THE DUTY OF THE OHIO STATE MEDICAL 
SOCIETY TO CONSUMPTIVES. 
BY 
J. E. WOODBRIDGE, M.D., 
YOUNGSTOWN, O. 
From Transactions 
Ohio State Medical Society 
1889. 
THE WILLIAMS PUBLISHING CO., 
Press of 
Cleveland, O. THE DUTY OF THE OHIO STATE MEDICAL 
SOCIETY TO CONSUMPTIVES. 
J. E. WOODBRIDGE, M.D., YOUNGSTOWN, OHIO. 
In calling your attention to the duty of the Ohio State 
Medical Society to “ Consumptives and their Medical 
Advisers,” you will perhaps deem me guilty of wasting 
your time on a subject on which little of consequence can 
be said, and which, at most, is a matter of minor im- 
portance. If so, your opinions are well sustained by the 
summary manner in which the subject has been treated 
by the best medical authorities in all ages of the world’s 
history. 
Hidden away in the nomenclature of diseases you may 
find the various names by which it has been designated. 
Search your text-books, but you will find nothing in the 
manner in which phthisis has been treated to lead you to 
conclude that the disease is one of unusual importance ; 
and if you search the records of this Society for any 
evidence that consumption demands, or ought to have, 
any special attention paid to it or to its victims, you will 
find it wanting; and yet we have under consideration an 
infectious disease more fatal than small-pox or cholera or 
scarlatina, more fatal than all combined—in fact, num- 
bering among its victims, as shown by the last census of 
the United States, more adults than all other infectious 
and contagious diseases together; affecting all classes of 
people, of every age, condition and sex ; leading its victims 2 
CONSUMPTIVES. 
by slow gradations, extending often over a series of 
years of hopeless invalidism to the grave. Its death-rate 
is truly appalling. But we have become accustomed to 
its ravages, and in a measure reconciled to them, and re- 
gard deaths from consumption as a kind of visitation of 
Providence, from which there is no escape, and yet the 
same kind of a visitation of cholera or small-pox would 
arouse such a feeling of horror and indignation as none 
of us would like to face. 
The consumptive, however, pursues the even tenor of 
his way, and in a large majority of the cases that come 
under my observation, insufficiently or improperly fed, or 
both, unscientifically and generally poorly clothed, their 
dying arouses no indignation, and often but scant sym- 
pathy. They are regarded simply as the victims of an 
incurable disease, and walking about with their clouded 
brows awaiting the dropping of the curtain over the final 
act, they constantly remind one of the terrible inscription 
over the entrance to Dante’s Hell, “All hope abandon 
ye who enter here.” 
But a new day is dawning on our friends. 
When Lewis A. Sayre, at the meeting of the American 
Medical Association at Philadelphia, in 1876, battled 
bravely and alone for the true pathology of the so-called 
tubercular diseases of joints, he was perhaps all uncon- 
sciously brushing away the mysticisms and errors of ages 
from the pathology of a far more important disease; and 
when a Swiss peasant, condemned to die of this disease 
in the sunnier lands to which he had expatriated himself, 
returned to his bleak mountain home to end his days, and 
instead, continued to live, he touched the key-note to its 
treatment, and the time is almost here when the pathology 
and treatment, and even the nomenclature, but, most of 
all, the prognosis of the disease must be re-written, and in 
a far more hopeful spirit than has characterized its history J. E. WOODBRIDGE, M.D. 
3 
in the past. Look at that past. Glance at the literature 
of consumption during the past century. Study the 
writings and teachings of the best authorities of the present 
day. What a conglomerate it is ! 
Future generations, reading this stuff, will say it was 
written by isolated members of a widely scattered profes- 
sion, having no means of communicating with each other, 
and yet this is the close of the nineteenth century, the 
age of telegraph and telephone, of county, state, national 
■and international medical societies. But none of them, 
so far as my observation has extended, pay much atten- 
tion to the most fatal disease which we are called upon to 
treat. 
What have we of the Ohio State Medical Society done ? 
Nothing. In 1878 Dr. Loomis read, before the American 
Medical Association, an able and exhaustive report on the 
climatic treatment of consumption, which bore evidence of 
careful thought and research; it was fully abreast of its time. 
But ten years have passed since then and we live in an 
age of progression—an age in which mighty events are 
crowding each other off the stage of action. A decade now 
means more than a century did some hundreds of years 
since. And can any gentleman point me to any positive, 
more recent advances we have made in knowledge of the 
pathology, prophylaxis, or treatment of consumption ? 
While wonderful discoveries are being made, and the 
profession which we love and practice is making its full 
share of them, the great mass of that profession is in no 
sense better prepared to answer any question bearing 
upon the treatment of this disease than were its members 
three hundred years ago. 
Give any large number of physicians a typical case of 
incipient consumption and ask them what they would do 
for it, what kind of reading, think you, their answers 
would make ? From a knowledge of what has gone be- 4 
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fore, it would be safe to say that the patient would receive- 
some very contradictory advice. He would probably be 
told to stay at home, take cod-liver oil and tonics, and 
a hundred other remedies ; to use Borgeon’s method ; 
to go to southern California, New Mexico or Colorado ; 
to Rome; to the Riviera ; to Davos Platz, and, in short, 
to almost every inhabited or habitable spot on the globe. 
One patient, after consulting the fatuity physician, visited 
Philadelphia, New York and Boston, consulting seven 
eminent gentlemen; was advised to go to southern Cali- 
fornia, to Bermuda, Chautauqua Lake, Denver and Flor- 
ida. All could not be right. Nearly, if not quite all, 
were probably wrong. Yet these are far above the aver- 
age members of the medical profession. How, then, would 
a patient fare with the average practitioner ? A gentle- 
man, resident of New York city, after consulting his 
family physician, who advised him to go to Europe, but 
who frankly admitted that he did not know what would 
be the best place, called in an eminent authority who 
advised him to go to Rome. In various parts of Europe 
he consulted the most celebrated physicians, and finally 
returned to this country, and after this long experience 
gave as his deliberate opinion that neither the medical 
men of Europe nor America know anything about the 
climatic treatment of consumption; and it must be con- 
fessed that even the best medical literature of the day or 
age gives such varied and widely divergent theories on the 
subject, that such opinion would seem to be well founded. 
Now the medical advisers of consumptives should be 
taught enough about the prophylaxis and treatment of 
consumption to save the profession the disgrace of so 
much contradictory advice to the victims of so important 
and wide-spread a disease. 
Your author has given many years to the subject, and 
if his time and yours were unlimited he could tell you of J. E. WOODBRIDGE, M.D. 
many existing differences between celebrated health 
resorts, as seen through partial and highly colored adver- 
tisements, and impartial, truth-seeking eyes. 
He has wintered in southwestern Texas, a few years 
since the Mecca for consumptives, and in the southeastern 
portion of the United States; has visited various points 
on our Atlantic coast and many of the resorts of Colorado, 
New Mexico and southern California, and has found that, 
in many instances at least, the place that from a distance 
of some hundreds or thousands of miles seemed most 
desirable, on closer inspection proved least so, and it is 
his belief that the ideal health resort for consumptives, 
if there be one, has either not yet been discovered, or suf- 
ficiently advertised to attract much attention. Colorado, 
with its wonderful sunshine, pure air, high altitudes, 
grand scenery and occasional pine forests, possesses many 
advantages not found elsewhere, but some of its best 
advertised health resorts are unfit for residence of even 
healthy men. As, for instance, Colorado Springs, which 
really has much to recommend it, was, at the date of my 
visit,. November, 1888, a town of about seven thousand 
inhabitants, without sewers, is at times exceedingly dusty, 
is subject to high winds, has irrigation ditches on each 
side of its streets, and the sun sets early, making the day 
short. 
Your author asked one of the leading physicians of 
the place how he could reconcile the existing conditions 
with its claims as a health resort. The doctor answered 
that, “ dust is considered an antiseptic to external wounds, 
and may it not perform the same office in the lungs? ” 
Many such instances might be given to show the insur- 
mountable obstacles which lie in the path of the individual 
practitioner who endeavors to do his whole duty to his 
lung patients. Individual members of the profession 
may, and no doubt have, in exceptional instances, at 6 
CONSUMPTIVES. 
least, made some progress in a knowledge of this branch 
of our subject, but it has been at a fearful sacrifice of 
human life, and it may be doubted if the lesson is always 
worth the price paid for it. 
During all my investigations, one prominent fact has 
always presented itself, viz., that the climate which 
seemed most nearly curative of consumption is most 
aseptic, and, as a consequence, when you place your 
patient under the best climatic influence, you also place 
him where he will do least harm, where he is least likely 
to communicate his disease to his friends and attendants. 
And if this is true, and can be demonstrated to the satis- 
faction of the Ohio State Medical Society and of the 
American Medical Association, so that these bodies could 
go before the world confidently teaching the correct 
climatic treatment of this one disease, would not that add 
greatly to their already high reputation ? We are rich in 
deep thinkers and careful and scientific investigators, and 
here is a broad field for the exercise of their talents. 
But how is this to be done? Let the Ohio State Med- 
ical Society appoint a committee charged with the duty of 
the investigation of all matters of interest to consumptives 
and their medical advisers, and especially of the climatic 
treatment of the disease, and report the result of its 
labors at the next meeting of this Society. Such a com- 
mittee could accomplish much that to the individual 
practitioner would be impossible. 
DISCUSSION. 
Dr. H. J. Herrick, Cleveland, Ohio, said : 
Mr. President: At the present time, any thought rela- 
tive to consumption is worthy of attention. If the 
thought is drawn from clinical experience, as is that of 
this paper, it comes with the force that commands atten- 
tion ; if it comes only from speculation and theory, it 
meets speculation and theory from others. J. E. WOODBRIDGE, M.D. 
7 
The author accepts the theory of the contagiousness of 
tuberculosis, and that theory, judging from the literature 
of to-day, seems to be gaining ground. It must be ad- 
mitted by those who advocate this theory, that it is rather 
a sequence of the theory that tuberculosis is caused by 
the bacillus, rather than a conclusion drawn from clinical 
experience. The mortality from some form of tubercu- 
lous disease varies in different communities at from io to 
12 per cent, of all deaths. No community, climate 
or location is exempt from it. Yet no physician, I think, 
from his clinical experience, can from cases observed, 
present even a shadow of a ground for the theory of in- 
fection. Such would be my decision, were I to review 
my experience in quite extensive practice for the last 
thirty years. I should quite as soon speak of the conta- 
gious character of pneumonia, inflammation of the brain, 
or other idiopathic diseases. I have a paper on the 
modern views of tubercle which I hope to present 
to this Society, in which I attempt to show that the 
modern views as to the etiology of tubercle are not 
established beyond question; further, it appears that the 
treatment, based upon the theory of a specific cause, 
does not add any advantage to the patient. Further, I 
do not believe that tuberculosis finds in climate the most 
effective line of treatment. The atmosphere is a condi- 
tion of one of the most elementary and essential functions 
of the body, viz., respiration. The process of respiration 
we are quite familiar with. Physiology in detail gives us 
the changes wrought in the blood by air through the 
vesicles of the lungs. 
The pernicious effect of air must be found in the fact 
that it is not capable of meeting the wants of respiration, 
or that there is borne through it some noxious or infecting 
material which affects the blood deleteriously in its passage 
through the lungs. The fact, however, that the masses 
are able to breathe and enjoy with perfect health a certain 
atmosphere, is prima facie evidence that some other func- 
tion must be looked to for affording the benefit derived. 
Other factors besides air are essential for healthy life. 
When the medical profession join in the thoughtless 
experiment of sending patients to some other climate, 
warmer or colder, with greater or lower altitude, dry 8 
CONSUMPTIVES. 
or moist, with no definite conclusions as to the effect of 
either high, dry, low or moist atmosphere, I think we are 
very easily, and I fear thoughtlessly, shifting a hopeless 
case from our shoulders, a responsibility, with the vague 
hope, possibly, that good will come. Many are the 
victims that have sacrificed home comforts, kind friends 
and everything that would give promise, for the unassuring 
hopes of a “ change of climate.” 
I have come to regard food as a more important agent 
in the treatment of consumptives than climate, and if I 
include appropriate exercise and out-door life, I think we 
have the most important means at our command for the 
treatment of this most fatal malady. 
Of course, in speaking of food under the head of 
remedial agencies, I mean such a judicious selection of 
food as may be digested in the condition of impaired 
digestive organs and give to the blood all the nutritive 
material necessary for the restoration of the wasted 
tissues. In speaking of exercise, I refer to that which 
is adapted to the condition of the patient; I would 
emphasize the importance of body exercise in distinc- 
tion from that of the extremities. 
I have often observed the wholesome effect of garden- 
ing in certain patients who were manifestly in the 
incipient stage of consumption. Of course, open air 
life gives the best air to be had, hence the best element 
for respiration. In this connection I must express my 
distrust in all the local means so skillfully used at the 
present day. It seems to me that the pneumatic cabinet, 
hot-air inhalations, germicidal inhalants, et hoc genus 
omne, do not afford even a forlorn hope of relief. 
I wish to commend the thought of the paper as em- 
bodying the personal experience and observations of the 
author, and trust we may yet have further inquiries in the 
directions suggested by him. 
Dr. John McCurdy, Youngstown, Ohio, said: 
I thought when the gentleman started out that he had 
discovered something new, but I see he has not. I want 
to take issue with him. I have been practicing medicine 
thirty-three years, and I do think we have made mighty 
strides in the treatment of consumption. I do think a J. E. WOODBRIDGE, M.D. 
great deal of advice given by physicians in the country is 
good advice and safe, that is, for the well-being and 
longevity of our patients. I think about two years was 
the average length of time a consumptive would live, and 
we have brought that period up to at least twelve years, 
and I think if you take the disease in time, it can be 
averted in three-fourths of the cases. Send your patients 
to an altitude of seven thousand to nine thousand feet, 
and keep them there. In many instances recovery will 
be secured, and, if the patient is kept west of the Mis- 
sissippi, he may enjoy good health. Continuously, I think 
we have done a great deal. There is, of course, a certain 
type of consumption that is destructive. I know I have 
benefited a good many by telling them to go to Colorado. 
I think I have benefited a good many by keeping them at 
home. There are some where the case responds to drugs 
nicely; others where drugs are of no use, but I think we 
have done a great deal to lengthen the lives of consump- 
tives.