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* just stated, is originally a curative process, the means which nature uses to rid the body of that which offends, of that which is foreign to the system, and ought to be "out of it; hence the folly of using medicines to keep down the cough, as all cough remedies sold in the shops merely do, without taking means at the same time for removing that state of things which makes cough necessary, that is, the congestions, the cloggings up, which occasion the exudations previously described.
All that the Author aims to do in these pages, is to speak his own sentiments, as formed from what he has seen; and it is perhaps the best method of preventing the perpetuation of error. Authority has most unfortunately too often rolled back the tide of true progress for ages. The Author has observed, that spitting of blood, in any manner or form, does, in an overwhelming majority of cases, when neglected, terminate, sooner or later, in confirmed Consumption; hence the instinctive shudder or appallingness which dashes over a person, the first instant of his noticing that he has spit blood; in vain may the physician in his kindness and sympathy, talk about its coming from the throat, or the gums, or from congestion, it is but too often, as intelligent 'practitioners know full well, not a cause of Consumption, not a symptom of threatened Consumption, it is an effect of Consumption begun, of progressive lung decay: not always so, most assuredly, but it is so, in more than a large majority of cases, except in women.
Some persons spit a little at a time, the expectoration is merely tinged with red, it ceases, and after various intervals, returns.
Others bleed a pint or more at a time, coming on often without any appreciable or adequate cause, ceasing spon taneously almost, and the person fancies himself as well as he ever was in his life, and in a few months the fact of the haemorrhage has been forgotten; but sooner or later, another attack, and another, until a fatal issue. As a general rule, a man does not have more than three or four large haemorrhages before death steps in. In many cases, there is not the slightest cough noticed, until some months after the first or even second expectoration of blood; it is the absence of cough that encourages the patient to believe that it cannot possibly be Consumption. Consumptives who expectorate blood have usually less cough at first than those who have never had a haemorrhage, it is because the haemorrhage relieves the clogging up, which is the immediate cause of tubercles, which are again the more immediate cause of cough, hence small and frequent haemoptoes retard phthisis.
In women, spitting blood is not a specially dangerous symptom, unless attended with one or two other symptoms, which the watchful physician will readily detect. Sometimes haemorrhage from the lungs may occur in men without involving the existence of consumptive disease. See the case mentioned on page 82.
In this and similar cases, it is of the highest importance to determine the nature of the haemorrhage, for upon that depends the subsequent treatment and result. Spitting of blood therefore, as it is so generally an indication that a fatal disease is in progress in the system, should decide the person to call in a physician at once, for it is a symptom which should excite alarm in all cases ■whatever.
Its sinking in water is, of itself, no sign of Consumption, as all yellow expectoration will sink in time. Let the reader remember to spit out every atom possible, and never swallow it; better out than in; otherwise it soon fills up the lungs, and there being no room for air, suffocation soon takes place, or being re-absorbed into the blood, it poisons and putrifies the very fountain of life. Usually, the expectoration of Consumption is of a heavy, yellow nature, that of Bronchitis is varied, yellowish, dark, greenish, stringy, tenacious.
But it is a fact not to be disputed, that up to this time the expectoration gives no reliable indication as to the existence of Consumption, until the patient is in the very last stages of the disease, therefore a more definite description of it has not been given, especially as by it alone, the physician forms no opinion. But a daily expectoration, of any amount, of & yellowish nature, over a month or two, should excite attention, for it is an ominous symptom.
CHILLS AND FEVERS.
This is a frequent symptom in the graver forms and advanced stages of Consumption, and very many persons are hurried to the grave by treating them as a kind of Fever and Ague ; the already weak system is shocked by immense doses of quinine and other powerful tonics, which, while they sometimes only remove the chill for a day or two, very greatly aggravate the cough, and soon the symptom returns with greater violence, in a weaker body. Very many instances of this kind have come under the Author's notice; and the patients were destroyed, from a misconception of the nature of the symptom; they are more of the nature of the rigors of disorganization and of absorbed matter, than of the chill of Fever and Ague, but treated as this latter, every dose administered, only kills the surer and the sooner.
by which is meant, three or more stools in twenty-four hours, of a lightish color, and thin as common mortar or even whitewash; this is a symptom of the later stages, but if propejrly controlled, persons often live in comfort for months, and sometimes years, who otherwise would have perished in a few days.
The condition of the bowels is a matter of the first importance in all stages of consumptive disease, more especially in the advanced stages, when they are inclined to be loose.
If the passages are dark or greenish, they are favorable, although they may be thin. In proportion as they are thin and of a lightish color, they are debilitating and dangerous, whether few or many. The first best advice is, send for a physician at once; in the meantime, be quiet, lie down on a bed or sofa, eat not an atom of any thing, except as much ice as may be desired, and drink nothing but thick flaxseed tea, or gum arabic, or slippery elm bark mucilage, that is, water thickened with these.
Many a valuable life has been shortened, if not lost, by taking something for loose bowels, that is, diarrhoea, by following the over-confident advice of a well meaning neighbor or friend, who has no life to lose by the inefficacy or over efficacy, or inappropriateness of the means which he himself recommends. Over confidence is always the result of ignorance, inexperience and reck lessness. In all forms of loose bowels, it is as dangerous to arrest it too soon, as it is to neglect it too long. When arrested too soon, the brain becomes affected, and drowsiness, insensibility, and death soon follow. When the patient dies by being let alone, or by taking salts, castor oil, or other such things, which only aggravate the disease, he retains his senses to the very last, as is commonly observed in cholera, ■which is nothing more than a violent diarrhoea.
IS CONSUMPTION COMMUNICABLE?
Some of the most eminent writers on the subject have died of Phthisis, Laennec, Hastings, Wooster and others, whether from thinking about it so much, or from being so frequently where it was, I cannot say; I only state a known fact. Again, most assuredly the large majority of widowers and widows who apply to me, have had their companions to die of Consumption. The use the reader should make of these facts is, habitually not to eat, or drink, or sleep in a room where a consumptive person is confined. If called to sit up with them, eat some plain food every four hours during the night, in another room; and let a door, or window, or fire-place be partially open all the time. Impure air of any kind, if habitually breathed for a long time, especially if the person be sitting about in comparative rest, is capable of generating consumption from the beginnings and much more, if a person be inclined that way, or have had near relations die with it.