through me against my spine.' All this time his pulse was regu- lar, full, strong, but rather slow. II is strength was good, for he got out of bed several times without help. At one o'clock I repeated the calomel and morphine. At two o'clock he said 'the pain has left my breast, and gone to my heart and left arm; do you think that is a good sign V I asked him if in changing it still retained its severity, and he answered me ' yes.' I applied my hand over the heart, but there was no palpitation. He also said, 'Doctor, I think I am getting weaker—feel my pulse.' I filt it, and although it beat regularly, it seemed slower and weaker. I left the room for about fifteen minutes, and was suddenly called in to see him die. He breathed two or three times after I reached his bed- side." His body was opened after death. His lungs were perfectly sound throughout, and were free from any signs of disease, acute or chronic. In the left ventricle of the heart '• there was an irregular bruised looking patch, about the size of a dollar, and on the outer edge of this was the fatal rupture!" The patient had died literally of a broken heart. This bruised looking patch presented 11* 250 BRONCHITIS AND KINDRED DISEASES. a dark, bloody appearance, the fibrous, muscular por- tion being destroyed. The patient had been laboring under a slight diarrhoea for several days, but his friends believed him to be in vigorous health; and says Dr. Nott, "It is remarkable that so much disease should have existed, with so few symptoms to indicate it, though similar examples are on record. There can be no doubt that organic disease had existed for months, leading inevitably to death." This case is given with the express purpose of im- pressing upon the reader's mind, that the internal organs of the body are actually disorganized, destroyed some- times, without giving any indication of it, until within a few hours of death. And that because the throat does not complain of such sudden changes as I have spoken of, it nevertheless does suffer from each repeated violence, until destroyed irreparably, [ggr3 And so is it with the lungs, very many persons die of Consump- tion, and after death a large portion of their lungs are found on examination to have decayed away without the patient ever having complained of pain in the breast until within a week or ten days of death, though the distressing cough and emaciation gave sufficient evidence of the nature of the disease. Before remarking on the second cause of frequent loss of voice in clergymen, I will step so far out of my way as to mention a few more items in reference to the death above described, the patient having been the most cele- brated clerical orator of the present century, at least in the denomination to which he belonged for the greater portion of his life, John Newland Maffitt. He had been preaching in Mobile for some weeks; " immense crowds were attracted day after day by his DEATH OF MR. MAFFIT. 251 extraordinary pulpit eloquence. When at the zenith of his success evil reports pursued him. He became very much excited, was much occupied in writing for several days and nights; in writing was suddenly taken ill on the evening of the 27 th of June, 1850, and died in seven hours. What influence his protracted mental excitement exercised in causing the disease, must remain in doubt; and though the malady is one which marches steadily onward, it is highly probable that its termination was hastened by moral causes." It is thus seen that he died of disease of the heart, which must have been in pro- gress for many weeks, and that it is impossible for him to have died of any other cause. Peace to his memory ! SECOND CAUSE OF LOSS OF VOICE, Speaking or singing, when it requires an effort, or gives discomfort or pain to do so. A clergyman has a cold, he is hoarse, he feels com- pelled to fulfil an engagement, and begins to speak with labor ; as he proceeds or warms up he speaks more easily, and at length one wrould not suppose that anything was the matter with him ; but when it is over, he in a short time begins to suffer, sometimes actual pain, at others utter prostration of the whole man, a heavy tired- ness in the throat, or raw burning feeling; this lasts from a few hours to some days, and before he is fully well, inexorable appointments tempt him to a repetition, until all recuperative energy of the parts is lost, and the voice is gone for life, which, with a few days rest and care, might have been raised on the side of good morals and virtue, and religion, for a quarter of a century. The reasons which have been given in my office for such a course are: " I was compelled to ;" " I could not help 252 BRONCHITIS AND KINDRED DISEASES. it;" " The appointment was out, and it was too late to recall it;" " The people would have been disappointed." The question which presents itself to my mind on such occasions is simply this—" Can it ever be necessary to sacrifice the health, to ruin the constitution, and to risk life, in order to advance the interests of religion in such cases?" Do her true interests require it? Is it true economy ? It may be useful to give some rules to be observed on the part of public speakers. 1. Speak in a conversational tone, with very much the same pause and emphasis as judges employ from the bench. This cannot interfere with earnestness or im- pressiveness of address, but really adds to both. 2. Never begin to speak on a high key; commence in a low tone and gradually rise, feeling your way to the most distant hearer. 3. Do not continue utterance until the lungs are almost entirely emptied of air, but take breath when they are about two-thirds exhausted. 4. Do not speak with greater rapidity than will pre- vent your giving a complete and perfect enunciation to each syllable; endeavor if possible to sound every letter in every word; this will compensate to a wonderful ex- tent for loudness and vehemence of tone and ges- ture, and consequently husbands the physical strength both of the body in general, and the voice organs in particular. Rapidity of enunciation depends to some extent on temperament and other circumstances. Frank- lin says that Whitfield articulated his words so per- fectly, that he could distinctly hear him at the distance of several squares, viz: Whitfield spoke from the top of the steps at the door of the court-house in Market- RULES FOR PUBLIC SPEAKERS. 253 street, Philadelphia, west of Second-street, " and his voice was distinct until I came near Front-street, when some noise in the street obscured it, and I concluded he could well be heard by thirty thousand people." It is said of the oratory of Jonathan Edwards, that » ere he reached the climax of his terrible appeals, the whole audience had risen up in.one tumult of grief and consternation. And amid all this, there stood the calm, imperturbable man, reading on as softly and gently as if he were in his own study." 5. Unless the effort to speak is painful, or tiresome to the whole body, it is best, when there is merely weak- ness in the vocal organs, to use the voice at three or four regular times a day, by reading, conversation or declamation, to the extent of not making an effort; the moment you become sensible of an effort in speaking, cease, instantaneously cease; at each exercise of the voice, stop before you are tired ; but gradually increase the time. Do not speak at one hour, or day, much louder or longer than you did the hour or the day pre- ceding; in this way you will gradually invite the natural strength to the voice muscles, just as the muscles of the othcr'parts of the body, when weakened by disease, regain their natural power by moderate and gradually increasing exercise. It is generally irregular speaking which is so injurious to public men—making no effort for a day, or week, or month, and then all at once delivering a speech, or sermon, or oration. By observing these prin- ciples, a man by speaking every day, may every day get better until he is perfectly restored; the opposite course, or even simple neglect of a slight chronic throat ailment will almost inevitably terminate fatally. 6. After delivering an address, do not go immediately 254 BRONCHITIS AND KINDRED DISEASES. into a colder atmosphere; remain after the assembly has dispersed for five, ten, twenty minutes, or more, accord- ing to the difference between the internal and external temperature of the air. And even after having waited some time to allow the system to become cooled, close your mouth resolutely, then hold over it and the nose a handkerchief, and then leave the house, walking briskly for five or ten minutes, or until the blood has begun to circulate freely, then remove the. handkerchief, but still keep the mouth closed until you have entered your dwelling. If practicable never ride, but always walk from the place of your public exercise, as walking tends more to prevent chilliness. These suggestions are appli- cable to night air all the year round, but only to cool weather in the day time. Their observance should be rigid in proportion as the weather is cold. Never retire to bed or undress within an hour of speaking or singing. The reader will perceive that all the above sugges- tions under the sixth head are in reference to one prin- ciple, the avoidance of cooling off quickly after exercises. There are many other points in reference to the gene- ral subject of equal importance to clergymen, but it is not practicable to present them here. In a volume similar to this, entitled " Clerical Health," a wider range is taken. The nature, causes, and prevention of some of the more common diseases to which ministers and theological students are liable, are to be considered. TobePublished July, 1852. All that I have said is to induce clergymen and others to take warning from the first slight symptoms of dis- ease. To accomplish this, I will, in addition to those already given, present two cases; one showing how insidiously the symptoms grow, and how easily they FIRST THROAT-AIL SYMPTOMS. 255 may be removed when promptly attended to; the other being an example of their certainly fatal tendency when long neglected. FIRST THROAT-AIL SYMPTOMS, As described by a clergyman, in February, 1852, (1105.) " Eighteen months ago I noticed the first very slight symp- toms of interference with my voice, in the collection of phlegm, obliging me occasionally to clear my throat. But I felt no uneasiness about the matter at that time, and never examined to see if there were any inflamma- tion. Six months later, which was about a year ago, I began to feel, during my afternoon sermon, some irrita- tion in the throat, extending down to about the top of the breast bone, with something like a raw sensation, which, however, would pass away during the evening. " In the course of the summer and fall my voice became more affected, although still not very decidedly, but as if I had a slight cold, and there was a deficiency in clear- ness when I attempted to sing. " I now scarcely ever have any sensation of soreness so low down as the top of the breast bone, but there is usually some feeling of that kind in the region of ' the apple.' There is a decided redness of the parts about the palate and of the back wall of the throat, with a decided roughness, especially of the latter, and an elon- gation of the uvula. There is a constant collection of phlegm, generally of a light color; of no great consis- tency, but sometimes having a nucleus of more sub- stance. The tendency to clear the throat by hemming or swallowing is quite decided and frequent, but not painful nor very troublesome. There is no soreness in swallowing, nor any difficulty in ordinary speaking. I 256 BRONCHITIS AND KINDRED DISEASES. can go through one preaching service without incon- venience, excepting a slight hoarseness towards the close, which remains through the rest of the day, but is not felt the following morning. So long as I practiced the indulgence of a second service on the Sabbath, which was until about six weeks ago, I found that the effects of that second service were a decided increase of the hoarseness, and some soreness felt in speaking towards the last. " I have only occasionally been troubled with a dry tickling in the region of the voice organs, and it has then been only of a few moments' continuance. There is a redness in the tonsils and in the parts a little an- terior as well as behind them. The uvula does not oc- casion cough or tickling, or other uneasiness, except a very, slight sensation when the parts are at rest, as if something were resting there. I have a decided tendency to costiveness, and usually there is something of a bad taste in the mouth on rising, and sometimes to a considerable degree. Seldom any unpleasant feeling at the pit of the stomach." Within two months this gentleman was able to con- duct a service of an hour and a half without any felt in- convenience, and I considered him able to preach daily to advantage. THROAT-AIL NEGLECTED. " C. C. C, aged 40 years, married at eighteen, five chil- dren, delicate constitution naturally, but never had any seated disease until two and a half years ago, when I was first slightly troubled with a sore throat, this conti- nued month after month; a slight cough came on; after several months I found that when I had been silent for sometime, I could not speak without moistening my ASTHMA. 257 throat with a little water. Shortly after I raised a small quantity of blood, and generally had a severe coughing spell night and morning, but never at all through the night, and very little through the day. These symptoms continued the same until ten months ago, when I had in May another attack of spitting blood, which has since become more frequent, until at present I expectorate blood mixed with heavy yellow matter. Now my cough troubles me through the night. The phlegm raises very easily, almost without an effort, it is dark and greenish, gummy and heavy. My bowels for several months are much relaxed, and there is a feeling of weakness about them. Have had night sweats at times for six months, and have them now towards morning. I have pain and weakness in my limbs; a little fever sometimes. Have been quite irregular for a year, with a great deal of pain in both breasts and sides, changing often, except that in the centre of my breast from the throat down, where appears to be the seat of my disease, and often when I cough, the soreness flies from that point to both breasts. My stomach is weak; the food sometimes sours, and is thrown up." Such is the description of the commencement, pro- gress, and termination of a slight affection of the throat. Slight indeed at first, but terminating in two years in the decaying stages of consumptive disease. ASTHMA. Its great distinguishing symptom is a difficulty of breathing, coming on at various intervals of days, weeks, months, years. The air is in the lungs but can't get out, swelling, distending, and causing an intolerable feeling of oppression of suffocation. The sensation arising 258 BRONCHITIS AND KINDRED DISEASES. from not getting fresli air into the lungs and that which is caused by not getting it out is the same. It is a smothering. A sense of suffocation ; of impending death. Of this, Whitfield died. A fit [of asthma usually comes on about midnight, from eleven to two o'clock. The patient is aroused from sleep with difficult breathing, and a most distressing feeling of tightness across the breast which impels him to sit upright in bed, the head leaned forward, the arms stretched out, the shoulders raised, the mouth open, the eyes protruding, the breathing heavy, loud labored and wheezing, the feet and hands cold, and of a deadly damp- ness. The patient speaks by signs or in monosyllables. He feels as if he could not spare the time to utter the shortest word. He has not breath to do it. The at- tempt to do so in a severe attack, would in reality al- most kill him. A very strong lunged man may count a hundred above his breath, but it wearies an asthmatic more to speak a single word. Showing that at the time he is living upon a hundredth part of air less than a per- son in health, of course relief or death must take place in a very few hours. While an attack is present, a most distressing cough comes on, dry and harassing at first beyond description; but it cannot be controlled, although it is worse than having to talk, and with a desperate energy all the strength of the system is summoned to the effort, but when once begun, there is no stopping it, and at last with the most inconceivable and utter prostration the patient falls down in hopeless helplessness, scarcely knowing whether death or life is to be the issue of the next moment. When death does not take place, the symptoms begin to abate about two o'clock in the morn- ASTHMA. 259 ing, by free urination and by the phlegm which caused the cough and which prevented the pent up air from pass- ing out, loosening a little, then more and more until large mouthfuls are expectorated at a time, and by early day light the patient is sound asleep. At length he wakes up, spends the day in comparative comfort with the prospect, however, of a similar night, but not so violent, the attacks become more and more moderate until the patient regains his usual health, and in a few days after, one would not suppose any thing had ever been the matter with him. And thus he remains until a fresh cold, a torpid liver, constipated bowels, or over feeding calls him to a new reckoning, and the bill, the penalty, like a bank notice, " must be paid." I consider asthma as an incurable disease. That is, incurable by artificial means. Children who have it sometimes grow out of it. It sometimes wholly disap- pears during the marriage state. At the " turn of life " in women it occasionally leaves the system, not to return. When I say that asthmatic disease is incurable, I mean only that the system will be always liable to an attack. A fit of asthma cures itself generally. Like a common cold, it runs its course just as measles or small-pox, if nothing is done until it is fully established. But if attacked in the very beginning of its onset, asthma, like a common cold, can be cut short off. Persons subject to asthma have generally some feeling a day or more beforehand, which warns them of its approach, and if proper means are at once employed, the attack is almost, if not entirely forestalled. But when the person delays, in the hope that it may not come on, that it may pass off of itself, as it sometimes does, but not generally, 260 BRONCHITIS AND KINDRED DISEASES. then they have to suffer, and sometimes die for their inattention. All persons are liable to take colds as long as they live ; that liability may be very greatly diminished, but never can be wholly got rid of. In the same manner an asthmatic person will be always liable to an attack of asthma, but, as in the case of a common cold, proper care and attention, and habits of life, will indefinitely postpone both. In this sense only is asthma curable—it may be indefinitely postponed. By regulating the gen- eral system, by using means to make it less susceptible to taking cold, by suitable attentions to the skin, the feet, the condition of the stomach, liver and bowels, a person who is liable to an attack every few weeks may not have one in five years. This I have succeeded in doing wherever a patient is found willing to use sys- tematic efforts fbr the accomplishment of the object. There is one form, which may be called Chronic Asthma, not amenable to remedial means. It is a kind of perpetual asthma, seldom very violent, never wholly absent. The person always feels stopped up or bloated. Such patients are generally of full habit. They are always taking cold or getting bilious; constipation, snuffling of the nose, discharges of" thickish stuff" from the nose and lungs; tongue furred, dry, whitish, or of a red or yellow tinge; no appetite, even a loathing of food. In the intervals of a cold or biliousness these symptoms are .not present, except in part and to a slight extent; but all the time there is a distressing breath- lessness. Going up a few steps, walking a little fast, causes them to pant for breath; and often in walking along the street at a moderate gait, they are compelled to stop to get breath. Looking so well all this time, DYSPEPTIC SYMPTOMS. 261 and not being willing to be considered invalids, they employ themselves in looking around while thus pant- ing to get breath, as if they were expecting some per- sons, or were examining an object at a distance. This is a most distressing affection, because it is always present in a greater or less degree, and is aggra- vated by so many slight causes. Much may be done to mitigate this form of asthma, and make it bearable, but it lasts with life. It may be of some satisfaction to the asthmatic to know that it does not destroy life soon, except now and then. Usually asthmatic persons live to the age of fifty and sixty years or more, with good health between the attacks. It is generally an inherited disease, not always. Asthmatic people do not die of consumption, at least I have never known a well authenticated case of the kind. Consumptive persons usually recover when asthma supervenes, provided there is no serious disease in other important parts of the system. I consider asthma cura- tive of consumption. In consumption the air cannot get into the lungs, in asthma it cannot get out in quan- tities sufficient to answer the purposes of health and life. A NEW CLASS OF CASES. Applications are made to me by persons who have one or all of the following three complaints: 1. Some slight affection in the throat; 2. Cough more or less troublesome ; 3. Pains of various kinds and degrees about the chest. But in connection with one or more of these ailments, which indeed are slight of their kind, there are symptoms of another character more or less annoying, far more dis- 262 BRONCHITIS AND KINDRED DISEASES. tressing than the three first named. I will name and number the more prominent of these symptoms, not meaning that any one person has them all at one time ; but the most of them are present in the course and pro- gress of the disease, with varied degrees of aggravation. 1. Feet uncomfortably, painfully cold. 2. Pit of stomach has a raw, burning, sore or heavy feeling. 3. Spirits more or less depressed all the time. 4. Frequent feeling of chilliness. 5. A sensation of discouragement. 6. Oppressed with forebodings of the future. 7. Difficulty of mental concentration. 8. Pain or weakness in small of back. 9. Swelling or tight feeling over the stomach. 10. Great thirst, causing fullness or oppression if satis- fied. 11. Food sours in the stomach. 12. Pure water causes sourness sometimes. 13. Food is sometimes retched up or spit up. 14. Distressing gnawing or sinking at stomach. 15. Frequent sensation of sinking or faintness. 16. Alternate flushing and chilliness. 17. Disposed to sweat on falling asleep. 18. Wandering, shifting pains all over the body. 19. Burning spots on top of head, shoulders, back and elsewhere. 20. Sleep restless, unsound, unrefreshing. 21. Disturbed by disagreeable dreams. 22. Bad taste in mouth of mornings. 23. Lumpy feeling in throat and at edge of the ribs. 24. Burning feeling in throat or along breast bone. 25. Great deal of wind on stomach. DYSPEPTIC THROAT-AIL. 263 This long array of symptoms arises from a single form of disease, and are often complicated with slight affections of the throat and lungs, and strange as it may appear to the general reader, I look upon such cases as more hopeful of cure than when the lungs or throat alone are decidedly affected, inasmuch as other parts of the body divide the violence of the disease with the lungs. Sometime ago I saw a tall spare gentleman, 1104, aged 38 ; had been ailing fifteen years ; symptoms became gradually worse until he had to give up his business, and when I saw him he had been confined to his home for some weeks, not being able to go from one room to another without discomfort, causing cough, chilliness, fatigue. He had constant night sweats, great constipation, unsatisfying sleep; large expectoration of whitish mucus, and greenish yellow thick matter; cough- ing it up day and night, a tcacupfull perhaps in twenty- four hours; appetite variable and poor; pain, heaviness, weight, load in stomach all the time; pain in the fore- head, temples, between the eyes, aching of the limbs, great thirst, extraordinary chilliness, pulse weak and very rapid, spirits depressed, had fallen away very much. This was certainly a formidable array of symptoms, but considering their character and connection, I ex- pressed an opinion that there was greater hope of arrest- ing the progress of the disease than if the lungs only had been affected. I saw him next, fourteen days after my first visit. His appetite was regular and good; his sleep satisfac- tory ; constipation removed, night sweats entirely gone, walked half a mile out of doors daily in March, with comfort and advantage; expectoration entirely changed, and cough very much abated, although nothing had 2()4 BRONCHITIS AND KINDRED DISEASES. been done expressly for it, and the only remnant of pain was in the stomach, and even that was almost entirely gone, and the future looked hopefully bright. So much for having a disease divided, and entering courageously upon a course of treatment, however nu- merous may be the symptoms. But let not the reader imagine, that with similar symptoms, he would derive a like benefit, and so speedily. Such an improvement does not take place sometimes in the practice of months. In many cases not at all, much depending on the energy of the patient, the facilities of good nursing, and affec- tionate, willing attentions. And particularly do I -wish the same thing to be understood in reference to all the cases of remarkable improvement and restoration which have been already given. The vast majority of cases, when they do get well at all, do so by slow degrees, through various drawbacks, hindrances and discourage- ments ; and at a great expense of time, of patient atten- tion, and of energetic determination to follow implicitly the directions which are given from time to time. It is no child's task to get rid of diseases which have been burrowing in the system for years and years. A con- stitution which has for many months been subjected to a pulling down process, is not to be repaired in a day or week, or month, by a few drops or pills. If built up at all, it is to be done by a systematic effort, long conti- nued, to invite back the strength, to husband its re- sources, more by natural and safe means, than by un- certain and violent and frequent medicines. In such cases, physic is an occasional aid, nothing more. Let the invalid consider these remarks well, and repress all extravagant expectations of instantaneous effects, of speedy cures, unless he applies within the first month, UNSEEN EASES. 265 or two of the first appearance of his symptoms, then in- deed, but only then, may a speedy and permanent re- storation to substantial health be confidently anticipated in affections of the throat and lungs. • UNSEEN CASES. A large proportion of the persons for whom I have prescribed, I have never seen, or have seen but once. Perhaps the majority of the cases already given in these pages is of this character. Any one who fabricates an article from a pattern furnished, soon learns to work without that pattern. There is in the diseases to which this book is devoted a routine course of symptoms, a kind of family likeness. It is true, that scarcely any two cases occurring in a month, are in all respects the same; age, sex, constitution, habits of life, all modifying the symptoms, aggravating some, ameliorating others, but the great general, prominent, distinguishing features are similar, requiring a similar general treatment. In acute, in critical diseases, it is important that the physi- cian should see the patient daily, sometimes hourly; but in those of a chronic character it is widely different, as changes take place slowly, and are not of a speedily threatening character. The comforts, conveniences, facil- ities of home, very far outweigh any advantage to be derived from the daily inspection of a physician. And it is my hope that hereafter, as heretofore, by means of my general publications, and by private instructions adapted to individual cases, as their varying circum- stances may require, I may be able to place within the reach of many whom I may never see, the means of cure, and thus be of some little use, now and then, to the world I live in. It is certainly more satisfactory to first 12 266 BRONCHITIS AND KINDRED DISEASES. see a person desiring advice, and I prefer it, when it can be done without inconvenient expense, trouble, or ex- posure, but this advantage is often more than counter- balanced by the loss of time occasioned by persons making preparation to leave home, sometimes requiring weeks if not months, the disease in the meanwhile infix- ing itself more deeply, and now and then, in the delay, passing the Rubicon of life. Therefore when persons cannot come at once, the better plan is to place them- selves under treatment without delay, and make their visit at some more convenient season afterwards. The great fatality of throat-ail and consumptive disease, as in cholera, is in the delay of the proper attentions, and not in the nature of the ailments themselves. This senti- ment should never be forgotten. TUBERCLE. I am anxious to compensate the reader for any time he may have expended in perusing this book, although he may never come under my care. I think I may do so by divesting him of some of the terror of tubercles under which he may very possibly suffer. Many per- sons seem to think, that if they have tubercles on the lungs, death is inevitable. It is true, that tubercles are the seeds of death, but in a qualified sense. They do not always spring up. They must soften, ripen and rot, else they may exist in the lungs for life without doing any appreciable injury. They are made to decay by a succession of bad colds, by long continued weaken- ing sickness, or discharges from the body, by riotous living, by irregular practices and habits of life, by for bidden indulgences. These things can be avoided by all, and to those who have the strength of will to avoid TUBERCLE. 267 them, tubercles have no terrors. Health is a duty : a duty which all can perform. Perhaps there is not an exception in a million. Let the reader discharge that duty by avoiding what I have named, and in addition by practicing regular, systematic habits of life, studying and striving to be temperate in eating, in drinking, in sleep- ing, in exercise, in business; maintaining a quiet, steady, unanxious, ungrasping, cheerful frame of mind : these are antidotes to tubercles; under their influence tubercles can never ripen, it is a medical impossibility. Tubercles attack various parts of the body, each part giving a different name to the disease. Tubercle in the lungs, is consumption. Tubercle in the neck, is king's evil. Tubercle in the joint, is white swelling. Tubercle in the back bone, induces spinal disease. Tubercle in the hip joint, is hip disease. Tubercle in the loins, is lumber abscess. Tubercle in the abdomen, or rather in the mesenteric glands, is called in the South, Negro consumption, the proper name is Tabes Mescntcrica. It causes death by the glands of the abdomen hardening and preventing the nutriment which is derived from the food, from passing into the general circulation, hence such persons waste gradually away to skin and bone, painless and without cough or expectoration often, to the very last hour. Tubercle in the bowels is a frequent cause of chronic diarrhoea, especially in high livers, such as cat high seasoned food, and drink freely of wines and stronger liquors. Such usually die in the prime of life, which ought to be between fifty and sixty years of age. It is almost always fatal. 268 BRONCHITIS AND KINDRED DISEASES. Tubercle in the lining of the nostrils of a horse, is called "glanders." Tubercle in the brain causes symptoms varying ac- cording to the locality of their deposite. Miss Ophelia W—, a young lady of rare excellence of character, and of great mental promise, was attacked with this fatal form of disease. Her first symptoms were extraordi- nary mirthfulness and talkativeness, succeeded by a dis- tressing silence for weeks together, and an expression of countenance so desolately sad that it was painful to con- template it. And thus she died in her nineteenth year. For this disease there is no remedy. Tubercles are not necessarily fatal or even appreciably injurious in the lungs, for in numberless instances they remain dormant for life. In fact, few persons die after forty years of age of any disease, in whose lungs are not found tubercles which have remained innocuous. It is only when made to soften, ripen, and cause destructive decay by repeated bad colds and weakening diseases, that they become so ruinous to human life. Nor does it follow that their softening must necessarily destroy life, it is their nature, like that of a common boil, to soften, increase, turn yellow, burst, discharge, and then heal up, as it does in innumerable instances in the lungs, in white swelling, in king's evil; and the scientific me- thod of conducting them all, is to treat them as a consti- tutional disease. Their nature is, when thus aided, like many other diseases, to cure themselves, and that they do so without any aid, spontaneously, no physician thinks of denying. But the misfortune is that nature is not let alone, she is thwarted at every turn, the invalid turns at once to medicine, to warm rooms, to bundling up the body, to forcing himself to eat, to repressing his TUBERCLE. 269 cough, to torturing his body by all sorts of contrivances, tiring some muscles, over-straining others, forcibly con- straining a third class, and interfering with the circula- tion of the whole, for it must be apparent to the least thinking reader, that if one spot of the body is pressed upon, the blood is kept from flowing through that spot, it stagnates there, and instantly there is a tendency to putrefaction ; water itself becomes putrid if it is kept from motion, and so with the blood, and one drop of blood being tainted, aids that much towards tainting the whole mass, and thus it is that as far as the lungs are concerned, braces of every description must under all conceivable circumstances be injurious in their tendency. Tubercle and cancer are much alike, both begin by a hard lump, both are separated from depraved blood either by exudation, deposition, or secretion, the great difference is two fold. Cancer is organized, living; tubercle is unorganized, lifeless. Cancer cannot but be fearfully painful. Tuber- cle may be painless. Tubercle and cancer are not the beginning of the disease, they are the result of depraved blood. Consumption begins in reality before tubercles are deposited, and of course before cough commences, and it is before there is any cough, before there is any tubercle, that consumption is to be most confidently at- tacked, and then its arrest and perfect cure is as certain as imv thing can be. The question then arises, how can the existence of consumptive disease be discovered in these impalpable beginnings? Imperfect circulation of the blood; Imperfect respiration of the air; These both must and do always exist for some time, before the blood becomes impure, before the tubercle is 270 BRONCHITIS AND KINDRED DISEASES. deposited, before the cough takes place, before softening occurs, &c. The pulse and the breath must therefore be watched over. But there is no invariable rule for the pulse, some persons seem to have good general health with a pulse of fifty in a minute. I recently received a letter from a gentleman saying, " My pulse formerly averaged sixty-eight beats in a minute, but in 1847, in a passage from Hong Kong to Amoyin China, feeling a little un- well, I found it to be forty-five, at which it has conti- nued ever since, full and strong, and my general health is good." On the other hand persons may be in good health with a pulse which beats eighty times in a minute; but these are both exceptions; as a very general rule I do not feel satisfied if the pulse is over seventy-two; from sixty-eight to seventy-two is the general number of per- sons in the enjoyment of substantial health, and of the two, I feel safer to have it sixty-eight in men of mature age, and two higher in women. The pulse then being variable, there is no standard in reference to health of unvarying applicability. It must therefore be taken in connection with the breathing, not as to the number of respirations in a minute, for although grown persons in good health breathe about eighteen times in a minute, yet good health may be present at any number from fourteen to twenty-two, but any num- ber over eighteen, is suspicious. The pulse and the breathing should be taken when the person has been sitting quietly some half an hour, and not within two hours after eating a regular full meal, for motion and digestion excite both the pulse and the breathing. A person can never accurately time his own breathing, for A GENERAL RULE OF HEALTH. 271 the moment his attention is drawn to the subject it be- comes unnatural; it must therefore be counted by a second pecson when the subject is wholly unconscious that the observation is being made. A good general rule of health is when the breathing multiplied by four, gives the pulse of the same indivi- dual. Thus a breathing of seventeen in a minute, gives sixty-eight pulsations in a minute. But when the mul- tiplication exceeds eight}', there is danger. The number of pulsations and the number of respirations per minute, being different in different persons without impairing the health under certain limitations, that is, not over eighteen and seventy-two, the action of the lungs must be estimated in some other way which is uniform, which has one standard to every class of circumstances. Spirometry meets these conditions, and with the pul- sations and respirations, constitutes an unfailing test. It is therefore that I consider it one of the most valuable ideas of modern medicine. As previously explained, it is the measuring of a man's breath. The common sense and ingenuity of the people has led them to experi- ment on the best method of doing this, and to conclude that those men are not likely to die of consumption who have large chests. Why 1 Because the larger the chest, the more lungs, the more air. The same remark is made of good runners, good divers, of those who can count a hundred audibly at a single breath, holding the nose all the time, with the thumb and finger, and being careful not to draw in more breath through the lips during the experiment. Others have made the measure- ment by competition as to who could blow out a candle at the greatest distance. A person who can blow out a candle fairly burning, not near a wall, at the distance of 272 BRONCHITIS AND KINDRED DISEASES. thirty inches between the candle and the mouth, may be said to have a good pair of lungs. But all these are only approximative, something is due to tact, something more to practice, and after all there is an unsatisfactory indefiniteness. In spirometry these objections do not apply. It is a mathematical measurement designated by figures,, which answer to a certain set of conditions. The amount of air capable of being expired from a man's lungs is accurately measured to a single cubic inch or half inch. Different persons require a different amount of air, but these are regulated by nature herself, who modifies them by certain fixed proportions. Sex. Age. Breathing. Pulse. Height. Weight. Capacity. Male 40 17 68 6 feet 140 262 These seven correspondences occurring in one man, are unfailing indications of the full healthful condition of the lungs, and when the pulse and breathing are steadily over these and the capacity is under in such a man for a month or two, or .more, then are the founda- tions of Consumption being laid, and infallibly so as far as my experience has gone. But these three deviations are seldom if ever alone. Notes of alarm are sounded in other parts of the empire of life. Some two or three, or more of the forms of ailments named on page 262, are present in a degree more or less decided, some short- ness of breath, some weakness in legs and knees in as- cents, a little decline in flesh either in weight or firm- ness of feel, some tendency to chilliness not usual, a growing susceptibility to take cold ; sleep not as satis- factory as it used to be; not that substantial relish for food as in other years, and not as perfect comfortable- ness after meals; perhaps the skin is dry, or there is a EARLY INDICATIONS OF CONSUMPTION. 273 feeling of feverishness at times, a bad morning taste, and a whitish or rough tongue. I hope the reader will not misunderstand what I have said. The last symptoms enumerated are of themselves no more the sign of founding consumption than they are of a north-wester, for if they were let alone, and every atom of food were let alone for a day or two, they would in myriads of instances disappear of themselves. They must be in connection with a wrong condition of the pulse and breathing and lung measure- ment. And more, these things must co-exist for weeks together, if not months. What I mean to say is this: that if these circumstances are present in a marked de- gree all the time, for two or three months, then is it as certain as any thing else in medicine is certain, that such a person is inevitably falling into consumptive disease, unless mild, moderate, safe and continued means are taken to correct these conditions and eradicate the causes of them. And it is to the detection of, and attention to these early indications of approaching consumption that all my published efforts are directed. And if I can only succeed by these efforts, continued for a life time, in securing an early attention to these things on the part of any considerable number of my countrymen, then shall my own decline towards the grave be cheered with the reflection that I have left a useful mark behind me. For it is impossible of denial, that if these things were properly regarded in their beginnings, Consumption would be a rare disease, instead of being so common, that perhaps never an eye shall trace this line which shall not one day fill with tears by reason of the ravages of this same universal scourge. I have no sympathy with those, who hold out induce 12* 274 BRONCHITIS AND KINDRED DISEASES. ments to the common multitude, that by their medicines, their contrivances, or their skill, the cure of fixed Con- sumption is an event of common occurrence, for in any given case it is possible, not more; while it is in the highest degree probable in any given case, that such case will die, and that at no distant day. A cure, that is, a permanent arrest of unmistaken Consumption, ought in all cases to be striven for, resolutely, hopefully, to the last day of life, |2§p" but assurance of probable success in any instance is a wrong done to a weak and trustiitg fellow man. CLUSTERS OF TUBERCLES. I here give the reason for the statement just made, that the permanent arrest of consumptive disease in its advanced stages should be always striven for to the last. To a person in actual Consumption, what I am about to say will afford more solid, rational comfort and encour- agement than will repay him for the trouble of reading this book. And knowing as I do the full truth of the statements, and which too will be corroborated by any intelligent physician, I will make them in a manner not capable of misapprehension, every word has its full natural meaning, there are no mental reservations, nothing to be " understood" in the sense of the agree- ments of nominatives and verbs, so inscrutable and per- plexing to the young grammarian. I wish to direct very special attention to these remarks in reference to Consumption, since many have been hastily abandoned, and have died in consequence of their neglect, who otherwise might have lived. A person never dies from a first or single attack of Consumption. Persons generally get well of one, two, CLUSTERS OF TUBERCLES. 275 three, or more attacks of this disease; but each attack weakens and impairs the constitution, and these contin- uing to follow one another, there is at length a wreck and ruin of the whole. I mean by an attack of Con- sumption, as follows: From causes previously named, tubercles, which may be termed the seeds of Consumption, form about the lungs : not over the lungs generally, but in small patches or clusters, as large as a half dime piece, and many times larger; between these patches the lungs are healthy and sound; these patches of tubercles would produce no inconvenience, if they did not ripen; that is, enlarge, turn yellow, and run together a liquid mass, as small shot if laid side by side on a shovel in the fire, will run together, when melted. When this ripening process commences, by the tubercles beginning to increase in size, preparatory to softening, the person begins to cough more, and he thinks he has taken a fresh cold; as the mass becomes more liquid, it moves more or less by change of position, or by the air, in breathing, passing through it; this motion causes it to act, as any other foreign body would act in the lungs, a crumb of bread for example; that is, produces a tickling sensation, which causes irrepressible cough; this cough is an effort of nature to rid the lungs of this foreign, irritating, inflam- ing substance; it is an effort of nature to cure the patient; as soon as it is all out, the cough subsides, and the pa- tient begins to get well; just as a boil begins to get well when all the matter is removed from it, and never before. Tubercles ripen in spots, as berries do in a berry patch. But, unfortunately, no sooner is the patient rid of one ripening process, feels better, and begins to hope anew, when another cluster begins to ripen, and the same pro- 276 BRONCHITIS AND KINDRED DISEASES. cess has to be gone over again; and thus it is in cease- less succession for months and even years sometimes, until the poor suffering body is wearied and worn to a skeleton, and death at last ends the tedious conflict. This is the case where there are a number of clusters of tubercles, in different parts of the lungs. But some- times, from causes unknown to us, there is but a single cluster, while the lungs are in every other part perfectly sound. In a case like this, a person goes through all the symptoms of regular Consumption, more or less violent, according to the size of the patch, and strength of his constitution; and when the last remnant of matter is coughed up, the cough ceases, the system gets repose, gains strength, and the man gets permanently well, be- cause there is no other cluster of tubercles to carry him through a similar process. The most of constitutions are able to go through several such attacks; any one, on reflection, will find that those whom he has known to die of Consumption, did not do so until they had gotten better and worse many times, and the appearance of the lungs after death confirms this view of the case. From this we may see the propriety of resolutely bat- tling with Consumption to the very last, in the hope that each may be the last cluster to contend with ; for very often, even if a final cure is not effected, a year or two more of life is added, in a considerable degree of health- fulness and comparative enjoyment. And although I would not say anything to excite strong hopes of life in a person who is already confined to his room and bed from Consumption fixed in the system, yet what has been stated in reference to clusters of tubercles, should not be lost sight of, as the following case will show, taken from the London Lancet, p. 185, March 1852, giving a report CLUSTERS OF TUBERCLES. 277 of a medical lecture by T. Thompson, M. D., F. R. S., where the patient having all the prominent marks of Consumption in May, 1848, was treated accordingly, and to all appearance was cured, and remained so for two years, when she died of bilious diarrhoea. There was naturally a strong desire to see her lungs, to decide whether she did really have Consumption, and whether or not the disease had been permanently arrested. The lungs were taken out and carefully preserved by Dr. Quain, in London, and may now be seen at any time as " an example of what in conventional language may be termed a ' cure' of Consumption in the third stage." The full account is given in the " Transactions of the Pathological Society for 1851-2." The lungs have five lobes or divisions, three on the right side, two on the left; nearly the whole of the upper lobe of the left lung was destroyed by tubercular disease, but it was so con- tracted as to present a cavity about the size of a large walnut, containing about half a teaspoonful of a whey- like fluid. The left lung displaced nine inches of water, while the right lung displaced twenty-three inches. This shows how large a portion of the lungs may decay away, and yet recovery may take place, and good health be enjoyed. Giving ocular proof, as Dr. Quain observes, " of the great extent to which the ravages of Consump- tion may extend, and yet be stayed." The whey-like substance contained in the cavity, is in the nature of a lubricant thrown out by nature to keep the parts from becoming rigid and dry, and which may keep up through life, in persons who have been cured, some cough and expectoration, which in such a case are of healthful tendency. 278 BRONCHITIS AND KINDRED DISEASES. The reader has perhaps had opportunities of noticing in his own sphere of observation, proofs of the fact stated above, that persons do not die of first attack of Consump- tion, in dialogues of this kind: ' How is such an one 1 He is quite well now, but sometime ago we thought he was going into a decline.' Such cases are where -the cluster of tubercles was single, and limited ; they softened, decayed away, emptied by cough and expectoration, and a little fever or hectic; a cavity was left, which being small, soon healed up, and health was restored; and dozens of such attacks may occur before the lungs are sufficiently impaired to cause loss of life. Therefore It is rational and right to make determined and hopeful efforts to arrest Consumption in every stage. TUBERCULAR DISEASE HEREDITARY. Consumption, scrofula, insanity, are hereditary dis- eases, as much so as peculiarities of constitution or per- sonal appearance. " A peculiar thickness of the under lip has been hered- itary in the imperial House of Hapsburg, ever since the marriage, some centuries ago, with the Polish family Jagellon, whence it came. The thick and hanging under lip, is in this case, alike the sign of royalty and animalty, all such persons being dear lovers of the good things of this life, especially of good eating. In the English royal family a fullness of the lower and lateral parts of the face is conspicuous in the portraits of the whole series of sovereigns, from George I. to Victoria, and has been equally marked in other members of the family. The females of the house of Gordon have long been remark- able for a peculiarly elegant conformation of the neck. The Clackmannanshire Bruces, who are descended from TUBERCULAR DISEASE HEREDITARY. 279 a common stock with the famous Robert Bruce of Scot- land, are said to have that strongly-marked form of the cheek bones and jaws which appear on the coins of that heroic monarch, as it did in his actual face when his bones were disinterred at Dumfermline, about thirty years ago. The prevalent tallness of the inhabitants of Potsdam, many of whom are descended from the gigantic guards of Frederick I.; the Spanish features observable in the people of the county of Galway, in which, some centuries ago, several Spanish settlements were made; and the hereditary beauty of the women of Prague, are well-known facts which have frequently attracted the attention of chronologists. The burgesses of Rome (the most invariable portion of every population) exhibit at the present day precisely the same type of face and form as their ancestors, whose busts may be seen carved in relief on the ancient sarcophagi; and the Jewish phy- siognomies portrayed upon the sepulchral monuments of Egypt are identical with those which may be observed among modern Jews in the streets of any of our great cities." The great mass of consumptive persons inherit it from their parents: from fathers who were impregnated with disease before marriage; from mothers who never had any constitution, having been brought up to do nothing but read novels, lounge about and eat during the day, and spend their nights in crowded, heated rooms; who were guiltless of ever having used a broom, or baked a loaf, or broiled a steak, or arranged their own rooms, or darned a stocking, or made a dress; but who would sit by the hour and allow a mistakenly loving mother of twice their age, wear out her life in doing these same things for her, while she is doing nothing for herself but sowing 280 BRONCHITIS AND KINDRED DISEASES. the seeds of a blasted constitution which is to make her a puling invalid for life, not however to ' break out' until a short time after marriage, when having no stamina of constitution, she dies in her first confinement, or lives along only to give birth to a degenerate, effeminate race, who live a brief day of pain and sickliness and suffering, and die before they pass their " teens," or very soon after. But there is even a worse picture than this to be drawn from the actual life of these frail scions of a better stock. In many instances there is not stamina enough for re- production, as if nature, with instinctive providence, stepped in to save the race. Soon after marriage, if not revealed before, ill health appears. This renders the young wife unfit to discharge her domestic duties ; some one must be obtained to supply her place, as she now has no affectionate mother "to slave" for her. In addi- tion, the young husband is naturally disquieted at his wife's suffering from sickness, his attention is drawn away from his business, a physician is called in, and a yearly bill is the consequence. These different items become a serious drawback on a young man's income. He begins to see that he is not laying up any thing, next, that it is as much as he can do to make " both ends meet." He now begins to think that he is spending the prime of his life to no purpose, and for the first time the terrible reflection flits across his mind, " It is not worth while for me to attempt to get rich." Then he's lost! When once a young man is discouraged from his ambi- tion to be rich, I say he is lost—that is, lost to high purposes, to manliness, to eminence, position, influence. A few, it is true, are content to live along, without plung- ing into deeper depths, but the majority, perhaps the TUBERCULAR DISEASE HEREDITARY. 281 great majority, losing their ambition, other greater losses follow, of pride, of self-respect; then comes the want of excitement, to be gratified by other leaks from the income,—the theatre, the circus, the negro songs, the society gatherings, the porter bottle, the lager beer, the gin sling, the brandy to-day, and the drunkard's grave. And all this from having a sickly young wife, made sickly by being brought up to do nothing, at the expense of a mother's life-long slavery. This is not imagination. It is an uncolored picture of a sad reality. My practice brings me in contact with persons whose histories are similar to the sketch I have given, so much so, that in being counselled as to the proprieties of mar- riage on the part of that worthier class of young men, who have to depend on themselves in the world, it has been a standing advice: Of two young women, one of a pale, frail look and form, with ten or twenty thousand dollars, the other with nothing but a strong healthful body, and a will to work, by all odds take the latter, for should they both live fifteen or twenty years, the former will spend and be a drawback to more than the amount she brought, while the latter will save, if indeed she does not do something towards making that amount, with the infinite difference between a family of puny, sickly, complaining children, and one of cheerful, hearty health- fulness. For aside from criminality, no more poignant pain pierces a parent's heart than to see a darling child suffering from a diseased body, to know and feel that for life long it must painfully strive in a hard world, where it is often a struggle for subsistence even with good health, but to have to engage in these struggles in a body of pain and feebleness, and suffering, what parent's heart can contemplate it without the saddest of all emo- 282 BRONCHITIS AND KINDRED DISEASES. tions ! Therefore, if the reader wishes to have no part nor lot in fathering upon society a family of children whose constitution is blasted at the root, let such reader make health a personal duty, and take care also, that the companion for life have substantial health and good principles, if nothing else, not even a penny's dower, not a second coat. Consumption and insanity, and idiocy are transmis- sible : are given to the children by the fault of the parents. And it is a fearful fact which statistics verify, that more than two-thirds of all idiotic children are born of parents, one or both of whom would get drunk. No man is so perfectly like a fool as when he is completely drunk. At such times the animalties of our nature are rampant, and the type of " fool" is indelibly fixed upon the future being. This does not happen to the habitual drunkard only. It happens in the act, if either parent had never been drunk before, and should never be drunk again. By all the holy considerations of a parent's na- ture, let this fact be never forgotten through life. FOOD. As the preservation of health, and recovery from all forms of disease have inseparable relations with what we eat, several tables of food are given for reference. Food, its Digestibility, Nutritiveness and time re- quired for its Digestion. The following table is one of very general interest and utility. The food easiest digested, does not always contain the most nourishment; nuts, for example, and oils are more nutritious than boiled rice, yet the latter is digested in one hour, while the former require several hours. Food which is most nutritious is marked the FOOD. 283 highest; wheat, for example, is marked ninety-five, be- cause out of one hundred parts, ninety-five, that is, 95 per cent, of it is taken up by the nutrient vessels, and applied to the nourishment, and support, and strength of the system. The article of food most difficult of digestion, is marked one, the "easiest, one hundred. For the table giving the time, in which food is digested, the world is indebted to Dr. William Beaumont, of St. Louis, .Missouri, to whom was allowed the rare opportunity, never thus afforded to man, before or since, of looking into the stomach, while digestion was going on, watching its progress from hour to hour; hence his statements are taken for granted by all eminent medical writers throughout the world. The orifice, which is still open, was made in the stomach of Alexis St. Martin, who is yet living, on the sixth of June, 1S22, by the accidental discharge of a musket, loaded with powder and duck shot. Dr. Ueaumont has informed me that it was his inten- tion to visit St. Martin in Canada, and make further ex- periments. The lovers of science throughout the world and throughout all time, would be laid under still greater obligations to this gentleman, if he fulfils his intentions, for a thousand years may pass without repeating the rare opportunity. In the following table the digestibility of oils, means the time at the end of which they pass out of the stomach. Boiled rice and soused pigs' feet being the easiest of digestion, that is, soonest prepared to leave the stomach, are marked in the last column, one hundred; they are digested in the shortest time, that is, one hour. While fresh beef suet boiled, requires five hours and a half. 284 BRONCHITIS AND KINDRED DISEASES. TABLE OF FOOD.—No. 1. Mode of c o ss o 0>"3 preparation. is #3 Q- boiled 3 33 raw 2 50 do. 2 50 35 do. 1 50 54 boiled 2 50 broiled 3 33 boiled 2 30 41) do. 3 45 20 roasted 3 33 do. 3 30 28 broiled 3 1 boiled 2 45 do. 3 30 28 fried 4 25 boiled 4 15 23 do. 3 45 20 do. 1 45 57 baked 3 15 30 do. 3 30 2rt melted '3 30 28 raw 2 30 41) do. 2 50 boiled 4 30 22 baked 3 33 do. 2 30 4U boiled 3 15 30 do. 4 15 23 fried 3 30 28 raw 3 30 28 fricassed 2 45 3(3 boiled 2 50 do. 3 45 20 baked 2 45 30 roasted 4 25 do. 4 30 22 boiled 3 33 hard boiled 3 30 28 soft boiled 3 33 fried 3 30 28 roasted 2 15 44 raw 2 50 whipped 1 30 m fried 3 30 28 boiled 4 25 roasted 4 25 boiled 230 40 roasted 2 30 40 fried 4 2b boiled 2 30 40 Aponeurosis............ Apples, mellow......... Do. sour, hard...... Do. sweet, mellow.. Barley................. Bass, striped, fresh...... Beans, pod............. Do. and green corn.. Beef, fresh, lean, rare... Do. do. do. dry.... do. steak........ with salt only___ with mustard, &c. Do. Do. Do. Do. Do. old, hard, salted... Beets.................. Brains, animal......... Bread, corn............ Do. wheat, fresh — Butter................. Cabbage, head......... Do. with vinegar. Do............... Cake, corn............. Do, sponge...... Carrot, orange......... Cartilage, gristle....... Catfish, fresh.......... Cheese, old, strong..... Chicken, full grown--- Codfish, cured dry..... Corn (green) and beans. Custard............... Duck, domesticated.... Do. wild............ Dumpling, apple....... Engs, fresh............ Do. do............. Do. Do. Do. Do. do....... do....... do....... do....... Flounder, fresh.. Fowls, domestic. Do. do. Gelatin.......... Goose, wild...... Heart, animal..... Lamb, fresh.. . TABLE OF FOOD. 285 TABLE OF FOOD.—No. I.—Continued. Liver, Beef's, fresh............... Marrow, animal, spinal........... Meat and Vegetable!............. Milk............................. Do............................. Mutton, fresh.................... Do. do..................... Do. do..................... Oysters, fresh.................... Do. do.................... Do. do.................... Parsnips......................... Pig, sucking..................... Pig's feet, soused................. Pork, fat and lean............... Do. recently salted............. Do. do. ............. Do. do. ............. Do. do. ............. Do. do. ............. Potatoes, Irish.................. Do. do................... Do. do................. Rice........................... Sago............................ Salmon, salted.................. Sausage, fresh.................. Soup, barley.................... Do. bean...................... Do. beef, vegetables, and bread. Do. chicken................... Do. marrow bones............. Do mutton.................... Do. oysters................... Suet, beef, fresh................ Do. mutton.................... Tapioca........................ Tendon, boiled.................. Trlpo, soused................... Trout, salmon, fresh............. Do. Turkey, domestic........... 1)0. d»............ Do. wild.............. Turnips, flat............... Veal, fresh................. Do. do.................. Vegetables and meat hashed. Venison, steak.............. Mode of preparation. boiled do. hashed boiled raw roasted broiled boiled raw roasted stewed boiled roasted boiled roasted boiled fried broiled raw b tewed boiled roasted baked boiled do. do. broiled boiled do. do. do. do. do. do. do. do. do. do. do. do. fried roasted boiled roasted boiled broiled fried warmed broiled 1 1 30 1 30 2 30 2 25 2 18 3 30 4 4 30 3 30 1 35 286 BRONCHITIS AND KINDRED DISEASES. In the next table are found articles whose amount of nutriment is ascertained. That is, in one hundred ounces of roasted beef there is an amount of nourishment equal to twenty-six ounces. The use of the table is this, that as a general rule where persons are costive, they should use such food as has most bulk and least nutriment. TABLE OF FOOD.—No. 2. * I c 2 O ~ S'5 ° o KIND OF FOOD. CO ed o °J 3 = J3 OS W.5P o. < = h.m •o Almonds, raw, 66 Apples, do. 10 I 50 5 sweet and mellow. Apricots, do. 26 Barley, boiled, 92 2 5 Beans, dry, 87 2 30 4 boiled. Beef, ■oasted, 26 3 30 3 fresh, lean, rare—broiled is dig. Beets, boiled, 15 3 45 3 [in 3 h. Blood, do. 22 Bread, jaked, 80 3 30 3 warm corn bread, is easier of dig. Cabbage, boiled, 7 4 30 2 raw cabbage " " Carrots, do. 10 3 15 3 Cherries, raw, 25 Chickens, fricasseed, 27 2 45 4 Codfish, boiled, 21 2 5 Cucumbers, raw, 2 Eggs, whipped, 13 1 30 7 Flour, bolted, in bread, 21 do. unbolted, do. 31 Gooseberries, raw, 19 Grapes, do. 27 Haddock, boiled, 18 Melons, raw, 3 Milk, do. 7 2 15 5 digest in 2 hours if boiled. Mutton, roasted, 30 3 15 3 " 3 " broiled. Oats, oat meal, 74 Oils, raw, 96 3 30 3 Peits, dry, 93 Peaches, raw, 20 Pears, do. 10 Plums, do. 29 Pork, roast. 24 5 15 2 raw or stewed, digest in 3 h. Potatoes, boiled, 13 2 30 4 broiled or baked, " 3t h. Rice, do. 88 1 10 Rye, rye bread, 79 Sole, fried, 21 Soup, barley, boiled, 20 1 30 7 meat soups digest in 3 to 5 h. Strawberries, raw, 12 Turnips, boiled, 4 3 30 3 Veal, fried, 25 4 31 broiled digests in 4 hours. Venison, broiled. 22 1 35 6 Wheat, in bread, 95 3 30 3 TABLE OF FOOD. 287 The next table is added simply as a matter of con- venience, to save time in ascertaining the easiest articles of digestion at a glance. TABLE OF FOOD.—No. 3. ARTICLES Of DIET. IN STOMACH. Preparation. Rice........................................ Pigs' feel, soused............................. Tripe, soused................................ Eggs, whipped................................ Trout, salmon, fresh......................... Trout, salmon, fresh.......................... Soup, barley.....................••'.......... Apples, sweet, mellow.... ................... Venison steak................................ Brains, animal................................ Sago........................................ Tapioca...................................... Harley....................................... Milk......................................... Liver, beefs, fresh........................... I'.ggs, fresll................................... Codfish, cured dry........................... Apples, sour, mellow................................jraw ( ubbage, with vinegar.............................. do. Milk...............................................I do. Egg«. fresh.........................................roasted boiled do. do. raw boiled fried boiled raw broiled boiled do. do. do. do. broiled raw boiled Turkey, wild....................................... do. Turkey, domestic...................................boiled (J.shulne........................................... do. Turkey, domestic...................................roasted Goose, wild....................................... do. Pig, sucking....................................... do. Lamb, fresh.................................»......broiled Hash, meat and vegetables...........................wanned Beans, pod.........................................i boiled Cake, sponge.......................................baked Parsnips............................................boiled Potatoes, Irish.....................................roasted Potatoes, Irish......................................baked Cabbage, head......................................raw Spinal marrow, animal..............................boiled Chicken, full grown................................fricasseed Custard............................................baked Beef, with salt only...............................boiled Apples, sour, hard .................................raw (>y stors, fresh....................................... do. Eggs, fresh.........................................soft boiled Bass, striped, fresh.................................broiled Beef, fresh, lean, rare...............................roasted Beefsteak...........................................[broiled Pork, recently salted...............................Taw Pork, recently salted................................Istewed 288 BRONCHITIS AND KINDRED DISEASES. TABLE OF FOOD.—No. 3.— Continued. ARTICLES OF DIET. Mutton, fresh.......................................broiled Mutton, fresh.......................................boiled Soup, bean......................................... do. Chicken soup...................................... do. Aponeurosis........................................ do. Dumpling, apple.................................... do. Cake, corn.......................................... baked Oysters, fresh......................................roasted Pork, recently salted................................broiled Porksteak.......................................... do. Mutton, fresh.......................................roasted Bread, corn.........................................baked Carrot, orange......................................boiled Sausage, fresh,.....................................broiled Flounder, fresh.....................................fried Catfish, fresh....................................... do. Oysters, fresh......................................stewed Beef, fresh, lean, dry................................roasted Beef, with mustard, &c..............................boiled Butter...............................,..............melted Cheese, old, strong..................................raw Soup, mutton.......................................boiled Oyster soup........................................ do. Bread, wheat, fresh.................................baked Turnips, flat.......................................boiled Potatoes, Irish...................................... do. Eggs, fresh.........................................hard boiled Eggs, fresh........................................fried Green corn and beans.............................boiled Beets.............................................. do. Salmons, salted.................................... do. Beef...............................................fried Veal fresh.........................................broiled Fowls, domestic.................................... boiled Fowls, domestic....................................roasted Ducks, domestic.................................... do. Soup, beef, vegetables and bread.....................boiled Heart, animal......................................fried Beef, old, hard, salted...............................boiled Pork, recently salted.................................fried Soup, marrow bones................................boiled Cartilage........................................... do. Pork, recently salted................................ do. Veal, fresh ........................................fried Ducks, wild........................................roasted Suet, mutton.......................................boiled Cabbage............................................ do. Pork, fat and lean..................................roasted Tendon...............•.............................boiled Suet, beef, fresh................................... do. IN STOMACH. Preparation, Time of digestion. A. m. 3 3 3 3 3 3 3 3 15 3 15 3 15 3 J5 3 15 3 15 3 20 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 30 3 45 3 45 4 4 4 4 4 4 4 4 4 15 4 15 4 15 4 15 4 30 4 30 4 30 4 30 4 30 5 15 5 30 5 30 TABLE OF FOOD. 289 The per centage of Carbon and Nitrogen in some kinds of food is as follows : to, o.l4 42] 00 00 361 00 77, 0.2!) 77 0.35 S0| 00 (Join Arabic.......... Sugar................. Starch................ Arrow Koot........... S. Almond Oil........ Olive................. Lard............... Suet.......................~!>| 00 Htilter......................0.1 00 Wheat....................39 2. Rye.........................3rt 1. Oats........................!-W 2. Rye Bread..................|3l| Peas, dry...................136 39. Peas, green. ................42i 4. Beans.......................881 38. Lentils.....................37| 38. Potatoes....................11 0.36 Cabbnge....... Turnips........ do. dried... Artichokes.... Blood......... Milk........... Loan Meat.... Mixed.......... Soup.......... Apricots....... reaches........ Cherries....... Gooseberries... Apples........ Beet", roast..... Veal, roast..... Venison, roast.. .12 200 -03 .03 .03 15. 18. .7.1 .17 .93 .57 14. 15. The Carbon In food supplies elements of respiration, of warmth. The Nitrogen supplies elements of nutrition. AMOUNT OF DAILY FOOD. Perhaps few readers know how much food one person ought to eat in twenty-four hours. Twelve ounces of wheat a day will feed a man well. The common allow- ance of food to the inmates of Penitentiaries in the United States is one pound of meat, one pound of bread, and one pound of vegetables a day. A person in ordi- nary business should have one and a half pounds of solid food a day, sedentary persons one-third less. Eight hundred convicts, who did not work, had their diet re- duced to half a pound of bread, and one ounce and a quarter of meat, made into soup: in a few weeks one half of them were afflicted with scurvy and other diseases. Always, Consumptive persons fall away, and are chilly. The whole object i^f food to all, is to supply nourishment 290 BRONCHITIS AND KINDRED DISEASES. and fuel; the amount of each is given as to a few arti- cles. The first column gives the proportion of nutri- ment, the second the amount of fuel, or elements of heat. Milk .... one, Nutriment . . . . 2 Fuel Beans . . . one, u . • 21 a Oat meal . one u . . 5 u Barley . . one (( . . 7 u Wheat . . . one cc . . 8 a. Potatoes . . one u . . 9 (< Rice .... one « . . 10 l< Turnips . . one (( . . 11 (< Arrrow-root 1 Tapioca . . V one (( . . 26 u Sago .... J Starch . . . one (( . . 40 u Hence, the last named articles are given to young children, requiring as they do a great deal of warmth; but they would not live long if fed on these alone. They must have milk in addition, or some other article con- taining a larger amount of the flesh-forming principle. One pound is equalled in weight by about twenty- eight silver half dollars. PREPARATIONS. 60 Drops make one Teaspoon. 4 Teaspoons " one Tablespoon. 2 Tablespoons " one Ounce. 2 Ounces 2 Wine-glasses 4 Gills one Wine-glass. one Gill or Teacup. one Pint. PREPARATIONS, RECIPES, ETC. which follow, are frequently referred to in my practice in conjunction with dietetics. PREPARATIONS, RECIPES, ETC. 291 1. How to Toast Bread.—Keep the bread a proper dis- tance from the fire, so as to make it of a straw color. It is spoiled if it is black, or even brown. 2. Toast Water.—Take a slice of bread about three inches across and four long, a day or two old. When it is browned, not blackened, pour on it a quart of water which has been boiled and afterwards cooled. Cover the vessel, and after two hours, pour off the water from the bread gently. An agreeable flavor may be imparted by putting a piece of orange or lemon peel on the bread at the time the water is first poured on the bread. :>. Barley Water.—Take two-tablespoons of pearl bar- Icy, wash it well in cold water, then pour on it half a pint of water, and boil it fifteen minutes; throw this water away, then pour on two quarts of boiling water, and boil down to a quart; then strain it for use. An ounce of gum arabic dissolved in a pint of barley water is a good demulcent drink. 4. Flax-seed Tea.—Take an ounce or full table-spoon of flaxseed, but not bruised, to which may be added two drams of bruised liquorice root; pour on a pint of boil- ing water, place it covered near the fire for four hours, strain through a cotton or linen rag. Make it fresh daily, may add a little lemon juice or vinegar or loaf sugar. 5. Tamarind Whey.—Two tablespoonfuls of tamarind, stirred in a pint of boiling milk; then boil for fifteen minutes, and strain. 6. Wine Whey.—Take a pint of milk, put it on the fire; as soon as it begins to boil, pour on eight or ten tablespoons of Madeira wine, in which has been stirred two teaspoons of brown sugar; stir the whole until it 292 BRONCHITIS AND KINDRED DISEASES. has been boiling for fifteen minutes; then strain through a cloth. 7. Boiled Flour and Milk.—Take a pint of flour; make it into a dough ball with water; tie it tightly in a linen bag; put it into a pan of water, (milk is better), cover- ing the ball, and let it boil four or five hours; place it before the fire to dry, cloth and all; take it out of the cloth, remove the skin, dry the ball itself. Grate a tablespoon of this, and stir it into a pint of boiling milk, until a kind of mush is formed. 8. Boiled Turnips.—Small turnips boiled make one of the best articles of food which invalids and convalescents can use. Carrots may be added; half and half. Boil them once ; repeat the boiling in fresh water until they are quite soft; press the water out through a coarse cloth; then mix enough new milk to form a kind of pulp; season with salt, and then place them before the fire until it is a little dry or crusted. 9. Beef Tea.—Cut into thin slices a pound of lean meat, pour on a full quart of cold water, let it gradually warm over a gentle fire; let it simmer half an hour, taking off the skum; strain it through a napkin. Let it stand ten minutes, then pour off the clear tea. 10. Cracked Wheat.—Dry some common wheat, then grind it in a coffee mill; boil it three or four hours, or until it is of the consistence of well boiled rice; add a little salt, a little milk, butter, cream, or molasses may be added, as in using hominy. It should be always washed clean, and then boiled long enough to become of the consistence of boiled rice or hominy. A pint of wheat dried and ground is enough for two days ; not to be used for supper. PREPARATIONS, RECIPES, ETC. 293 11. Dandelion Diet Drink.—-Take three ounces of the bruised root of the dandelion flower, which should be gathered in July, August, and September; pour on a quart of water, boil it to a pint, and strain it. 12. Blackberry cordial is the most agreeable of all non-medicinal agents, in diminishing the frequent, thin and litdit colored passages; to be prepared thus:— Put the blackberries in a pot of water, boil until the juice leaves them, strain through a flannel bag; add spices, loaf sugar, cinnamon and cloves to the taste, then boil again for twelve minutes, skim, and let cool. To three quarts of this juice add one quart of the best I'Vcnch brandy. 13. To Boil Rice.—Take a pint of rice, wash it well, then soak it two hours in cold water; have ready two quarts of boiling water with a little salt in it, in a stew pan. Half an hour before you wish to use the rice, pour the water from it, in which it has been soaked, and with a tablespoon shake the rice gradually into the stew pan without stirring it; let it boil ten minutes, then strain the liquid from the rice; return the rice to the stew pan, and let it steam fifteen or twenty minutes, a short dis- tance from the fire, it will then be done, and the grains will be separate; add a little butter, and send it to the table. In graver cases, it should be prepared as followrs:— Wash it well, then parch it brown or black like coffee, and while a pot of water, with a handful of salt in it, is boiling, sprinkle in the rice, bad grains being removed, and let it boil twelve minutes by the watch, stirring it all the time ; pour off the water, cover up the vessel, place it a little distance from the fire, and when cool enough, eat it with a little butter or sugar. 294 BRONCHITIS AND KINDRED DISEASES. 14. Mulled Wine.—Pour half a pint of boiling water on a dozen bruised cloves, a quarter of an ounce of bruised cinnamon, and half a nutmeg grated ; let it stand an hour, strain, and add a full teaspoon of sugar; then pour this into a pint of hot sherry or port wine. 15. Gum Arabic Water.-^Dissolve two or three table- spoons of the gum in a pint of water. 16. Rice water is made like barley water. 17. Oatmeal, or Water Gruel.—Oatmeal two table- spoonfuls, water one quart." Mix well, and boil for fifteen minutes, stirring it often. Strain through a sieve, and add sugar and salt to make it agreeable. 18. Sago.—Sago one tablespoonful, water one pint. Boil them gently, stirring often till the mixture is smooth and thick, then add sugar. When proper a little wine and grated nutmeg may be added. 19. Arrow Root and Tapioca.—Prepare like sago. 20. Oyster Rroth.—Cut into small pieces one or two dozen oysters, and boil them with their liquor in a pint of water for ten minutes, adding a little salt. This forms a very pleasant and sufficiently nourishing drink in the convalescence from many diseases. 21. Egg Soup.—The yolk of one or two eggs, butter the size of a walnut, sugar to suit the taste, water one pint. Beat up the yolk with the water, and then add the butter and sugar. Stir it all the time it is on the fire, and when it begins to boil pour it between the saucepan and mug till well frothed, when it is ready for use. 22. Chicken Water.—Half a chicken, the fat removed and bones broken, water two quarts. Boil for twenty or thirty minutes, and add a little salt. When a very nourishing article is required, add a tablespoonful of PREPARATIONS, RECIPES, ETC. 295 rice, and boil very slowly for two hours, skimming off all the fat. 23. Reef Tea.—Lean beef cut into small pieces, one pound, water one quart. Boil for twenty minutes, re- moving the skum as it rises. When cold, strain, and add a little salt. 21. Foot Rath.—Add four ounces of nitric acid, to four of muriatic acid in a glass bottle or vessel; to this add eight ounces of water, that is, half a pint; of this solution take from three to five ounces, measured in a glass or wooden measure, and put it in three gallons of water as much as ninety-six degrees of heat; this must be in a wooden vessel, and narrow enough to make the water come well up to the knees. Put the feet in at bed time for half an hour; if it does not cause a prickling feeling in the feet, add more of the acid mixture next night. At the end of the half hour, have the feet and legs wiped dry, and then hold the feet to the fire until the heels and between the toes are perfectly dried, get into bed and have a bottle two-thirds full of hot water to each foot. The bottles should be well corked and rolled up in a piece of flannel, diagonally with the covers of the flan- nel turned in so as to be an additional protection to preventing the corks from coming out. Warm bricks or irons are objectionable as being liable to set the bed- ding on fire. 2f>. Shower Paths, Cold Paths, common-sense reader will perhaps, from the state- ments which have been made, think it a very laudable desire to diffuse information among the people as to the symptoms of dangerous, insidious, and wide-spreading diseases. Countless multitudes have paid the forfeit of their lives by ignorance or neglect of the early symptoms of Consumptive disease. Perhaps the reader's own 344 BRONCHITIS AND KINDRED DISEASES. heart is this instant smitten at the sad recollection of similar cases in his own sphere of observation. Whoever lends a helping hand to the diffusion of use- ful knowledge, is, in proportion, the benefactor of his m kind. Whether it be useful for men to know the nature and first symptoms of a disease which is destined to de- stroy a sixth of the population, is a question which each one must decide for himself; the Author believes that such an effort is useful. It is not practicable for all to s'tudy medicine, nor is it to be expected that for every cough one has, he shall go to the expense of taking medical advice; it therefore seems the dictate of humanity to make the necessary in- formation more accessible, and there is perhaps no better way of accomplishing this object than the general distri- bution of a book like this: and when the Author pre- tends to no new principle of cure, no specific, and no ability of success, beyond what an entire devotion to one disease may give any ordinary capacity, no apology is necessary for confining the book to causes and symptoms. The author lays no greater claim to success, than what any man of common capacity might expect, who, under similar circumstances, and possessed of equal advanta- ges, should, for the same length of time, confine himself rigidly to the treatment of a single disease. Without saying anything to make the reader believe that his practice is widely extended, or crowned with unvaried success, the Author thinks that it has been suf- ficiently so, to merit the investigation and study of every intelligent mind. These wide-spread and fearfully fatal diseases are so, not necessarily, but by inattention and neglect. They are estimated to destroy prematurely one in every six, in civilized society ; not however from RECAPITULATION. 345 their essentially incurable nature; not because they are necessarily fatal in every case; not one in ten of all who have these diseases need die; there is scarcely a doubt that nine out of ten would promptly and permanently recover, if the Author's views were adopted, by which these diseases could be distinguished in their very ear- liest stages, and a rational treatment were forthwith be- gun and carried out with determined perseverance. The Author truly hopes that by this book, and by private correspondence in reference to the diseases treated of, he may be able to place within the reach of many whom he may never see, the means of cure, and thus not be wholly useless to the world he lives in. RECAPITULATION. 1. Throat-Ail, Chronic Laryngitis, Clergyman's Sore Throat, is a disease of the root of the windpipe, answer- ing to " Adam's Apple." 2. Croup is a disease of the body of the windpipe. 3. Bronchitis is a disease of the branches of the wind- pipe. 4. Consumption is a disease of the air-cells, the lungs themselves, which are at the extremities of the branches of the windpipe, as buds or leaves are at the extreme ends of the branches of a tree. 5. Throat-Ail when it is decided, and of some months continuance, is presumptive evidence of a consumptive constitution or tendency ; except where it has been brought on by undue exercise, or use of the voice, as by singers and public speakers. See page 237. (5. Throat-Ail is only ameliorated by the application of the nitrate of silver; it is sometimes aggravated by it, and unless it is a slight affection and confined to the 346 BRONCHITIS AND KINDRED DISEASES. voice-organs, it is never permanently cured by any ar gentine washes; while in many instances they are alto- gether useless; and when wholly relied upon, they are pernicious, in consequence of the loss of time which they occasion. 7. Bronchitis is not a disease of the throat or tho lungs, but of the branches of the windpipe which arc? situated between the two. 8. Consumption is as certainly, as often, and as per manently cured, when properly attended to in its first beginnings, as any other serious disease. 9. If the lungs have'not begun to decay away, and if tubercles are not extensively deposited, a permanent cure is probable. 10. If the lungs have decayed but to a small extent, a restoration to comfortable health is not unlikely. 11. When decided decay has taken place in the lungs, a permanent arrest of the disease is a possible event. 12. When Consumption is fixed in the system, there is but little prospect of any other than a fatal termina- tion. 13. In any case of apparent Consumption, it is not possible to decide certainly that it is not Consumption, without the use of lung measurement. 14. Inasmuch as all educated physicians admit that the lungs may be in a state of actual decay, without its being detected by the stethescope, the plessimeter, or by auscultation, these means are not reliable in any case. 15. Inasmuch as it is an impossibility for any ma- terial portion of the lungs to have been lost without its being detected by lung measurement, then no case of actual or threatened, or supposed consumptive disease should be decided on without this lung measurement being taken. 16. If any part of the lungs have decayed away, spi- rometry most certainly detects it. RECAPITULATION. 347 17. If the lungs are whole and entire, and in full healthful action, spirometry will infallibly indicate it. is. If spirometry indicates full lung action in any given case, it is wholly impossible that the lungs in that case should be unsound as to consumptive disease, any and all other symptoms to the contrary notwith- standing. 19. In deciding in any particular case whether or not Consumption exists in any stage, no physician should rely on any one, or two, or three symptoms, or means of diagnosing. 20. A warm air or climate aggravates Consumption in all its stages, and cures it in none. 21. A steady, cool, still, dry atmosphere promotes the cure of Consumption in all its stages. 22. A windy climate, a damp climate, a sultry cli- mate, will render Consumption most fatal in all cases. 23. Sea voyages aggravate Consumption, unless they arc over thirty miles from land, and are continuous for several months. 24. Cod Liver Oil is perhaps the best remedy now known for general scrofulous disease. It is an aid of some value in the treatment of consumptive persons who are under twenty-five years of age, and of those of any age, who when in health were decidedly inclined to be fat, or fleshy. But in other cases it is generally in- ert, or so impairs the appetite, or deranges the stomach, or affects the bowels, as to be a positive injury. In all cases where it imparts flesh and strength, it does good. 25. The true principle of treating Consumption is to regard it as a constitutional, and not a local disease. 26. Persons benefited, or cured by a sea voyage or by " going to the South," are those who have an affec- tion of the stomach or liver, rather than of the lungs. 27. It is not insisted on that Consumption is curable in its advanced stages, or that it is easily cured in any stage, but that if the symptoms are all properly attended to on their very first appearance, a perfect and perma- nent cure is a common occurrence. 348 bronchitis and kindred diseases. 28. The eradication of Throat-Ail and Consumption cannot, unless in the very earliest stages, be rationally calculated upon, except by a steady, systematic, deter- mined perseverance: see page 236. 29. A cough equally steady or violent, or as likely to be so during the day as well as the night, is presump- tive evidence that the ailment is elsewhere than, in the lungs. 30. Spinal irritation is sometimes masked by promi- nent consumptive symptoms (page 240), when the lungs themselves are free from special disease. Several such cases are under present treatment with encouraging promise of favorable results, which if treated as ( on- sumption, would prove speedily fatal; B. S., 1121, ex- hibited the average pulse of health, with full, perfect lung measurement: the reverse another of surpassing interest, by reason of youth and accomplishment and mental culture, monopolizing merited sympathies, bearing for weary weeks and months, with steady endurance the ceaseless suffering which characterises spinal affections, and yet no consumptive decay. 31. However marked and efficient may be the effects of the treatment of Throat-Ail and Consumption, persons will remain cured, entirely free from the symptoms of these ailments, [J^p3* only so long as they take care of themselves. By regular habits of eating, sleeping, and exercise. By lives of temperance. By avoiding all needless exposure and over effort. By habitually and conscientiously guarding against the things which first caused the disease, since no malady, except such as small-pox, can be so perfectly cured, as not to return, as often as there is exposure to its cause. 32. By the almost total neglect of the physical educa- tion of our children hitherto, our sons and daughters perish by multitudes before maturity, and many of our old family names have already died out. New York, April 2, 1852. INDEX. PAOK Air and Health.................. 78 Author's < trillion . .. .142, 2U1, 249, 345 Asthma, Perpetual.............. 36 " Common ............... 257 " Case, of................ 315 Bronchitis, what is it 1.......... 6 " Symptoms............ 9 " how acquired........ 35 « Philosophy of........ 43 Defined.............. 44 " llixtoryof............. 53 Bad Habits of tin; Young.... 217, 299 Breathing. Remarks on..........■ 270 Brandy and Throat Disease 19, 180, 341 Hath/and Bathinu........68, 229, 295 Boarding-School Education.. .298, 32S1 Boston Statistics of Consumption. 301 Consumption, what is It?........ 6 " Swnptoms......... 10 " how acquired..... 35 riiilosopliy of...... 46 " History............ 54 '• Definition.......... 61 Communhahility... 98 " Curnhilitv.......98,322 Threatened.......203 '< Heal, Arrested--- 205 '< Spurious.......... 211 " 1'rinriples of Cure 65. 220, 242 " Early Indications .. 273 Contents of Lungs.............. 78 Heart............... '9 Congestion Descrilied............ 43 Capdlary Circulation............ 41 Development................ *p PAOE Clergymen, Chapter to...........243 " how diseased........ 217 » Cases of, 14. 16. 20 23. 33, 51, 154, 182, 240 Cities, Mortality of.............. 335 Country, 336 ry Circulation............ 41 . Growth, Manner of. Dangerous Delays............... 36 " Exposures............ 29 Diarrhoea.................... • ■ u7 Danger of Cutting Tonsils.........109 Disease, Hcturn of Prevented. .17, 338 Not by Medicine........ 318 Debilitating Indulgences......218, 299 Death, Manner of............... 86 " Edward Irving........... ■> Washington.............227 " Whitfield................. 258 " Franklin.................3'fi " Combo........ ......... 125 " Maffitt...................2j0 Editors, Suggestions to........... 138 Exposures, Dangerous............ 29 Expectoration................... 90 Edwards' Jonathan, Oratory.....2j3 Fever and Ague, of........... 96, 318 Frail and Feeble Persons......... 126 " Children, Treatment of..... 3:; I Food, Tables of................. 28-* " Amount Needed Daily.. 186, 289 Features, Hereditary............. 2,8 Female Boarding Schools.... 298, 329 Franklin's Death................ 316 ....... 69 Cell Chill and Fever..... 96, ill, 158 145 J,|""","''' .....269, 278 Clerical' Health.................. 254 Clerks......................... 299 Croup Heart, Contents of............... 79 Disease and Death........ 248 How to Remain Cured........... 120 Home and Its Advantages........ 152 Health, a Talent................ 246 a Duty.................. 207 ,.............. 267 Children."Training of............233 ! High Livers Precocious............ 320 and Study............. 328 Inflammation Described.......... 43 " Health of............. 324 Imprisonment, Long............. 77 r.mffh .....90,93,201,223 •■ how pwtucod............ 306 Lawyers, Cases of.........19, 21, 162 Cod liver Oil.................... 241 Lungs Described................. 4b 350 INDEX. PAGE Lungs, contents of.............. 78 Last Words..................... 88 Lake-shore Situations............ 159 Life, Average Duration of........ 300 Mistaken Patients....... 171, 182, 190 Measures, Table of............... 290 Medical Science, Value of ... 298, 343 Merchants, Cases of, 16, 24, 156, 178, 207, 235, 240, 243 Mortality of Cities................ 335 Nitrate of Silver................ 237 New York City Mortality........ 336 Over Feeding................... 68 Oxygen, Effects of Breathing___ 71 Over-tasking the Brain ......... 329 Object of the Book,. .142, 302, 303, 339 Parallels....................___ 65 Principles of Cure......63, 65, 220, 225 Phosphate of Lime.............. 71 Prairie Situations................ 159 Pulse............................ 270 Patent Medicines.......191, 302, 341 Recipes......................... 291 Respiration...................... 305 Relapses, how occasioned........ 310 Recapitulation................... 340 Spirometry.... 47, 81, 83, 166, 195, 272 Smoking, Effects on Throat...... 18 Shortness of Breath.............. 306 Smallpox...................... 324 Sea Shore...................... 158 Sea Voyages.................... 159 Spitting Blood................... 94 Starvation, Suicide by........... 72 Sick Headache.................. 24 Stay at Home to Die.............. 152 Some Candies poisonous ........ 342 PAOK Symptoms, Deceptive............ 177 " Suspicious........... 218 " Enumerated.......... 262 "' of Dyspepsia......... 321 Throat-Ail, what is it?.......... 5 " Symptoms........... 7 " how acquired........ II " Philosophy.......... 40 " History.............. 48 " Diseases............ 226 " First Symptoms......255 " Neglected, results of.. 256 Tables of Measure.............. 290 Food................. 284 " Mortality.............. 335 Tobacco, Eliects of............... 17 Tubercles, how formed........... 46 " Diseases of, Classified. 266 " Not Necessarily Fatal 268 " Clusters of............ 274 Tendencies of the Times........ 145 Treatment of Unseen Cases...... 205 Theological Students............. 243 Tonsils, Danger of Cutting....... 309 Unseen Cases Treated...........265 " Unwell"....................... 312 Voice Organs Described.......... 42 Vaccination..................... 323 Women, Cases of, 26, 171. 173, 203, 212, 250, 311, 312 " Few Healthy.......... 325 Washington at Morristown....... 187 Death of............ 227 Whitfield's Oratory............... 252 Death.............. 258 Weakly Children................ 333 Young, City Education of........298 Young Ladies Education ........329 THE WORKS OF EDGAR ALLAN POE: WITH NOTICES OF HIS LIFE AND GENIUS, BY J. R. LOWELL, N. P. WILLIS, AND R. W. GRISWOLD in two Volumes, l2mo., with a Pohteait of the Author. Phice, Two Dollars and Fifty Cents. NOTICES OF THE PRESS. " The edition is published for the benefit of his mother-in-law, Mrs. Maria Clemm, for whose sake we may wish it the fullest success. It however, de- serves, and will undoubtedly obtain, a large circulation from the desire so many will feel to lay by a memorial of this singularly-gifted writer and unfortunate man."—Philadelphia North American.. "Poe's writings are distinguished for vigorous and minute analysis, and the skill with which he has employed the strange fascination of mystery and terror. There is an air of reality in all his narrations—a dwelling upon partic- ulars, and a faculty of interesting you in them such aa is possessed by few writers except those who are giving their own individual experiences. The reader can scarcely divest his mind, even in reading the most fanciful of his stories, that the events of it have not actually occurred, and the characters had a real existence."—Philadelphia Ledger. '* We need not say that these volumes will be found rich in intellectual excitements, and abounding in remarkable specimens of vigorous, beautiful, and highly suggestive composition ; they are all that remains to us of a man whoso uncommon genius it would be folly to deny."—N. Y. Tribune. " Mr. Poe's intellectual character—his genius—is stamped upon all his produc- tions, und we shall place these his works in the library among those books not to be parted with."—iV. Y. Commercial Advertiser. " These works have a funereal cast as well in the melancholy portrait pre- fixed and the title, as in the three pallbearing editors who accompany them in public. They are the memorial of a singular man, possessed perhaps of as great mere literary ingenuity and mechanical dexterity of style and manage- ment as any the country has produced. Some of the tales in the collection are as complete and admirable as anything of their kind in the language."— Military Review. " A complete collection of the works of one of the most talented and singu- lar men of the day. Mr. Poe was a genius, but an erratic one—he was a comet or a meteor, not a star or sun. His genius was that almost contradiction of terms, an analytic genius. Genius is nearly universally synthetic—but Poe was an exception to all rules. He would build up a poem as a bricklayer builds a wall; or rather, he would begin at the top and build downward to the base; and yet, into the poem so manufactured, he would manage to breathe the breath of life. And this fact proved that it was not all a manufacture—that the poem was also, to a certain degree, a growth, a real plant, taking root in the mind, and watered by the springs of the soul."—Saturday Post. " We have just spent some delightful hours in looking over these two vol- umes, which contain one of the most pleasing additions to our literature with which we havo met for a long time. They comprise the works of the late Edgar A. Poe—pieces which for years have been going ' the rounds of the Eress,' and are now first collected when their author is beyond the reach of umar praise. We feel, however, that these productions will live. They bear t le stamp of true genius ; and if their reputation begins with a ' fit audi. enco Ji'iugh few,* the circle will be constantly widening, and they will retain it piouJuent place in our literature."—Rev. Dr. Kip JUST PUBLISHED, In one Volume, \2mo., cloth, Pkicx $1.85, THE NIGHT-SIDE OF NATURE; OR, GHOSTS AND GHOST-SEERS. BY CATHERINE CROWE, AUTHOR OF "SUSAW HOFLET," " LILLY DAWSOIT," ETC. OPINIONS OF THE PRESS. This book treats of allegorical dreams, presentiments, trances, apparitions, troubled spirits, haunted houses, etc., and will be rend with Interest by many because it comes from a source laying claim to considerable talent, and fa written by one who really believes all she says, and urges her reasonings with a good deal of earnestness.—Albany Argus. It embraces a vast collection of marvellous and supernatural stories of su- pernatural occurrences out of the ordinary course ot events.—N. Y. Globe. Miss Crowe has proved herself a careful and most industrious compiler. She has gathered materials from antiquity and from modern times, and gives to English and American readers the ghost-stories that used to frighten the young ones of Greece and Rome, as well as those that accomplish a similar end in Germany and other countries of modern Europe.—Phila. Bulletin. It is written in a philosophical spirit.—Philadelphia Courier. This queer volume has excited considerable attention in England. It is not a catchpenny afl'air, but is an intelligent inquiry into the asserted facts respect- ing ghosts and apparitions, and t psychological discussion upon the reasona bleness of a belief in their existence.—Boston Post. In this remarkable work, Miss Crowe, who writes with the vigor and grace of a woman of strong sense and high cultivation, collects the most remarkable and best authenticated accounts, traditional and recorded, of preternatural vis- itations and appearances.—Boston Transcript. This is a copious chronicle of what we are compelled to believe authentic instances of communication between the material and spiritual world. It is written in a clear, vigorous, and fresh style, and keeps the reader in a con- stant excitement, yet without resorting to claptrap.—Day-Book. The book is filled with facts, which are not to be disputed except by actual proof. They have long been undisputed before the world. The class of facta are mainly of a kind thought by most persons to be " mysterious;" but there will be found much in the book calculated to throw light upon the heretofore mysterious phenomena.—Providence Mirror. This book is one which appears in a very opportune time to command at- tention, and should be read by all who are desirous of information in regard to things generally called mysterious, relating to the manifestations of the spirit out of man and in him.— Traveller. This is not only a curious but also a very able work. It is one of the most interesting books of the season—albeit the reader's hair will occasional- ly rise on end as he turns over the pages, especially if he reads alone far into the night—Zion's Herald. A very appropriate work for these days of mysterious rapplngs, but one which shows that the author has given the subjects upon which she treats considerable study, and imparts the knowledge derived in a concise manner. ^-Boston Evening Gazette. This is undoubtedly the most remarkable book of the month, and can not fail to interest all classes of people.— Water-Cure Journal. To the lovers of the strange and mysterious in nature, this volume will pos- sess an attractive interest—N. Y. Truth-Teller. The lovers of the marvellous will delight in its perusal..—Com. Advertiser JUST PUBLISHED, LAYS OF THE SCOTTISH CAVALIERS. By WILLIAM E. AYTOUN, PB0FES.10B OF LITERATURE AND BELLES LETTBES IN THE UNIVERSITY OF EDINBURGH, AND EDITOR OF BLACKWOOD'S MAGAZINE. One Volume, 12mo., Cloth—Pbice $1. " These strains belong to stirring and pathetic events, and until poetic descriptions of them shall be disregarded, we think Mr. Aytoun's productions well calculated to maintain a favorite place in public estimation."—Literary Gazette. " The ballads in question are strongly tinged by deep national feeling, and remind the reader of Macaulay b ' Lays of Ancient Rome;' and, from the more picturesque nature of the subject, are, perhaps, even still more highly colored. ' Edinburgh after Flod- den,' ' the Death of Montrose,' and ' the Battle of Kilircranke,' are strains which Scotch- men will not willingly let die."—Men of the Time in 1852. " Choosing from the ample range of Scottish history, occasions which are near and dear to the popular sympathy of his country. Mr Aytoun, confident of the force of strong convictions and a direct appeal to the elementary emotions of the human heart, has presented us eight noble lays—clear in feeling, simple and direct in expression, and happily varied and variable in measure, which will, we are confident, outlive many, it not all, of his more pretentious and ornamented contemporaries."—Literary World. ALSO, THE BOOK OF BALLADS. EDITED BY BON GAULTIER. One Volume, 12m0., Cloth—Price 75 cts. "Bon Gaultier himself, hie wit, satire, and versification, remained a 'Yarrow un- visited.' The opuscula of that humorous writer, eomehow marvellously escaping the prehensile fingers of our publishers, were yet unknown to American readers ; though an occasional whiff and stray aroma ol the choice volume had now and then transpired through the columns of a magazine or newspaper. " Hon Gaultier's Book of Ballads is simply the wittiest and best thing of the kind since tho Rejected Addresses. Its parodies of Lockhart (in the Spanish Ballads), of Tenny- son (his lovely sing-song puerilities), of Macaulay (the sounding Roman strain), of Moses (the ' puff poetical'), are, with a dozen others, in various ways, any of them equal to tho famous Crabbc, and Scott, and Coleridge of the re-ascending Drury Lane." Literary IKorta. IN PRESS, Man on lie scant. BY The Abbe Prevost. JUST PUBLISHED, THE LADIES OF THE COVENANT. MEMOIRS OF DISTINGUISHED SCOTTISH FEMALE CHARACTERS, Embracing the Period of the Covenant and the Persecution. By the REV. JAMES ANDERSON. In One Volume, \2mo., cloth, Pbice $1.25—extra gilt, gilt edges $1.75. OPINIONS OF THE PRESS. " It is written with great spirit and a hearty sympathy, and abounds in incidents of more than a romantic interest, while the type of piety it discloses is the noblest and most elevated."—N. Y. Evangelist. " Seldom has there been a more interesting volume than this in our hands. Stories of Scottish suffering for the faith have always thrilled us ; but here we have the me- moirs of distinguished female characters, embracing the period of the Covenant and the Persecution, with such tales of heroism, devotion, trials, triumphs, or deaths, as rouse subdue, and deeply move the heart of the reader."—N. Y. Observer. " Many a mother in Israel will have her faith strengthened, and her zeal awnkened, and her courage animated afresh by the example set before her—by the cloud of wit nesses of her own sex, who esteemed everything—wealth, honor, pleasure, ease, and life itself—vastly inferior to the grace of the Gospel; and who freely offered themselves and all that they had, to the sovereign disposal of Him who had called thorn with an holy calling j according to his purpose and grace."— Richmond, (Va.) Watchman and Observer. "The Scotch will read this book because it commemorates their noble countrywo- men ; Presbyterians will like it, because it records the endurance and triumphs of their faith ; and the ladies will read it, as an interesting memorial of what their sex has done in trying times for truth and liberty."—Cincinnati Central Christian Herald. " It is a record which, while it confers honor on the sex, will elevate the heart, and strengthen it to the better performance of every duty."—Richmond (Va.) Religiovt Herald. " The Descendants of these saints are among us, in this Pilgrim land, and we earn- estly commend this book to their perusal."—Plymoth Old Colony Memorial. " There are pictures of endurance, trust, and devotion, in this volume of illustrious Buffering, which are worthy of a royal setting."—Ontario Repository. " They abound with incidents and anecdotes illustrative of the times and we need scarcely say are deeply interesting to all who take an interest in the progress of Chris- tianity."—Boston Journal. "Mr. Anderson has treated his subject ably , and has set forth in strong light the en during faith and courage of the wives and daughters of the Covenanters."—N. Y. Albion "It is a book of great attractiveness, having not only the freshness of novelty but every element of historical interest.—Courier and Enquirer. "The author is a clergyman of the Scottish kirk, and has executed his undertaking with that spirit and fulness which might be expected from one enjoying the best advan- tages for the discovery of obscure points in the history of Scotland, and the warmea4 sympathy with the heroines of his own creed."— Commercial Advertiser. Clntmnook; OR, RECOLLECTIONS OF OUR HOME IN THE WEST. By ALICE CAREY. Illustrated oy Daelet. One vol., 12mo. " We do not hesitate to predict for these sketches a wide popularity. They bear the true stamp of genius—simple, natural, truthful—and evince a keen sense of the humor and pathos, of the comedy and tragedy, of life in the country. No one who has ever read it can forget the sad and beau- tiful story of Mary Wildermings; its weird fancy, tenderness, and beauty ; its touching description of the emotions of a sick and suffering human spirit, and its exquisite rural pictures. The moral tone of Alice Carey's writings is unobjectionable always."—J. G. Whittier. " Miss Carey's experience has been in the midst of rural occupations, in the interior of Ohio. Every word here reflects this experience, in the rar- est shapes, and most exquisite hues. The opinion now appears to be com- monly entertained, that Alice Carey is decidedly the first of our female au- thors; an opinion which Fitz-Greene Halleck, J. G. Whittier, Dr. Griswold, Wm. D. Gallagher, Bayard Taylor, with many others, have on various occasions endorsed."—Illustrated News. " If we look at the entire catalogue of female writers of prose fiction in this country, we shall find no one who approaches Alice Carey in the best characteristics of genius. Like all genuine authors she has peculiarities; her hand is detected as unerringly as that of Poe or Hawthorne; as much as ihey she is apnrt from others and above others; and her sketches of country lifo must, we think, be admitted to be superior even to those delight- ful talcs of Miss Mitford, which, in a similar line, are generally acknowledged «o be equal to anything done in England."—International Magazine. " Alice Carey has perhaps the strongest imagination among the women of this country. Her writings will live longer than those of any other woman among us."—American Whig Review. " Alice Carey has a fine, rich, and purely original genius. Her country stories are almost unequaled."—Knickerbocker Magazine. " Miss Carey's sketches are remarkably fresh, and exquisite in delicacy, humor, and pathos. She is booked for immortality."—Home Journal. "The Times speaks of Alice Carey as standing at the head of the living female writers of America. We go even farther in our favorable judgment, and express the opinion that among those living or dead, she has had no equal in this country ; and we know of few in the annals of English litera- ture who have exhibited superior gifts of real poetic genius."—The (Portland, Me.) Eclectic. MISS CHESEBRO'S NEW WORK. DREAM-LAND BY DAYLIGHT; A PANORAMA OF ROMANCE. Bt CAROLINE CHESEBRO. Illustrated by Daeley. One vol., 12mo. *' These simple and beautiful stories are all highly endued with an exquisite perception of natural beauty, with which is combined an appreciative sense of its relation to the highest moral emotions."—Albany State Register. " There is a fine vein of pure and holy thought pervading every tale in the vol- ume ; and every lover of the beautiful and true will feel while perusing it that he is conversing with a kindred spirit."—Albany Evening Atlas. " The journey through Dream-Land will be found full of pleasure ; and when one returns from it, he will have his mind filled with good suggestions for practi- cal life."—Rochester Democrat. " The anticipations we have had of this promised book are more than realized. Itis a collection of beautiful sketches, in which the cultivated imagination of the authoress has interwoven the visions of Dream-Land with the realities of life." Ontario Messenger. " The dedication, in its sweet and touching purity of emotion, is itself an ear- nest of the many 'blessed household voices' that come up from the heart's clear depth, throughout the book."—Ontario Repository. " Gladly do we greet this floweret in the field of our literature, for it is fragrant with sweets and bright with hues that mark it*to be of Heaven's own planting." Cornier and Enquirer. " There is a depth of sentiment and feeling not ordinarily met with, and some of the noblest faculties and affections of man's nature are depicted and illustrated by the skilful pen of the authoress."—Churchman. " This collection of stories fully sustains ber previous reputation, and also gives a brilliant promise of future eminence in this department of literature." Tribune. " We find in this volume unmistakeable evidences of originality of mind, an almost superfluous depth of reflection for the department of composition to which it is devoted, a rare facility in seizing the multiform aspects of nature, and a still rarer power of giving them the form and hue of imagination, without destroying their identity."—Harper's Magazine. " In all the productions of Miss Chesebro's pen is evident a delicate perception of the relation of natural beauty to the moral emotions, and a deep love of the true and the beautiful in art and nature."—Day-Book. notices of episodes of insect life. " A more charming book, fresh with the fragrance of the country air and musical Hth the rustle of insect wings, is not likely to be seen often. In the clearness of its type, the beauty of tho illustrations, and the whole manner of its presentment, tho " Episodes" fairly gives the laural to its tasteful and enterprising publisher."—Lit. World. " Tin re is a moral, we may say a religious lesson, inculcated in every chapter of this book."— Watchman and Reflector. " The style is easy, flowing, natural, and happy. The ideas are such that the reader will arise from their perusal, a ' wiser and a better man.' "—Courant. " We defy any one to rise from its perusal, without thanking the hook for many new Ideas, added to one's previous stock of information, as well as feeling better and more kindly disposed, for the lessons of humanity and benevolence it teaches."—Bost. Courier. " A most attractive work to all ages, for while it is amusing and playful in its language, It is replete with valuable information. It might be called Science made pleasure, or lact made fanciful. A finer specimen of typography is rarely seen, and we commend it to all those who would see in nature constant illustrations of the power and goodness of its great Creator."— Newark Daily Advertiser. " Wonderfully beautiful, graceful, and entertaining. Children can read it with un- derstanding, and be enraptured by it; and this is no small thing to say of a work not especially intended for juveniles."—Ontario Repository. " By a happy combination of taste and knowledge—science and poetry, with anec- dote and description, the naturalist and the mere reader for amusement are equally gratified. It is a book for the library,—and just the thing «s a companion for a journey, or the winter evening fireside. It is well adapted for the sick-chamber too, and tho weary invalid as lie reads may fancy that he smells again the sweet fragrance of spring flowers, and listens to tho hum of a bright summer's day ; and, not least of all, the ten- dency of these beautiful volumes, is to elevate our conceptions of the grandeur and love of the Almighty Creator."—Old Colony Memorial. "This is a work of rare and varied beauties. It is beautiful within and without; beautiful in conception and in execution ; beautiful as it comes from the hands of the author, the engraver, the printer and the binder."—Albany Argus. "This Is one of the most tasteful books of the season, very entertaining and amusing, and at the same time the work ot an accomplished naturalist."—Christian Register. " The author has availed himself not only of the greater abundance of material which the summer months supply, but also of the brighter hues afforded by the summer sun- shine, for the enrichment of his glowing descriptions, which become gorgeous while reflecting a parti-colored glory that eclipses the splendor of Solomon."—Journ. of Com, No work published during the year, has received so extensive and favorable notices from the British Quarterlies and Newspapers as the Episodes of Insect Life. A few are here given as specimens of the whole. "The whole pile of Natural History—fable, poetry, theory, and fact—is stuck over with quaint apothegms and shrewd maxims deduced, for the benefit of man, from the contemplation of such tiny monitors as gnats and moths. Altogether, the book is curi- ous and interesting, quaint and clever, genial and well-informed."—Morning Chronicle. " We have seldom been in company with so entertaining a guide to the Insect World."—Athen teum. " Rich veins of humor in a groundwork of solid, yet entertaining information. Al- though lightness and amusement can find subject-matter in every page, the under cur- rent of the " Episodes" is substance and accurate information."—Ladies' yiwfpaper. " A history of many of the more remarkable tribes and species, with a graphic and Imaginative coloring, often equally original and happy, and accompanied both by accu- rute figures ot species, and ingenious fanciful vignettes."—Annual Address of the Presi- dent of the Entomological Society. "This second series of "Episodes" is even more delightful than its predecessor. Never have entomological lessons been given in a happiev strain. Young and old, wise and simple, grave and gay, can not turn over its pages without deriving pleasure and Information."—Sun. "The headpiece illustrations of each chapter are beautiful plates of the insects under description in all their stages, capitally grouped, and with a scenic background full of playful fancy : while the tailpieces form a series of quaint vignettes, some of which are especially clever."—Atlas. "The book includes solid instruction as well as genial and captivating mirth Th« scientific knowledge of the writer is thoroughly reliable.—Examiner. IN PRESS, PHILOSOPHERS AND ACTRESSES. AESENE HOUSSAYE. With Beautifully-engraved Portraits of Voltaire and Made, de Parabera. THE HOUSE OF SCARRON. VOLTAIRE. VOLTAIRE AND MLLE. DE LIVRY. ASPASIA (THE REPUBLIC OF PLATO) MADEMOISELLE GAUSSIN. CALLOT. LA TOUR. RAOUL AND GABRIELLE. MADEMOISELLE DE MARIVAUX. THE MARCHIONESS' CAPRICES. THE MISTRESS OF CORNILLE SCHUT. CHAMFORT. CONTENTS. ABELARD AND HELOISE. THE DEATH OF ANDRE CHEN1ER, THE MARQUIS DE ST. AULAIRE. COLLE. THE DAUGHTER OF SEDAINE. PRUDHON. BLANGINI AN UNKNOWN SCULPTOR. VANDYKE. SAPPHO. A LOST POET. HANDS FILLED WITH ROSES, FILLED WITH GOLD, FILLED WITH BLOOD. THE HUNDRED AND ONE PICTURES OF TARDIF, FRIEND OF G1LLOT. THREE PAGES IN THE LIFE OF MADAME DE PARABERE. DIALOGUES OF THE DEAD UPON THE LIVING. "The title of Areeiie Houssaye's volume is not to be literally understood. There is more in it than falls at first upon the tympanum of our intelligence. The scene and action of the book are by no means restricted to academic groves and theatrical green-rooms. Its author allows himself greater latitude. Adopting a trite motto, he declares the world a stage. His philosophers and actresses com- prise a multitude of classes and characters; he finds them everywhere. Artists and thinkers, women of fashion and frequenters of courts, the lover of science and the; favored of wit and beauty—the majority of all these, according to his fantastical preface, are philosophers and actresses. Only on the stage and at the Borbonne, he maliciously remarks, few actresses and philosophers are to be found. " To a good book a title is a matter of minor moment. It was doubtless, diffi- cult to find one exactly appropriate to a volume so desultory and varied as that of Houssaye. In the one selected he has studied antithetical effect, as his coun- trymen are prone to do ; but we are not disposed to quarrel with his choice, which was perhaps as good as could be made. Philosophers certainly figure in his pages — often in pursuits and situations in which few would expect to find them; ac- tresses, too, are there—actresses as they were in France a century ago, rivalling, in fashion, luxury, and elegance, the highest ladies of the court, who, on their part, often vied with them in dissipation and extravagance. But Houssaye is a versatile and excursive genius, loving change of subject, scene, and century; and he skips gayly down the stream of time, from the days of Plato and Aspasia to our own, pausing here and there, as the fancy takes him, to call a flower, point a moral, or tell a tale."—Blackwood's Magazine. JUST PUBLISHED, CHARACTERS IN THE GOSPEL ILLUSTRATING PHASES OF CHARACTER AT THE PRESENT DAY. By Rev. E. H. CHAPIN. One Volume, 12mo., Cloth—Price 50 cts. SUBJECTS. I. John the Baptist; the Reformer. II Herod; the Sensualist. IH. Thomas; the Skeptic. IV. Pilate; the Man of the World. V. Nicodemus; the Seeker after Religion. VI. The Sisters of Bethany. " Each of the persons here named is taken as a representative, or type, of a class still found In the world, whose characteristics the preacher draws out and illustrates for the instruction, reproof, or correction of his hearers and readers. The work is done with a skilful hand, and in a stylo attractive and impressive. The book furnishes not only agreeable, but very useful and instructive reading."—Boston Traveller. " The preacher has selected the most striking traits in each character delineated, as typical of classes at tho present day. The practical nature and perpetual freshness of the fl. is pel narrative are strikingly exhihited, in the parallels he draws between the time* therein described and our own."—Journal of Commerce. " They are forcible in style, vigorous in thought, and earnest in spirit; and, although there is much in it from which we would most decidedly dissent, the book may be profitably perused by every mind of common discrimination."—Courier If Enquirer. "As we read his pages, the reformer, the sensualist, the skeptic, the man of the world, the seeker, the sister of charity and of faith, stand out from the Scriptures, and Join themselves with our own living world. The volume is very instructive, eloquent, and quickening, full of thoughts and purposes most vital to our liberal views of Christianity."—Christian Enquirer^ " The author of this work is well known as an eloquent lecturer, and those who read this volume will not be disappointed in their expectations. It is intended to help the reader to realize the vivid truthfulness and the perpetual freshness of the gospel narra- tive. While we dissent from some of his opinions, we recommend it as an able and eloquent work."—Albany Express. " Mr. Chapin has an easy, graceful style, neatly touching the outlines of his pictures, and giving great consistency and beauty to the whole. The reader will find admirable descriptions, some most wholesome lessons, and a fine spirit. He must not, however, look for deeply spiritual views, nor for an estimate of men and deeds by the orthodox standard. They are rhetorically very creditable, and deal with religious truth with an earnestness not always to be found in the writer's denomination."—N. Y. Evangelist. "Mr. rhapin is a graphic painter. 'He writes in a forcible, bold, and fearless man- ner: and while wo can not accord with all his views, many suggestive thoughts and useful reflections may be derived from its pages."—Religious Herald (Richmond, Va.) "These discourses have been delivered by Mr. Chapin from the pulpit, and all who have listened to the speaker can attest to the charm which his eloquence throws around any subject that he handles. These discourses teem with beautiful imagery, and abound with strong, pungent truths, and whoever reads one will read the book through."—Olive BrancJi (Boston.) %m, tentiful, itiui Sniqtrc IBnrk. JUST COMPLETED, EPISODES OF INSECT LIFE, BY ACHETA DOMESTICA. IN THREE SERIES, BEAUTIFULLY ILLUSTRATED, I. INSECTS OF SPRING. II. INSECTS OF SUMMER. III. INSECTS OF WINTER. Each Volume complete in Itself—Price $2.00. The same, elcgantTy colored after Nature, making a superh Gift Booh for the Holydays. Price $4.00 per Volume. OPINIONS OF THE PRESS. " These volumes are highly creditable to American taste in every department of book* making ;—it is impossible to give an idea of the periection of workmanship and the ad- mirable keeping of parts they exhibit. In order to appreciate this, one must see the volumes, and having seen them, he will at once transfer them to his own table, for tho instruction and amusement of old and young."—N. Y. Observer. " Moths, glow-worms, lady-birds, May-flies, bees, and a variety of other inhabitants of the insect world, are descanted upon in a pleasing style, combining scientific information with romance, in a manner peculiarly attractive."—Commercial Advertiser. " The style is the farthest possible remove from pedantry and dullness, every page teems with delightful matter, and the whole i9 thoroughly furnished with grace and beauty, as well as truth. One giving himself over to its fascinating charms, might read- ily believe himself fast on to the borders, if not in the very midst of fairy land."—Roches- ter Daily Democrat. " We have in this work deep philosophy and an endless flow of humor, and lessons set before us, drawn from ants, beetles, and butterflies, which we might do well to pon- der. We can think of nothing more calculated to delight the passing hour than the beautiful delineations we find in these three volumes."—Christian Intelligence " The whole insect world is represented in these volumes, many of them disguised so as to present what politicians would call a compromise between a human and an insect We cordially commend these volumes to the attention of our readers."— Boston Museum. "A book elegant enough for the centre table, witty enough for after dinner, and wise enough for the study and the school-room. One of the beautiful lessons of this work is the kindly view it takes of nature. Nothing is made in vain, not only, but nothing is made ugly or repulsive. A charm is thrown around every object, and life suffused through all, suggestive of the Creator's goodness and wisdom."—N. Y. Evangelist. " What a monument is here raised to that wonderful, tiny race, so often disregarded, but which nevertheless amply repays the care we may bestow in studying their pecu- liarities. The interest of the reader of these volumes is well sustained by the humor and sprightliness of the writer."—Zion's Herald. " It is a beautiful specimen of book-making. The character of the contents may be already known to our readers from the long and very favorable attention they have re- ceived from the English reviewers. The illustrations are at once grotesque and signifi- cant."—Boston Post. " The book is one of especial beauty and utility, and we heartily thank the publisher for his enterprise in putting it within the reach of American readers. It is worthy of a place in every family library. Elegantly illustrated and humorously yet chastely writ- ten, it is calculated to amuse aid instruct all classes of readers."—Com. Advertiser. .*. . *■-, ■■'■■:■ ,. .. «, <4'-H S -i£w4"* v.^xm.,'. :iii!i''lii 04