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0ONSUMPTIOX
BY
E. H. STOCKWELL, M. D.
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714
THE AUTHOR CAN BE CONSULTED PERSONALLY OR BY LETTER AT
  No. 3 EAST FOURTH STREET.
        CINCINNATI, OHIO.
            18 5 8. 
 
CONSUMPTION
BY
  /
/
E. H. STOCKWELL, M. D.

i?f i$
          OFFICE :
No. 3 EAST FOURTH STREET,

        CINCINNATI, OHIO.

            1858. 
   Entered according to Act of Congress in the year 1858, by
                   E. H.  STOCKWELL,
In the Clerk's Office of the District Court for the District of Ohio. 
PHTHISIS.
         The organs and functions of the human body are  liable to  a
       variety of lesions.  Specific lesions receive specific names.  But
       the one under examination—consumption, in the profession and
       out of it, is known by a variety of names.   Some  of the  words
       by which the disorder is known, are arbitrary,  while others are
       not.  Analogies, localities and symptoms have had more to do in
       giving names to consumption, than its real  nature.  A name
       that would embrace  the  definition of the  disease,  would be  of
       great service.   Until a cognomen is suggested, that will embrace
       the essential characteristics of the complaint under consideration,
       the old phraseology will be used.
          Phthisis signifies a wasting, a fading.  Tabes is  said to be  a
       consuming.  Marasmus means a wasting.   Macies  is a wearing
       away.  Cachexy is  a vicious  state of the body.   Dyscrasia is
       also a pernicious habit of  the system.  Atrophy is a want  of
       flesh. Scrofula is from  scrofa—a sow, swine  were  supposed  to
       be subject to the disorder, characterized by indolent tumors, chiefly
       in the neck.  Coxarum is an ulcerous disease  of the hip joint.
       Lumbar abscess or Psoas abscess, is an abscess which occurs in
       the small of the back.   Tabes dorsalis is an ulcerous disease  of
       the bones of the back.   Tabes mesenterica is  a tuberculous dis-
'  '    ease of the glands in the mesentery.   Phthisis pnlmonalis is a
        consumption of the lungs.  Laryngeal phthisis is a consumption
        of the larynx.  Tubercle means a little process or roughness, and
        is applied to small cheesy bodies that appear in various parts  of
        the body, especially in the lungs, and  always found in the second
        and  third  stages of pulmonary consumption.   Tuberculosis is  ap-
        plied to the habit or state of the constitution which produces tub-
        ercles.   Hectica is a fever that occurs in the third stage  of con-
        sumption.  Hectic fever is the same thing.   Consumption  is a 
4
Consumption.
consuming.   Emaciation is a wasting of the flesh.   Decline is a
gradual diminution of the strength and flesh.   Debibility is weak-
ness.   Bad habit is a mischievous or vicious state of the consti-
tution.  King's  Evil is  scrofula.   The Evil is  the same thing.
All these words stand for a common disorder.  The root in all these
ills is the same.  It may manifest itself at different  localities, it
may in different  individuals manifest different phenomena, and it
may be of all degrees, yet it is the same deceptive disorder in all
the above specifications.  Paleness,  emaciation, and  debility are
always the symptoms of phthisis, whether it manifest itself pro-
minently at  the larynx, lungs, lymphatic glands, mesenteric
glands, bones of  the back, hip-joint or small  of the  back.  And
when  the third stage  arrives—the suppurative, hectic fever will
occur  in all the forms of the disease.  The  bad,  evil habit pre-
vails in all of them.   So does the peculiar tuberculous material.
  A KNOWLEDGE OF PHTHISIS YALUABLE TO ALL.

   Statistics on  a large scale declare that one-sixth of mankind
die of consumption.  A knowlege, then, of the nature, symptoms,
prevention, and remote causes  of a disease so universal and des-
tructive, must be of immediate interest and utility to alb   All
may be easily made acquainted with  the  predisposing causes of
this disease.  The means for the prevention of phthisis are acces-
sible to, and capable of application by all.  Much of the remedy
for the relief and  radical cure of consumption  is hygeianic,
consequently within the reach and use of every judicious person.
Besides, that part of the remedy which is medicinal, must often
be left to the discretion of the patient and near  friends in many
particulars.   Again, the disease, in its nature, during  its onset
and first stage, is sly, insinuating and deceptive, and rarely suf-
ficiently alarms the subject  to call a physician until the  second
stage, when  it assumes a more defiant air.  And as the first stage
is by far the most curable one, its first symptoms should be known
by all as familiarly as household  words, so that it may be met in
its weakness and infancy, for it grows to gigantic strength.  Fur- 
Consumption.
5
thermore,  the foundation of  consumption,  in  the majority of
cases, is laid during childhood,  youth and early maturity, while
the person is under and within reach of parental care and coun-
cil, at the very time when proper advice and  conduct, would nip
it in the bud.  Moreover, the saddest havocs  of this destroyer is
among the young, the beautiful and the gifted, those from whom
the world expects and demands the most.
HISTORY  OF PHTHISIS.
  Consumption is a disease of variable climate.   Rsgularity of
weather is opposed to it, whether it  be warm or cold.   Sudden
changes and extremes of heat and cold favor it.   As the temper-
ate belt approaches the torrid or frigid, consumption disappears.
Extremes in temperature  when  coupled with  other  agents are
fruitful remote causes of this disease, hence its prevalence in this
latitude.   It also accompanies poverty, filth, dense population,
and idleness.  It is associated with fear, indolence and sentimen-
tality.  Civilization  often  encourages  it.   Barbarism  enforces
upon  its subjects air and  exercise, but civilization often fosters
ease,  idleness, confinement, the indifferent effiminate qualities of
the mind, sickly imaginations, and unbridled passions.   When it
developes dim tendencies into sentiments, sentiments into ideas,
and ideas into abilities, then it antagonizes the tubercular diathe-
sis.    Bat while it does this to the budding democrat, it frequent-
ly in the seedy democrat, sinks ability in ideas, ideas in sentiments,
and sentiments in less  than tendencies, and as a consequent
breeds in the blood the cachectic  evil.
  Occupation does something for Phthisis :-
Varnish Painters,..................37
Tailors,..........................14
Engravers,.........................14
Printers,.........................14
Clerks,..........................14
Polishers,........................12
Plasterers,........................12
Sculptor's,........................12
Stone Cutters,.....................12
Watch Makers,....................12[
Carpenters,........................9
Blacksmiths.......................9
Slaters,...........................9
Agriculturalists.....................9
Butchers,.........................5
Bleechers......................... • 5
Dyers.............................5
Watermen,........................5
Gardeners,.........................4 
6
Consumption.
  By this table it will be seen what per cent, in the  above occu-
pations die of tubercle.  Gardners are the least liable to it.
  At what period of life does consumption number the most vic-
tims ?   Louis' observations  in 123  cases, give the following :—
from the age of 15 to 20, he met with 11 deaths; from 20 to 30,
he met with 39 deaths;  from 30 to 40, he met with 33  deaths ;
from 40 to 50, he met with  23 deaths;  from 50 to 60, he met
with 12 deaths ; and from 60 to 70, he met with 5 deaths.  Dr.
Passavoine's observations in  920 cases of death among children,
(532 girls and 388 boys,) who died from the age of 2 to 15, 538
were consumption.   In childhood and youth, consumption slays
its greatest number; the next period is between 20 and  30.  By
these observations it will be seen that consumption is not confined
to any period of life, yet it prefers  youth and early maturity.
  What is the duration of consumption in a given case ?   Louis'
observations in 314 cases, give the following:  34 died  within  3
months;  69 died within 6 months  ; 69 also died within 9 months;
32 died within 12 months; 43 died within 18 months;  30 died
within 24 months ;  12 died within 36 months; 11  died  within
4S months ;  5 died within  5 years;  1  died  within 6 years ;  3
died within 7 years; 1 died  within 8 years;  3 died within 10
years; 11 died within 40 years ; and one died within 54 years.
The average time has been computed at two years.
  Louis' observations enabled him to assert that after the age of
15, if tubercles occur at all in the body, their presence  in the
lungs is certain ; that the deposition of tubercles occurs  first at
the  apex of the  lung; that consumption is more frequent in wo-
men  than in men ; that pneumonia is more easily resolved in the
consumptive lung than in the healthy ; that bronchitis commences
at the base of the lung, and that chronic peritonitis indicates pul-
monary tubercle.
              THE STAGES OF PHTHISIS.
  Consumption has three well marked stages.   There are three
epochs in its alarming career.  They are easily distinguished by
the physician.  They are the First, the Second, and the Third, or 
Consumption.                      7
the Forming, the Depositing, and  the Softening or Ulcerous.
The vicious state of the body which forms or begets the material
called tubercular, is the First or Forming stage.  This stage may
be of short or of long  duration.  It is obscure, deceptive and
dangerous.  During this stage vigor is lost by piecemeal, beauty
vanishes by secret doors, robustness disappears as by mystery,
and symmetry departs by hidden ways.  Its progress is not mark-
ed by days, nor by weeks, nor hardly by  months, but by years.
This stage occurs prior to tubercle in any organ.  And it is
this stage that marks the real nature of the disease.  He who
would correctly understand Consumption must  study profoundly
the First stage.   For, afterwards appear complications that well
nigh overshadow the real disorder.   The deposition of tubercul-
ous matter causes local derangements which have been taken for
the root of the disease.   A dangerous mistake!  He who looks
at this fearful evil to the body, from the tubercle, will  be sur-
rounded  by darkness, and be without a light for the direction of
his course.  Tuberculous matter is formed in the general vascular
Bystem, especially in the lactiferous, lymphatic  and venous half,
but more especially at the point where arterial blood is  born—
where the pulmonary artery  pours  its tide into the pulmonary
vein.  From the head of the  arterial blood, it passes to all  parts
of the system, and repeats its  career through the sanguiferous
channels, times without number; and finally,  its natural outlets
being closed, it escapes from the vessels at  their weakest  points,
by transudation into the meshes of the tissues.  Even then, if
there is a suppurating surface in the system, or if one can  be easi-
ly made, the tuberculous matter will tend to that point,  and  es-
cape through it for months and  even years, before it will escape
by the pores of the capillaries into a vital organ.
  The Second or Depositing Stage creates  new  features—compli-
cations—local phenomena.   Phthisis generates a specific material
called tubercle, because of its shape.  It is cheesy in appearance,
and constitution; and when this product is  deposited upon any
membrane, into any  organ, from the vessels, the deposit introdu-
ces the Second Stage.  This  may continue a longer or a  shorter
time, depending upon the vigor of the body and the extent of the
vicious habit.   This deposite assumes various shapes, according 
8
Consumption.
 to the locality and the motion of the part.   It may be granular
 or tuberculated ; it may be gray or yellow; it may be aggregated
 or scattered.   It may be conjectured that the gray tubercle results
 from the old albumen that should have escaped at the surface and
 lungs, and that the yellow tubercle is from the non-developed
 blood.   If so, in the history of the two, the hard  minute tubercle
 would occur first, and if the other did not soon follow, it might
 remain as  a grey tubercle for years without mischief;  but if the
 yellow tubercle soon follows it, then it would be liable to dissolu-
 tion.   The yellow tubercle  indicates a still-born state  of  the
 blood, while the grey simply indicates the retention in the blood,
 of what should have passed away with expirations and perspira-
 tions.  If  the evil habit which causes the tuberculous material, be
 eradicated after the deposition  of tubercle, the tubercle  may be
 absorbed, or it may remain in a latent state through life, and pro-
 duce comparatively no mischief.  The tubercle is unorganized, and
 a foreign  substance and always  causes more or  less irritation,
 and occupies space which should be possessed by healthy tissue.
 The morbid irritability which is a prominent feature of consump-
 tion, in all of its  stages, is enhanced by the  mere tubercle,  and
 there is generally much  abnormal irritation in its neighborhood,
 caused by  its presence.
   The Third Stage is marked by the hard cheesy tubercles soften-
 ing, suppurating, ulcerating.   If the tubercles be in the center of
 an organ and  aggregated, a cavity will be the result of their  dis-
 solution, and the cavity  is called  a  vomica;  if it be upon  the
 mucous membrane, the ulceration will be superficial, and  no  ob-
 servable  cavity may be the result; and if the tubercles are sparse-
 ly scattered in the substance of the lungs, the cavities resulting
 from their  softening will be small, and perhaps too small for  de-
 tection.  This stage may arrive when  there are but few  tuber-
 cles in a  lung, and such may be cured, though the last stage  has
 arrived.    Every Third Stage  case  does  not possess the same
amount of  tubercles, and this is the reason why some in this stage
are curable, and why others are not.   If both lungs are filled with
tubercles and they soften together, the aerating membrane is des-
troyed, and respiration  is impossible, no  matter who is  present
cr what is given.   And because some such cases do  occur,  and 
Consumption.
9
are beyond help, the hasty in opinion,  declare that every case
that arrives at the Third Stage is incurable, and more, that a case
is not consumption that does not reach the Third Stage, that does
not fill both lungs with tubercles, and that does not end in death.
Such minds perhaps had better be indulged in their seedy notions.
The Third Stage is marked by hectic. Pus is the general cause of
this fever in consumption.   It may result from severe irritation.
And as pus is not developed in the First nor Second stages, but is
always in the Third, Hectic is restricted to this  stage,  unless
caused by severe  irritation, abscess in pneumonia or ulceration in
bronchitis.  If inflammation as a complication, nor severe irrita-
tion does not occur in the career of consumption, then hectic fever
will not occur until the Third Stage.
  In contending with this giant of a disease, the pernicious state
present in the First Stage,  is the  one  for the physician to ever
keep in mind, and is the condition that must  be  combatted by
medication, and not the tubercle, nor the ulcer.  They are but re-
sults  of  a  prevailing morbid  habit.  The morbid  anatomy is
caused by a morbid physiology which constitutes the disease to be
fought, to be  routed, and to be vanquished ; and until then will
the disease advance with haughtiness and power, in spite of drug
and. doctor.
        THE  SYMPTOMS OF THE FIRST STAGE.

  The symptoms of phthisis are divided into rational and physi-
cal.   The physical are obtained by auscultation and percussion,
and the rational are those obtained through all other channels.
The physical signs are restricted to the Second and Third Stages,
because organic lesions do not occur in the lungs during the First
Stage.
  There is a ready susceptibility to the changes of temperature.
The body is  easily oppressed by heat, and easily chilled by cold.
The skin is feeble ;  it is inclined to paleness.  Its  action is vari-
able ; there  is  no permanency  in its vigor.   When exposure
comes reliance cannot be placed in  its resistance. Its susceptibili-
ty is  morbid.   The feet, hands, tips  of the ears  and nose  sre 
10                      Consumption.

quickly cooled.  The power of the air is greater than "that of
the cutis.  The  person  feels that  he is the minor force.   The
skin demands protectiou from  the  atmosphere, yet the struggle
between  the  air and skin is often equal, sometimes the latter
for a while may be more than equal, but generally the  former is
the superior force.  Steady,  insensible perspiration is wanting.
  Respiration is unsatisfactory.  There is something lacking in
each breath.   Full benefit  is not experienced by breathing as
heretofore.  A prolonged  and voluntary inspiration  is often re-
sorted  to, to  realize full satisfaction from the  air.  Absorption
and  elimination  at  the lungs—aeration,  are  not equal to  the
wants of the system.  And the unsatisfactory feeling from breath-
ing gradually increases.
   The  throat is  pale or  cineritious, or patchy,  or  mottled, or
granular,  or  heavy or sluggish.   The breath  has a  sweetish,
sickly  smell.  The sputa  is scanty, frothy,  adhesive.   The
cough, if any, is dry,  hacking.   And there  is  shortening  of
breath  on exercise,  especially during  the ascension of heights,
as stairs and  hills.
  There is a prevailing lassitude.  Exercise soon  brings exhaus-
tion.  Fatigue follows labor, and chillings follows fatigue.  Two
states that should be carefully  guarded against.  Fatigue and
chilliness constitute the folding doors out of which the life of  the
consumptive   passes.    Elasticity  of muscle is  waning.  Eat-
ing and  sleeping do  not bring their  accustomed refreshment.
There is tireness in the morning.  The meal does not restore the
animal  spirits.   Fondness  for exercise is declining.   There is
hope and confidence, but they  are inoperative and without works.
There is an ebbing of action, enterprise, fortitude and courage.
A growing tide  of indifference and inertia  is advancing upon
the individual.
  The blood gravitates towards the  mucous membrane, especially
towards the mucous tunic of the air passage.  The cutis loses in
blood as that to the mucous  membranes increases.  The blood in
rate of movement through its  channels is perceptibly increasing.
Though no one week will  evince the more frequent movement of
the blood, still extremes  of longer time will indicate  it.  The
pulse is more frequent yet less vigorous.  The augmented speed 
Consumption.
11
is a sign of weakness.   The respirations per minute are growing
in frequency, shortness and scantiness.   The appetite is apparent-
ly good, yet the relish  of health for food is departing.   And the
bowels are gradually running into sluggishness.
  If the person has a hsemorrhagic habit, or if there is a defici-
ency of fibrine in  the blood, there may be in the First stage spit-
ting of blood ; for the mucous  membrane  of the air passage
though  free  from tubercles, nevertheless, is turgid with blood,
and this condition may lead to haemorrhage.  If it does occur it
will be passive, and serve to disgorge the embarrassed vessels.
  The augmentation of circulation may be so great as to amount
to a  fever in this stage.  If it does, it is remittent.   Flashes of
i^eat are very common. The fever will be preceded by chilliness,
and followed  by perspiration.
  There may be an issue,  a leakage somewhere  in  the system,
and if so, the consumptive state will be greatly  obscured by it.
The local suppurating  surface, for the time  being, eliminates the
specific material  which the tubercular diathesis generates, and
though  the cachetic is  present, the nocent material being elimen-
ated, as fast as formed, by the issue,  the peculiar phenomena con-
sequent upon its  retention in the blood, and carried a thousand
times through the system, are to a great extent obviated.  The
issue may be a fistula,  or  an  old catarrh, or a long standing leu-
corrhoea, or an ulcer in the  skin, or an old expectoration, or a
cutaneous disorder.  Such issues easily throw off stale albumen,
and often take on a part of the functions of the skin and lungs,
at least  so far as the removal from the system of decaying albu-
men, and this is the reason why the system rights itself so poorly,
after having  an old ulcer healed upon it.   And if such issues
exist  at the  time of consumption,  they become  doors for the
escape of old  perspirations and expirations—of tuberculous mater-
ial, and not only  obscure  the forming stage, but  prolong it, and
postpone the  second aud  third.  In one sense issues may cause
consumption.  After their long establishment, they vicariously,
relieve the lungs and skin of their office of discharging from the
blood, vicious albumen.  In  the mean time this material by
habit tends to  the  issue,  and not to the natural outlets for it,
they become  torpid from inaction, and when  the issue is healed, 
12
Consumption.
care not being bestowed in the meantime upon the skin and lungs,
they do not readily take on their old office, and the stale albumen
accumulates, and soon interferes with the blood making processes,
and all the fluids become contaminated,  tuberculous material is
formed and depositions occur.
  There is not necessarily any pain associated with this stage,
nor inflammation.   If they do occur they are adventitious.  Yet
there may be in this stage, much  bronchial irritation and inflam-
mation and cough, but they are,  when occurring, complications,
and not legitimate results from this stage of the disease.
  Paleness, emaciation, and debility, at first and for some time
scarcely  observable, yet gradually augmenting, are legitimate
consequences of this disease.
  The  physical signs of this stage are not of any value.  There
is no dulness on percussion nor any change in the voice or breath,
except perhaps a feebleness in the respiratory murmur.
      THE SYMPTOMS OF THE SECOND STAGE.
  All of the legitimate  symptoms  of the First  stage are aug-
mented in the  Second, but the characteristic  features  of this
epoch spring from local causes that constitute the great complica-
tions of the disease.  The tubercular material  which the First
stage concocted and generated, which has been circulating through
the system, times  without number,  is now escaping from  the
vessels in  virtue of their augmented permeability from weakness
and overdistention, and  depositing  itself upon the mucous sur-
face of the air passage, in the air cells, and in the meshes of the
lungs, or elsewhere.  As this morbid, stale, unorganized mate-
rial escapes from the vessels, it is liquid, composed of  a fluid and
solid, the former is serum, and the latter is albumen, the first is
soon reabsorbed, while the second is left to concrete.  The shape
of the concretion depends upon the place  where it is lodged and
tbe motion  of the part.  Sometimes it is granular, or tubercul-
ar, but this is accidental.   The blood is composed of  a fluid and
a solid portion,  the former serving as the solvent of  this latter. 
.Consumption.
13
That property of the serum which enables it to hold in solution
the albumen and fibrine of the blood, is alkaline, and the particu-
lar alkali is believed to be ammonia.  This is volatile, and when
the blood or parts of it, escapes from the conservative influence
of the blood  vessels, the fluid  constituent  of the blood loses its
solvent power over the solid constituent,  by the supposed  voliti-
lization of  the ammonia.  The serum is reabsorbed back into the
circulation, but the albumen is  left behind,  to breed mischief and
perhaps death.
   In this  stage, the skin and pulmonary lining  membrane, are
ten-fold more embarrassed than in the First stage.   The deposi-
tions are lifeless, incapable of vitalization, and hence foreign sub-
stances ; but are for the time preserved from decomposition by the
conserving power of the body.   Yet they enthrall the  tissues in
which they lie, by depriving them of their natural room, by  aug-
menting the weight of the part, by their dead  condition, and by
their abnormal irritation.  The irritation, gravity, and incapacity
of the lungs are augmenting.   The cough  is generally harsher,
dryer and  more severe, though the dryness of the cough will de-
pend upon the absence of inflammation in the mucous membrane.
The tubercles may throttle the  small pulmonary veins,  and pre-
vent the blood from moving through the lungs, on to the heart and
general system, and if so, the  blood will accumulate, the capil-
laries of the  vessels thus  corded, and  effusion  of blood into the
bronchial tubes, and expectoration  of  blood, will be the conse-
quence.   This form of haemorrhage is passive and will be service-
able to the engorged, incarcerated vessels.   If the case is one of
the mixed  variety,  the expectoration may be copious.   The ex-
pectoration of the First and Second stages, depends wholly upon
the inflammation of the bronchial membrane, which is not nec-
essarily a condition in these two stages of consumption, though
it often obtains.  Dyspnoea—difficult breathing, isfa necessary
consequence  of  tubercles in the lungs, provided their  amount is
sufficient to interfere much with the capacity for inhalation.  The
augmentation in the rapidity of respiration will depend upon the
same cause, unless fever is  present.  The rate of pulse and that
of respiration correspond.   Hasten one,  and the other will be in-
creased.   In this stage they are generally  frequent, that of res- 
14
Consumption.
piration about 23 per minute, and pulse about 100 per minute.
Emaciation is well  marked, so of paleness  and debility.  The
symmetry of the body is fast departing.  The shoulders are fall-
ing forward upon the chest; the spine  and head droop, and if
there has been pleurisy, there is a distortion in the chest at the
apex.   The ends of the  fingers may be bulbous and  the nails
very convex.  The sclerotic coat of the  eye may be very white.
The gums are bordered by a red narrow belt.  There may be
severe night sweats, though this symptom may occur in each
stage; quick exhaustion or exercise; variable  appetite; costive
bowels ;  pale skin,  and turgid  state of the air passage.  There
may be in this stage, albumenous or purulent expectoration, but
if so, it is no evidence of the softening of tubercules, but suppura-
tion from inflammation  in the mucous membrane, a prominent
feature in bronchitis.
   Among the rational symptoms of this stage,  upon which most
dependence may be placed,  are  paleness, emaciation,  debility,
increased  pulse, increased  respiration, difficult breathing,  red
border of the gums, and diminished calorification.
   The physical signs of the Second stage are a  prolongation and
augmentation of the expiratory murmur,  and  a shortening and
diminution of the inspiratory murmur; a jerking  inspiration  •
senile inspiratory murmur ; sibalent or sonorous rale at the apex
of the lung, provided there is a chronic habit,  and the vesicular
murmur is elsewhere; bronchial inspiration ; tubular inspiration  •
pectoriloquy;  bronchophony;  any change at  the apex of  one
king and not at the other in the respiratory murmur; any change
in the resonance of  the voice at one apex  and  not found at the
other ;  the  pulmonary crumpling sound ; the absence of  the
thrill on one side and its presence on the other, and dullness on
percussion.
       THE  SYMPTOMS OF THE THIRD STAGE.

  Here is a fresh complication.  There has occurred the diathesis
that created the  tubercular matter; and that material has been
deposited and it has remained as a concretion a longer or shorter 
Consumption.
15
time; but now decomposition  in  the  tubercle occurs; it  is not
only dead, but dissolution is rapidly going on in it.  The Third
stage is the one of Dissolution  to the tubercle; the Second stage
is the one of Burial to the tubercle ; and the First stage is the one
of Birth to the tubercle,  though in fact of Death to the blood.
This dissolution  does  not take place  in the tubercle, unless the
conservative  influence  of adjacent parts  is much  diminished.
And this removal of the  vital influences of adjacent parts from
the tubercle, is brought about by inflammation.   The nocent in-
fluence of dead material upon  capillaries is often, yes generally
sufficient to the diminution of their tone and circulating energy;
the vis a froute is reduced or suspended, and the vis a tergo,
remaining perhaps the same,  causes  an afflux into the place of
weakness, and accumulations, congestions, stagnations, extraver-
sations and infiltrations follow.   By  these means the vitality of
the part is lessened, the conserving power is diminished, and suf-
ficient decaying elements  are mingled with the already dead tub-
ercles, to commence and to rapidly accomplish the dissolution of
the tubercles.  This softening  then of the concretions is started
and pushed through by inflammation about them.  And this in-
flammation is Pneumonia.  It may be, and generally is, restrict-
ed to" the immediate neighborhood of the tubercle.  The tubercle
if it softens, has  finally overcome the  conservative  influence of
immediate tissues; inflammation  follows ; also suppuration of
immediate tissues and  dissolution of  tubercles; the fluid mass
escapes into the bronchial tubes, from  thence it is carried off by
expectoration.  Suppuration is to  the blood what ulceration is to
the tissues, yet they are sometimes used synonymously.  When
a part dies by layers, one following the other successively it is
called  ulceration  ; and the breach  is called an ulcer ;  but when a
section of an organ dies, the  lesion is called  an abscess, or a
vomica; the latter term  is applied to the cavity formed  by the
softening of a bed of tubercles  in  the  lungs.  The pus  from the
decay ot blood and the solution of the tubercle is pernicious to
the system, especially if any part is absorbed into  the vascular
system, and causes great irritation and hectic.
   The new features  then of  the  third stage are Pneumonia,
Dissolution of tubercles, Cheesy  expectoration, Vomica,  and 
16
Consumption.
Hectic  fever.  All of the characteristics  of Jthe Third  stage,
spring from  the  softening of the  tubercles.  And as a  conse-
quence the features of this stage are local or proceed  from the
local mischief.
  The features of the First stage are universal and constitutional,
while the features of the Second and Third stages are local.  The
first throws light  upon the second, the second throws light upon
the third, and  the third only upon the phenomena that result
from  it.
  The rational symptoms of the Third stage are colliquative diar-
rhoea ; difficult swallowing called dysphagia, because of the con-
nection between  the  pharynx and  larynx, the latter at the time
being  ulcerated ; a difficulty  in speaking,  termed  dysphonia,
caused by an ulcerated state of the larynx;  a want of voice, cal-
led aphonia,  caused by an ulcerated larynx; pain and burning in
the larynx, caused by  ulcers in the larynx; want of uniformity
in the positions of the nipples, for in this stage, the pleura is
often  inflamed, adhesions follow  between the pleura and lungs,
and they distort the chest and change the position of the nipples;
a depression about one clavicle that is  not about the other, for the
reason just given; a want of uniformity in the positions of the
Bhoulder blades,' for the above reasons also;  hectic fever;  great
suffocation caused by the discharges into the air  pipes ; ragged,
floculent,  cheesy, nummulated sputa, and severe paroxysms of
chills  and fever.
  The physical signs of the Third  stage,  are a  permanent local
crepitous rale at the apex of a lung ; cavenous breathing ; a gur-
gling; coarse crepitations ; metallic tinkling; amphoric respira-
tions ; clieks; metallic echo, and the blowing respiration.
             THE VARIETIES OF PHTHISIS.
  The facts are sufficiently numerous  to  justify four  varieties.
They are the Acute, the Chronic, the Unmixed, and the Mixed.
  The Acute variety runs  its course in a  few weeks or months.
The reason of this lies in the suddenness and intensity  of action 
Consumption.                     17
of the remote causes.  They are so  concentrated and so potent,
as to bring the system  at once under their controlling influence,
immediately begetting the consumptive habit, and pushing it rap-
idly through its stages, causing death in a short time.
  The Chronic variety may be years in passing through the three
stages.  In this variety, the vigor of the system is almost equal
to the remote causes.  Their encroachment upon the system, at  <
first, is slight, and only overcomes it by a persistent and extend-
ed struggle.  In the Acute, the onset is terrific,  while  in the
Chronic it is almost indifferent; in one variety the stamina is at
once broken  down, while in the other it is spun out into years.
   The Unmixed variety is rare, and as often, confounds  patient
and physician.  In this variety, the disease pursues its legitimate
career.  It keeps from side issues and complications.  It  aims to
represent the career of consumption without the air of  morbid
sensibility, inflammation, etc.   It seems to be jealous of other
ills.; and desires to  go through  the various stages simple-handed
and  alone.   There is no inflammation  but that  which occurs
about the tubercles when they  are  softening.  There is no bron-
chitis, no pleurisy,  no  peritonitis,  nor no pneumonitis until the
Third stage.  The  cough is slight, often  none, the  expectoration
for the  First and Second  stages is scanty; the night-sweats, the
pain in the chest, the difficult breathing, and the evening fevers5
are  almost wanting.  The generation  and deposition of the tub-
 ercles occur without exciting much  morbid irritability.    They
occur under guise, lie  in ambush until softening, and then spring
 upon the individual with  Indian ferocity,  bathing arrow  and
hatchet in the life's blood,  and brandishing them  reeking with
the  crimson tide.
   The Mixed variety  is  generally met with.   So often  .do the
Chronic and  the  Mixed  varieties appear, and so  rare  are the
Acute and the Unmixed, that many doubt the occurrence of the
 latter at all.  In the Mixed variety,  the  morbid susceptibility is
 very great, causing severe  irritations; frequent, early  and late
inflammations, and  of course, cough, expectoration, pain, night-
sweats, fever, chills, etc.
2 
18                     Consumption.
        PREDISPOSING CAUSES OF PHTHISIS.

  They are whatever permanently undermines the vigor of the
constitution.  They are hereditary  vices, repeated fevers and in-
flammations,  diseases poorly treated, recessions of cutaneous dis-
orders, repeated  fatigues, sexual excesses, excessive  labor, foul
air, living in  dust, mental  depression, indolence, long confine-
ment to shade, living for a long time upon poor food, insufficient
clothing, sudden closing of issues without  attention to the elim-
inating  organs   simultaneously,  fear, want of  determination,
stagnant air, excess of eating after fasting,  repeated sudden tran-
sitions from heat to cold, sudden  cooling of the body after exer-
cising, sentimentalism, gloom and sickly imaginations.
       THE  IMMEDIATE CAUSES  OF PHTHISIS.

  Much agreement obtains among medical men respecting the
remote causes of  consumption,  but respecting the immediate
causes among them, there is much disagreement.  Without enum-
erating the various theories, we at once give our own, leaving
the arguments for its substantiation for the chapter on the Nature
of Phthisis.  One  of the immediate causes of consumption  is
an enervation in the whole nervous system, and  especially in the
respiratory system of nerves ; or  more explicitly, a deficiency  of
Nervous Force, or  Electricity, in the nervous fibres of the general
body, and especially of the respiratory section.
  The nerves of impression which belong to  the  respiratory cir-
cle, originate in the entire mucous membrane of the air passage,
in the skin of the  face, head, neck, shoulders and chest.   The
nerves of innervation which  belong to the respiratory circle, end
in the muscles of respiration.  The respiratory ganglia  are  situ-
ated in the corpora restiformia  of the  medulla  oblongata, and
they receive the centripetal, and give off the centrifugal nerves
of respiration.  The  ganglia are  sources of force.  The nerves
of impression are  conductors of influence to the  ganglia, and 
                        Consumption.                     19,

serve to arouse them to action.  The nerves of innervation  are
conductors of the force generated by the ganglia to the respirato-
ry muscles. But these nerves of impression and innervation,  are
rendered conductive not by the papillae, nor by the ganglia, but
by the electricity of the atmosphere.
  The blood  vessels are recepticles of digested food ; the red cells
are recepticles of oxygen  from the  air, and the nerves are  the
recepticles of atmospherical electricity.   Deprive the nerves of
electricity, or the red cells of oxygen, and  they become inopera-
tive, as surely as the stomach when deprived of food.   Man feeds
on oxygen and electricity indefinitely more than he does on bread
and meat.  These he requires only occasionally, but those are de-
manded by him at every inspiration.  Electricity is to the nerves
what air is to the  lungs, and food is to the stomach.  The nerves
obtain this electricity  from  the atmosphere, through the. lining
membrane of the  air passage, and through the  external surface.
As long as these two membranes are  healthy, so long will the
centripetal nerves  obtain from the atmosphere the  electricity  that
they and  the centrifugal nerves require, to render them conduc-
tive.   But in consumption they are lacking in  this celestial food.
The nerves in consumption are hungry.  Their electrical leanness
prevents them from  performing  their offices of impression  and
innervation sufficiently.   Impressions and innervations are alike
feeble and morbid, and as a consequence, ganglionic  and  muscu-
lar action is  marked by feebleness and irregularity.
   But there is another proximate cause.   This is  a deficiency of
oxygen in the entire blood, and especially iit the red cel\s.   The
consumptive then  is  wanting in two atmospherical  elements-
Electricity and Oxygen.  Oxygen as usual does not get to the
blood.  The red cells are hungering for oxygen, as the nerves are
for electricity.
   A deficiency of these rich atmospherical elements,  the recepti-
cle of one being the nerves,  and the recepticle of the other being
the red cells, is the immediate cause of consumption.   The cause
is a starvation—a lack of aerial food.  It is not positive,  but ne-
gative.  It is not  something from without; nor is it a hereditary
something, but a deprivation of oxygen and electricity.
   The office performed by the electricity received by the nerves 
20
Consumption.
 from the atmosphere, has been pointed out; it renders the nerves
 conductive.  But the offices performed by oxygen, received by the
 red cells from the atmosphere, have  not been specified.  These
 offices  are, the complete  transmutation of  chyle into arterial
 blood, calorification in the capillaries, disintegration of the gan-
 glionic cells, and the disintegration of muscular cells.   The blood
 is not fully vitalized until it meets the oxygen at the lungs, the
 carbon is not oxidized until it meets the oxygen in the capillaries,
 the ganglia  do not act independent of oxygen to  disintegrate
 them, and the cells of muscles do not act  in the  production of
 tone and contraction, without oxygen to disintegrate them also.  A
 want of electricity then will interfere with the transmitting power
 of  nerves, and a lack of oxygen  will interfere with the blood-
 making process, with calorification, with ganglionic action, and
 with muscular action.   And  these  offices   are  the  essential
 offices to life.   Interfere with them, and yon  interfere  with  life.
 The consequences then of'• these deficiences of oxygen  and elec-
 tricity are seen in  the states, phenomena and facts that appear
 during the career of consumption.
  Some suppose that the cause of consumption is a deficiency of-
 some of the elements of the food received by the stomach.   But
 this is a mistake.   The food eaten by  the consumptive is the
 same as that eaten by the healthy.   So it may be said of the air,
 but the air does not reach the blood of the consumptive in suffici-
 ent quantity.  To be sure the air around the consumptive is the
 same as that around the healthy person, but they do not receive
 it alike.  »Between the consumptive and the air of  heaven, there
 is a stubborn barrier, upon which man depends much more than
 he does upon the food of  the breakfast and  dinner  table.   And
 what is of great satisfaction, we know what that barrier is, and
 often what will  remove  it.  The  permeability  of the aeratino-
 membrane in consumption  is diminished by  the gravitation  of
 blood to it, by turgescence, heaviness,  thickening and embarrass-
 ment.   Also, there is a  barrier in the  skin,  that prevents the
blood and air from meeting there.   And this barrier is known
and often the remedy that will  remove it.  The barrier is not the
same as at the aerating tunic, but the opposite.   Here is not tur-
gescence,  but  an exsanguine  state.   The mucous  tunic of the 
Consumption.
21
whole body, and especially that of the air passage, is overloaded
with blood, and this excess is at the expense of the blood  of the
skin.    The lungs are water-logged,'the cutis is upon the  beach,
the nerves are windless, and the red cells are without provisions.
This is  the condition  of the consumptive.    Excess of blood  to
the lungs prevents full respirations, and a deficiency of blood  to
the cutis, prevents natural perspiration.  The  first faulty func-
tions in the consumptive are respiration and perspiration.  And
they are faulty from  opposite causes, one  from excess, and the
other from a deficiency.   Both depend  upon an insufficiency  of
oxygen and electricity.  Restore them by any means, and respi-
rations  will become long,  deep and copious, and perspiration will
become steady, insensible and persistent.  As long as the oxygen
and electricity are furnished to the system according to its wants,
so long  will the functions of the lungs and  skin be maintained.
Not only are the healthy play of the lungs and cutis necessary
for the  reception of oxygen and electricity, but oxygen and elec-
tricity are necessary to the normal action of the  perspiring and
aerating membranes.   Remote causes are often sufficient to pale
the skin and to gorge the mucous membrane, and if they are al-
lowed to continue and keep up the recessions from the cutis, the
barrier  will be erected which intercepts the embraces  of air and
blood at the lungs and skin, which  interferes with respiration
and perspiration, which  prevents the incoming  of oxygen and
electricity, and inaugerates the consumptive diathesis.
              THE NATURE OF PHTHISIS.

  By the word nature, we mean the definition or characteristics
or pathology of Phthisis. The nerves are poorly supplied with elec-
tricity from the atmosphere ; the blood is poorly supplied with oxy-
gen from the air ; respirations are interfered with; perspiration
is checked ;  the aerating membrane is diminishdd in permeabili-
ty; the cutis  is lacking in blood  for its  functions; the blood
avoids the cutis and  tends to the mucous membrane; the pro-
ducts which should  be eliminated by expirations and perspiration 
22                      Consumption.
 are, to a great extent, retained within the blood ; the whole blood
 becomes contaminated by their retention ;  the blood is foul from
 old breaths and sweat; this defilement  of the  blood  interferes
 with the blood-making  process; good  blood is  not elaborated,
 but still-born blood ; still-born blood and stale elements  fill the
 blood with vicious material ; the pabulum requisite for nutrition,
 secretion, calorification  and disintegration is not manufactured ;
 these great processes are diminishing ;  the  evil products hourly
 accumulate;  the capillaries of the whole system  become feeble;
 they readily allow accumulations, over-distention,  extraversation
 and  infiltration ; the stale, nocent material escapes from the blood
 vessels into the meshes  of the tissues ;  it forms  tubercles ; they
 embarrass  and aggravate the organs in  which they are deposited;
 by their foreign influence they soon  overcome  the vital  proper-
 ties of adjacent vessels,  and decompose; their dissolved material
 falls into the air-tubes, and is expectorated, leaving  frightful le-
 sions, and  causing the fearful hectic.
   Constituents of Sweat—
     Acetic Acid,              Lactic Acid,
     Oxalic Acid,              Formic Acid,
     Butyric Acid,             Chloride Soda,
     Chloride Potassa,          Muriate Ammonia,
     Phosphate Soda,          Phosphate Potassa,
     Oxide Iron,               Sulphate Ammonia,
     Water 11 gr. per minute,  Stale Albumen 100 gr. per day.

   Constituents of Expirations—
     Carbonic Acid,            Nitrogen,
     Ammonia,                Phosphorous sometimes,
     Water 7 gr. per minute,   Stale Albumen 24 gr. per  day.

   Constituents of good Inspirations—
     Oxygen,                  Electricity,
     Nitrogen.
   To a limited extent, the same elements enter the system from
the air through  the cutis.
   Thus it may be seen what results  to  the  blood  whenever  the
pulmonary  membrane and  cutis lose their  eliminating  power. 
Consumption.
23
Foul products, at every pulsation, are marching up from the re-
cesses  of the  body, to  the lungs and skin, for elimination, and
the atmosphere is sweeping their outer surfaces for the reception of
the products at the same time. Besides, as the heart sends the blood
to the  lungs and skin, for the purpose of eliminating mischievous
elements, the air has in its  bosom  what the  blood demands, to
render it equal to the wants of the body.  While the air is sweep-
ing every cell of the lungs and the entire skin, it is giving to the
blood  its most important  constituents.  While a scavenger,  at
the same time, the noblest cup-bearer, bearing  from the  skies
nectar and ambrosia to the occupants of earth.
   Specific functions in blood-making—
     Digestion,                Absorption,
     Circulation,                Assimilation,
     Sanguification.

   Specific functions in blood-consumption—
     Secretion,                 Nutrition,
     Calorification,            Disintegration.

   Specific functions in blood-purification—
     Perspiration,               Expiration,
     Hepatic Secretion,          Renal Secretion,
     Intestinal Secretion.

   In the history of these  functions, blood-making occurs  first;
 afterwards occurs blood-consumption,  and  finally blood-purifica-
 tion,  During the consumption of blood,  two of the sub func-
 tions defile the blood, they are calorification  and disintegration.
 And because of  this defilement, are instituted the purifying func-
 tions—expiration,  perspiration, hepatic secretion, renal secretion,
 and intestinal secretion.  Connected  with  the vascular system
 there  are five eliminating organs.   One of which is wholly ex-
 porting—the renal, but the  others are importing while they are
 exporting.  The intestiual canal secretes and  absorbs ;  the  liver
 not only secretes bile, but it receives all that is taken up by the
 gastric and intestinal veins  from the  digestive tube; the  lungs
 are inspiratory as  well as expiratory, and  the cutis is equally 
24
Consumption.
double in its action, for it absorbs and perspires.   And the state
that suits and favors one office, does equally the other office.
  The mucous membrane of the digestive tube, the aerating mem-
brane of the lungs and  the  cutis receive the  material  out of
which blood is made.  These three membranes are permeable to
gases and fluids.   Their pores are minute, and to render any sub-
stance capable of absorption by them, it must be in size less than
the pores in their membranes.   The air being finely  divided, it
requires no digestion for reception by the lungs and skin.   Both
readily pick it up when  they are normal.  But much  of the food
that enters  the stomach is coarse, and requires before absorption is
possible, thorough solution, hence the salivary, gastric, pancrea-
tic and enteric juices.   Each  secretion  having a  gland for its
formation.   And  as the food enters the canal, each gland pours
into it a solvent for the digestion of some one of the elements of
food—starch, albumen or oil. These menstrua act upon the starch
albumen and oil, and dissolve them ; they are  then  rendered ca-
pable of absorption by the lacteals and  capillaries  of the veins,
also capable of being circulated by the blood vessels.
  As soon as the food is digested,  absorbed, and commences to
circulate in the lacteals, or lymphatics, or veins, cells are furn-
ished to the fluid mass thus moving, by the mesenteric, lymphatic
and other glands, and the  moving chyle thus furnished with cells,
immediately begins to evince vital properties,  and this introduc-
tion of the chyle into life, by the cells from  an inanimate to an
animate state, is Assimilation.  The  fluid is now not chyle  nor
blood, but something that approximates to blood.   The fluid thus
acquiring vital qualities,  moves  on towards  the  lungs by the
heart and  pulmonary  artery,  and soon reaches  the  aerating
membrane  of the  lungs, when  and  where  it  receives   from
the atmosphere what enables it to become blood, fit  for all the
wants of the organism, and  this is  Sanguification  or Aeration.
The blood is now perfected, rich in every desireable quality.  It
then leaves the lungs by the route of the pulmonary  veins,  and
goes to all parts of the body.
  Food, water and air finally make red, rich blood.  They do not
become so at once, but by degrees.   The steps in this important
work  are—prehension, mastication, salivary solution, deglutition,
gastric solution, hepatic neutralization, pancreatic  solution,  ente- 
Consumption.
85
ric solution, absorption, admixture, circulation, assimilation and
aeration.  These are the progressive steps of aliment to blood.
Leave out any of them, and the next cannot be taken, especially
any one of the higher steps.  Two of these steps are vital; they
are assimilation and sanguification.  The last step is taken at
the lungs, and it depends upon the permeability of the aerating
membrane.   But in consumption, this permeability is interfered
with.  The lungs are enthralled by too much blood, and by feeble
capillaries, while the skin is suffering from anaemia.   A  barrier
more or less  potent intervenes  between the ascending blood  and
the air;  at the  same time foul expirations  and perspiration are
retained with  the  blood that  is  incomplete, because it cannot
reach the air.  These two facts, viz.; the rapid accumulation in
the blood of  refuse acids, alkalies, salts, albumen,  etc.,  and the
growing deficiency of oxygen and electricity from the air, so de-
file, retard and impoverish the blood, as to literally prevent, gra-
dually, sufficient aeration for life, and likewise assimilation,  and
finally every important function   The result is, that  blood is not
to  a sufficient extent  manufactured, though  the  material  that
should have  been made into blood, remains in the vessels, not as
vitalized material, but as still-born blood, blood without sufficient
life to enable it to be used by the processes  of secretion  and nu-
trition, and this with the old albumen  which should  have been
 eliminated by the skin and lungs, for they are the only outlets of
 Stale albumen  in the body, gradually  accumulating, going the
 rounds of the circulation, times without  number, if  there is no
 suppurating surface, finally ooze through the weak walls of  cap-
 illaries, and  are deposited upon mucous surfaces,  into  air-cells,
 into the meshes of the lungs, upon serous surfaces, and into other
 parts of the  body, in a fluid state,  subsequently the serous portion
* is removed by absorption, and the solid part remains  and con-
 cretes and assumes such shapes as the  make of the part with its
 motion may give the plastic deposit.  And this deposit is called
 Tubercle, which is nothing but old, stale albumen and still-born
 blood, that have escaped from the circulation by permeation into
 the tissues,  because the natural outlets for  the  removal of  such
 material are closed or  nearly so, there being  no other way ot
 escape, unless there is  at the time a suppurating surface.  Such 
26                     Consumption.
is  the  nature of consumption and  the  origin of tubercle.   The
nature  of a disease being given, the remedy may be discovered.
     THE HEREDITARY FEATURE OF PHTHISIS.

  In one sense consumption  is hereditary, and in another it is
not.   The idea prevails that  something,—germ, seed, or morbid
material, is transmitted from the parent to the offspring, which
remains with the child for a longer or shorter period, latent, and
when certain circumstances occur, it becomes active, and lays
waste the system.  In this sense there is no  transmission.  No-
thing positive or real  is inherited by the child from the parent.
The offspring from the very moment of  conception  possesses its
assimilation and aeration,  that is, it elaborates its own blood.
The blood  as such  of the parent in utero does not  pass  to  the
foetus,  but such material  as is  capable of  being wrought into
blood by the  foetus.   But  instead of  evil germs being inherited
by the offspring, a certain conformation may be inherited.  There
may be a  feeble skin, a morbid  susceptibility,  and an aerating
tunic inclined to turgesence inherited.  A want of symmetrical
stamina may be transmitted.   Certain qualities of the mind, as
a lack of determination, a want of character, a morbid sensibility,
an inclination to sentimentalism, a bent of mind to despondency,
a retiracy that evades the active rough scenes of life,  a submis-
sive  spirit, fear and an absence of fortitude, may be  inherited.
And if so, they will directly mould the body into their likeness.
As the will, so the  body.  A  firm will  makes a sinewy body.
The body is literally the recepticle of the mind, as much so a3 the
air is a recepticle of the beams of the sun.
  The conformation inherited  favorable  to the development of
consumption, must  be a feeble cutis, a  circulation  that readily
gravitates towards the pulmonary membrane,  and  an aerating
membrane easily enthralled.   Such a conformation will when re-
peated exposures, excesses,  hardships, and  carelessness come,
favor cutaneous weakness and pulmonary embarrassment, will
serve to prevent the incoming of oxygen and electricity, the out- 
Consumption.                      27
going of carbonic  acid and stale  albumen, and the perfection of
the blood-making process.
  But such a conformation is easily corrected and wholly eradi-
cated.   The child of consumptive parents should  be taught that
this conformation may be in its organization, and that a life and
a course of conduct may  be  adopted that will oppose and finally
correct it.  It should be taught in early life the lessons of courage,
fortitude, character, choice, ability, independence,  energy, and
determination.   It  must be taught to  go out through the will,
and not  to remain in sensibility and  intellect.   They are good
in their place, but  the person must not  end there, but must go on
to ability, to character,  to action, armed by a will of naked  in-
sight and  energy.   Acquisition  merely,  is  debilitating, but
coupled writh, rather ending in action, is  life-giving.  A tide of
sufficient volitition from  the soul passing  into the brain, and  in-
to the motor machinery,  will correct the most consumptive con-
formation, and  make it impossible for tubercle to ever occur in
the tissues.  The troop of brave qualities that legitimately pro-
ceed from a free will, will consume the consumptive tendency,
as certainly as  fire will dry stubble. Nothing is more favorable
to  the spread of tubercle than a soul  without force armed with
insight  and emotion.  To prevent, check, and cure consumption,
Psyche must be invoked—personal qualities must be established.
The age in a consumptive sense wants  character.  He who loves
struggle, effort, friction, lightning and  thunder, will never die in
mid life with an old cough.   The mind either favors or antagon-
izes life.  If the^atter, then  external causes are superior to the
vigor of the body, but if the former, then the vigor of the body
is equal to any emergency.
   IS  CONSUMPTION CONSTITUTIONAL  OR LOCAL.

  Naturally there are but two  outlets  for the escape of stale,
unvitalized albumen in the body.  They are the  cutis and the
lungs.   Every  expiration and  perspiration  of a  healthy body
contains  old, dead, defiling albumen.  But if the functions of 
28                      Consumption.
the skin and lungs are interfered with permanently,  than this
pernicious material  accumulates in  the  blood, and  defiles it.
This defilement goes on until the vital processes of blood-making,
are intercepted, and  then the chyle which  should have been
manufactured into good blood is but partially developed,  incom-
pletely  vitalized, but poorly passed through  its  vital career, and
is unfit for nutrition and secretion.  By  this interference, the
stale albumen gets fresh additions from the new blood, because of
its faulty  developement, and  the two, both  albumen, one dead
from old age, and the other still-born, go the rounds of the cir-
culation, occupying every vessel, and  liable  to  be deposited at
any weak point of the vascular system.  The structures essential
to the elaboration  of arterial blood,  are  lacteals,  lymphatics,
mesenteric glands,  lymphatic glands, the other blood  glands,
veins, and the aerating membrane.   In these organs the blood is
mack.   And these organs are not local but general.  Again the
vicious  albumen not  eliminated by the lungs and cutis, is re-
tained and possessed  not by a portion, but by all the vessels of
the body,  though the  barrier to its  escape is in the lungs and
skin.   The consequence is, that  the  entire constitution becomes
contaminated—tainted with tuberculous material, also pervaded
with that inability that prevents the construction of good blood.
The disease then may be said  to be  constitutional, and not local,
unless the skin  and aerating membrane may be considered local.
For as  soon, in the career of consumption,  as  respiration and
perspiration are firmly established,  no matter by what means or
by whom, will the further generation  of tubercle cease, will the
system  improve in vigor and flesh, will  tubercles be absorbed,
will ulcers heal, and never before.   Hence it may be  said, that
consumption is both local and constitutional.   The first difficulty
is in the lungs and skin, and this gives rise to the general taint.
Obviate at anytime the anaemic state of the skin  and the hyperae-
mic state of the pulmonary membrane—break down the barriers
between the air and blood, let them meet and fondly embrace each
other, at the skin and lungs, and consumption ceases at that mo-
ment.   Here is the mitigation, the relief and  the cure,   Nothing
ever cured a case of consumption, in fact, but atmosphere  loaded
with fresh oxygen and  electricity.   Faith  in  these two  elements 
Consumption.
29
may be unbounded.  The great objoet is to-get to them, to remove'
the barrier that erects itself between blood and air.  And that med-
icine that will-so modify the skin and lungs, so  as to enable the
blood and air to meet fraternally, is the means to be used, and the
one to be relied upon for the cure of consumption.  Though the
air cures, medicine enable the patient to obtain  it.  To lift the
blood from the lungs and send it to the skin, and there maintain it,
are the indications in all cases.   That will break down the barrier
that now intervenes between the blood and air, and enable them
to rush with all fondness into each others arms.
            IS  CONSUMPTION  CONTAGIOUS.

  Virus, in some form, gaseous, fluid or solid, is  necessary to
render a disease contagious.   In phthisis there is no virus.  The
disease is  not dependent upon the  reception of a reality, but de-
pendent upon the fact that enough of oxygen and electricity are
not received.  In consumption reception and elimination are both
wanting.  There is not  enough of fresh, but too much of stale
material.  What should be discharged by the superior emunctories
is retained and  lodged in the tissues.   No virus escapes from the
consumptive.  It is not contagions.  But while the disease is not
infectious, the habits of the consumptive are more or less catch-
ing.  Such a patient inclines to the htfnse, to the warm room, to
inaction, to lounging, to stooping, to lazy positions, to irregular-
ity  of eating, drinking and sleeping, to mental weakness, to being
waited upon, to do-nothingness, to morbid sentiment, to impotent
thought, topological inference, to fretted volition, and to indiffer-
ence  of character.  We assimilate to that which is about us.
And  we may acquire the ways of the consumptive.  And by
such associations mischief may  result to the healthy, by taking
on such habits as lead to mental and physical debility, and then
the barrier between air and blood will be erected, and the ground-
work  laid for the  consumptive career.  Again, the consumptive
likes confinement, the fire, the bed, and the lounge.  Air if not
impeded, like  water, will purify itself by its own motion, but 
30
Consumption.
when imprisoned, it stagnates, and becomes unfit for respiration.
Such  places are the  ones that the consumptive  chooses.  His
whole nature seems inclined to places that are filled with impov-
erished and contaminated air, and to unsymmetrical ways.  And
he who  accompanies  the consumptive, subjects himself to these
injurious circumstances,  and they favor  the reduction  of vigor
and the  establishment of weakness.  In this sense is consump-
tion contagious, but in no other.
 PHTHISIS CAUSED BY  COLDS AND INFLAMMATION.

   Colds will  run  through  their stages, generally, in ten days.
 Inflammations have their limitations.   Nothing is  equal to the
 production of tubercle that does not cause a permanent weakness
 of the skin and aerating membrane.  This is not possible for cold
 nor an inflammation to do once in a thousand cases. They are both
 local.  They are of short duration, and they rarely result in con-
 sumption. If consumption ever follows them immediately, it is be-
 cause they were equal, during their career,  to the permanent en-
 feebling of the skin, to the permanent engorgement of the air-pas-
 sage, and to the erection of a permanent barrier between the blood
 and air.  Any agent that can persistently intercept the meetino- of
 the blood and air at the lungs and skin, is sufficient to cause con-
 sumption.  This result is sometimes affected by colds and inflam-
 mations, not as a rule, but as an exception.   Colds and inflamma-
 tions are local and generally of short duration,  but they may be
intense and protracted, then perhaps, they may prevent perspir-
ation and respiration sufficiently to cause  the tubercular diathesis.
         THE CURABILITY OF CONSUMPTION.

   This  must be  determined  by post  mortem examination •
by the stethoscope; by experience; by the science involved in
the immediate cause of phthisis ; by the science involved in the 
                        Consumption.                      31
    •
 nature of consumption, and by the science involved in the reme-
 dy for the disorder.
    Post mortem examinations, in any quantity, prove that small
 and large ulcers in  the lungs heal as in other tissues.  Sound
 cicatrices in  the lungs are met  with  by  every physician who is
 familiar with the dissecting room.
   The accurate auscultator can note  the formation  and disap-
 pearance of ulcers in the lungs, as certainly as he can upon the
 extended surface.
    The experience of physicians of sound judgment, who are not
 experts with the scalpel and sthethoscope, is that cousumption has
 been cured and may be again.
    The science involved in  the cause, nature and remedy, instead
 of opposing the view that consumption is curable,  favors and
 demonstrates that it is curable.
   The state—the morbid condition, that  has to be fought in con^
 sumption,  is the same in all of the stages.  It is not one state in
 the First stage, another in the Second, and a different one still in
 the  Third, that the physician  has to combat, but he  is called
  upon through the entire  course  of  the disorder, to  remove the
  barrier between the blood  and air.   Do  this in the First stage,
  and consumption is cured ; do this in the Second stage, and con^
  sumption is cured, and do this in the Third stage and consump-
  tion is cured.  The stages  differ only in  degree.  The local com-
 plications  of the second and third stages, need not  trouble the
  physician at all, if he can remove  the barrier between the blood
  and air, at the lungs and  skin, so that they will mutually inter-
  change their constituents, according to  their  inherent laws.   If
  the pernicious  habits of the mind are neutralized ; if invigorate
 ing ones are substituted ;  if the hygeianic ways of the body  are
  established in all their abundance, richness and geniality, and if
- such medicines are given as will extend  and hold the blood per-
  manently to the periphery, then will consumption yield before the
  conservative power  of the  system,  as  certainly, as  the  snow
  banks of winter will melt and disappear before the breath and
  smile of coming spring.
    Rule is always stronger than misrule.   Truth is mightier than
  error.  God is always the  majority.  This is  so in physics as in 
32                     Consumption.

metaphysics, tubercle as in ethics.  In correct mental habits and
conditions, in proper bodily habits and  conditions, and in medi-
cines that will co-operate with and uphold such habits and con-
ditions, are the means  that can mitigate, relieve, and cure con-
sumption.  And he who knows the cause and nature of tubercle,
and the properties of medicines, can specify the individual means.
           PREVENTION OF CONSUMPTION.

   A knowledge  of  the prevention of  consumption  must be
more precious than gold to parents.  F-or childhood, youth and
early maturity are  the fruitful seasons for consumption.  While
we are under parental care, and within reach of parental council,
is the time when the foundation of consumption is generally laid.
And by knowing  what are the remote Causes of consumption,
and what are the means for the prevention of it, the parent may
obviate nine-tenths of  the woe caused by this devouring  disorder.
   The human  Will is as much a Force in nature to be  used and
felt,  as Electricity or Caloric.   It has a specfic work to do, and it
must do it, or  sink to the earth  for a footstool for those  who will
do it.  If it  does  not perform its legitimate function, then it
either dies outright, and mingles with the sand, clay, and loam
under our feet, or it lingers out a miserable existence as a physi-
cal or mental slave.
  From the first breath to the last, this celestial  Force should
peer, yes regally look through feature, gesture, voice and motion,
so sufficiently, so individually, as to make itself felt as a Power
to be respected, as to  make itself felt as Power equal to any
similar one, as  to  make  itself felt as Power  superior  to any
irresponsible force  in  all nature.  Man must look  upon the ele-
ments, upon all nature below him,  as a means to be used by him
in his career of progress and authority, and upon all other men
as merely  his equals.   Such a Will passes through life, like an
orb through the heavens,  with weight, influence and  impetus,
superior to any impediment that may happen to be in its path.
Such a Will loves darkness  and the glare of noon ; it courts the 
Consumption.
33
winds and the storms; winter and summer, spring and autumn,
are alike  welcome; the wilderness presents charms to it;  bold
adventure is  food  to it; self-relience gives it joy;  the current,
tide and struggle of life are sweet to it; duty, responsibility, labor
and  care are what it most relishes ; misfortune only doubles its
energies ; opposition gives  point and  edge to its actions; the
evil of others brightens  and strengthens its principles, and the
follies and weaknesses of the world serve only to  erect higher its
own self-hood.
  This force, armed with insight and spontaneity,  or only by the
nobleness that is innate  in  all,  expressed in  all  that  a  person
thinks,  feels, and does,  is the prevention for  the whole world of
will-be-consumptives.  It is as certain to prevent Consumption as
frost is to prevent  Yellow Fever.
  To be more specific, practice through life, Industry, Economy,
Enterprise, Sagacity, Temperance, Courage, Fortitude, Independ-
ence, Toleration, Sociability, Vivacity,  Gallantry, Taste, Honor,
Justice, Charity, and Piety.   These virtues will make a practical
cordon that will protect  body and mind from  all foes visible and
invisible.  Such  a brood of celestial  qualities flocking into the
cerebrum and from thence rushing into the 500 muscles of voli-
tion, hourly, so abet and co-operate with Life as to preserve body
and mind from every stale particle, nocent action, and lurking
foe.
   Every constitution that is  lacking in this personal force, is
liable sooner or later to be overtaken by consumption.  Of what
value is a mere pile of dirt  in the shape of a man, unless he has
running through it this personal thunder-bolt—the  Will!  Infuse
that into  one hundred or two-hundred  pounds of lime, carbon,
oxygen, hydrogen, nitrogen, and a few other elements, and you
have something worth respecting and something   that will com-
mand respect.  It is this force  that  snaps parental control  at
eighteen and twenty.  It is  this force that makes character every-
where.  It was this force that made King Phillip, Jackson, Luth-
er, Cromwell and the heroes of every  age.  It is the magnetism
in man.   It is this that  gives one man control over another.  It
makes the honor  and  electricity in men.   Instead  of subduing
this force  of  the soul, this red energy, this flame and sword of
       3 
34                     Consumption.
the immortal part, it should be fostered and encouraged.  Teach
the coming man that he is  the immediate and  commissoned
Agent of Being; that he is backed,by the Eternal in the midst
of the temporary, supported by the Infinite while surrounded by
the finite.   It is this force that makes us talk so much of Liberty,
for it is free; and being free, it has duties, one of which is to keep
the blood freed from tubercles,  by  living a life of such positive-
ness as to repel every vicious thing and foolish practice.
  A negative individual  is not  equal to the elements,  currents,
and cares of life.  Such a person is swept away by them, as the
swollen  stream does flood-wood.   The responsible  force  should
be always  superior to the  irresponsible.  And it  may be so by
proper education.  Feeling is not the end of man, nor is thought,
but action.  Man wants skill not lumber.   He should be an
ability, not a ware-room.  But many are less than their surround-
ings.  Nature then out of man is major to that which is in him.
The life of the body is  antagonized by what is around  it.  A
warfare is continual between the body and the world around it.
And  one will  be  master.  Man  has the privilege of being the
major force, and can keep at bay any atmosphere, wind, heat or
frost.  But to do so he must  send the will into every nook and
corner of his being.  His own constitution must not be a wild-
erness, an  unexplored  region to his  will.  Groups of muscles
must not lie on his bones through  life without his knowledge,
and without his occupancy.  He must energize his entire volun-
tary system, and by that  means, he  can co-operate  with Life, so
that longevity with all its best consequences may be fully real-
ized.
  Such  a vigor will always keep the blood  in crimson currents
rushing up to, through  and  off from the skin ; will  keep  the
blood from accumulating upon the aerating membrane will;
keep open the  million ways to oxygen  and electricity, and will
keep open the channels for  the escape of old acids, alkalies and
stale  albumen. 
Consumption.
35
             THE  REMEDY  FOR PHTHISIS.

  This is two-fold.  It is hygeianic and medicinal.  It is a grave
disorder, and the resources of both the  art of health and the art
of disease have to be  taxed  to  obtain the remedy that can  dis-
arm it  of its consuming energies.  The disease is no Indian
palisade, but a real Russian Malakoffi   Hygeian and medicine
must be invoked with great  judgment and skill.  Together they
contain the remedy for consumption.
   When inflammation, or fever, or suppuration, or ulceration, or
night sweats, or irritable stomach, or irritable bowels, or severe
cough, or severe  pain, or difficult breathing, or  rapid  pulse, or
frequent respiration, occurs during the career of consumption,
then medicine will be required, to meet these  side issues in its
career of mischief.  Besides, the legitimate disorder will demand
a steady, persistent course of medication.
   The great indication to be filled in every case of consumption
is to remove  the barrier that intervenes between the air and blood
at the lungs  and skin, and to permanently protect them in their
mutual exchanges.  Accomplish  this, and the disease vanishes,
like fog before the ascending sun.
                 HYGEIANIC REMEDY.

  The body  of the consumptive is like  the worn-out  lands  of
Virginia.   It is sterile not naturally, but by excessive croppings.
And it must have a season  or two  of fallow.  The first thing to
be done is the laying aside of all business, except that which per-
tains to the restoration of health, for one year at least.  Whoever
gets overtaken by tubercle, may set aside all else for a twelve-
month, but the application of the remedy necessary for the resto-
ration of health.  The four seasons must be laid aside  for that
one object.  If rosy health  comes sooner, the recipient is fortun-
ate.   Whether the  patient takes medicine  or  not, devote the
whole of the coming year, from the present moment, to the res- 
36                     Consumption.
toration of health.  Time is necessary  for recovery whatever is
done;  besides, the consumptive patient must know at the begin-
ning, that the remedy can  only in part be bought, that a part
must be faithfully worked out  by  itself.  A draft on  your own
will is  demanded just as  much as one upon pills, lotions and in-
halations.  Both are required, and persistently too, to extricate
you from the quicksands that are rapidly yielding under your
feet.  The gain wanted is  in vigor,  good breath, strong pulse,
symmetry and flesh, and not in money, nor lands, nor place, nor
learning.   All the energies you have  should  be bestowed upon
your impoverished constitution, during  the  coming  fallowing
year.

  Speak with definiteness and volume.  Consume all the air pos-
sible in  speech.   Expel each word by a copious expiration.
Never  speak quick.   Cultivate the  explosive habit of speech.
Let a current of air expel each  word,  not hastily nor sluggishly
but with  weight, volume and sonorousness.  Avoid a high note;
keep upon a base key.   Habituate yourself to slow,  copious,
regular breathing.   Give no countenance to despondency.  Laugh
in the midst of hemorrhage.   Cheer is a better stimulant than the
best of wines.  It will send the blood at once from a breach to the
remotest  part.  Be listless in nothing.  Act from your innermost
force.  Do the least thing with enthusiasm.   Take a lively inter-
est  in whatever you do.   Let dispatch be a marked characteristic
of all you do.  But avoid hurry as you would a gaping precipice.
Move with importance and  sufficiency.  Be  a power.   Keep the
company of courage,  fortitude, energy, and cheerfulness.  They
are the choicest  comrades and the truest friends.   Be no bravado
nor improvident, but if  ill-luck overtakes yon,  be its master, and
never let it jump upon your back.  Fear nothing but wron g;
treat cough,  hemorrhage, emaciation and sweat, as you do the
peccadilloes of a friend.  Be not  alarmed by them, but simply
harbor  and tolerate them, until you can conveniently rid yourself
of them.   Defy them not by swagger, but  by a manly, valiant,
superior life.

  Between suns take exercise.   Use the day in  consuming your
muscles.   But  yield the night up to respiration and  nutrition. 
Consumption.
37
Suspend the mind and its instruments as night approaches, fold
your  arms,  and resign yourself to the care of Life.  Give  to
Nature  every  authority and opportunity during the absence of
day.  The rule of the body is waste and reparation.   Day light
and the former should be linked, and night and the latter should
be coupled.   Though the consumptive is everywhere marked  by
emaciation, yet he demands muscular waste from his own will as
much as the laborer.   But in exercising, there are  two rocks
against  which he is liable to dash his bark.  They are extreme
fatigue  and  chilliness.  If possible keep without their reach, if
not possible, be calm,  cool, self-possessed, and say to them,  Do
your best.  When warm by exercise or otherwise, do not cool  off
suddenly.  Here is a pitfall that engulfs hundreds.   When warm,
for the sake of coolness, do not sit down in the shade, nor upon
a stone, nor upon the  ground, nor stop in a current of air, nor
let the wind blow upon your back, nor drink cold drinks ; but
keep exercising moderately, or put  on sufficient clothing to pro-
tect the  system, or go  into a warm room,  or do whatever will
prevent a  sudden diminution of bodily warmth. Let the excess
depart gradually.   As eating is for  reparation, aud exercise is for
disintegration, the  nexercise should always precede  eating.  If
you do  not  exercise, let your meals  be correspondingly  light.
The rule for eating lies in the use of the muscles. If the muscles
lay the long day idle upon the bones, then let the  stomach lay
the long day idle in the abdomen.   Consumption of food should
be measured by  decomposition of flesh by action.   Exercise
every day unless inflammation is present;  if so, keep your bed
until it  has been resolved.  Let your exercise consist of walking,
running, riding in carriage or on horse-back, playing, going up
hills  and stairs and using the arms and lower  limbs, in all pos-
sible ways, in  doors and out.   Remember that you have five-
huudred locomotive engines immediately under your skin that
you can  control  by a nod.  Remember also that the action  of
these sources of force, calls blood into them from the central or-
gans, causing a gravitation of  the circulation from  the center to
the periphery,  and as the blood rushes into the muscles as they
aet, the  blood is  induced to go to the skin  at the same time, for
the small blood vessels  that go to the skin,  come from the vessels 
38
Consumption.
that feed the muscles immediately beneath  the skin, and this
flow of blood to theskin during muscular exercise, favors perspir-
ation, the organ of which is literally dying for want of blood.  If
then you tax each of the five-hundred muscles vigorously a  num-
ber of times every day, you thereby unload the lungs and every
other central organ, of their excess of blood, and pour it into the
muscles and the skin, where there is a dangerous deficiency.  By
exercise then you can establish a real equilibrium of the circula-
tion,  and restore the tint of health to the pale cutis.  Do not
labor, but act and exercise from choice and desire.  In what you
do, preserve entertainment, satisfaction and interest.  Do not act
against your will, but with it.  Hunt much;  fish much ; swim in
the proper season ; sing often if there is any music  in your larynx
upon a base key; talk for the sake of entertaining whomsoever
you may be with ; make it a  duty to cheer and animate others;
never allow others to  sympathize with you by manner or conver-
sation, but if at  all by doing something for you ; let no one con-
verse with  you upon  your illness except your physician ; horse-
back riding may be indulged in, on all possible occasions ; be not
afraid of the air; it is what you must have or you will never re-
cover.  Much better be chilled to the marrow,  than not have the
fresh  air and exercise.   If you cannot avoid fatigue and chill,
when you  exercise and take the air fresh from the atmospheric
ocean, take them anyhow whatever  the consequences.  Do any-
thing that is pleasant and that  enlivens the feelings without pros-
tration following.   Cheerful employment is  as  good as  food.
Amusment that  does  not enervate, in  all its variety, should be
allowed and encouraged.

  Temperance in all things should be the watch-word  of him who
is afflicted with tubercle, but especially is it demanded in sensual
pleasure.   Excesses here are too often the remote causes of con-
sumption.

  Be regular in your sleep.  Do not sleep before  sun, nor  after
sun,  nor between suns.   To the consumptive, night is for repose,
and day is for action.  After the  regular  sleep of the night is
over, do not dose and  linger in bed and importune Somnus, but 
Consumption.
39
rise, take an air-bath, adjust your garments and seek the air of
the new-born day.  As soon as you touch the  couch, forbid all
thought.  Say to fancy, thought, memory and feeling, Be still.
Hush the mind.  Open the doors  of the  mental chambers and
invite  into  them resignation, tranquility, repose and slumber.
Place at once a recently plucked poppy leaf upon each eyelid, and
an equal b rrier at  the gate of each of the other senses.  Yield
all up to  Nature, and let her have supreme sway.   The entire
sensative and voluntary man must be suspended.  Let Life only
be manifested  until the East presents you with the new  day.
Night is the time for nutrition aud  reparation.   And if possible,
never  intercept them, for they"are the  great healer3.   The  bed-
room,  all things in it, and all about it, should be as neat as the
art of  the chamber-maid can make it.  Banish  feather beds, hair
mattrasses and comforters.  Fresh air  should come into  and go
out of the bed-room at its leisure.  Moving air is demanded all the
time, night and day, over the nostrils of the consumptive.  Let the
Bleeping apartment be well ventillated during the day and night.
Never allow it to be wholly closed.   You are sick because you do
 not get air enough—not  enough of oxygen aud electricity.
 Hence invite the air to you under all circumstances.  It is laden
 with freshness, nutriciousness, stimulation and  warmth.  Do not
 fear cold-taking, but  fear rather  not  enough  air-taking.  You
 have enough gross food, but you are lacking in insensible, aerial
 aliment, and you have too much pent up perspiration and expira-
 tion.  Keep then the skin and lungs exposed to the freshest air.
 Atmosphere will furnish to the consumptive that which  it  is de-
 ficient in, and  take away  that which  it has to excess and  to its
 hurt.

    Let  the  clothing be equal, easy, protective  and  comfortable.
 during thecold and cool seasons,  wear woollen stockings, drawers,
 shirts" wristlets and mittens.  And as soon as soiled change them.
 The inner garments should be changed weekly.   Never sleep in
 any garment  worn during the day.  The night dress should be
 lar*e and capable of easy removal.  Boots are  preferable to shoes
 because they protect the ankles.  Remember that the wrists and
 ankles are  vulnerable points.   They possess  no fat, and  their 
40                      Consumption.
nerves and vessels lay immediately beneath the skin, so much ex-
posed  are they, that  the atmosphere readily  reaches  them and
prevents them  from carrying  the  warm blood and the  nervous
force into the hands and feet.   For this reason  the  wrists and
ankles should be carefully  protected.  Instead of wearing wrist-
lets, the tops of gloves may be made long so as to embrace the
whole wrist.   Whenever*your garments become wet by exposure,
keep exercising until you reach your.chamber and then change
them, or until they become dry.  If chilly at  any time and you
are  near a  fire, turn your back to it  and heat it thoroughly.
Heat applied (o the back engenders  nervous action, but cold ap-
plied to it lessens  nervous  action.   If you  are much  influenced
by the changes of  the weather, or if you are exposed to the night
air,  wear  a  doe-skin  shirt and drawers.  It is more  protective
than wroollen, and  sufficiently  porous for the evaporation of the
skin.  Take great care of the feet.   They are very fond of atten-
tion. Wear  boots with thick soles; change the socks often and
frequently, use the'hot salt water bath,  being careful to raise the
temperature of the bath at  its close to its highest bearable point.

  The human body contains two sets of organs, viz., involuntary
and  voluntary—one set exclusively under the reign of Life, and
the other under that of Life and the Will.   And a rule obtains in
their action of great value, viz., the majority bear sway.   If the
majority of the organs are  healthy,  then will their healthy influ-
ence extend into the minority organs that are diseased ; but if the
majority are  ill, then  will their evil iufluence reach out  into the
minority that are well.  In proportion to the number of healthy
organs in disease, in that proportion is the chance for  the return
of health, also,  in  proportion to the number of diseased organs
in any malady is the fear of death.
  The organs that are subject to the will are the five senses, the
cerebrum, the entire mind, the  five-hundred muscles, the mouth,
the  stomach, the bowels and bladder in their excretory action,
the reproductive organs, the lungs as far as the  kind of air they
receive, and  the entire skin.  The two organs  that are primarily
at fault in consumption are directly under the control of the
mind—the lungs and  skin. 
Consumption.                      4l
  And as the involuntary organs lie immediately beyond or with-
in the voluntary, and are indirectly reached by the latter, a large
majority of the organs  of the body  may  be acted  upon by the
will.   And if it is sufficiently enlightened to correctly influence
and condition  the organs within its reach, the majority-rule may
be placed among the voluntary organs, and also among the nor-
mal, and enabled to extend  gradually  into  the minority organs
that are a prey to disease.  This division of the organs, and this
rule that obtains among them, should  be understood by the con-
sumptive, and a life should  be quickly put in practice calculated
to obtain all the advantages therefrom.
  Prominent among the organs within the reach  of the mind, is
the skin.  It  is  the body's  grand envelope.  In  it are situated
the means by  which the body may be superior  to any change of
 the atmosphere.  The war with the elements must be  fought by
the skin.  Permit its sentinels to  sleep, and the  atmosphere ad-
vances upon the body  with speed and force, but keep them on
active duty, keep them awake, vigorous,  in concert and abreast,
to the coming air, whether hot, cold, wet, or malarious, and they
are equal to the maintainance of the supremacy of  the body.
  Among the means for the preservation or restoration of cutan-
eous action and vigor, are baths of the tonic quality.   Of these,
the air, hot  water, salt water, acid, astringent, and  alcoholic
baths, are best.   Besides, dry friction from any means, with the
hand,  coarse  woollen mitten,  coarse flannel, coarse towel, hair
mitten, brush mitten  or flesh brush,  is  excellent.  The coarse
woollen or brush mitten is  to be preferred for rubbing the skin.
The acid and salt bath  may be used alternately every other night.
The air bath  should be used night and morning  with universal
friction.  Debility  of the cutis is prominent in  consumption, and
the very best  means faithfully and perseveringly  applied, will be
 required to overcome the paleness and weakness of the surface.
 Warm water is debilitating ; cold water is  more so unless reac-
 tion immediately follows; vapor  baths are  quickly stimulating
 but are very evanescent.  Avoid all extreme action  in any organ.
 Permanent effects are wanted.  The consumptive cannot recover
in  a day  nor by a  charm, but by  the slow process of nutrition
 and secretion.  Too much attention cannot be paid to the spine, 
42
Consumption.
especially the cervical and dorsal portions of it, in the form of
friction.

  Eat generously at breakfast and dinner, but sparingly at supper.
Quantity injures ten times to quality  once.   Avoid both.  Re-
ject  those  dishes  that  experience shows are  hurtful.   Warm
drinks are  preferable  to cold.   Food  should be  well cooked.
Chew your  food.   Be a long time  eating and spice it well with
anecdote, legend, pun, wit and humor.  Extract fun from every
possible object.   Eat cautiously  alter fasting, for  the appetite
then is not a reliable guide.  Use coffee at  breakfast if you de-
sire it;  use cider at dinner with a little white mustard seed and
horse raddish in it, whether you desire it or not; and use biack
tea at supper if you choose.   If you use milk, scald it first, and
use it warm.  Cold milk is too often injurious.   Fresh milk be-
fore it cools, is invaluable.  Butter-milk and sour-milk, because
of their ease of digestion are to the consumptive the  best possible
food.  Wild meat is preferable  to  tame.  Beef and mutton are
next to wild meat.  Pork may be wholly discarded.   Eggs brok-
en in'o hot water and slightly cooked may be often used.  Sweat
cream, fresh butter, warm yeast biscuit, light yeast cold bread,
make good blood.  Capsicum in the form of pepper sauce or fine
powder taken with food, will  much aid digestion,  and will im-
prove the appetite.  The stomach of the consumptive will bear
a little capsicum or cider or native wine at each  meal. They
may be taken for the stomach's sake in moderation.   These are
all the stimulants that are required except coffee and  tea.  The
dinner will bear them better then the  other meals.   In this dis-
ease there is a tendency to cough at bed-time, and a full stomach
aggravates  this  tendency, hence  a light supper is particularly
recommended.  One dejection of the  bowels each day must  be
maintained.  In no instance neglect this.  Habit and food must
be the main reliance for this steady action of the bowels.  If not
sufficient, an aparient pill at bed-time, or a mild enema may  be
used.  If the bowels are inclined to sluggishness, and they  gen-
erally are,  then  use cpening  food.  For this all the vegetable
acids are  good ; butter-milk, slightly sour-milk,  figs, ripe fruit,
asparagus,  tomatoes in  all forms  of preparation,  the white  of 
Consumption.
43
the egg, with some hot milk, fresh meat, pie-plant, peach sauce,
etc.  If the bowels are too active, then use binding food.   For
this, use salt meat; dry  food; black pepper and soft flour bread
scalded in  milk  as  warm as practicable; avoid those dishes
used for the torpid state ; hot brandy slings; coffee made of roast-
ed corn, etc.   The carrot soup is above price in the cool and cold
seasons of the year.  Broths,  porridges, soups and teas are easy of
reception, require  no digestion comparitively,  are diffusive and
nutritious.
  In consumption the whole  mucous membrane is embarrssed,
the'digestive section however is not so  much so as the pulmonic,
yet sufficiently to hinder and often to prevent digestion.  For this
reason, all those  dishes that the culinary art can reduce down to
a fineness that obviates  any  further reduction by the digestive
organs, will be valuable to the consumptive. The stomach should
be taxed within its ability but never beyond it. If the stomach
can digest solid food easily, the fluid dishes need not be used.
But if it is incapable of  digestion, then fluid food must be used.
Let it be borne in mind that digestion is nothing more than solu-
tion of coarse food.   Digestion divides the food to a minuteness
that renders the particles less in size than  the pores in the walls
of the capillary vessels, and as soon as the food  becomes thus fine,
it leaves the digestive tube and passes  into the circulation.  And
this reduction of food may  be effected by the cook when  the
Btomach is unable to do it.
  Be regular at meals.   Eat nothing between meals.   Sufficient
food can be  taken at two meals to furnish the system  with all
that it can consume in  its vital processes in  twenty-four hours.
Never eat to heaviness.   If you do not exercise, then you must
eat lightly.   By exercise you consume the tissues, and then food
is required to repair them.  But if  you do not  wear  out  the
tissues, then food will be required only in small amounts, suf-
ficient to meet the necessary consumption of food by the invol-
untary action of the body. The days  that you are compelled to
pass in-doors because of bad weather or inflammation, be very
guarded against eating as much as yon do when you do  exercise
out-doors.   Such days are generally intolerable, because caution
in this particular is not practised. 
44
Consumption.
  Refined sugar in  water may be taken  often, especially when
there is a tendency to  cough.   A glass of pure water we]l fur-
nished with the best white sugar  will often allay the irritation of
the  air  passage, besides it is readily absorbed and circulated
throughout the body, and used in calorification—a process alarm-
ingly deficient in consumption.   If alcoholic articles are used,
the best is old whiskey.  It may be used in hot water, or cold, or
by itself with the best sugar.  It  is a quick stimulant; it passes
at once to all parts of the system, and  it contains valuable com-
bustible material, which  is much  needed.  When used, it should
be for diffusive  stimulation, for combustion, and for the aid it
gives to digestion.  Therefore use it  after eating in moderation,
and as a medicine.

  The involuntary man is pervaded by Life, and  the voluntary
by Will.  They  are  both efficient and potent forces, yet they are
not independent of conditions and means.  They require certain
materials to work with, and certain conditions to work in.  And
when  furnished according to  their wants, they will produce a
body full of vigor, symmetry and  endurance.  Reliance may be
placed in them when thus furnished.  They are then more than
equal  to  any antagonizing cause,  for they  will vitalize  and
mentalize  the body  for years  in  the midst of changes,  seasons
and opposition.   Too much confidence cannot be placed in Life
and the Will as potent forces for the preservation and invigora-
tion of the body when they are supplied with their  genial means
and  conditions.   The consumptive may rely  upon them for his
restoration as certainly as the chemist does upon chemical affinity
for the composition or decomposition of a body. They are natural
having Being for their support, and when surrounded with their
proper circumstances they are fully equal to their intention and
business.   Faith here should be complete and works correspond-
ing to it.   If so, rosy health will return, and the coming years
may be enjoyed in their richness. 
Consumption.
45
                  MEDICAL  REMEDY.

  Obstinate co&tiveness, irritable bowels, severe diarrhoea, want
of appetite, acidity of the stomach, irritable stomach, night-sweats,
frequent pulse,  rapid  respiration, fever, inflammation, suppura-
tion, ulceration, severe irritation in the air passage, cough, diffi-
cult breathing, and pain, are the conditions of the body that will
more or less resist hygeianic measures, and  if so, will demand
something more efficient.  Besides these local disorders, back of
all of them, is the consumptive habit to overcome.   Accomplish
the latter, and the former will soon cease to torment.  The per-
vading bad habit feeds and keeps up the local  derangements, and
they in turn aggravate and intensify the general cachexy.  They
encourage, and play into each  other's hands.  The removal  of
which will require medical aid.

  Pain :—If severe, it is the result of inflammation.  Generally
it is the consequence of pleurisy, but it may be from bronchitis, or
pneumonia, or peritonitis.   The inflammation  of the serous
tunics always gives severe pain ;  that of the mucous is not so
severe, more dull and situated  in the median line of the chest.
"When present,  warm  applications to the hands and feet embrac-
 ing the wrists and ankles will  be required.  Mustard, salt and
hot water, in the form of baths, or fomentations, will make suit-
 able applications.   Rest and the recumbent posture must be en-
forced.   Mustard to the  spine  and over the  breast sufficient to
produce redness  may be used.  Camphorated spirits ;  alcohol
 and water ; vinegar  and water;  essence of peppermint, ether
 and spirits of camphor in equal quantities ;  a layer of cotton ;
 hot  fomentations of hops, may  be used to  quiet pain from in-
 flammation.  Internally, in small and repeated doses, antispas-
 modics, sedatives, and diaphoretics should be employed. Nar-
 cotics as such should be forbidden.  If used, they should be coupled
 with  those articles  that  will prevent any  other  than an ano-
dyne effect.  The inhalation of volatile anodynes, aud the vapor-
 of antispasmodics and sedatives, in small quantities, occasionally
repeated, often  act most satisfactorily in giving ease. 
46
Consumption.
  Difficult Breathing:—This depends upon a variety of causes.
For instance, closure of the mOuth and nose ;  submersion of the
face;  want of air;  foul air; dusty air; polypus of the nose;
enlarged tonsils ;  oedema of the larynx ; spasm  of  the  larynx ;
depositions in the trachea; spasm of the bronchi; depositions in
the bronchi; foreign substances in the  air-passage ; enlarged
thyroid  gland ; cord around the neck ;  emphysema  ; cwdema  of
the lungs;  tubercles in the lungs; thickened mucous membrane
of the air-passage;  consolidation  of the lungs from" any cause;
bronchitis ; pneumonitis ;  asthma; air or fluid in the pleural sacs ;
water in the pericardium ; enlarged heart; organic lesions in the
heart; aneurism of aorta;  tumors jn the chest;  obesity ; over-
distended stomach ; gravid uterus ; ascites ; broken rib ;  pleuri-
sy; peritonitis; hepatitis; tight lacing; and palsy  of  respira-
tory muscles.  Any thing that intervenes between the blood and
air, so as to prevent them from receiving from each other all that
their natures  require, will cause difficult breathing.  The air will
take from the blood certain foul products, and the blood will take
from the air certain fresh  products,  and  when these two offices
are performed, ease is experienced, otherwise difficult breathing
is experienced.   And  any  of the above causes may interfere
with this mutual action of blood and air.  And  a remedy for a
given case will depend upon  the cause.

  Cough:—This like oppression is dependent  upon a variety of
causes.   Among  them may be  mentioned, enlarged tonsils •
elongated uvula ; pharyngitis ; chronic inflammation of and hard-
ened  wax in the ear; laryngitis; tracheitis ;  bronchitis; asth-
ma ; pneumonitis ; tubercle ; hysteria ;  whooping cough ;  dis-
ease of the  liver;  pleuritis; a fat abdomen; gastric derange-
ments ;  ascites;  gravid  uterus sometimes ; phlegm and dust.
The treatment will vary with the cause.  When  from phlegm it
is a healthy eliminating.effort.  When from irritation instead of
being sanative, it is exhaustive and often baneful.  In the act of
severe coughing, there  is a great  expenditure  of nervous and
muscular force, as much so as in chopping.  The cough is often
a leakage where are wasted nervous and muscular energies. And
in no  case of consumption should the nervous and muscular forces 
Consumption.
47
be unnecessarily expended.  They should be carefully husbanded.
Exhaustion from any  source is mischievous to the consumptive,
and should be  always avoided if possible.  Besides,  the cough
when excited by an  irritable mucous  membrane, causes the air
to pass over the irritable surface so forcibly and so bullet like, as
to impinge and aggravate it.  The cough when excited by bron-
chial irritation merely,«in turn aggravates the irritation, and thus
they feed and aggravate each other.   The cause  of the cough is
then increased, and muscular and  nervous force rapidly wasted.
  When the cough depends upon an irritation caused by a grav-
itation of blood to the air passage, then the remedy for it must
not be the same, as for morbid  irritability, but  that which will
return the  blood  to the periphery and there maintain it.  And
this is the major cause of cough in consumption.  Mere narcotics
or anodynes to stop the cough when it is caused  by an over-load
of blood on the mucous and aerating membranes, are  not only
insufficient, but they are  pernicious.   Thousands have been en-
gulphed here.   Opium in such cases,  though an apparent friend,
is in fact a deadly foe, unless deprived of its narcotic properties
by associates that suspend its deadening influence.
   When the cough proceeds from a morbid  sensibility of the air
passage, the inhalation of volatile anodynes will be of great ben-
efit.  The inhalation of the vapor arising  from burning or boil-
ing  sugar, also of burning  or boiling resins and balsams, will
often give much temporary relief.  Relief from cough often fol-
lows sips of cool water sweetened with refined sugar, frequently
repeated, at least as  often as the irritation returns.  Again, one
half of the coughing is from habit.   People cough because they
can.  It is a pernicious practice,  unless compelled, and then cop-
ious inhalations of fresh air should be resorted to, and an effort
of the mind made to stifle and suspend the cough.  The constant
habit of trying to remove the irritation by forcible coughing, can-
not be too severely censured.  The consumptive should  obviate
coughing as much as possible by every safe means, and especi-
ally by full, deep,  copious, slow respirations, and by dint of will.
Every hack, hawk and cough stifled by good breathing and by
resolution, is worth more than a pint  of the most precious cough
syrup.  This intervention of the mind to prevent coughing in- 
48
Consumption.
stead of favoring it, according to the usual practice, frequently
repeated,  will in time grow to a remarkable power.  The mind
when disciplined in this direction, can be made to nearly control
the cough.  When  air is forced  repeatedly and severely out of
the lungs over the delicate and irritable lining membrane of the
air passage, by all the force of the entire thoracic  aparatus, the
mucous tunic will be roughened,  fretted, chafed and irritated, but
when cool air is inspired with deliberation,  force and resolution,
repeatedly, the existing irritation will be  lessened, the whole
passage will be cooled and soothed, the natural  relations between
the blood  and air will be encouraged, and  the  blood filled  with
fresh oxygen and electricity will readily leave the lungs and seek
the most  distant parts of the body.  Nothing more favors gener-
ous circulations, than liberal respirations.  They constitute a pul-
monic lever by which the blood may be  lifted  into every part of
the body.   Fresh air copiously breathed is  the  best cough syrup
known.   Avoid quick breathing.  Teach the chest, to prolong the
air in the  lungs.  Rapid respirations do not let  the air remain
long enough to aerate the blood.  Prevail on the air to linger in
the pulmonic cells,  to enter them joyously, and to leave  them
with regret.   As far as practicable sit, lie, stand straight.  Sym-
metry of  ibrm and position, favor enlarged breathing.   Distor-
tion  opposes  every  respiration.   In  walking keep the eye above
the horizon, and compel the soles of the feet to guide you.   When
you are walking with the eyes up and the  toes down, the chest
will  be thrown out, and the spine will be erect, and  such states
are  the most favorable to full breathing and to general circula-
tion  of blood.

   Sputa.—There  are six varieties, viz:  the serous or aqueous,
the mucous, the albumenous, the  sanguineous,  the purulent, and
the tubercular. The jputa may be free, easy, adhesive,  stringy,
sticky and tenacious ; or sweetish, brackish, nauseating and in-
different ;  or scanty, copious, and moderate;  or opaque, trans-
parent, translucent and clear; or floculent, cloudy, ragged and
cheesy; or lumpy, frothy, viscous,  vitrions, spumous and nummul-
ated ; or white, yellow, purple, green, florid, rusty, streaked and 
Consumption.
49
crimson; or floating, precipitated and suspended.   The cheesy,
ragged, nummulated sputa belong to the tuberculous variety.

  Inflammation.—This may be expected in either of the stages.
It always introduces the Third stage, and the treatment calculated
to cure the prevailing  cachexy will anticipate inflammation.  Ifc<
is always  a complication.   The tubercular  disease is not inflam-
matory, though inflammation  is very liable to spring up during.
the career of tubercle.  It may be bronchitis, pneumonitis, pleur-
itis or peritonitis.   Medicines suitable for this disease should be
of that nature that will hold the vis a tergo in  check all the time,
and that will augment the  vis  a fronte.  The proclivity  of the
disease is to the diminution of the latter and to the augmentation
of the former.  The heart  and arteries must be bridled, and the
capillaries must be energized.   Such  medicines as will control
the  central part of the circulation, and that  will  augment the
peripheral are the ones to be used not only for  the prevention and
cure of inflammation  but also for the removal of the consumptive
habit.  When  inflammation does occur in  tubercle, food and ex-
ercise should be suspended, for they aggravate the central forces
of the circulation, and tend to embarrass the inflamed part.  The
Third stage  is introduced by inflammation,  but  the  remedies
 adapted to the onset of this stage are not adapted to its termina-
tion. Inflammation is to be fought  at the beginning, while ulcer-
 ation is to be  fought  at the close.  Nauseants and counter irri-
 tants for the first, and tonics for the  second.

   jFever.—In consumption there  it  always a morbid irrita-
 bility and an  augmented  rate of movement  of the blood.  The
 pulse is  ninety  or more.  Physiological action   cannot occur
 when the blood moves at that rate.   Such a movement is morbid.
 There is not a  cell in the organism that has its conditions met  by
 such haste of circulation.   The heart and arteries must be con-
 trolled, and  the  pulse reduced, not by destructive  means but by
 diffusive and suspending means, to seventy-five beats per minute.
 Nutrition and  secretion cannot take place while the blood is rac-
 ing through the system.   Fever always wars with nutrition and
 secretion.  Cell action is impossible in fever,  hence fever must be
        4 
50
Consumption.
combatted at every step in consumption.   The entire treatment
must anticipate fever and inflammation and obviate both  if pos-
sible, for they are the red enemies of health.  The type  of this
fever is remittent.   Exacerbations occur at noon and evening.
And such medicines will be required as will regulate the circula-
tion, hold in check the  heart and arteries, invigorate the capil-
laries, obviate fever,  prevent inflammation, guard against  flashes
of heat, intercept chills, keep up secretion, favor nutrition, and
preserve seventy-five beats per minute.  Keep the blood moving
slowly, calmly, and  persistently and  the  consumptive is  on the
way of rapid recovery.   If it cannot be accomplished wholly,
approximate to it as  nearly as possible.  Do not  though burden
the system with drugs, in fact the senses should not know  by the
effects of them, that the system is under their influence.  Treat-
ment may be required for a year or more^  and it should be of
that nature  that  will  admit of long  continuence.    Its  action
should be silent and  insensible.  All that  oau be  done at all, can
be done by the minor  doses.  Medicines, to cure, must be con-
stitutional, persistent, silent and alterative.   The treatment must
regulate the heart, must secure the lungs from oppression, must
determine the blood  to the skin, must obviate capillary weakness,
and maintain seventy-five beats  per minute.   Such a procedure
will guard against fever, inflammation, irritation, chilliness, pain
and  cough, and  favor the great processes of calorification, nutri-
tion and secretion.

  Hectic.—This  will occur in the Third stage.   It is the result
of ulceration or suppuration.  Pus causes it.  It  occurs in bron-
chitis when the mucous membrane is inflamed to a degree that
causes pus.   Severe and  protracted irritation  .may  cause  it.
When it occurs in consumption it is caused  by the ulceration of
tubercles.  For it, there should be joined with  the anti-inflam-
matory, anti-febrile, and anti-cachectic treatment,  a gentle, genial
tonic course.   Tonics oppose the suppurative and ulcerative pro-
cess.  They aid the vis afronte in  the diseased  part; they  en-
able the capillaries of the locality involved in the production of
pus, to maintain their steady, onward currents of  blood, not only
up  to the part, but through  it, and off from it, and thus con- 
Consumption.                     51
tinnonsly.   And as long as blood can be made  to thus sweep
through a part, suppuration, ulceration, and  every other morbid
action,  will be prevented.   Proper tonics when hectic is  present,
aid the small vessels  in and about the part of softening, and
thereby shorten the career and limit the extent of  the ulceration.

  Night Sweats.—From the beginning to  the end of phthisis,
the skin is feeble.  Debility of the capillaries of the cutis is a
prominent feature of the disease.  Healthy perspiration is  want-
ing.  And as a consequence, transudation, not cell-secretion, is
liable to occur in any  stage.  It may be slight or copious owing
to the degree of weakness.   And this debility, favoring the es-
cape of the serum of the blood upon mechanical principles, must
not be lost sight of for* moment.   To obviate this waste of vital
fluid, air baths, acid baths,  hot salt water baths, alcoholic baths,
astringent  baths, and friction  with woollen mittens, or  brush
mittens, must be used with  judgment and perseverence.   When
it occurs the patient  if able  should leave the bed, remove the
night garment, and  apply  friction with woollen mittens,  the
coarser the  better, to  the whole person, especially to  the  entire
spine, and  use the limbs in  such  ways  as  will  call  the  blood
quickly to the surface and extremities.   The  sweat is the result
of weakness and to stop it,  energy must be restored, and air, dry
brisk friction and exercise have a tendency to beget in the skin
the vigor to stop the passive leakage.  Do not fear the night-air
of your sleeping room when you are using brisk friction and ex-
ercising.  They will arouse the skin and  enable you to return to
the bed and also to sweet sleep.  If assistance is required for the
application of the above means, secure it, if not the action of the
patient  should  be had.  If the night garments  become moist,
change  them.   At the same time be calm and cool and breath
copiously aud resolutely.

  Hemorrhage.—When  the mitral valve of the  heart does not
completely close the orifice between the left auricle and ventricle,
as the ventricle contracts upon its contents, it being many times
the most muscular section of the heart,  the blood  will not  only
pass forwards iBto the aorta but it will pass backwards into the 
52                     Consumption.
pulmonary veins, and this retrogression of the blood into the
lungs, occuring at the same time that progression of blood from
the right ventricle of the heart is going on to the lungs,  will
cause not only a stagnation of blood in the lungs, but accumula-
tion, over-distention, and permeation.  The blood filtrates into the
air tubes and is evacuated by expectoration.
  The mucous tunic of the air passage may by weakness,  especi-
ally if the fibrine of the blood is wanting, allow passive hemorr-
hage.  This variety of hemorrhage may occur in the First stage.
  When the tubercles are numerous, they more or  less cord the
veins of the lungs, and prevent  the blood from passing on to the
heart.   Blood by this means accumulates in the capillaries of the
lungs; at the same  time the right ventricle is advancing the
blood into the  lungs with all its force, and the two causes are
sometimes sufficient to produce extraversation  and hemorrhage.
   Sometimes an ulcer divides a blood  vessel and if the vigor of
the vessel continues up to the lesion, which is not often the case,
hemorrhage will take place copiously.
   Severe blows and straining may rupture  a vessel in the lungs
and cause dangerous bleeding.
   Again hemorrhage may occur at  the lungs vicariously,  or it
may be a habit of the lungs,  as it often is of the nose.
   Whenever bleeding from the lungs  does  occur, the  patient
should assume an easy posture,  apply something warm to the ex-
tremities ; take salt water, and preserve mental  calmness  and
quiet,  carefully avoiding all solicitude and fear, remembering that
cheerfulness is the most potent styptic known,  when joined with
 warmth, coolness and the recumbent posture.

    Consumptive Habit.—In this disease the general bad habit and
not the complications, should receive the attention of the phy-
sician.   The  mere collaterals  may receive  attention until life
ceases,  and the disease will steadily advance.   To cure consump-
tion the tubercular habit must be  met.  The root of the disorder
must be removed, and in doing it, the medicines given must not
interfere with  sleep,  nor exercise, nor  eating,  nor enjoyment in
any way.  All the normal processes of the body and mind  must be
fostered.  And to  guard against interference  with these  great 
Consumption.
53
functions, and at the same time administer medicines that have a
direct tendency to break up the general cachexy, that will relieve
the embarrassed lungs and  fill the pale skin with warm currents
of blood, a certain period of the day must be selected for taking
the medicine.  And this period is after the entire voluntary man
has been  suspended—after  retiring to bed, when all  thought
and action are stopped,  and Nature has supreme sway.  After the
patient is calm warm and quiet in bed, is the time to give medi-
cine for the cure of consumption.  Medicine for the cure of the con-
stitutional  disorder should not be given but once in twenty-four
hours.  Medicines  for the improvement of digestion should  be
given after eating.  Medicines for  costiveness should  be taken
after retiring and only once a day.  And as far as possible, the
remedy for the cough, should be taken at the same time, though
the complications of consumption, will require attention, as they
occur, for they are local and temporary. 
 
CONTENTS.
Phthisis,................................................................  3
Knowledge of Phthisis important to all,......................................  4
History of Phthisis,.......................................................  *»
Stages of Phthisis,....................................................  • •  6
Symptoms of First Stage,..................................................  '
Symptoms of Second Stage,................................................12
Symptoms of Third Stage,.................................................14
Varieties of Phthisis,..........................................  ...........16
Predisposing Causes of Phthisis,............................................1°
Immediate Cause of Phthisis,..............................................18
Nature  of Phthisis,.......................................................21
Hereditary Feature of Phthisis,.............................................26
Phthisis, Constitutional or Local,............................................*7
                                                                             OQ
Phthisis Contagious,..................................................---""
Colds and Inflammations Cause Phthisis,.....................................30
Phthisis Curable,.........................................................aw
Prevention of Phthisis...............................................
Remedy for Phthisis,.................................................
Hygeianic Remedy,..........................*............" •.......'
Medical Remedy,...............................-...................
Pain,............................................................
 Difficult Breathing,.......................................*..........
 Cough.............................................................
 Sputa,............................................................
 Inflammation,....................................................
Fever.......................................................
Hectic,.......................................................
 Night Sweats,...................................%.................
 Hemorrhage,...................................................
 Consumptive Habit,..........................
.32
.35
.35
.45
.45
.46
.46
.48
.49
.49
.50
.51
.51
.52 
 
 
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