Compliments of the Author 
REPORT OF THE RESULTS 
IN 
THIRTY-ONE CASES OF PHTHISIS 
TREATED AT 
Aiken, S.O., during the Season 1878-79. 
BY 
W. H, GED DINGS. M.I)., 
Aiken, So. Carolina, 
Member of Aiken County Medical Society, of Medical Association 
of So. Carolina, and of the American Medical Association. 
Reprinted from The Medical Record, 
November 15tit, 1879. 
NEW YORK: 
WILLIAM WOOD & COMPANY. 
1879. REPORT OF THE RESULTS 
IN 
THIRTY-ONE CASES OF PHTHISIS 
TREATED at 
Aiken, 8. C., during the Season 1878-79, 
BY 
w. H. GED DINGS, M.D., 
Aiken, So. Carolina, 
Member of Aiken County Medical Society, of Medical Association 
of So. Carolina, and of the American Medical Association. 
Reprinted from The Medical Record, 
November 15 th, 1879. 
NEW YORK: 
WILLIAM WOOD & COMPANY. 
1879. REPORT OF THE RESULTS IN 
THIRTY-ONE CASES OF PHTHISIS 
Treated at Aiken, S. C., during the Season 
1878-79. 
The climate of Aiken lias been often and fully de- 
scribed, but thus far the results of treatment at that 
well-known health-station have never been laid before 
the profession. 
The publication in the Medical Record last 
spring, by Prof. Loomis, of a few cases successfully 
treated in the Adirondack region, determined the 
writer to carry out a resolution made several years 
ago, to publish each year the results in all the cases 
of consumption that came under his observation in 
the course of the season. In preparing these cases 
for the press, it was found, however, that some of 
them were so imperfect—the patients presenting 
themselves only once or twice—that their publication 
would be only a waste of space. The number thus 
omitted is quite considerable, constituting the large 
majority of cases presenting themselves for advice. 
The case histories are taken from my daily record; 
and not being intended at the time of their entry for 
publication, the symptoms given are, in many in- 
stances, more or less incomplete. It is thought, 
however, that they are sufficiently full to remove all 
reasonable doubt as to the diagnosis of the disease, 
its stage of development, and the results of treatment. 
Being exclusively private patients, the writer has not 
felt at liberty to give their names, or even their ini- 4 
tials; but they may, in nearly every instance, be 
recognized, and, if necessary, verified by the name of 
either the attending or of the consulting physician, 
which, as a rale, is given immediately after the num- 
ber of the case. Some few of the cases have been 
under observation for several years; while others, 
and by far the larger number, were treated for a few 
months only. It is needless to state that the greatest 
care has been taken to make the report as correct as 
possible; and to secure this end, many cases were 
omitted, in which, although they presented general 
symptoms sufficiently marked to warrant their being 
classed as phthisis, the physical signs of that disease 
were either wanting or of a doubtful character. As 
this class usually represents cases in the initial stage, 
which are, of course, more amenable to treatment 
than those farther advanced, their omission materially 
reduces the number of successful cases, a fact which 
should not be forgotten in estimating the general 
result. 
Case I.—Male, 41 years, patient of Dr. Paddock, 
of Lenox, Mass. Disease began with bronchial 
catarrh in the winter of 1877. Patient visited Aiken 
for the first time in Jan., 1878, previous to which he 
had lost 14 lbs.—his weight, when he arrived in 
Aiken, being 122 lbs. He had also had occasional 
night-sweats. At that time there was dulness on 
the left side, extending from the clavicle to the fourth 
rib in front, and half down the scapula behind, the 
respiration being bronchial in character. Up to the 
21st of March of that year, he had gained 4 pounds 
in weight, and his general appearance was much im- 
proved. The expectoration was greatly reduced in 
quantity. He passed the summer at Lenox, attend- 
ing to his business, which was that of a grocer. 
Dec. 31, 1878.—Patient’s weight is 126 lbs., color 
healthy, pulse 92, temperature 98^°; expectoration 
half an ounce, some of which sinks. On the left side 
the dulness extends from the clavicle to the third 
rib, showing a diminution in the extent of the infil- 
tration since the first examination. On the back 
there is no change in the area of dulness. Expiration 
prolonged. Bronchophony. Patient neglected to 5 
take care of himself, ceased taking the remedies pre- 
scribed, and for a time lost ground. 
April 21st.—Dulness in front unchanged, but behind 
it is reduced to a small space above the spine of the 
scapida. Respiration bronchial. General health 
much improved. A letter received a few weeks after 
his return home states that the improvement has 
continued. 
Case II.—A middle-aged male from Washington, 
D. C., a patien of Dr. S. C. Busey, of that place. 
This case, which has pursued a very chronic course, 
dates from boyhood; has always had more or less 
trouble with his respiratory apparatus. He consulted 
me for the first time in December, 1875. He then 
had an infiltration of the right lung, as evidenced by 
dulness between the scapula and vertebral column. 
The patient had just returned from Florida without 
haring derived any benefit from his residence there. 
Several years ago he contracted a croupous pneu- 
monia, involving the affected lung; was for a time 
quite ill; but, after resolution had taken place, there 
Avas no change in the size or character of the chronic 
infiltration. He has been an annual visitor to Aiken 
for the past five or six years, and always derived 
much benefit from its climate; but this year (1879), 
being in Savannah, he concluded to give Eastman a 
trial. While there he had a succession of hemor- 
rhages, which reduced him to such an extent, that 
Dr. Busey was summoned from Washington to him. 
Yielding to the urgent entreaties of the patient, Dr. 
B. had him conveyed in a special car to Aiken. He 
had one or twro hemoiThages on the way, and, at the 
time of his arrival, wTas so prostrated, that he had to 
be brought on a bed from the cars to the hotel. His 
condition at that time wTas such as to cause his 
friends the greatest anxiety. 
Jan. 19, 1879. Physical examination reveals dulness 
on the right side, extending over the supra-scapular 
and upper half of the infra-scapular region. Respi- 
ration bronchial, and at some points distinctly caver- 
nous. On the left there is marked duhiess behind, 
with prolonged expiration. He had but one hemor- 
rhage after his arrival in Aiken, and from that time 6 
on, the course of the disease was one of very slow, 
but steady and uninterrupted improvement. For a 
long time he had to be rolled about in a chair, and 
many weeks elapsed before he entirely regained the 
use of his limbs. 
April 15th.—The patient is much improved, having 
gained in weight and strength. He can now walk 
about, and may be said to be as well as he has been 
during the past two years. 
Case III.—Male, 52 years of age, a patient of Dr. 
F. Donaldson, of Baltimore. Many years ago patient 
had rheumatism, with cardiac complication. Last 
July (1878), after taking a prolonged hip-bath for the 
relief of hemorrhoids, lie had a severe chill followed 
by fever, which continued to recur until September, 
at which time he began to cough. 
Jan. 24.—Pulse 112, temperature 102°. Over the 
left front there is diminished resonance from the clavi- 
cle to the fourth rib, with marked dulness under the 
scapula of the same side. Breathing decidedly bron- 
chial, with loud expiration. During the month of 
February was troubled with palpitations and pain in 
the cardiac region, and complained of great weakness 
and giddiness. No abnormal murmurs could be de- 
tected, but the oedema of the limbs in connection 
with the above symptoms indicated the existence of 
some serious cardiac lesion. There was some im- 
provement in the condition of the patient until March 
4th, at which time there was an exacerbation of the 
disease, with increase of fever, sweats, etc. Physical 
examination revealed dulness on the right side with 
bronchial respiration. The cardiac symptoms also 
became more troublesome. April 15th, there being 
no prospect of improvement, the patient was advised 
to return home. 
Case IV.—A young lady from New Jersey; Dr. 
Hayes Agnew, of Philadelphia, consulting physician. 
The neck much disfigured with large cicatrices, the 
result of scrofulous ulceration of the cervical glands. 
Has lost flesh ; lies on the left side. 
Jan. 28.—Pulse 96, temperature 101V ; diminished 
resonance over the upper portion of the right lung, 
with jerking, bronchial respiration. Feb. 26tli.— 7 
Pulse 104, temperature 1011°. Dulness distinct under 
right clavicle, with audible expiration anteriorly as 
well as posteriorly. On the left side there is no dul- 
ness, but the respiration is bronchial in character. 
The patient gradually grew worse, returned home at 
the close of the season, and died in August. 
Case V.—A middle-aged clergyman from Gloucester, 
Mass., a patient of Dr. Morrill Wyman, of Cambridge. 
Disease commenced with bronchial catarrh in April, 
1878. Has had one slight hemorrhage. 
Feb. 1, 1879.—The upper portion of the thorax on 
the right side is much depressed. There is an ex- 
tensive area of dulness occupying nearly the whole 
front of the right lung. There is also dulness behind, 
but not so extensive as in front. March 7th.—Much 
improved, coughs less, but the expectoration con- 
tinues profuse. Has a good color, and has gained 
eight pounds. March 13tli.—Patient looks fresh and 
ruddy; pulse and temperature all but normal. Ex- 
pectoration still profuse. April 9th.—Pulse 84, tem- 
perature, 98£°. Coughs much less, and the expecto- 
ration is reduced to a fourth of what it was a month 
ago. April 26tli.—Pulse 84, temperature 99°. Has 
continued to improve ; has gained four pounds since 
last examination. May 20th.—Had an attack of diar- 
rhoea a week ago, which caused him to lose six pounds, 
three of which he subsequently regained. He now 
weighs nine pounds more than he did when he ar- 
rived in Aiken. There is diminished resonance, not 
amounting to positive dulness, extending from the 
clavicle to the third rib, over which region the respi- 
ation is normal, the expiration being barely audible. 
He coughs little, except in the morning, at which 
time he expectorates two or three drachms of muco- 
purulent matter. 
Case VI.—A bright little girl of six or seven years, 
Portsmouth, N. H., who, being under the care of a 
homoeopathic practitioner, consulted me only occa- 
sionally, so that her case history is more or less im- 
perfect. The disease was the result of an attack of 
pertussis. 
Nov. 6, 1878.—Pulse 120, temperature 99|°. The 
right lung is infiltrated from the apex to the fourth 8 
rib, as evidenced by distinct dulness both in front 
and behind.* This patient did remarkably well un- 
til Feb. 1st, when she had an attack of bronchial 
catarrh. She recovered readily from this, and con- 
tinued to improve until late in the spring, when she 
was lost sight of. 
Case VII.—A married lady, patient of Dr. McBur- 
ney, of New York. Disease started with bronchial 
catarrh in Feb., 1877. Lost flesh, at first quite slowly, 
but, diarrhoea supervening, the emaciation progressed 
very rapidly. 
Feb. lOtli.—Pulse 100, temperature 100U, in after- 
noon .as high as 104°. Expectorates several ounces; 
is very anaemic, and has had but little strength. 
Physical examination reveals extensive disease of the 
left lung, with softening of tissue. The advanced 
stage of the disease, the high temperature and great 
emaciation, precluded in this case all hope of improve- 
ment. She remained a few weeks in Aiken and then 
returned to New York. 
Case VIII.—A young lady, 24 years of age, from 
an adjoining county, in regard to whose case Dr. 
Hydrick, her medical attendant, kindly furnished the 
following history : “ The patient came under my ob- 
servation about one year ago. Her previous history 
is one of pulmonary disease of several years’ duration; 
had hemorrhage in Oct. (1878). The family history 
is not good ; her mother, sister and brother having 
fallen victims to pulmonary disease.” The disease 
was ushered in with hemorrhage in the spring of 
1877. Has had “asthma” since her childhood. 
After this attack she was ordered to Florida, but on 
reaching Charleston she consulted the late Prof. 
Geddings, who informed her that her native air was 
preferable. Under his treatment she improved, and 
remained in fair health until Oct. 1, 1878, when she 
had several hemorrhages and lost fifteen pounds. 
Feb. 11th.—Patient is rather pale ; pulse 110, tem- 
perature 100|°. Has night-sweats. On the right 
side there is dulness under the scapula, with feeble 
respiratory murmur and occasional zonchi. On the 
* The symptoms afforded by auscultation were accidentally omitted. 9 
left tlie respiration is bronchial in character, with loud 
prolonged expiration. At the base of both lungs there 
are evidences of emphysema. March 15th.—Pulse 
92, temperature 99|°. Patient looks much better. 
March 31st.—Patient returns home much improved, 
is stronger, has a better color, and coughs less. Has 
increased several pounds in weigfit. The dulness on 
the right side is of course still perceptible, but the 
mucous rales have entirely disappeared. On the 
left side, to the outer side of the heart, the respiration 
is still bronchial in character. 
Case IX.—Male; patient of Dr. Biicliler, New York. 
Had an attack of haemoptysis in 1860, with cough of 
several months’ duration, from which he recovered 
completely, and remained perfectly well until August, 
1878, when he again commenced to cough. 
February 18, 1879.—Patient has lost five pounds 
since the attack in August, and looks quite pale and 
sallow. Pulse, 104; temperature, 99°. On the left 
side, and to the left of the heart, tlip percussion sound 
is short, and the expiratory murmur prolonged. Over 
the back the respiration on that side is very harsh. 
On the right side there is dulness over the apex, 
the respiration being quite feeble. 
March 4th.—Color much improved; coughs less, 
and has gained one pound. 
March 27tli.—Has had slight attacks of congestion, 
with tingeing of the sputa, but now feels quite well. 
April 23d.—Is stronger and expectorates less. The 
dulness, however, is much more distinct, extending 
on the right as low as the second rib. 
April 29th.—Patient goes home improved in gene- 
ral health, but without any material change in the 
local symptoms. 
Case X.—A married lady, patient of Dr. George C. 
Webber, of Millbury, Mass., who writes that “she 
has incipient trouble in one lung,” and “ that she has 
lost three sisters by phthisis.” 
February 24tli.—Color pale; pulse, 120 ; tempera- 
ture, 98|°. On the right side there is dulness on per- 
cussion below the clavicle, with bronchial breathing 
over the upper portion of the lung. Left side dull 
under the clavicle. 10 
March 20th.—Pulse, 105 ; temperature, 100|°. Has 
gained seven pounds in weight, and is greatly im- 
proved in color. Left apex still dull. On the right 
side the dulness is still present, but greatly dimin- 
ished in extent. 
April 8tli.—Has continued to improve ; has gained 
two pounds additional during the past month, mak- 
ing a total gain of nine and a half pounds since her 
arrival in Aiken. 
May 2d.—Pulse, 104 ; temperature, 99|°. Coughs 
and expectorates much less; weighs more than she 
ever did in perfect health. The area of dulness is 
still present, but the respiration is all but normal. 
Case XI.—March 1st, a young man, eighteen years 
of age, a patient of Dr. P. Donaldson, of Baltimore. 
His father, two uncles, and an aunt had consumption. 
Has frequent attacks of haemoptysis; has morning ex- 
acerbations of fever, and sweats at night. On the 
right side, the percussion sound is dull. The expi- 
ratory murmur is prolonged over the front and back. 
Vocal fremitus quite pronounced on that side. March 
17th, no return of the bleeding since the 8th ; the 
morning paroxysms of fever have ceased to recur, 
the temperature never rising above 98; coughs only 
occasionally, then only after exerting the voice. 
May 12th.—Goes home much improved; has had 
no return of the hemorrhages; has gained three 
pounds, and is much stronger. 
Case XII.—A young German, a patient of my own, 
who removed to Aiken in 1874, with an infiltration of 
the apex of the right lung. He had had several at- 
tacks of haemoptysis, and presented all the symptoms 
of the first stages of phthisis. He improved rapidly, 
but, disregarding my advice, he accepted a situation 
in a store, where the confinement soon brought on a 
return of the old symptoms. He abandoned his po- 
sition, and after drinking the blood of freshly slaugh- 
tered animals for several weeks he regained the 
ground he had lost. Remarking his rapid improve- 
ment while drinking fresh blood, he was advised to 
change his occupation and become a butcher; but in- 
stead of this he unfortunately opened a bar-room, 
where the irregular life, late hours, and constant ex- 11 
posure to cold draughts, favored the development of 
laryngeal phthisis, with extensive ulceration of the 
vocal cords. He grew gradually worse, and at the 
close of the last season was apparently very near his 
end. The chronic course of the disease (seven years), 
and the repeated arrest of the process, led to the 
belief that, had he exercised common prudence, his 
life might have been prolonged many years, and that 
there was in his case even a fair chance for a perma- 
nent arrest of the process. 
Case XIII.—This patient, a young lady from New 
Rochelle, was far advanced in phthisis when she ar- 
rived in Aiken ; her appetite and digestion were very 
poor, and she was affected with chronic diarrhoea. 
Emaciation very marked; her complexion of that pe- 
culiar pale tint so often met in the advanced stages of 
consumption. The physical signs present were : ex- 
tensive dulness over the right lung, with loud, moist 
rales on both sides, obscuring the other sounds. This 
patient held her own at Aiken, and subsequently went 
to Florida, where she died a few weeks after her ar- 
rival. 
Case XIV.—A young girl of fifteen, from Adams, 
Mass.; Dr. C. W. Burton attending, and Dr. John T. 
Metcalfe consulting physicians. The disease was 
ushered in with a copious hemorrhage on March 10, 
1878. The bleeding recurred several times, and was 
followed by fever, remittent in character and tertian 
in type. In May it was discovered that the right 
lung was extensively infiltrated. Profuse expectora- 
tion now set in and continued until August 1st, at 
which time she began to show some signs of im- 
provement. This improvement continued until the 
cold weather of fall necessitated her remaining within 
doors. Growing somewhat worse, she was sent to 
Aiken. 
December 11,1878.—The patient, who has improved 
during the journey, is pale, with bright red spots on 
either cheek. Pulse, 98 ; temperature, 981°. Weighs 
ninety pounds. Catamenia, which had just com- 
menced, have not reappeared since the outbreak of the 
disease. Expansion of the thorax, which is limited 
almost exclusively to the left side, two inches. There 12 
is dulness over the whole of the right lung; respira- 
tion decidedly bronchial, with loud expiratory mur- 
mur. Moist rales audible over the whole of the right 
lung. On the left side the respiratory murmur is ex- 
aggerated. 
January 9th.—Much improved in appearance; has 
gained two pounds. Expectoration reduced to half 
an ounce. A portion of the parasternal region is par- 
tially resonant. 
February lOtli.—Weighs ninety-eight pounds, a 
gain of eight pounds since her arrival in Aiken. 
Coughs in the morning and evening only. 
March 13th. —Weiglis ninety-nine and a half pounds, 
a total gain of nine and a half pounds. The area of 
resonance is increasing in extent; a triangular space, 
with two inches of the sternal end of the clavicle as a 
base, and the junction of the third rib and sternum 
as an apex, being quite clear. 
April 14th.—Weighs 100| pounds; making a total 
increase in weight of ten and a half pounds. The 
catamenia have returned. The clear triangular space 
above mentioned has grown larger, the apex being 
now at the junction of the fifth rib and sternum. She 
walks several miles without experiencing the least 
fatigue. The great and steady improvement in this 
case was as remarkable as it was unexpected ; the 
large extent of diseased surface and the age of the 
patient having naturally led to the expectation that 
the result would be anything but favorable. 
Case XY.—A middle-aged mulatto, one of my own 
patients; first presented himself about eight years 
ago. He was having quite a profuse hemorrhage 
from the lungs. The attacks of haemoptysis contin- 
ued to recur at longer or shorter intervals. A physi- 
cal examination afterwards revealed dulness and 
other signs of infiltration of the right lung. The 
patient, believing that his hemorrhages were due to 
malarial poisoning, made repeated applications for 
life insurance, but was invariably rejected. There 
has been no return of the bleeding since 1874; the 
cough has ceased, and the patient’s general appear- 
ance is that of a person in good health. The only 
physical signs remaining at this date (June 1st) are 13 
slight dulness under the right clavicle and first rib, 
with some feebleness of the respiratory murmur. 
The patient’s trade is that of a tailor, a fact worthy 
of note, in a case in which recovery has taken place ; 
that occupation being justly regarded as decidedly 
conducive to the development of pulmonary phthisis. 
So extensive is its prevalence in Vienna among that 
class of workmen, that it is sometimes designated as 
“ the disease of the tailors.” 
Case XVI.—A young man of twenty-three, from 
New York. Consulting physician, Dr. A. L. Loomis. 
Mother and brother died of consumption. Disease 
began in October, 1877, with “cold,” followed by 
fever and emaciation; cough beginning a month 
later. Has had [night-sweats and one slight hemor- 
rhage. Loss of weight, twenty pounds. Color bad. 
Breathing rapid, with deficient expansion. Pulse, 
106; temperature, 102°. Dull on the right side from 
clavicle to fourth rib, and over the greater portion of 
the scapular region. Respiration bronchial, with 
moist rales everywhere audible. On the left side, 
dulness with moist rales. This patient remained a 
few weeks at Aiken, and then went to Florida, where 
he afterwards died. During his residence at Aiken 
there was no material change in the patient’s condi- 
tion. 
Case XVII.—A young lady from Chicago; a pa- 
tient of Dr. R. P. Lincoln, of New York. The disease 
in this case began with bronchial catarrh in the au- 
tumn of 1875. She came to Aiken for the first time 
in the winter of 1876-77, with an infiltration of the 
left lung, extending from the chavicle to the third rib. 
She improved during the winter, and passed the sum- 
mer at Faribault, in Minnesota. She returned to 
Aiken the following winter, and did well, coughing 
only a little in the morning and evening. The pulse 
and temperature were normal, and her weight in- 
creased from 110 to 113 pounds. In March there 
was a slight exacerbation of the disease, as indicated 
by increase in the area of dulness, bronchial respira- 
tion and pleuritic pains on the affected side. This 
attack was of short duration, and she went North in 
the spring in good condition. She passed a portion 14 
of the summer at Bethlehem, N. H., and then went 
to Amherst, Mass., where she was laid up with an at- 
tack of pelvic cellulitis. This complication, together 
wTith the want of proper food, reduced her consider- 
ably, and caused her to lose much of the ground she 
had previously gained. As soon as able to travel she 
was brought to Aiken. 
Dec. 14, 1878.—Notwithstanding the deprivation 
of her accustomed exercise, her physician having or- 
dered her to maintain the recumbent posture, pa- 
tient has passed much of her time sitting or lying on 
the veranda, and there has been a rapid improve- 
ment in all her symptoms since her return to Aiken. 
Pulse, 88; temperature, 99|°. Expansion, 2". Ex- 
pectorates one ounce. The extension of the area 
of dulness noticed last March is now quite distinct, 
but that corresponding with the older infiltration has 
become more resonant. The respiration is bronchial, 
with prolonged hissing expiration. A few moist rales 
indistinctly audible under the left scapula. 
Jan. 22, 1879.—General appearance good. Lung 
symptoms much improved. 
May 1, 1879.—Much improved. Pulse, 80 ; tem- 
perature, 97-J0. Weighs at least 120 pounds, which is 
above her normal weight. Coughs a little in the 
morning, raising a few teaspoonfuls of muco-purulent 
matter. Left side dull from the clavicle to the third 
rib, but much more resonant than at last examina- 
tion. Has contracted a slight attack of acute bron- 
chial catarrh, which gives rise to a loud persistent 
ronchus, which masks the other symptoms elicited 
by auscultation. In this case, which has been three 
years under observation, the disease was arrested at 
least twice, and there was every reason to hope that 
the good results would have been of a more perma- 
nent character, had it not been for the unfortunate 
complication which for a whole winter deprived her 
of all exercise in the open air. 
Case XVIII.—A man of thirty-one, a patient of Dr. 
Santoir, of Brooklyn. Disease began with an attack 
of pneumonia in July, 1878. Patient’s general ap- 
pearance indicates that he is in the last stages of 
phthisis; emaciation very great; has lost over thirty 15 
pounds ; cannot digest food, and vomits continually. 
Patient grew rapidly weaker, and was removed to 
Beaufort, S. 0., and then to his home in Brooklyn, 
where he died. 
Case XIX.—Male, twenty-two years; patient of Dr. 
Chapman, of New Haven. Was taken sick on the 4th 
of March, with bronchial catarrh. He was at first 
treated by an irregular practitioner, and lost flesh 
rapidly. After placing himself under Dr. Chapman’s 
care, there was a marked improvement in all his 
symptoms. 
Dec. 28th.—Color unhealthy; pulse, 120; temper- 
ature, 100|°. Weight, 117i pounds. Expectorates 
quite a large amount of muco-purulent matter, some 
of which sinks. Patient has had night-sweats, as wTell 
as occasional attacks of Inemoptysis. On the left side 
there is an area of dulness occupying the whole upper 
half of the lung, front and back, with bronchial breath- 
ng and loud prolonged expiration; crackling mucous 
rales audible over the whole lung. On the right side 
no dulness, but prolonged expiratory murmur. 
Jan. 1,1879.—Looks and feels better. Pulse, 108 ; 
temperature, 100 5°. Expectorates less. 
Jan. 28th.—The dulness now extends from clavicle 
to fourth rib and half down the scapula. Weighs 
118J pounds. A gain of three-quarter pound. 
Eeb. 8th.—Weighs 119£ pounds; a gain of two 
pounds. 
March 23d.—Pulse, 92 ; temperature, 100°. Weighs 
more than he has ever done in health. 
March 28th.—Cough tighter; is quite hoarse, and 
has diarrhoea. Pulse, 112 ; temperature, 101°. 
April 10th.—Pulse, 100 ; temperature, 100°. Has 
rallied from the late attack, and looks quite ruddy. 
April 18tli.—Pulse, 92 ; temperature, 99|°. Weight, 
117 pounds; a loss of two and a half pounds. 
May 10tli.—Pulse, 88 ; temperature, 99|°. Has 
had a slight, but persistent, diarrhoea since May 
5tli. 
May 17th.—Pulse, 104 ; temperature, 100£°. Com- 
plains of pain in the left lung, extending through to 
the back, probably indicative of extension of the dis- 
ease. Patient has lost four pounds. 16 
May 21st.—Appears to be losing ground; starts for 
borne. 
In tliis case there was marked improvement in all 
the symptoms, increase in weight, lowering of tem- 
perature, lessening of cough and expectoration, until 
the warm weather of spring caused the attack of 
diarrlicea, with subsequent extension of the disease 
and loss of all he had previously gained. 
Case XX.—A middle-aged lady from Norwich, 
Conn. Had a severe attack of the epidemic influ- 
enza, which prevailed so extensively in 1874; has 
coughed ever since, and in October, 1877, had a co- 
pious hemorrhage, followed by loss of flesh, night 
sweats, etc. 
Jan. 4th.—Pulse, 120; temperature, 101° ; expan- 
sion, 28 to 30". Suffers in the forenoon with 
chilly sensations, succeeded by fever. Sweats pro- 
fusely, and expectorates at least four ounces of muco- 
purulent matter, all of which is said to float. There 
is extensive dulness on the right side, extending in 
front from the clavicle to the fifth rib, and behind 
from the supra-spinous fossa to a line corresponding 
with the lower third of the scapula. The respiration 
on that side is bronchial, with abundant mucous rales. 
On the left side no dulness, but very harsh respira- 
tion. The general appearance of the patient is de- 
cidedly unfavorable; she is quite weak, and slight 
exertion produces fatigue. 
Jan. 14th.—Pulse, 112 ; temperature, The 
sweats have ceased, and patient feels stronger. 
March 29th.—The condition of the patient during 
the last two months has remained unchanged; to- 
day, however, she is much paler, and evidently 
weaker. 
April 14th.—Pulse, 120; temperature, 102£°. Pa- 
tient is losing ground. 
April 30th.—She leaves for home, her residence at 
Aiken having prolonged life through the winter, the 
advanced stage of the disease not admitting of any 
more favorable result. 
Case XXI.—This patient, a young man from 
Brooklyn, who had been hitherto attended by an ir- 
regular practitioner, was far advanced in consump- 17 
tion ; left lung, as well as the larynx, being exten- 
sively diseased. Emaciated to the last degree with 
cedematous swelling of the ankles, it was evident that 
death would take place at an early date—a prognosis 
that was verified a few weeks later. 
Case XXII.—An unmarried lady, a patient of Dr. 
F. I. Knight, of Boston. The disease began with 
chronic pleuro-pneumonia in December, 1876. On 
her way South she was exposed to the influence of 
severe cold in the depot at Philadelphia, which gave 
rise to severe pain in the chest and a dry, troublesome 
cough. 
March 2d.—Pulse, 112 ; temperature, 101^°; color, 
pale. Articulates with great difficulty, being com- 
pelled most of the time to speak in a low whisper. 
Slight dulness under the right scapula, with bronchial 
respiration. 
March 10.—The aphonia has increased; has fever 
in the afternoon. 
March 20.—Pleuritic pains ; has less fever, but com- 
plains of weariness after slight exertion, and has 
night-sweats. 
April 5th.—General health much improved; laryn- 
geal symptoms as at last examination. 
April 28tli.—The improvement noted on the 5th 
has continued; she is stronger, and has increased in 
weight. No improvement in the laryngeal symptoms, 
except that the voice is more distinct. 
Case XXIII.—Male, forty-one years old; patient of 
Dr. Van Bibber, of Baltimore. Hereditary predispo- 
sition to consumption on the father’s side. Disease 
began with bronchial catarrh in the autumn of 1877. 
Has had several attacks of blood-spitting, and suffers 
with occasional night-sweats. The patient has been 
some time in Aiken, and is in much better condition 
than when he arrived, having gained at least five 
pounds. 
March 4th.—Color, good; pulse, 76; temperature, 
100°. Dull on left side, between the clavicle and 
second rib, with bronchial breathing. There are also 
the same evidences of disease between the scapula 
and vertebral column of that side. 
April 4tli.—The patient has contmued to improve, 18 
having gained three additional pounds during the 
past month, making a total increase of eight pounds 
since his arrival in Aiken. There has been no return 
of the bleeding. 
Case XXIV. —Male, set. 42 ; Albany. Has been 
under the care of a homoeopathic practitioner. The 
lung affection commenced in July, 1870, with an at- 
tack of bronchial catarrh followed by hemorrhage 
and occasional night-sweats. Passed the winter of 
1871 and 1872 at Nassau, and improved there. Stayed 
at home the following winter, losing ground wTith the 
approach of the warm weather of spring, but remain- 
ing tolerably well until 1874, from which time until 
1876 he passed the winters at home, but came South 
in the spring. Went to Colorado in 1877, and grew 
better. Came East in October, and remained in New 
York until February. 
March 5th.—Color, tolerably good ; pulse, 96 ; tem- 
perature, 99f° Expectorates four ounces of muco- 
purulent matter in twenty-four hours. Dull on the 
right side, from the clavicle to the lower border of 
the fourth rib, with loud amphoric respiration, and 
other signs of a large superficial cavity. Under-right 
scapula bronchial respiration, with loud, prolonged 
expiration. On the left side there is no dulness, but 
the respiration is decidedly bronchial. 
March 28th.—Much better; pulse, 84; tempera- 
ture, 99°. Has gained two pounds. 
April 5tli.—Goes North much improved in appear- 
ance. 
Case XXV.—A young man of 22, a patient of 
Dr. Calvin Ellis, of Boston. One brother had con- 
sumption, but recovered. The disease began with 
bronchial catarrh in June, 1878. Has had occasional 
night-sweats and hemorrhages. He came to Aiken 
in December, but, disappointed because his cough 
did not disappear as rapidly as he had hoped, he 
went to Florida. During a hunting expedition in 
that State he was much exposed, and subjected to 
great fatigue, which, in connection with insufficient 
food, and that of bad quality, brought on fever. 
Growing rapidly worse, he determined, after a short 
stay on the St. John’s, to return to Aiken. It was evi- 19 
dent from the fever, the obstinately recurring hemor- 
rhages, and increasing emaciation, that the disease 
had taken a fresh start. Prior to this date the affec- 
tion was said to be confined to a limited area in the 
left lung. He has lost twenty-five pounds. 
March 20th.—Over the left apex the percussion 
sound is short, with very harsh respiration; the ex- 
piration being prolonged. On the right side there 
is a small area of dulness below the clavicle, with pro- 
longed expiratory murmur. 
April 23d.—The patient’s general symptoms have 
undergone no material change. The dulness on the 
right side is now very distinct, extending as low as 
the third rib. 
May 6th.—Patient goes home much worse in every 
respect. Much of the trouble in this case may be 
attributed, not so much to his ill-advised removal to 
Florida, as to his reckless and injudicious mode of 
life after his arrival there. 
Case XXVI.—A married lady; Drs. Loomis and 
Nicol, consulting physicians. No history noted. 
April 4th.— On the right side there is an area of 
dulness under the second and third ribs, near the ster- 
num, with bronchial respiration. On the back, same 
side, there is also dulness under the upper third of 
the scapula, with increased vocal fremitus. In other 
respects the respiration presents the same character 
as in front. Patient complains of circumscribed 
pleuritic pain over a region corresponding with the 
area of dulness. 
May 3d.—The patient looks quite well; has gained 
three pounds in weight, and coughs but little. The 
dulness has disappeared, and the respiratory murmur 
has lost its bronchial character, being feeble without 
any prolongation of the expiration. 
Case XXYII.—A married lady from Memphis; Drs. 
Thornton and Maury. The disease commenced with 
an attack of hemoptysis in May, 1877. Has lost 
eighteen pounds. During the journey the patient 
was so extremely weak that she had to be earned 
from one car to another, and even now she is unable 
to walk across the room without assistance. She was 
sent to Aiken as a deniier-ressoi'/, her friends having 20 
regarded her condition as hopeless, and it was feared 
that she would die on the way. Has had frequent 
hemorrhages, and the night-sweats have been quite 
profuse. She had been some weeks in Aiken, and 
had already gained several pounds. 
April 13th.—Very pale, emaciated, with quick and 
feeble pulse. There is distinct dulness over the up- 
per portion of the left lung. 
(The symptoms afforded by auscultation were not 
noted, but the general appearance of the patient, the 
dulness on percussion, and the history of the case, are 
such as to admit of no doubt as to the nature of the 
disease.) 
May 25th.—Patient has had several slight hemor- 
rhages, and has suffered with occasional attacks of 
pleuritic pain. In other respects her condition is 
greatly improved. 
June 3d.—Has gained six pounds in weight, looks 
better, and is much stronger, being now able to walk 
about without assistance. The improvement in this 
case was as great as it was unexpected. 
Case XXVIII.—A young girl of fifteen, from Cin- 
cinnati ; Drs. Carson and Richards. Disease com- 
menced with cough on March 7th. Pulse, 96; tem- 
perature, 101°. 
April 17th.—Left side dull in front, from the clavicle 
to second or third rib ; respiration feeble and indis- 
tinct in character. On the right side the respiration 
is louder, with audible expiratory murmur. 
April 24th.—Improving; coughs very little, and then 
only in the morning. 
June 8th.—Pulse, 88; temperature, 98f°. Cough 
has disappeared entirely, and the patient presents all 
the appearances of a person in perfect health. Not- 
withstanding her having several sharp attacks of diar- 
rhoea, her weight has increased from 135 to 
pounds. 
Case XXIX.—Male, forty years, from Worcester, 
Mass. ; patient of Dr. Calvin Ellis, of Boston, and Dr. 
Thomas Gage, of Worcester. Began with bronchial 
catarrh in January, 1879. Has gained three pounds 
since his arrival in Aiken, thirteen days ago. 
April 22d.—Color good; if anything, rather too 21 
florid. Expectorates one ounce of mnco-pnrulen t 
matter; pulse, 108; temperature, 101£°. Dull on tlie 
right side, from the clavicle to the second rib in front, 
and as low as the angle of the scapula behind. 
April 30th.—Continues to improve; coughs less, 
and the expectoration is somewhat reduced in quan- 
tity. 
May 18tli.—Patient does not look so well, and there 
are indications that the disease is extending. 
May 22d.—Color bad; is evidently losing ground 
very rapidly. Area of dulness extends in front to the 
lower border of the third rib. Patient much worse 
than when he arrived. 
Case XXX.—A young German from New York, 
twenty-five years of age. The disease began with bron- 
chial catarrh in 1875, followed by several slight hemor- 
rhages. Spent the summer on Schooley’s Mountain, N. 
J., where he lost hie cough and returned to New York, 
to all appearances quite well. There, by the advice 
of his physician, an eminent specialist in pulmonary 
affections, he resumed his business, but was soon 
again compelled to relinquish it on account of a re- 
turn of the old symptoms. He was then sent to the 
Adirondack region, where he again improved; but 
finding himself ill on his return to New York, he 
started for Europe, where he was treated successively 
at Falkenstein (Dr. Detweiler), at Davos, and at Meran 
(Dr. Pircher). The patient has passed the whole 
winter at Aiken, but has done so well that he has 
not required medical advice. His only object in con- 
sulting me is to ascertain to what extent he has im- 
proved. 
May 13th.—Pulse, 88; temperature, 99|°. Looks 
well, and has a good healthy color. Has increased in 
weight. At all the other resorts he has frequented, 
the sputa have been more or less tinged with blood; but 
since his arrival in Aiken there has been no trace of 
bleeding. He expands the chest to the extent of 
three inches without any great effort. Dulness quite 
pronounced under and below the right clavicle ; in 
the axillary line the percussion sound is short. On 
the back of the same side there is also dulness under 
the supra-spinous fossa of the scapula. Auscultation 22 
reveals bronchial respiration over the left apex, with 
prolonged expiration in the axillary region. Mucous 
rales, formerly observed by Dr. Pirclier under the up- 
per portion of the scapula, have all disappeared. 
Case XXXI.—A young married lady, patient of 
Dr. L. Weber, of New York. Disease began in March, 
1878. The following letter from her physician will 
serve as a history of this interesting case : 
“Mrs. , from healthy family, had several slight 
attacks of bronchial hsemoptoe about ten months ago, 
during pregnancy. These attacks recurred from time 
to time, although rarely combined with fever. When 
I examined her some six months ago, I said to her 
attending physician that I found on the left side pos- 
teriorly unmistakable signs of catarrhal pneumonia 
of the chronic variety, with tendency to cirrhotic dis- 
ease of the lung-tissue 
Yours respectfully, 
L. Weber.” 
136 West Thirty-fourth St. 
Jan. 15, 1879. —Patient has lost flesh, her present 
weight being 121 pounds. In addition to the symp- 
toms mentioned by Dr. W., she complains of occa- 
sional attacks of dyspnoea. There is a slight dulness 
under and to the left angle of the scapula (auscul- 
tatory symptoms not noted). Patient has felt much 
better since she came to Aiken, and the hemorrhages 
which were previously quite frequent, have only re- 
curred three times since her arrival. 
Jan. 19th.—Pulse and temperature normal; no re- 
turn of the bleeding. The attacks of dyspnoea are 
much less frequent. 
Feb. 10th.—Pulse, 80; temperature, 98i°. The 
cough, which has been gradually lessening, has now 
ceased entirely. 
April 24th.—Pulse and temperature normal. No 
return of the cough or of the hemorrhages. Has 
gained fifteen pounds, and is, to all appearances, per- 
fectly well. Physical examination reveals nothing 
abnormal, except harsh respiration on the left side. 
It will be seen by the table (p. 24), that nineteen out 
of the thirty-one cases were more or less improved; that 23 
in four of these there was entire cessation of cough, the 
patients being to all appearances quite well when they 
left Aiken. In five cases the patient neither gained 
nor lost, or gain in one direction was counterbalanced 
by loss in another. Of the eight classed as having 
grown worse, several had gained in weight and showed 
other signs of improvement; but, owing to carelessness 
or ignorance, relapsed. The one case that died was 
evidently in the very last stage of the disease when he 
presented himself for treatment. The results are 
submitted without further comment to the profession 
at large; and although chiefly intended for their in- 
formation, it is hoped that other physicians in charge 
of the various sanataria throughout the country may 
be induced to preserve careful records during the 
coming season, and conscientiously present for publi- 
cation the results attained at their stations. It is 
hoped that those who may be inclined to act on this 
suggestion, will, if possible, adhere to the plan pre- 
sented in this paper, and thus enhance the value of 
their reports w hen compared with others. It should be 
remembered that the above report does not include 
all the cases of consumption that occurred in the 
writer’s practice, but only those which were under 
observation for periods longer than one month. Quite 
a large number presented themselves only occasion- 
ally, and, not being under continuous treatment, wTere 
omitted. A fact worthy of note, and one to wiiicli 
the reader’s attention is most earnestly directed, is, 
that patients wintering at Aiken, as a rule, did better 
tliau those which did not arrive until after the warm 
weather of spring had begun. Another point in the 
report which should be noted is, that those cases 
which failed to improve at Aiken were in no wTay 
benefited by removal to other resorts. 24 
Tabular Statement of Cases of Phthisis treated at Aiken, 
South Carolina, during the Winter of 1878-79. 
Case No. 
Lung affected. 
Term of 
residence 
in Aiken. 
Besult. 
Increase 
in weight. 
I 
Left. 
4 
months. 
Improved. 
Not noted. 
II 
Both. 
5 
seasons. 
Improved. 
** 
Ill 
Both, with cardiac 
complication. 
3 
months. 
Grew worse. 
0 
IY 
Itight. 
4 
months. 
Grew worse. 
0 
Y 
Bight. 
4 
months. 
Improved. 
9 lbs. 
VI 
Bight. 
7 
month 8. 
Improved. 
Not noted. 
VII 
Left. 
1 
month. 
Grew worse. 
0 
VIII 
Both. 
2 
months. 
Improved. 
Not noted. 
IX 
Both. 
3 
months. 
Unchanged. 
X 
Both. 
4 
month s. 
Improved. 
9% lbs. 
XI 
Bight. 
3 
months. 
Arrest. 
3 lbs. 
XII 
Bight, with laryn- 
geal complication. 
5 
years. 
Arrest with sub- 
sequent relapse?. 
Not noted. 
XIII 
Bight. 
6 
weeks. 
Unchanged. 
XIV 
Bight. 
6 
months. 
Improved. 
ioy lbs. 
XV 
Bight. 
8 
years. 
Arrest. 
Not noted. 
XVI 
Both. 
1 
month. 
Unchanged. 
XVII 
Left. 
3 
seasons. 
Improved. 
XVIII.... 
Both. 
1 
month. 
Grew worse. 
0 
XIX 
Left. 
5 
months. 
Unchanged. 
Not noted. 
XX 
Bight. 
4 
months. 
Grew worse. 
XXI 
Left, with laryn- 
geal complication. 
3 
months. 
Died. 
0 
XXII 
Bight. 
2 
months. 
Unchanged. 
Not noted. 
XXIII.... 
Bight. 
3 
months. 
Improved. 
8 lbs. 
XXIV... 
Left. 
2 
months. 
Improved. 
2 lbs. 
XXV 
Both. 
(i 
weeks. 
Grew worse. 
0 
XXVI.... 
Bight. 
1 
month. 
Improved. 
3 lbs. 
XXVII... 
Left. 
2 
months. 
Improved. 
6 lbs. 
XXVIII.. 
Left. 
2 
months. 
Arrest. 
10>£ lbs. 
XXIX... 
Bight. 
1 
month. 
Grew worse. 
0 
XXX 
Bight. 
4 
months. 
Improved. 
Not noted. 
XXXI.... 
Left. 
3 
months. 
Arrest. 
15 lbs. 
SUMMARY. 
Arrested 4 
Improved 13 
Unchanged 5 
Grew worse 8 
Died 1 
31