tx^^ii r Q ;p k/ tntJ)eCttpof3Jrtttgork CoUege of l^f^v&imni anb ^urgeonsi Hibrarp ^^ The price of this book is fixed at fifty cents in paper binding, seventy-five cents in cloth, and one dollar in extra gilt binding. Those in paper covers only are mailable. Any person, therefore, remitting fifty cents, free of postage, to J. H. Potter, M. D., No. 404 Broadway, New York, Vidll receive a copy by mail. The postage is from three and a half to five cents, to any part. THE CONSUMPTIVE'S GUIDE TO HEALTH; OR, THE INYALID'S FIYE QUESTIOi^S, AND THE DOCTOK'S FIYE Al^SWERS. A COMPREHENSIVE PRACTICAL TREATISE ON PULMONARY CON- SUMPTION, ITS PREVENTIVE AND CURATIVE TREATMENT, ETC., ETC., ADDRESSED IN POPULAR LANGUAGE TO NON-MEDICAL READERS, AND INCI- DENTALLY TO PHYSICIANS AND STUDENTS. BY J. HAMILTON POTTER, M. D., No. 404 BROADWAY. SEC OND EDIT/I^^W^V Titf ?^ * ' II^EW Y J. S. REDFIELDl^yKlN*TON HALL. 1 8 5^ KC 3 ki4 ^ii Entered according to Act of Congress, in the year 1849, by J. HAMILTON POTTER, M. D., in the Clerk's Office of the District Court of the United States, in and for the Eastern District of Pennsylvania. BAKER, GODWIN & CO., PRINTERS, Tribune Buildingt. PREFACE TO THE FIRST EDITION. Prompted by a desire to study as fully as possible the class of diseases treated of in the following pages, the author was sometime since induced to visit Europe, where superior hospital advantages are enjoyed, and private instructions given by the most eminent physicians upon special diseases, Auscultation, Percussion, &c., &c. Having availed himself of these and other advantages in the colleges and hospitals of Paris, Brussels, Lon- don, Dublin, Glasgow, Edinburgh, and several other cities, he re- turned to his native country, rejoicing in the belief that the pro- gress of consumption, bronchitis and other diseases of the chest, and diseases of the throat can be arrested by the hand of Science. Under this belief he determined to devote special attention to the treatment of those diseases. He has hurriedly prepared this little work, during detached moments snatched from his profes- sional engagements, and presents it to his patients, friends, and the public — to whom the work is respectfully dedicated — with the sincere hope that it may be instrumental in averting the rav- ages of the peculiar scourges of our climate. The author cor- dially invites just and candid criticism. Philadelphia, Nov., 1819. PREFACE TO THE SECOJ^D EDITIOX. There are several diseases considered in this edition which were not mentioned in the first. The diseases referred to are frequent precursors of consumption, and therefore, the author thinks a consideration of them very clearly comports with the main subject upon which he writes. They are, Lengthened Uvula, Tonsillitis, Laryngitis, Trachitis, Asthma, Fallmg of the Bowels, Falling of the Womb, Fluor Albus or Whites, Amenorrhoea, Dysmenorrhoea, Chlorosis, Barrenness, Dyspepsia, Constipation, Catarrh, Common Colds, &c., &c. Notice has not been made of all of the diseases of the chest, the author not wishing to extend his work with matter which he fears would not interest the gen- eral reader. He has not written upon Hydrothorax, Pneumo- thorax, or Hydropneumothorax ; Cancer. Apoplexy, Gangrene, He- patization, Camification, or Atrophy of the lungs ; a reference to the glossary, will tell the reader what these diseases are. Very little is written upon diseases of the heart, as it would require a good knowledge of anatomy for the reader to understand a paper upon the subject. Female diseases are so frequently and directly the causes of consumption in ladies, and of inconveniences which render life so burdensome to them, that the author has been induced to devote much ^attention to this branch of the profession ; the success Vlll PREFACE. which has attended his extensive practice in this line, has amply repaid him. Perhaps there is no class of diseases upon which the practitioner should devote more study; we are to bear in mind that not more than fifteen ladies in every twenty are en- tirely exempt from some affection peculiar to their sex. CONTENTS. FAGi:. Anatomy and Physiology, 23 Auscultation and Percussion of the Lungs, .... 74 '* « " " Heart, .... 77 Air and Exercise, 39 Abdominal Supporters, , 140 Asthma, . . . , . - . . . . . . 106 Amenorrhoea, 123 Antidotes, . 174 Bronchitis, 103 Bathing, . . , 35 Beds, 55 Barrenness, , . 126 Baths, 170 Climate, r . . . 69 Complexion, . . . : 130 " Most liable to Consumption, .... 29 Clothing, 49 Crowded Assemblies, ........ 56 Cold Bathing, 35 Card to Invalids, 152 Catarrh, 102 Common Colds, 102 « Sore Throat, 105 Clergyman's Sore Throat, . . . . . . . 101 Cases treated, . . . . . . .. , • 154 Credentials, 15 X CONTENTS. PAGE. Counter-poisons, . . . I74 Constipation, . . . . . . . . . 112 Chlorosis, . . ........ 125 Cough, 95 Croup, 100 Diet, 44 Diet for Invahds, 171 Dyspepsia, 114 Diseases of the Air Passages, 98 Diarrhea, 96 Debility, .96 Dysmenorrhoea, 124 Early Marriages, ......... 65 Enlarged Tonsils, 98 Expectoration, 95 Falling of the Womb, 118 Female Diseases, . .. . . . . . .116 Frequent Pulse, ......... 96 Formulae for Medicated Baths, . . . . . .170 Falling of the Bowels, ........ 141 Glossary, 20 Heart Diseases, . . . 107 " « How detected, 77 Hereditary Predisposition, ....... 64 Hygiene of Women, ........ 127 Hernia, 149 Haemorrhage, 95 Introduction, .........' 9 Inhaling Tubes, . . . . . . . . .137 Jellies, &c., . . • 171 Leucorrhoea, ... ....... 121 Lengthened Uvula, 98 Laryngitis, . . . . . . . . • .98 Mind, &c., . . . ' . . ■ 57 Modes of generating Chlorine, . 93 Medicated Baths, ! 170 Morbid Excitement, 70 Nostrums, dosing with, ....... 58 CONTENTS. XI Night Sweats, Occupations which favor Consumption, On the Rearing of Children, Pulmonary Consumption, What is it ? . '' " Symptoms of, . " '* How detected, " " What causes it, " " How prevented, . " •' How to be treated, Position, ..... Pneumonia, . . . . , Preface to the First Edition, . Preface to the Second Edition, Pleurisy, ..... Prolapsus Uteri, . . . . Preparations of Wild Cherry, Pulmonary Inhalation and Formulae, Pain in the Chest, Piles, . . Pessaries, ..... Rearing Children, . Rupture, . . . . , Receipts for Jellies, . Sleep, . . • . . Sleeping Apartments, Sore Throat, . . . , Shoulder-Braces, Summary of Treatment, Symptoms, how to be treated, . Syrups, &c., .... Tight Lacing, .... Tonsillitis, .... Trachitis, . . . . Trusses, .... Tar Beer, .... Use of Tea, .... Use of Tobacco, Use of Coffee, . . . PAGE. 95 32 66 27 28 74 31 35 79 41 108 5 6 109 118 173 91 95 146 .19, 143 66 149 171 52 52 105 135 91 95 172 67 98 100 149 173 50 51 50 Xll ILLrSTEATlONS. PAGE. Use of Liquors, 50 Uvula, elongated, . 98 Voice, Preservation and improvement of, .... 110 Voice, Loss of, .110 Varieties, . . ....... 131 Various Diseases, effects of, ...... 56 Water, hot and warm, 63 Whites, • 121 ILLUSTRATIONS. Effeminacy, . . 64 Symmetry and Health, 116 Anatomical Plate, 23 Consumptive, .,......• 41 Not Consumptive, ......... 42 The Venus, 68 A Deformity, 68 Shoulder-Brace, • . 135 Abdominal Supporter, 140 Inhaling Tube, 137 INTRODUCTION. The first physicians were the priests of Egypt ; their practice consisted principally of incantations and mystical spells, not perfectly unlike those of our modern prophets. But the Greeks were the first to give medicine the semblance of a science, and the name of JEscnlapius was the first which was rendered illustrious by real philosophy and research ; he was elevated by his admiring countrymen to the title of " Great God of Physic," and splendid temples were erected to his honor in every part of Greece. But, rising like a great overshadowing rock from the de- sert far up against the blue heavens, with its top sur- mounted by a flame whose light illumines the farthest shores, behold Hippocrates, the father and founder of medicine ! his theories are based upon research, experiment, philosophy, facts ; which have secured for him, even in modern times, the title of " Medical Philosopher." The present is the age of utility, of discovery, and of extraordinary advancement in the useful arts and sciences ; its achievements have no parallels in the history of nations. The sombre as- cendants of hereditary custom and ignorance have been consumed by the triumphant blaze of modern ambition and greatness. The long annals of ancient 2 10 INTEODTJCTION". glory shone only like the transient glare of the me- teor, while the solid fabrics of our times are the imclying foundations upon which knowledge is build- ing the celestial temple of amelioration and philan- thropy. In this age immortal Freedom was born, under the banner of Washington ; and, could the genius of despotism reanimate the warlike hordes of Attila, and the martial bands of Scythia, and array them against her sacred temple, every hill and every valley would glisten with the irresistible steel of her valiant sons, who would sweep them at one charge, like a receding wave , back to the shady shores of for- getfulness. As liberty is the basis of true religion, of national prosperity, and of individual happiness, so also is she the fostress of science. And while the world is dazzled by the wonderful achievements of machin- ery, and the results of steam and electricity in bring- ing distant nations and friendly firesides within speaking distance, how much more worthy of our admiration are those philosophical researches and advancements in medicine, which tend to the pro- longing of human life, and the alleviation of suiier- ing. The names of Jenner, the insti tutor of vaccina- tion, and of Harvey, who discovered the circulation of the blood, are embalmed in more real glory than pertains to all the conquerors and statesmen whose great names will forever grace the annals of nations. Who shall place limits to our attainments in the healing art ? The older ph}- sicians, who have devot- ed a lifetime to the study of what was known and approved in their day, are sometimes jealous of ad- mTEODUCTION. 11 vancements with whicli they cannot keep pace. The use of chloroform was opposed bjthem, on its first introduction, as an impertinent innovation — good for nothing, or it would have been used in their day. ^y them, also, consumption is held to be forever in- curable ; and every new discovery and advancement which has the desirable object in view, is frowned upon as mere presumption. All new theories are op- posed, at first, but when they become established truths, their opposers creep in, if possible, unobserved, and adopt them in self-defense. The public mind is somewhat distracted, just now, upon the subject of medicine, on account of the many different theories for the annihilation of the established science, and for the cure of disease, which are obtruded upon its notice. In view of this matter, philosophers and philan- thropists have the consoling reflection that much good will come of it ; for difference of opinion excites scrutiny, discussion and investigation, all of which are indispensable in our search after truth. Here- tofore, the greatest reproach upon our art was its un- certainty, particularly in pathology and therapeutics ; these perplexities are fast giving way before the triumphant genius of the present age. The practice of medicine is no longer mysterious, experimental, obscure, uncertain, expectant ; it is now a true and j^ositive science, adorned by genius and learning. "We now understand the nature, causes, symptoms and seat of disease, the indications which call for the interference of tlie physician, and the modus 12 INTRODUCTION. operandi of the vast field of remedies wliich a benign Providence lias placed at our disposal. The brilliant in intellect, the delicate and beautiful in person, and the lovely and amiable in heart, have always been the peculiar victims of consumption. Shall we, in utter servility, chain our understandings to the maxims of ignorance, and let earth's fairest flowers lay and fester and rot because our predeces- sors have failed to accomplish in consumption, what Jenner has in small-pox, Lugol in scrofula and goitre, Trousseau in throat diseases, and Civiale in urinary calculi ? Physicians, by their precepts and jpractice^ have so long and so successfully taught the community to believe that consumption is incurable, that people are now extremely averse to any agitation of the subject, and hold to their erroneous convictions with extraordinary tenacity. This is all wrong, and jTiust give way ; people are often — in these times — forced to believe and adopt propositions which are opposed to all their former experience and to common sense. We can do anything if we but know how ; We can cure consumjption if we know how. ]^ot, then, that consumption is incurable, but that here- tofore physicians have not known liovi to cure it. That goal has been reached at last ; for the truth of this assertion, the author refers to the authority of Drs. Stokes, Wood and Louis, and to the cases re- corded in the subsequent part of this work. The average of human life is now only eight years. Whereas we have the authority of the Bible that it should be seventv. One-fourth of all who are INTEODdCTION. 13 bi3i'n, die before the eleventh month, one-tliird before the twenty-third month, and one-half before the eighth year, two-thirds before the thirty-ninth year, and three-fourths before the fifty-first ; so that out of every nine children born, only one attains to the age of seventy-three, and out of about twelve thousand, only one attains to the age of one hundred. — Buff on. There seems to be no reason why the human ma- chine should not run on to a good old age, say one hundred and twenty years — barring accidental death. Our race has no doubt brought upon itself and en- tailed upon succeeding generations many of the numerous diseases to which we are subject. I can- not think that it was the original design of the Almighty that we should be thus afflicted. Xew diseases are generated by new habits and modes of life ; they follow in the wake of civilization and reilnement. Think vou that the Arab of the desert, or the Indian of the forest, is subject as we are to an almost countless list of diseases ? Old age is almost their only dread, and, aside from war and violence, almost tlieir only cause of death. There is a saying among the Arabs that their patriarchs never die, but gradually dry up until they become so light, that finally a puff of w^ind blows them away, and they are wafted to Paradise. In intellect we advance, and are becoming giants ; but in body we deteriorate in a direct ratio. If we would increase our years, improve the standard of longevity, and live long, we must live to simple nature, abjure luxury, labor or recreate in tlie open fields and woods, plough, or hunt 14: INTKODTJCTION. the wily fox, or troll the pebbly mountain stream. Om* diet claims much care and study, and if we eat and drink to nature, we shall be called on for the practice of great self-denial. For such sacrifices, however, we reap immediate and rich rewards, in the blessings of sound health, strength, clear minds, valiant souls and bouyant spirits. J. H. POTTEK, M. D. 1^0. 404 Broadway. New York, January, 1852. CREDENTIALS. The author wishes to avoid publishing anything within these pages which his friends, the profession, or a discerning public woijid disapprove ; but it is his judgment, though perhaps that judgment may be erroneous, that all popular medical writers should prefix their credentials to their productions. Extract from a letter from the Hon. Richard Rush, late American Ambassador to France. Paris, June Isl, 1849. My Dear Sir : Dr. J. Hamilton Potter, one of our countrymen, commended to me, through good sources, as a physician of merit and worth, being about to leave France for London, I beg to give him this line of introduction to you. Asking you to receive him kindly, I remain, my dear Sir, Respectfully and faithfully yours, Richard Rush. To Colonel Aspinwall, Consul of the United States, London. Letter from Mr, Ford, of Lancaster, Pa., to the Hon. Charles Ogle. Representative Chamber, Harrishurg, Pa., March 26tJi, 1838. Dear Sir : The bearer of this letter. Dr. J. H. Potter, of the city of Philadelphia, is a gentleman of character and reputation, whom I would respectfully introduce to your acquaintance. Any attention which may be shown him, will be cheerfully acknow- I edged by Yours, respectfully, George Ford. 16 CKEDEHTIALS, Copy of Diploma from the Philadelphia College of Medicfne, Omnibus et singulis has literas lecturis Salutem. Notum sit quod nos Prases et Professores CoLLEon Medicine Philadelphiensis Reifublic^ Pennstlvaniensis Auctoritate constituti. Hoc scripto testatum volumus virum probum John Hamilton Potter, Omnia studia et exercitia ad gradum Doctoris in Arte Medica spectantia rite et legitime peregisse, eumque, coram professoribus examinatione comprobatum. Doctorem in Arte Medica crea- vimus et eonstituimus, eique, omnia jura, immunitates et privile- gia ad ilium gradum hie aut ubique gentium pertinentia dedimua et coneessimus. In cnjus rei majorum fidem hocce diploma, cora- muni Rostro sigiDo munitum, et cbirographis nostris subscriptum, sit testimonio. Annoque Domin^l 8^7. Philadelphia. Die Sexto Mensis Martis. Jacobus McClinto-ck, M. D., Anat. Prof. H. Gibbons, M. D., Theor. and Prax. Med. Prof. Chris. C. Cox, M. D., Inst. Med. et Jurisp. Prof. Alfredum L. Kennedy, M. D., Chemia. Prof. KusH Van Dyke, M.D., Mat. Med. et Therap. Gen. Prof. Carolus a. Savory, M.D., Obstetric etMorberete Prof. Jacobus McCuntock, M. D., Chirurg. Prof. M. W. Dickeson, M. D., Anat. Path, et Comp. Prof. J. R. Burden, M. D., Prgeses. J. McClintock, M. D., Scriba. (S'eal.) Copy of Certificate from the Pennsylvania Hospital. We, the Attending Managers, Physician and Surgeon of the Pennsylvania Hospital, Do Certify, that John Hamilton Potter, M. D., of New York City, hath attended the practice of the Physicians and Surgeons of the said Hospital for one year. In Testimony whereof. We have respectively set our Names to this Certificate, and caused the Seal of the Hospital to be there- unto affixed, this sixth day of March, in the year of our Lord, 1840. Jacob G. Morris, ) ^ Attest, G. Roberts SmTH, ] ^^-^^^agers. John T. Lewis, Treasurer. Geo. B. Wood, Physician. (Seal.) Geo. Fox, Surgeon. CREDENTIALS. 1 7 Copy of a Certificate from Dr. Oulmont, Chief of the Clinique of the Faculty of Medicine of Paris, France. Republique Francaise. Liberte, Egnlite, Fraternite. Administration generale des Hopitaux, Hospices civils et Secours de Paris. Je, soiissigne, Docteur en Medicine et Chef de Clinique de la faculte de Medicine do Paris eertifie que J. Hamilton Potter, M. D., de New York (Etat Unis d'Amerique) a suivi avee beau- coup de distinction mes Cours d' Auscultation et de Percussion. Paris, le 3 Juin, 1849. Oulmont. Portland, October 13//t, 1845. Dear Sir : Permit me to introduce to your favorable notice the bearer. Dr. Potter, a gentleman from New York, now on a visit to Maine for his pleasure and the benefit of his health. Youi-s, very respectfully, C. C. ToBiE, M. D. To Charles Snell, M. D., Bangor, Extract from a Letter from George Ford, Esq., Attorney, Lancaster, Pa. Representative Chamber, Harrisburg, March 26th, 1838. Hon. Edward Davis, Washington, D. C. Dear Sir : Allow me to introduce to your favorable notice and attention, Dr. J. Hamilton Potter, of Philadelphia. I have had abundant opportunity, during the present session of the Legisla- ture, of improving my acquaintance with him, and therefore cheer- fully recommend him to you as a gentleman, every way worthy of your acquaintance. Very respectfully yours, &c., George Ford. Extract from a Letter from Joseph T. Rowaud, M. D. Philadelphia, November 4:ih, 1843. Messrs. Brewers, Boston, Mass. Gents : I take pleasure in introducing to your acquaintance my friend. Dr. J. Hamilton Potter. Dr. Potter stands high in his profession here, and is a gentleman of irreproachable character. I am, Gentlemen, your obedient Servant, Joseph T. Rowand. 2* 18 CEEDENTIALS. Extract from a Letter from J. S. Pompelly, Esq., of Owego, N. Y. OwEGO Village, August 9lh, 1838. JOUN J. Si-EED, I J , . j^ Y Benjamin Ferris, \ ^^^^^^' ^^' ^' Gentlemen : I take the liberty of introducing to yotir ac- quaintance, and commending to your liind attention the bearer, Dr. J. H. Potter. I believe him to be skillful in his profession. Your Friend and humble Servant, J. S. POMI^LLY. Extract from a Letter from the Hon. D. S. Dickinson. BiNGHAMPTON, August 4th, 1838. Messrs. Thomas A. Johnson and > r» • . i r> x Henry G. CoLTON, painted Post. Gentlemen : I desire to present, for your favorable notice, Dr. Potter, late of Philadelphia. He has given high evidence of professional ability. Yours, truly, D. S. Dickinson. Prom the Quaker City, Philadelphia, December 29lh, 1849. The Consumptive's Guide to Health, by J. Hamilton Pot- ter, M. D. — We intended to have noticed this work long before this, and put it off from day to day, hoping for time to do it some- thing like justice. To say we are pleased with its plan and exe- cution, is to convey but a faint idea of our approval. It is positively the best written book, on a medical subject, that we have ever read. Every v/ord, written on a matter of such vital interest as consump- tion is, should be heard with favor ; but when, as in the present case, the v/riter treats of it, not only with ability, but scientifically, hopefully, rationally, and above all with his style divested of those technical mysticisms with which the followers of the medical pro- fession have persisted in destroying the utility of their books, too much praise cannot be accorded to the effort. Dr. Potter pronounces consumption a curable disease, and, in spite of the dogmatic assertions of those professors who, because they have failed, consider failure inevitable, insists that a thorough physician can treat as successfully diseases of the lungs, as any other illness whatever. We had marked some passages for in- CREDENTIALS. 19 sertion, but on the whole think it better warmly to recommend our readers to get the book at once and judge for themselves. At this season of the year, when the human frame is most liable to be influenced by the weather, a careful perusal of the preven- tive and curative mode of treatment which the Doctor recom- mends, cannot but be beneficial to both the healthy and the infirm. GLOSSARY. Before entering fully upon the discussion of our subject, a few medical terms are presented to the reader, and accompanied by clear and brief definitions. As these tenns will unavoidably occur as we proceed, the reader will at once discern and appreci- ate the author's motive in introducing them thus early to his notice. He thinks that every intelligent reader should master this much, at least, of the mystery which canopies and conceals the Science of Medicine ; whereby he may obtain glimpses into its depths profound, which are forever closed to the illiterate and obtuse. Acute. In Pathology, applied to diseases whose symptoms are violent and whose course is short. Alvine. Appertaining to the bowels. Amenorrhcea. Obstruction of the menses. Antiphlogistic. Means which tend to reduce inflammation. Atrophy. A wasting of any part of the body, or of the whole body. Auscultation. Art of forming a diagnosis by listening to the sounds of the lungs, heart, arteries, and veins. Bronchitis. Inflammation of the mucous lining of the bronchi- al tubes. Cachexia, (from KOKOi, bad; and e^t?, a habit.) A bad condition or habit of the body, arising from scurvy, syphilis, scrofula, Carnjfication. Conversion of any texture of the body — ^not flesh — ^into a substance resembling flesh. Chronic. Applied to diseases of long continuance, opposed to acute. Congestion. An unnatural accumulation of blood in any organ, caused by defective circulation. Consumption, (from consumo, to waste away.) Wasting of the body; any disease attended with emaciation; but fetrictly tuberculous phthisis. Costal. Pertaining to the ribs. Cynanche, (from kvw, a dog, and ayx(>y to suffocate.) Sore throat. GLOSSARY. 21 Diagnosis, (from ctayfi^oxr^-w to discern or distinguish.) The art of recognising- a disease by its symptoms, and of distinguish- ing one disease from another. Diaphragm. The midriff — muscle separating the cavity of the chest from the abdomen. Diathesis. Any morbid peculiarity of constitution. Dysmenorrhcea. Difficult or painful menstruation, with paid in the back, loins, &c. Effete. Barren, worn out, impoverished. Epiglottis. The cartilage at the root of the tongue that ftills upon the glottis, or superior opening of the larynx. Expuition, (from exspuo, to spit out.) The act of spitting. Fauces. The back part of the mouth including, the pharynx. F-^ces. Alvine excretions. Gangrene. A mortification of living flesh. Glottis. Superior opening into the windpipe, at the larynx, covered by the epiglottis. Hydrothorax. Dropsy of the chest. Hydropneumothorax. Pneumothorax complicated with a serous infiltration. Hygeia. The goddess of health. Hygienic. Pertaining to health. Hysteria. Spasmodic disease, dependent on uterine irregularity. Larynx. The top of the windpipe, including the organs of voice. Laryngitis. Inflammation of the larynx. Leucorrhgea. Fluor albus. The whites, a secretion of whitish mucus from the vagina of women. Menorrhagia. Flooding, immoderate ^ow of the menses or of blood from the Uterus. Normal. Natural, healthy. (Edema. Tumefaction from serous effusion. (Esophagus. Gullet, or tube leading to the stomach. Parenchyma. The spongy and cellular substance or tissue that connects parts together. Pathognomonic. A term given to symptoms v/hich are character- istic of, or peculiar to, a disease. Pathology. Science or doctrine of diseases. Parturition. Child-birth. Percussion, (from percutio, to strike.) Physical examination of the chest, abdomen, &c., by striking their walls ; and is either mediate or immediate, direct or by a pleximeter. Phthisis, (from (pdi^^ to consume.) Pulmonary consumption. Pharynx. Top of the oesophagus, or canal leading to the stomach. 22 GLOSSARY. Plethoric. Having the vessels over-charged with fluids. Pneumothorax. Perforation of the plura with infiltration of air into the cavity of the chest. Pneumonia. Inflammation of the lungs. Pulmonary, (from pulmo, the lung.) Belonging to the lungs. PuRiFORM. Resembling pus. Regimen. Regulation of the diet and habits. Rubefacient. An application which produces redness of the skin without blistering. Scrofula, (from scrofa^ a sow, because hogs are often afifected by it.) A disease consisting of hard indolent tumors of glands in various parts of the body, which suppurate, degenerate into ulcers and discharge a white curdled matter — not pus. Sternum. The breast-bone. Strumous. Of the nature of scrofula ; synonymous with scrofu- lous. Tonsillitis. Inflammation of the tonsils, quinsy, cynanche tonsil- laris. Thermal. Warm, applied chiefly to the waters of warm springs. Tonsils. Oblong, sub-oval glands situated on each side of the back part of the mouth. Trachitis. Inflammation of the mucous membrane lining th trachea, croup, cynanche trachealis. Tracheotomy. A surgical operation, incision into the windpipe. Trachea. The windpipe. Tubercle. A scrofulous tumor ; a morbid product occurring in various textures of the body, in connection with the scrofulous or tubercular diathesis. Uvula. The pendulous body behind the soft palate. Veluivi palatl The soft palate. HEART, LUNGS, BRONCHIAL TUBES, &c. a. The Heart. bb. The Lungs, cc. The Bronchial Tubes. d. Divisions, or ramifications of the Bronchial Tubes. e. The Windpipe, or Trachea. /. The Vocal Box, or Larynx. ANATOMY AND PHYSIOLOGY. The thorax, or cavity of the chest, is somewhat conical in shape, narrow above and broad below. It is bounded by the ribs, breast-bone, costal cartila- ges, intercostal mnscles, vertebral column, and dia- phragm. The articulation of the bones composing the chest, is such as to admit of motion ; thus, it di- lates and contracts in respiration. It contains the 24 ANATOMY AND PHYSIOLOGY. heart and great vessels, the two lungs, bronchial tubes, pleura, oesophagus, nerves, &c. The heart is hollow and muscular, and is the central organ of the circulation. It is bounded in front by the breast- bone, posteriorly by the spine, on the sides by the lungs, and below by the tendinous centre of the diaphragm. The lungs are situated on each side of the chest, separated from each other by the heart and a portion of the pleura; they consist of a right and a left lung. The right lung is sub-divided into three lobes, and the left into two ; the right lung is larger, but shorter, than the left ; they are of a pink- ish gray color, somewhat mottled with black ; their texture is spongy, consisting of small membranous cells — ramifications of the bronchise. The lungs are invested by a delicate serous membrane — the pleura — which also lines the cavity of the chest ; they are held in their position by their roots, formed by the pulmonary artery, pulmonary veins, broncliial tubes, bronchial vessels, and pulmonary plexuses of nerves. The bronchial tubes extend from the division of the trachea to their corresponding lungs, where they divide and sub-divide into their ultimate termina- tions in the minute air cells ; the number of these cells, and the surface which they present to the air, is surprising, when the small size of the lungs is considered. M. Rochoux estimates the number of cells to be 600,017,790. Keill's estimate was 1,744,186,015. Lieberkiihn's calculation gave them a surface of 1500 square feet. The surface of the bronchise alone. Hales thinks, is 1035 square inches. Thus, it will be seen that an immense aerating surface exists in the lungs for the contact of the blood with the air. The air has ready access to the blood of the pulmonary artery, but what the precise arrangement IS, which carries on this contact, we know not ; it is reasonably supposed to be capillary. The object of ANATOMY AND PHYSIOLOGY. 25 this contact is — to use Bichat's term — "hoematosis;" i.e., arterialization, decarbonization, oxygenation, or aeration of the blood, which renders it nutritive. Blood which passes from the heart to the lungs is a dark red, but when it returns it is a light red. Ar- terialized blood stimulates the brain, and gives to the muscles contractility, upon which depend all animal strength, force, and motion. This chemical pheno- menon of respiration was not understood by the an- cients ; but the process was generally thought to be a means of refrigerating the blood and cooling the body. Eespi ration subserves other purposes, not chemical : it is necessary to the sense of smell, to the act of speaking, laughing, sneezing, coughing, sighing, singing, crying, &c., &c. It is thought by physiologists that we take in about forty cubic inches of atmospheric air at each inspiration ; thus we con- sume two or three balloonsful every day. The gases absorbed by the blood, make the quantity ex- pired one-fifth less. In one day, then, w^e absorb about 14,400 cubic inches of oxygen and azote, and give ofi' about eight ounces of carbon. ISTumerous muscles are concerned in the function of respiration : the diaphragm, the intercostal, infra costales, sterno costalis, serratus posticus, inferior and superior ab- dominal muscles, pectoral muscles, &c., &c. The filaments of nerves sent to the lungs are from the pneumogas trie and great sympathetic. THE INVALID'S FIVE QUESTIONS, AND THE DOCTOR'S FIVE ANSWERS PART SECOKD. WHAT IS PULMONAKT CONSUMl'TION ? PuLMONAEY CONSUMPTION is a disease of the lungs, which man has brought upon himself, and which is developed by tiibercles^ which are formed in the substance of the lungs, and which soften and involve that substance in their own destruction. Tubercles are a peculiar morbid product — either secretive or excretive — of the blood, or of the lym- phatics ; in fact, tumors, dependent upon a tubercu- lous or scrofulous state of the constitution, and developed by almost any bad condition or habit of the body which renders it incapable of resisting the diathesis. What the precise nature of this diathesis is, is at present unknown. Tuberculous matter or tubercle, is, in consistence firm but friable, of a yellow color, and unctuous to the feel ; insoluble in water, sinking when placed in it, without smell, homogeneous and unorganized. Tubercles vary in dimension from the size of a millet seed, to that of a pigeon's Oigg. They are not con- 28 WHAT IS PULMOKARY CONSUMPTION? fined to the lungs, but are often found in the heart, liver, throat, intestines, brain, &c, &c. The disease has three stages, which are marked by the following symptoms. FiKST Stage. — Slight, frequent, hacking cough, accompanied by a tickling sensation in the throat ; the cough is dry, unless catarrh preceded the development of tubercle ; expectoration at first scanty, thready, grayish and sometimes spotted with blood; distressing dejection, languor, shooting or wandering pains in the chest and shoulder, a sense of constriction across the chest, a feeling of weight in the chest, quick pulse, loss of appetite, sometimes tenderness of the subclavicular region, difficulty of breathing and slightly hurried respiration, hoarse- ness, weakness of the voice, and extreme liability to take cold on slight exposure. Second Stage. — Decided symptoms are establish- ed ; the countenance is characteristic, the eyes are bright and clear, the digestive system sufi^ers. The patient has abdominal pains, and can lie on one side better than the other. Emaciation commences ; the pulse is full, hard, and increased from 80 or 90 to 120 or 140. The cough becomes more and more harrassing, especi- ally through the night and in the morning. There is an expuition of puriform and tubercular matter, increased difficulty of breathing, fever, morning and evening, chills or rigors, weakening sweats, irregular bowels, and often a coughing of blood from the lungs. Third Stage. — ^The chest becomes flat, the shoul- ders round, the clavicles prominent, the spaces be- tween the clavicles and upper ribs deepened, the voice sometimes becomes extinct, sometimes hollow and melancholy. Confirmed hectic is established ; excessive weak- WHAT IS PULMONARY CONSUMPTION? 29 ening sweats, diarrhea, great debility and extreme emaciation follow ; the nails become livid and incurv- ed, the mind is clear and hopeful, the feet swell and become cold, and at last, sometimes a slight delirium occurs. These stages are run through in from three to eighteen months, as a general rule, but sometimes the disease occupies years in its development and course. In cases of quick consumption, a few days or weeks suffice. People most liable to pulmonary consumption, have light hair and eyes, small chests, swollen upper lips, fair or sallow complexions, brilliant minds, large veins, slight frames, nervous and sanguine temperaments. Sedentary occupations favor the development of consumption far more than tliose which require vigorous exercise, in the open air, especially. Stu- dents, teachers, inhabitants of convents and prisons, weavers, factory 023eratives, tailors, milliners, seam- stresses, stone-cutters, feather-dressers, needle-grind- ers and brush-makers, are peculiarly liable to the disease. Women are more sedentary than men, and consequently more subject to consumption. It at- tacks at all ages, even from the unborn child to the decrepit centenarian. It is estimated that one-sixth of the deaths north of the tropics are caused by it. In England alone, there are about sixty thousand deaths annually, from the same cause ; and so pre- valent is the disease upon that island, that in many countries on the continent of Europe, consumq^tion is called " the English disease." I will subjoin a table, showing the number of deaths, comparatively, which occur each year in the several larger cities, which may not prove uninter- esting, but, perhaps, even instructive to my readers. In ISTew York, one person dies out of every thirty- 80 WHAT IS PULMONARY CONSUMPTIONS five of the inhabitants, yearly ; a standard which is entirely too low, but which it is hoped will be im- proved when the sewers are completed, drainage es- tablished, and people cease throwing offal, or waste bits from their kitchens, into the gutters ; and when the authorities keep our streets in a condition to be passable without stilts and smelling bottles ; and reduce our grog-shops from thousands, down to a few sober hundreds ; to say nothing of our artifi- cial milk-stills. Oh, shame ! shame ! to those who can, but do not, apply the remedy. In one neighbor- hood in this city, there are — as the author was in- formed on the premises by a proprietor — from three to five thousand cows ; they are confined in such close proximity, that they have barely room to lie down, and here they are kept upon still slops, and their milk sold through the city, until consumjption — which they soon contract — renders their fiesh fit and ready for the butcher's stall. TABLE OF YEARLY MORTALITY". Paris 1 Dies in 32 London 1 " New York ... 1 " Philadelphia . 1 " Glasgow .... 1 " Boston 1 " St. Petersburg 1 " Amsterdam . . 1 " 32 Baltimore . . . I Dies in 35 46 Berlin ] " 34 35 Brussels . . . . ] « 25 31 Madrid ] « 29 43 Naples ] " 28 41 Rome ] " 25 37 Geneva ] " 43 24 Vienna ] « 22 PAET SECOND. WHAT CAUSES PULMONARY CONSUMPTION ? Whatever creates the morbid diathesis, and excites it into action — as hereditary predisposition, scrofula, common colds, inflammations of the pulmo- nary organs, vitiated or deficient action of the secre- tory organs, too early marnage, and all debilitating diseases ; abuse of mercury, healing of old ulcers, cessation of habitual discharges, neglect of early symptoms, inhalation of impure air and of foreign substances, as gases, dust of metals, stone, &c.; de- formity, diminution of the capacity of the chest from a habit of stooping and from tight lacing, dis- placement of the abdominal viscera, dissipation, grief, exhausting indulgences, indolence and despon- dency ; disappointment, anxiety, intense mental application, bad or insufficient diet, irregularity in any function of the body, bad habits, too much or too little clothing, want of exercise, want of rest, want of sleep, dosing with nostrums, use of warm water in washing and bathing, sleeping in feather beds, sitting in over-heated and illy ventilated apartments, and frequenting crowded assemblies; residence in damp, harsh climates, and in exposed, windy situations ; living in cellars, underground kitchens, and dark, gloomy apartments, where the sun seldom enters ; sleeping in basement rooms, or in small, close chambers, or in a chamber with sev- eral other people, or in rooms with fires ; all seden- 32 WHAT CAUSES PULMONARY CONSUMPTION ? taiy employments, working in paper and other fac- tories, and constantly inhaling steam and dust from filthy rags, &c.; wealth, and a high state of mental cul- tm-e, luxury and refinement. All of these causes re- sult in debility, delicacy, efi'eminacy, imbecility, ir- resolution, cowardice, fickleness of mind, and aver- sion to all occupation ; a state of body and mind which is as sure to be followed by consumption, as are the storm-driven waves of the ocean to dash upon lee- ward rocks. So long as we continue to bring up our children upon velvet cushions and feather beds, feed them with delicacies, clothe them improperly, force the mind beyond its strength, and indulge them in exemption from industrious and laborious pursuits, so long will they continue to fade like hot- house plants. These mistaken notions are almost peculiar to this country. While our ladies and children are well nigh constantly in the house, growing delicate and etieminate, the ladies and children of Europe are out, laboring or sporting in the fields. No nation of people in the world, compare with the Americans in effeminacy, and what is so much coveted — delicacy. This is not beauty ; health is beauty. Our ladies fade and become old and wrinkled at twenty -eight or thirty, while an English lady is in her prime of beauty at forty. Our young girls become women at sixteen or eighteen, while in England they are not considered young ladies until twenty-five. Change of occu]:)ation is also a prominent cause of consumption. Young men brought up to some active out-door business in the country, are often placed in stores, counting-rooms, and offices in the city or town ; their habits are all changed ; they take very little out-door exercise, adopt a luxurious diet and different clothing, learn to smoke — if not to drink — keep late hours, read exciting books, attend WHAT CAUSES PULMONARY CONSUIVIPTION ? 33 theatres, concerts, balls and parties ; tliej soon be- come delicate^ take a cold, house themselves, take another, get sick and send for a doctor ; bleeding, blistering, tartar emetic and opium finish the work ; their constitutions are ruined, and they are a prey to consum2^tion. Another is sent to the academy, and thence to the college, where, by study, want of exercise, impure air, imprudence in diet, and perhaps a little dissipation, lie becomes debilitated, dyspeptic, nervous, susceptible to colds, and thus ruined in health. An athletic business man has made a fortune by his superior activity and sagacity ; he retires, and, in liis retirement, feeling the want of that excitement which he formerly derived from his occupation, seeks it in a new channel ; he reads more, smokes more, chews more, drinks more, scolds more, eats more, lusts more — exercises less, and enjoys less ; and if he does not return to busi- ness, will soon bring upon himself the business of an invalid, than which none is harder, nor more harrassing. But here let me mention a fact which is paramount. The greatest of all causes of acquired consumption is, the immoderate drainage from the system of the vital or seminal fluid. Delicacy for- bids me to enlarge upon the subject in this work, but there are valuable books upon these evils, which should be perused with care by the thinking and responsible adult, and their instructions ]3i'<5perly enforced at a suitable age — Vvdien suspicion renders it imperative — upon the young. Secret vice is spreading a pall over this fair land. Who shall ar- rest its progress ? how can we approach it properly ? Tv^hsi will stay its demoralizing and death-spreading venom ? Pliilosophers ! give ear and eye and un- derstanding to tliis subject, and save our youth from early ruin and premature graves. Yv^ell it is for America, that Germany and Great Britain are con- 3 34 WHAT CAUSES PULMONAET CONSUMPTIO]?? ? stantly supplying and re-supplying ns with tlieir best blood, which is constantly mingling and comming- ling, with our own. Otherwise should we degener- ate, with fearful strides, and soon bring the moth of despotism to protect us in our imbecility, from the first sturdy people who might mark us for their prey. PAET THIED. HOW CAN PULMONARY CONSUMPTION BE PEETENTED ? Aetee a careful perusal of the second part of this work, the reader will at once arrive at the conclusion, that to prevent pulmonary consumption, we must avoid, as far as possible, its causes ; without, however, relying upon tiiis hint, I shall advert directly to the most prominent and effectual avertive and preventive measures. Cold Bathin^g. — One of the most efficacious avertive means is the daily use of the cold-bath ; which may consist of a plunge, a shower-bath or a. sponge-bath. The bath is one of nature's great tonics ; it excites the skin, with its 7,500,000 pores audits per- spiratory and oil-secreting glands, to healthy action ; promotes the circulation of the blood, keeps the person clean and the skin healthy, materially assists the lungs, liver and kidneys in performing their functions, gives alacrity for exercise, develops the muscles and renders them hard and active, fortifies the system against vicissitudes of temperature, destroys the scro- fulous diathesis, promotes clearness and vivacity of the intellect, cheerfulness and virtue ; increases the appetite, greatly assists digestion,' clears the complex- ion, and lends charms which even youth and beauty cannot dispense with. Both hefore and after bathing, the skin should be excited to redness by means of a flesh-brush or crash towel, so that the reaction may be perfect. This precaution should not be neglected, on 36 HOW CAN Pl^LMONAEY any account, as colds, rheumatism, lassitude, diar- rhea, indigestion, pain in the loins, stiffness of the joints, congestions, bronchitis or laryngitis might result, and the otherwise salubrious bath be convert- ed at once into a source of disease. Bathing should be persevered in throughout the entire season — summer and winter. In winter — to promote re- action and prevent a chill — it is desirable, in fact imperative, to have a warm room either to bathe in, or to retire to immediately on emerging. The water em]3loyed should always be cold^ or at least cool ; in summer, there is little danger of obtaining it too cold — in this climate — but in winter, the icy chill should be taken from it by allowing it to stand in a warm room for a while, or by a slight addition of heated water or vapor. I consider water of the tempera- ture of 'TS® F. for summer bathing, and 60° F. for winter bathing quite warm enough. In spring and autumn, it might range from 65* to 70° F. People of delicate constitutions, sedentary people, and even some who esteem themselves robust, find it difficult to obtain immediate reaction after the cold bath, and think they cannot bathe in cold water, with profit or safety. This objection is at once wholly obviated, if the directions given in this paragraph are strictly adhered to. I loathe repetition, but will, for the sake of impression, subjoin the correct procedure. On rising from bed, the bath should be in readiness ; the person strips, applies the flesh- brush, hair mittens or crash towel, until the skin is reddened and a glow of heat is felt — which will cause cold water to feel pleasant upon the person — uses soap, with a small quantity of water, quickly, then the sudden plunge, shower, dash, or sponge, then the crash towel quickly and thoroughly applied, the clothing immediately resumed, exercise commenced, and reaction is m.ore perfect than it would be after & tepid' bath ; and the person will feel warmer, CONSUMPTION BE PKEVENTED ? 37 evolve more heat, and receive infinitely more bene- fit than could possible result from bathing in warm water. The reader must bear in mind that while I am insisting upon the use of cool water for the bath, I am on the subject of daily bathing iov preventive and hygienic purposes, for delicate people and people in health, and that I am not treating of the bath as a therapeittic — curative — agent for those who are ill of different diseases. If it were my purpose to treat of bathing as a remedy in disease, I should do so in a separate volume, as such consideration would far transcend the limits which I have assigned to this, which is not absolutely a monograph. The thermal waters of Wisbaden, Teplitz, Lan- decke, Baden-Baden, and Aix-la-Chapelle in Ger- many ; of Bath in England ; of Yichi, Adour, St. Sauveur.Aix, Dax, La Maloux, Cambo, Bonnes, (fee, &c., in France ; Leuk in Switzerland, St. Julian in Italy, and many others oii the continent of Europe ; the warm springs of the United States, in Virginia and l^orth Carolina, being in most cases impregnated with the different gases and minerals, are severally noted for their curative power in different diseases and are the resort of invalids. The healthy and robust despise these sickly haunts, and prefer a bold dash and a plunge into the clear, living river, the cool, crystal lake, or the free, broad ocean. People not used to the bath, should of course commence upon its use gradually, by bathing a little and a little more of the person each day, until they can endure a plunge or a perfect shower. But, on no account should a person commence with vjctrm wetter^ designing to make it colder and colder each day, as this would involve an achievement of far greater difiiculty, and is by no means so safe. The cold bath should on no account be prolonged until the person becomes chilly ; this habit constitutes one 38 HOW CAN PULMONAEY of the abuses of bathing, and, for delicate people, young children and invalids, is always an injurious and an exceedingly dangerous practice. It is not necessary to occupy many minutes in the whole operation of rubbing with the brush or towel, and wetting the person ; the latter operation is performed by a plunge into the bath-tub, or by means of a shower-bath, or even a sponge or towel, and a bowl of water, in from five to fifteen seconds ; which is quite long enough for invalids to endure the shock. People of robust constitutions, who bathe for pastime, as well as health and cleanliness, can, when the op- portunity of swimming is aJfforded, remain in the water for many minutes, without injury. Sea-water is preferable to any other for the bath-tub ; but as it is difficult to be supplied with that at all times, an imitation may be substituted, by medicating fresh, soft water with salt, soda, mineral acids , &c. The proper hours for bathing are immediately after rising in the morning, and occasionally just before going to bed at night ; but we should never bathe directly after eating, or when the mind or body is fatigued, or the person is cold, overheated, or in a perspira- tion. Invalids, who cannot bear the bath early in the morning, may bathe at eleven o'clock, or about three hours after breakfast. Hippocrates, Aristotle, Plato, Homer and other ancient authors, made frequent allusions in their writings to baths and bathing ; the ancient and luxurious Persians, the learned Greeks, and the rich and chivalric Pomans, erected public and private baths, which astonished the world by their almost unlimited extent and costly magnificence. If any merit can be attached to a custom or hygienic prac- tice on account of its antiquity, that of bathing should stand preeminent ; for none can much ante-date it. In the Old Testament history, we find the remote example of the patriarchs ; Abraham furnished water CONSUMPTION BE PREVENTED ? 39 for tlie three angels, his guests, who bathed ; Lot tendered water for the same purpose to the holy two in the gate of Sodom ; Pharaoh's daughter, attended by her maids, went down to the Kile to wash herself; the waters of Bethesda, Siloam and the flowing Jor- dan, laved the sons and daughters and washed away the infirmities of Judah. Air and Exercise. — We claim for our science the remotest antiquity ; and since the days of Hippo- crates, the great apostle who first gave it legitimate character and respectability, medicine, though still in its infancy, has advanced steadily and persever- ingly toward perfection; elaboratino- the very ele- ments, and nearly all material nature into healing agents. Gold, silver, quicksilver, copper, iron, lead, zinc, bismuth, &c., in the mineral world ; the water of the sea, and the almost innumerable family of plants, now yield to our science their long hidden sanative treasures. The field for exploration is so vast, so prolific, and so enticing to the scientific physician, that some are apt to lose sight of, and neglect to employ, nature's simpler remedies, and this because they are simple and familiar, but which came forth from the crucible of the Almighty, at once the great original supports and restoratives of animal life. These beneficent agents are in the power of all mankind, and the author wishes to im- press every person, and especially every invalid, w^ith the sure advantages to be derived from their employment, j^o preventive and hygienic agents are more simple and familiar, and none more salu- tary and efficacious, than the inhalation of pure, fresh air, and the taking of suitable exercise. Some phy- sicians entertain the notion, that when a person is threatened with diseased lungs, he must at once be housed in a well-heated apartment, and avoid the fresh air as though it were poison to him. N^o mis- take could possibly be more fatal ; none further from 40 HOW CAN PULMONAET sound medical philosophy ; and no course "will with more certainty fasten upon the misguided patient the very disease he seets to avert. By the inhalation of pure, fresh air, the blood is perfectly aerated ; in other words, deprived of carbonic acid and effete animal matter, supplied with oxygen, and rendered conducive to the healthy action of every organ or viscus to which it flows, and which depends upon it for life, nourishment and health. By exercise, the action of the lungs, skin, and circulatory system is accelerated ; this hastens the arterialization of the blood, the consumption of fat, and the formation of muscle, and thus a healthy and recuperative tone is given to the whole system. ISlo exercise can better subserve these purposes than walking, and if this be performed out of doors, the taking of air and exer- cise is most agreeably and usefully combined. If possible, every person, but more especially the con- sumptive, should spend several hours daily in the open air, occasionally expanding the lungs to their utmost capacity, by full and deep inspirations. Gymnastics, gardening, dancing, archery, hunting, fishing, swimming, and riding in a carriage or on horseback, all afford exhilarating and salutary exer- cise. The best time for exercising in the open air, during winter, is from eight to twelve o'clock in the morning, and from three until five o'clock in the af- ternoon. Of course these hours would not be suit- able during the extreme heat of summer; at that season, the cool of the day should be sought, though exercise at night is not so profitable as it is while the sun is shining, because animal life is nearly as much under the influence of the stimulus of light, as the vegetable creation ; and this stimulus is quite na- tural and requisite to the health of both. The early morning is the hour when nature unites her varied charms, and invites us forth to enjoy them. At the CONSUMPTION BP: PREVENTED? 41 dawn, the flowers and plants open, and exhale their aroma; and, stimulated by the sunlight, evolve their oxygen in floods. The sounds of the rippling brook, the trembling leaf, the waterfall, and the birds upon the branches, are then uninterrupted by the hum of busyjife. It is very improper to take active exercise immediately before or after eating. The author is so deeply impressed with the necessity of taking vigorous exercise in the open air, either to prevent or cure consumption, dyspepsia, scrofula, effeminacy, debility, nervousness, throat diseases, cold feet, con- stipation, depression of spirits, and many other ills to which the sedentary and thoughtful are peculiarly liable, that he will venture to repeat his injunctions, and will say to the reader — if you wish to get well, keep well, and livelong — exercise! A short walk once or twice a week, or a ride in a carriage, is not sufiicient. You must take very active exercise, un- der cheerful auspices, for several hours daily. Position. — If the reader will examine the plates which are intended to illus- trate the subject of this paragraph, he may read, in im- pessive and unmis- takable language, reflections which words cannot so adequately convey. For these express- ive figures, the au- thor is, in part, in- debted to that ac- complished artist, William CKOOiiE, Consumptive. Esq., of Pliiladel- 3* 42 HOW CAIT PULMONARY pliia, who has copied his de- signs with great truth and spirit. The author is deep- ly impressed with the im- portance of the precau- tionary measures of main- staining a fine erect position, and of cultivating perfect symmetry of the whole sys- tem ; considered not only for every member of the human family — in sickness and in health — but with strict reference to the un- fortunate consumptive. He has therefore aspired to eli- cit the special attention of his readers to these impor- tant considerations. It is remarked by observing for- eigners, who visit this coun- try, that many of our peo- ple, and especially our wo- men, are comparatively de- ficient in bust ; in other Not Consumptive. words, thin through the chest. The author thinks his own observations in Europe, especially in England and Ireland, confirm these remarks. These differences may be owing, in part, to climate, but he thinks them dependent in a great measure, also, upon the habit of stooping, want of exercise in the open air, and the neglect of other sanative and hygienic measures. Consumption is, without doubt — partly, at least — a mechanical dis- ease ; or, in other words, it is caused by loss of sym- metry. This, of course, comprehends contraction of CONSUMPTION BE PKEVENTED ? 43 tlie chest, stooping, gravitation of tlie abdominal viscera, and other internal displacements. In seek- ing, therefore, to prevent the malady, much depends upon care in preserving the most perfect symmetry of the person, and, in cases of displacement or de- formity, upon the judicious employment of proper mechanical remedies. While sitting or walking, the head, neck, and shoulders should be thrown as far back as is consistent with ease, grace, and loco- motion : the chest should be thrown forward ; these means serve to keep the viscera of the chest (kmgs, heart, &c.,) in the places assigned them by nature, to make tense the abdominal muscles or belts, and thereby prevent the unnatural gravitation of the viscera of the abdomen. If the symmetry of the chest and shoulders has been lost by a habit of stooping and hanging the weight of the arms and shoulders forward upon the thoracic muscles, the unnatural and mischievous attitude should at once be corrected, not only by care in restoring these or- gans to their proper places voluntarily, but by the assistance of a suitable and well adjusted shoulder- brace. Incases where the abdominal muscles are relaxed, permitting the viscera of the abdomen to gravitate into unnatural positions, the displacement must forthwith be cured, by an easy but efficient ab- dominal supporter. This instrument has a wide range of application, for a full account of which, the reader is referred to a subsequent chapter, devoted exclusively to this subject. It is indispensable to consumptives, ex- tremely useful to those whose occupation obliges them to remain much in the upright position, to the corpulent, to people of a costive habit, to thore afflicted with piles, weakness, or prolapsus, and to ladies during pregnancy and after confinement. 44 HOW CAN PULMONAEY Diet. — While we are chewing our food it comes in contact with the excretory ducts leading from the sa- livary glands of the mouth, and stimulates them ; caus- ing them to throw out an increased quantity of saliva, which mixes with the food. As soon as it is swallowed into the stomach, the food commences circumvolving round and round on the internal lining of that organ, stimulating it, and causing the secretion of the gastric juice. The gastric juice converts the food into chyme, which, in its turn, stimulates the valve at the pyloric orifice of the stomach ; the valve opens, and the food — now chyme — passes into the first of the small intes- tines — the duodenum; the duodenum then secretes the intestinal liquor. Here also the chyme stimulates the ducts leading from the liver and pancreas, and receives from them the bile and pancreatic juice, and by the action of these fluids, the chyme is converted into chyle, and the lacteal vessels, becoming aware of its presence, push forward their mouths into the complicated mass, and suck up the nutritious fluid ; w^hich, after being filtered through their glands, passes into the thoracic duct, and thence into the veins, where it mixes with venous blood and passes through the heart into the lungs, where it is brought into contact with the air, receives a quantity of oxy- gen, and becomes blood — arterial blood — fitted for the important ofiice of nutrition. From the blood is elaborated the bones, muscles, brain, nerves, eyes, teeth, hair, nails, and every part of the human sys- tem, which is constantly undergoing absor^^tion and renovation ; so that ]^apoleon Bonaparte, w^hen he wedded Maria Louisa, was composed of new and entirely difierent particles, and could not be styled the same "conglomerate mass of humanity, which placed the crown upon the head of Josephine. Who then shall say, "I do not care what I eat ?" We are made up from what we eat. Beef, pork, chicken, CONSUMPTION BE PKEVENTED ? 45 goose, oysters, eels, frogs, cabbage, carrots, radishes, &c., &c. What sort of a man, think yon, wonld ram, brandy, beer, and tobacco-juice nriake? Bah ! open the windows when the specimen enters, lest he spread a pestilence aronnd him. What sort of a brain wonld pepper, salt, catsup, sausages, spice, nutmeg, and turtle soup make ? Away w^ith him, to the mad house. Good, plain, wholesome food, will make up a fine-looking, full-sized, manly, strong, and talented God's image; while highly stimulating, over-rich, meagre, or badly cooked, indigestible food, will make you up a puny, little, insignificant demon. From the remotest ages, philosophers have labor- ed to establish and make positiye the science of hu- man life, or the science of longevity. They have vainly sought for a panacea to cure all ills, and inde- finitely prolong the life of man. Some have asserted, and endeavored to prove that a purely vegetable diet is the best j)romoter of health and longevity ; others, that an almost exclusive animal diet is the true secret ; others, that taking only water as a be- verage, constitutes the foundation of longevity. Some go so far as to assert that premature death is pro- duced by eating bread and other farinaceous sub- stances, which contain an excess of the materials which form bone. John de la Somet, of Virginia, was a great smoker, and lived to be 130. Francis Confit, in Yorkshire, attained the age of 150, and was a great lover and consumer of fresh raw eggs. Henry Hastings lived to be 110, and was a great gourmond ; he ate beef, oysters, game, pastry, &c., hysical signs connected with the dif- ferent diseases of the chest. These signs, when taken in connection with the history and symptoms of the case, enable him to define with great certainty the precise location and character of those diseases. The lungs of a person in health, give, during respira- tion, sounds which are termed normal, or natural. In disease, they give abnormal, or pathological, or unnatural sounds. These sounds afford to the phy- sician an ample field for study. He must study them until — like a musician — his ear is practiced. In diagnosing or detecting the tuberculous or scrofulous constitution, antecedent to the actual and apparent development of tubercle in the lungs, auscultation and percussion are, of course, not applicable ; this state must be detected by induction alone. Thus, if a patient's father, mother, brothers and sisters have all died of consumption, the inductive conclusion is, * It is not expected that the non-medical reader will peruse the answer to this question with much interest, as it is quite technical, and the author does not deem it desirable to insert the terms em- ployed, in the glossary. The author refers those who wish to study this subject, to his work on Auscultation and Percussion. HOW CAN CONSUMPTION BE ASCERTAINED ? 75 that he, too, has the germ of the fell destroyer plant- ed in his bosom. For the benefit of those who are particularly interested in this subject, the physical signs of consumption, in its different stages ; of bronchitis, pneumonia, and heart diseases — as re- vealed by auscultation and percussion — are sub- joined. The lungs, in their normal or healthy condition, give, on percussion, a clear sound over every part of the chest, except in the regions of the heart and liver, where it is dull. Auscultation of the respiration, gives two sounds, one belonging to inspiration, whicli is the stronger, and the other belonging to expiration, which is the v^eaker. These sounds are equally au- dible over both sides of the chest, but are heard more distinctly in the superior than in the inferior regions. Auscultation of the voice and cough, gives the natural pectoral fremitus, natural bronchophony, and natural pectoriloquy. In the first stage of consumption, we have, on percussion, dullness, on or under the clavicles. On auscultation of the respiration, we have a diminution of the duration of inspiration, and an augmentation of the duration and intensity of expiration. Occa- sionally, the pulmonary crumpling sound of Fournet, and l)Tuit de craqiiement jjyidrrionaire (a dry crack- ling rale.) Auscultation of the voice, gives an in- creased resonance at the apex of the lung. In the second stage^ percussion gives us a marked dullness under the clavicles, and extending also be- low them. Auscultation of the respiration, gives a diminution of duration and intensity of the inspira- tory murmur, augmentation of intensity and dm-ation of the expiratory murmur, bronchial resj)iration with humid crackling rale, succeeded by mucous rale in the upper lobes, puerile respiration in the lower lobes, and sounds of the heart audible under the 76 HOW CAN THE EXISTENCE OF clavicles. Auscultation of the voice and cough, gives broncliopliony and bronchial cough, and a di- minution of the natural vibration of the voice. Third Stage. Percussion gives a dull sound, if the cavity is small, and the contiguous portions of the lungs tuberculated. But if the cavity is large and empty, the sound is generally tympanitic. Oc- casionally, there is hruit cle pot feU (sound of a cracked jar.) Auscultation of the respiration, gives gargoidllement (a gurgling or cavernous rale,) which is equally marked during inspiration and expiration, cavernous respiration, amphoric respiration, tinte- ment tnetallique (metallic tinkling) occasionally. Auscultation of the voice and cough gives pectori- loquy , occasionally tinteraent 'inetalUque and caver- nous cough. In acute bronchitis, the sound upon percussion is normal, unless there is pulmonary congestion, when it is slightly dull. In these cases the dullness is most marked upon the lower and posterior parts of the chest. Auscultation of the respiration gives, on inspiration, a subcrepitant rale, and a mucous rale in the advanced stage, accompanying inspiration and exjoiration. In the early stage, sonorous and sibilous rales accompanying both inspiration and expiration. Sometimes the respiratory murmur is increased in intensity, sometimes diminished, and sometimes it is partially extinct. Auscultation of the voice and cough, reveals no reliable evidence in any form of bronchitis. In chronic bronchitis, percussion gives sounds very similar to those elicited in acute bronchitis. Auscultation of the respiration shows the respira- tory murmurs generally more feeble than natural, and always accompanied by a mucous, sibilous, or sonorous rale, and sometimes by a sub-crepitant rale. CONSUMPTION BE ASCERTAINED? 77 In pneumonia (inflammation of the lungs,) in the first stage, percussion reveals a slightly dull sound. Auscultation of the respiration, shows the respira- tory murmurs diminished — sometimes quite absent. There is a crepitant rale which is heard only in in- spiration. Puerile respiration, says Dr. Stokes, precedes the crepitant rale. In the second and third stages of pneumonia, percussion reveals a dull sound over the site of the inflammation. Auscultation of the respiration re- veals bronchial respiration, and absence of the respiratory murmurs and of the crepitant rale ; in the third stage, the muco-crepitant rale. In the healthy part of the lung, we have puerile or supple- mentary respiration. Diseases of the Heaet. — ^To become accom- plished in detecting the diseases of the heart, the physician or student must first study the chest and heart in a normal state, which will enable him the more readily to detect pathological variations. The first sound of the heart is heard during the contrac- tion or systole of the ventricles, and is in unison with the pulsation of the arteries ; it is heard plain- est under the fifth rib, and is the most dull, and the stronger of the two sounds. The second sound occurs during the diastole of the ventricles, and is clearest and is heard plainest under the third rib. The region of the chest which is rendered dull on percussion, by the heart, is about three fingers broad, extending from the third to the sixth rib. In com- mencing an examination of the heart, we first look at the chest, and observe whether it is symmetrical or hombe (arched) over the heart, indicating enlarge- ment of that organ. The beatings of the heart are next to be examined by the eye, next by the hand, and finally by the ear. The pulsation of the arteries must be examined at the wrist. The heart may be 78 HOW CAN CONSrMPTION BE ASCERTAIXED ? found pushed from its normal location, and its beat- ings, instead of "being heard in their proper places, may be heard under the sternnm, or even on the right side. The first or second sound of the heart may have a souffle (bellows' mm^mur) and this souffle may be heard by the intervention of the stethoscope, in the aorta and carotid arteries. It would be utterly inadvisable to discuss this subject at any length in a work of this description, intended as it is, princij^ally for the non-medical reader ; but if, by the author's remarks, he succeeds in inducing a few only of the profession, to study and become proficient in this all important branch of medical knowledge, he will not have written in vain. He will content himself with subjoining the physical signs — as revealed by auscultation — of a few diseases of the heart. COXTEACTIOX OF THE AOP.TIC SEMILrXAP. VALVES. Auscultation reveals hruit de souffle at i\iQ first ^oundi of the heart, which is heard at its hase / it is also heard in the aorta and in the carotid. CONTE ACTION OF THE :m:ITEAL OK LEFT AUEICULO- VEXTPJCULAK oPEXDs G. — Auscultatiou reveals hruit de souffle at WL^fii'st sound, which is heard at ihQ point of the heart. DiLiTATioN. — Pulse weak, slow and irregular; beatings of the heart heard all over the chest, their impulse also weak, slow and irregular. There is a more extensive dullness on percussion. 1^ ¥Uf> PAET FIFTH. HOW, OE BY WHAT :&IEANS, CAN PULMONAET COKSUMT- TION EE CUEED? By means of a full and rigid administration of the great laws of hygiene or health, applied to diet, air, exercise, bathing, clothing, mental employ- ment and ^the regulation of all the habits already laid down as preventives ; By the nse of mechanical remedies to restore lost symmetry, inflate the lungs, expand the chest, and support the abdomen and lungs ; By the direct inhalation or breathing of medicinal agents in powder, vapor and 'gases into the lungs, by means of inhalers and otherwise ; By means of medicated baths, which are varied to render them applicable to different constitutions. And by the employment of suitable and long-es- tablished medicines, addressed to the constitution ; to correct the tnbercular and scrofulous diathesis, cleanse the blood, pnrify the system, and regu- late digestion, nntrition, assimilation, absorption, secretion, &c., &c. This, this is the way to cure consumption I while the treatment at present em- ployed by most physicians in this tenible disease, is avowedly and in fact, only pcdUaiive. The symp- toms merely, are prescribed for; thus for cough, opiates, nausiants, and expectorants are administer- ed ; for debility, tonics ; for constipation, aperi- 80 HOW CAN PULMONARY ents ; for night-sweats, acids ; and so on through the multitudinous list of symptoms. The disease, how- ever, progresses surely and almost invariably toward the sad event which consigns the unfortunate patient to his tomb. How and why is this ? Why is not the curative treatment instituted? Plainly because, with the great mass of the profession, no true, sound, rational and philosophical principles at present per- tain, respecting this scourge of the human family, upon which they are able to institute a radical mode of treatment. Many medical gentlemen at once unite in condemning and blasting — if possible — the reputation and prospects of any member of the pro- fession, who presumes, in violation of the sacred edicts of the faculty, to entertain for one moment, the treasonable thought, that consumption can be cured. Unlearned and unprincipled adventurers in med- ical science, take advantage of this self-asserted in- capacity of most physicians to treat consumption successfully, and foist upon the credulous and un- wary invalid, some o?ie, perhaps several^ of the in- numerable empirical nostrums which they invent, and which are recommended (in shame I confess it,) by many gentlemen who have honorably and legiti- mately attained the title of Doctor in Medicine ; and by some manoeuvre, these men obtain cirtificates, which pur]3ort to be signed by people who have been cured of consumption, " after some ten or twelve of the regular faculty had given the patient up." The ex- traordinary facilities which the art of printing, in its present perfected state, affords these men of spread- ing far and wide their unprincij)led pretensions and unblushing falsehoods, is a secret of their wonderful success in making vast fortunes, at the expense of the sick, the distressed, and the unsuspecting. In this way precious time is lost, the favorable moment for successful treatment passes away, the CONSUMPTION BE CURED? 81 patient's disease alarmingly progresses, lie loses hope, nis friends despair, and his chance of recovery is ma- terially lessened, even nnder the proper treatment. The great mass of the profession have heretofore proclaimed consumption to be forever incurable ; thus at least seeking to shield their own incompe- tence. Their proclamations of course convinces us that, in their practice, the assertion is too true ; long arrays of gloomy epitaphs, in every churchyard, are also their witnesses. And because they fail, they would wish to consider failure inevitable. But the present is an age in which the huge black seal of superstition, which has long been fastened upon the fountains of knowledge, is being broken and scat- tered before the bright car of science and discovery, which enlightens every dark corner in the regions of ignorance; and, aspirations and projects which were, in ages past, considered to be only fanciful and chimerical, are now the common and indispen- sable servants of that mind which God, throughout creation, declares to be forever progressive. Beware, then, of those physicians who invariably pronounce the doom of death upon all consumptives. With them there is, by their own avowal, no retri- bution. I would have you equally beware of those who tell you that consumption is as curable as any fever ; that they cure eight out of ten cases of true consumption ; and that they can cure consumption even when the lungs are extensively destroyed by tubercles and ulceration. The last professions have not even the merit of the first, for they are unmiti- gated and unprincipled mendacity and deceit. The first are truth ! as far as those who proclaim them are concerned. But, reader, our profession boasts of names which are world-renowned and illustrious — bright stars in medicine. Stokes, "Wood, Louis, Laennec, Lugol, and Broussais, comprise autliority 5 82 HOW CAN rULMONART to whicli all who have read their works bow in rever- ence. They tell ns that consummation can be cnred, is cured, and that they have cured it. Let their words, then, be our motto, and let us press onward in those discoveries which are daily throwing new light upon, and giving us new powers over this ter- rific disease. After a long and laborious investigation of this subject, and much experience in the treatment of lung diseases, the author has been irresistibly led to the following conviction, in regard to the curability of consumption with our present knowledge. Up to a certain point or stage in the disease, he firmly and confidently believes it to be eminently curable ; but if the disease has progressed so far as to interfere essentially with the respiration and the perfect ar- terialization of the blood, the case becomes more complicated, and a cure is far more difficult ; in his belief, extremely doubtful ; although it is an unde- niable truth, that cures of advanced, cases have been made, as has been proved by post mortem examina- tions of individuals in whose lungs large cicatrixes or scars were found, these individuals having died, at advanced ages, of other diseases. The case of the late Dr. Joseph Parrish, of Philadelphia, is familiar to all. Since the above was written, I have seen so many cases get well Avhich my judgment and previous ex- perience would have j)i'onounced incurable, that I now do not despair of curing any case, unless a com- plication of extremely unfavorable circumstances seems to render it absolutely impossible. In truth, my experience and practice have taught me thp.t consump- tion is indeed a curable disease ! I would fain have confidence to pronounce any and every case, no matter of how long standing — no matter what the extent of its ravages, to be easily and perfectly cura- CONSUMPTION BE CURED? 83 ble ! But this, alas, is impossible ; in this, as in other diseases, I would say to consumptives, do not, because your case seems to be a bad one, or because physicians or others have pronounced you incurable, despair of being cured, under the treatment which I have indicated in this part of my book; which treatment has saved hundreds from falling into con- sumption, cured a vast number who were in the first stages, and restored many to health and happiness, who seemed to be on the very precincts of the grave. By despair all is lost ; by a firm and prayerful de- termination, and God's blessing, the goal maybe won. Even if I were to admit that popular i3ut fatal error — namely, the incurability of consumption, which, to my dying hour, will I proclaim to be an error, and labor to prove it such, still would I de- precate the equally popular and more fatal medica- tion of those gentlemen who doctor their patients against principle and against hope. Dissections and careful examinations of indivi- duals who have died suddenly, or by violence, are every day proving that at least four-fifths of the hu- man family have more or less tubercular deposit in the lungs and other parts of the system, even when nothing of the kind is suspected, and when there is no great apparent reason to infer that the individuals thus effected are in ill health. For the proof of this position we have, among other authority, that of M. Boudet, who has given the French Academy of Sci- ences the result of his extended and laborious inves- tigations of this subject. Out of 332 cases of indi- viduals examined by that gentleman, who had been accidentally killed, or who had died of various dis- eases, no less than 264 had either tubercles or scars across the lungs, or remains of caverns which had puckered together and healed. My own observation justifies me in the assertion, however startling it may seem, that scarcely a person in the civilized part of 84: HOW CAN PULMONARY the world attains to tlie age of fortj-five, without having had, at some period of their lives, tubercles in their lungs ; or, in other words, true tubercular consumption, and that thej have been cured of it, perhaps, several times. It is only when the disease gets full control over the recuperative powers of the system, that its symptoms become so apparent and its ravages so dreadful. Many facts can be adduced to substantiate the truth of my position, besides those already alluded to; and one is, that many individuals have been known to be in consumption for forty years, and finally to perish of it ; others have a cough for twenty, thirty, and even fifty years, and at last die of con- firmed consumption. Who can doubt the presence of tubercles in such cases ? Indeed, auscultation often reveals their presence when neither the patient nor his friends suspect the lungs to be effected. (How natural it is for a mean, untutored mind, to disparage and sneer at scientific achievements, which it cannot comprehend or profit by! Let those igno- rant pretenders in the art of healing, who decry aus- cultation, percussion, &c., wear the garment). lam of the opinion that tubercles are present in the lungs during all debilitated states of the body, from whatever cause induced, and during the prevalence of most diseases, and that they are gradually re- absorbed during convalescence and the accessions of robust health. M, M. Rogee thinks that spontaneous cures of tubercle have occurred in one-half of all who have lived till forty. Thus, it may be seen that consumption is just as curable as any other disease, except, of course, in its advanced stages ; and even then just as curable as any other case which has become desperate from long continuance, neglect, and improper treatment. I am frequently asked for a more explicit answer than the above constitutes to the question of the cu- CONSUMPTION BE CUKED ? 85 rability of certain cases, l^ow, the treatment which I adopt is either curative or j9all{atwe / depending upon the symptoms, pliysical signs, general health, habits, age, fiimily, constitution, temperament, &c., &c., of each case. If I am consulted in a case of consumption, in which I find absence of hereditary taint, absence of the strumous diathesis, absence of the signs of cavities, only slight emaciation, calmness of the pulse, but slight hectic, no atrophy, or puerile respiration, the digestive organs and larynx healthy, expectoration free, the disease to have supervened upon bronchitis or inflammation of the lungs, and the patient in easy circumstances, so that he can at- tend to his health, and the disease recent, I always prognosticate favorably, and adopt at once the cu- rative treatment. I do not wish the reader to under- stand that I look for all of the above favorable cir- cumstances to be combined in one case, to justify my hopes and exertions to cure. They are all of great value ; and, by weighing well the favorable and the unfavorable symptoms, physical signs and circumstan- ces, with my former experience in similar cases, I am able to determine whether I can put my patient upon the use of curative means with reasonable hopes of success. I regret to say that, perhaps, one of the most difficult circumstances which I have to contend with, in treating cases of consumption and bronchitis, is the want of sufficient interest on the part of patients to induce them to persevere in the use of remedies. I refer to curable cases. Alas ! the unfortunate, who are beyond the reach of reme- dies, and doomed irrevocably to the couch of ever- lasting rest, are full of hope, patient attention, and faith, and can scarcely be made to believe the fate which so surely awaits them. Every tubercle has imdoubtedly a tendency toward health. If, therefore, a treatment be insti- 86 HOW CAN PULMONARY tuted at an early period, which, will prevent a further deposit of tubercles, the disease is at once arrested ; it can have no progress. The tubercles previously deposited will become absorbed, or replaced by calcareous matter, (as has been shown by dissec- tions,) and a perfect cure, and perfect health must follow. The urgent necessity of seeking proper medical aid at the very commencement of the dis- ease, will be apparent to every one. People are too prone, upon the first appearance of symptoms of consumption, to procrastinate, or indulge in the dangerous delusion, that their disease is not pulmo- nary consumption. The first step toward an invalid'' s cure^ is to ascertain with certainty and 'precision what the disease is. If a patient has diseased lungs, or symptoms of consumption, or fears consumption, he should im- mediately have his luugs examined by means of auscultation assisted by percussion, &c. ; and this should be done by a physician well skilled and practiced in these sciences, so as to ascertain posi- tively and precisely, whether the lungs are aifected, and if they are found to be so, to ascertain definite- ly what the disease is, and exactly how far it has progressed. He should also give his physician a faithful history of his case and a complete account of his symptoms. These advantages, together with a perfect knowledge of the true nature or pathology of this class of diseases, will enable the skillful and experienced practitioner, to institute a rational, scientific, and confidential mode of treatment. With- out these indispensable pre-requisites, all is dark- ness, uncertainty, and confusion ; and the treatment in all cases, productive of a vast deal more of mis- chief and injury to the patient, than would result from permitting the disease to pursue its own course, CONSUMPTION BE CLfRED? 87 without attempting the institution of any curative means whatever. Utterly vain, then, and forever hopeless must be the practice of every yjhysician in chest and throat diseases, vv^ho is not capacitated to found his treatment upon correct information res- pecting his patient's malady ; which can only be obtained with certainty through the medium of auscultation, percussion, mensuration and pulsation. It is deeply to be regretted, that in this country, the opportunities for medical students to obtain a know- ledge of the indispensable sciences of auscultation and percussion, are so limited. In our medical institutions these subjects are utterly neglected ; or merely glanced at in such a slight and desultory manner, that the great mass of graduates, so far from being proficient and accomplished in these two sciences, (which require more time and study for their mastery, than music and astronomy,) that in- stances are not wanting, of their being unable even to give the definitions of the tw^o terms. Few phy- sicians attempt the study of sciences which they did not commence upon while students at college ; and hence it is, that not one doctor in ten, or perhaps in ten hundred, can bring auscultation and percussion to his assistance in practice. Invalids, therefore, should be exceedingly cautious whom they trust ; and on no account ]3]ace confidence in the opinion and statements of any physician, upon these subjects, unless he is well known to be specially qualified j)erfectly to examine the lungs and other organs by means of these sciences. Ko physician likes to assert or confess his incompetency upon any branch of medical science. Is it strange, then, that the ignorant will sometimes attempt to hide their inca- pacity by affecting to understand and practice aus- cultation and percussion ? If the mischief arising from such deception fell upon him only who prac- 88 HOW CAH PULMONAKT tices it, perhaps there would not be so much cause for regret ; but, may not the health and perhaps the life of the victimised invalid be thereby criminally put in jeopardy ? The next step should be, to examine the heart and the circulation, the stomach and rest of the alimentary canal, the liver, form of the chest, posi- tion in sitting, walking and sleeping ; the situation and size of the jDatient's sleeping apartment, kind of bed he slee|)s uj)on, his age, profession, habits, diet, peculiarity of constitution ; to ascertain whether he has latent scrofula, any form of skin disease, or any malady whatever. The patient's complexion, the color of his hair, eyes, &c., (fee, must also be taken into consideration. The examination ended, and the diagnosis made, the physician has a basis upon which to commence his treatment, which will not lead him into error. Hundreds of patients die annually of bronchitis, inflammation of the lungs, heart diseases, &c., &c., whose diseases are pro- nounced to be consumption. This is the result of ignorance, on the part of their medical advisers, of auscultation and percussion. Of course no precise rules can be laid down for domestic practice in cases of consumption, as no two cases agree exactly in their pathology, and no two patients have the same peculiarities of constitution, and no two ever contracted disease from precisely the same causes. Every direction which is given in the third part of this work on the |)revention of con- sumption, is applicable in its treatment, under cer- tain circumstances. The design of the treatment is, to prevent the further dej)Osit of tubercles, and to hasten the absorption of those already deposited. The consumptive should change his employment; the greatest benefit results from this course. If pos- sible, he should change his residence for a while, CONSUMPTION BE CUEED ? 89 even though he does not remove further than from one to six miles. He must give up all anxiety re- specting his occupation, or any matter which troubles his mind. He should have a cheerful home, lively society, recreation, and pleasant employment ; and should especially avoid all undue excitement. The patient must not trust to domestic remedies ; nor rely for one moment upon the counsels which some friendly non-medical adviser may volunteer to give, for how can it be expected that such a person can perfectly understand the case, and adapt the proper remedies ? Neither should he trust himself in the hands of empirics, nor in the hands of ignorant doctors; but apply at once to some physician in whom he can place implicit confidence, on account of his known intelligence upon the class of diseases upon which we are treating, and upon his general character as a scientific and skillful physician. It requires the exercise of a great deal of intellect on the part of the patient, and a perfect cooperation with his physician, to effect a cure of even incipient consumption. The patient should, as far as possible, resign all exciting or fatiguing business, and devote every thought and all his energy to the attainment of the one great end. I would say to all consump- tive patients, never remain in the house in the day time when the weather is pleasant and you are able to go out ; spend as much time as possible in the open air, and take all the active exercise which your strength will permit. The author has found it impossible to treat con- sumption successfully, without the employment of proper mechanical remedies ; these must, of course, be precisely adapted to each individual case. Among those which he employs, are visceral or abdominal supporters, breathing or atmospheric inhaling tubes, and shoulder braces. In almost every case of con- 5^ 00 HOW CAN PULMONAET sumption, there are concomitant symptoms which can be relieved in no other way. The author found these instruments extensively employed in France, Belgium, Holland, and other continental countries, and was the daily witness of their beneficial influence. It will be well to repeat, that all medicines and all curative means should be commenced uj)on, and con- tinued, under the immediate direction and supervi- sion of the regular medical practitioner ; as no list of remedies could be enumerated — however clear the directions might be which should accompany them — from which a non-medical person could possibly make selections, which would positively answer the indications, and be in every way applicable to the patient's case ; and, for these very obvious reasons, I refrain from giving formulae for medicines; confi- dent in the opinion, that vast and irreparable injury has accrued to countless numbers of invalids, who from various reasons have attempted to become their own doctors. The invalid must always bear in mind, that medicines which will suit the constitution and cure one person, will not answer in all cases, bat that different constitutions require different medical treat- ment. The different stages of the same disease also require diversified medication. Yery little medicine is absolutely requisite, but that which is given, must be of the right kind, and most perfectly adapted, not only to tlie precise disease, but to the precise stage of the disease. It is aj^palling to reflect upon the vast numbers of consumptives who have been dosed to their graves, by ignorant and careless practition- ers. The day is fast a23proaching, when physicians will devote themselves entirely to one class of dis- eases, and labor to become proficient each in his own particular branch, rather than, as at the present day, attempt the mastery of a field which is sufficiently ample to employ the study and genius of at least ten giant minds. CONSUMPTION BE CUEED? 91 Summary of the course which I pursue in cases OF Consumption. — If, upon a strict examination of the chest, by the means ah-eady stated, I find that my patient has true tubercular consumption, and is beyond the power of medical science — as all must die sometime, — I hold it to be a sacred duty — unless I am desired to refrain from telling the patient his situation — immediately to state the case as I find it. But if, in my judgment, the case is curable, I think it is the patient's privilege to hope that God will bless the means employed and restore him, as others have been restored. I en- courage my patient ; if his employment is sedentary, I advise a change ; I advise all consumptives, never to be found in the house when the weather and their strength will permit them to be out ; I regulate the diet, adapting it to each case. The sup23orter, shoul- der brace, and tube, I prescribe to all, where no com- plications of disease forbid their employment. I adapt medicines to each case, some to be taken by the mouth, others to be breathed in directly upon the lungs, and others to be absorbed into the system from medical baths. I 23rescribe suitable counter irritation, poultices, &c., upon the chest, and a great deal of friction to the whole person, I interdict all morbid excitement. I find out what causes have conspired to throw my patient into consumption ; I stop those influences and reverse the picture, leading the sick man back, by the assistance of proper med- icines, through the natural channels of hygiene, to that vigorous and healthful action of the organs of vitality, which alone can throw off disease. Pulmonary Inhalation. — This mode of admin- istering medicines consists simply of the inhala- tion or breathing of remedies either in the form of finely pulverized powders, which are diluted with inert substances • or of vapors or gases variously 92 HOW CAN PULMONAEY modified, and wliich pass directly into the air pas- sages and lungs. It seems to me that this mode of applying remedies which are intended to act direct- ly upon diseases of the lining membrane of the throat, bronchial tubes and lungs, must commend itself to the philosophic judgment and favor of every person with whose special favorite object or interest it does not happen to conflict. It forms at once the most powerful and effective means at our command for dissipating tubercle, allaying inflamma- tions, and of holding diseases of the lungs and throat in check, until by constitutional remedies we can correct the consumptive state of the constitution. It is one of the happiest hits in modern therapeutics ; and I am fully convinced from my success in this mode of medication, that it must soon be universal- ly adopted, and that it forms — in connection with means already noticed — the only rational and effec- tive treatment of consumption. I employ in this way various medicinal substances which I adapt with scrupulous precision to individual cases. I use the sulphate of zinc, one grain to thirty of the lyco- podium clavatum. The sulphate of copper, one grain to tliirty of the lycoj)odium clavatum. The sub-nitrate of bismuth, pure, the nitrate of silver, half a grain to thirty of sugar, and the acetate of lead, one grain to six of sugar. I also employ iodine in various forms; tar, chlorine, oxygen, prussic acid, camphor, hydro-sulphate of ammonia, ether, conium, &c., &c. The author is desirous of instructing the unfortunate invalid in as much as he can practice with safety, himself, which applies to the laws of health discussed under the third question in this work. But he has already given it as his opinion, that patients who require medicines, should, in all cases, avail themselves of tlie adapting know- ledge and judgment of the regular and scientific CONSUMPTION BE CURED? 93 physician ; as the advantages of doctering one'self are always uncertain, doubtful ; to say nothing of the danger- oi dabbling in what one does not under- stand. Every person can get along best at the busi- ness he has been brought up to, and it is not econo- my to attempt to practice those arts which it requires so many years to become master of. I understand the dread which people have of exorbitant charges, and also the fear of deception and knavery, but these are with certainty avoided, by placing confi- dence only in regular and respectable physicians. I have given considerable attention to the construc- tion of suitable inhalers, both for the inhalation of dry substances and vapors. I esteem those which I furnish to my patients to be perfect in their way. I subjoin a few formulae and directions for gene- rating chlorine, &c., &c. CONVENIENT MODES OF GENERATING CHLORINE. Take Pulv. Peroxide of Manganese . . 3iss. " Chloride of Sodium . . . 3ij. " Acid Sulph 3vi. Mix the peroxide of manganese and chloride of sodium in a glass dish, pour the sulphuric acid upon the mixture, and the chlorine gas will immediately begin to generate. Chlorine gas requires to be very much diluted with atmospheric air to render it eligible for inhalation ; a convenient apartment must therefore be selected, the windows raised, and the vessel from which the gas is evolved, placed upon the hearth or upon the floor in the centre of the room. The apartment should be as nearly empty as is convenient, as the gas would be likely to corrode guilded furniture, and to tarnish tapestry. As soon as the apartment is thus prepared, the patient may enter and walk the floor for five or six minutes. This gas should not be inhaled oftener than two or three times a week. The same general directions are applica- ble in the inhalation of chlorine, whatever may be the mode em- ployed to generate it. Or take Pulv. Peroxide of Manganese, . . 3ij. " Commercial Muriatic Acid, ... 31. 94 HOW CAK PULMONARY Put the peroxide of manganese into an earthen dish and set the dish into boiling water so that it will float, then pour the muriatic acid upon the manganese ; and in a few moments the gas will commence generating. The peroxide of manganese de- composes the muriatic acid — which is a solution of chloride of hydrogen gas in water — the hydrogen of the muriatic acid com- bines with the oxygen of the peroxyde of manganese to form the deutochloride of manganese, which by the moderate heat is com- pletely resolved into protochloride and free chlorine. OR TO EVOLVE THE GAS SLOWLY BJJT CONSTANTLY, Take Chloride of Lime jiv. Place it in an earthen vessel, and pour upon it half a pint of water, stir the mixture so that the chloride of lime may be diffus- ed through the water ; then suspend a viol of sulphuric acid with a small aperture cut in the cork so as to allow the acid to escape drop by drop directly upon the chloride of lime and water. Tlie acid takes the lime forming the sulphate of lime — gypsum— plasiei' of paris — and the chlorine is set free. This mode I con- sider the best, and safest. Tar Inhalation. — Place an earthenware vessel containing two or three ounces of tar, and one dram of the subcarbonate of potass over a spirit lamp in a convenient room ; as soon as the tar boils the fumes will mix with the air of the room, which may be inhaled for about twenty minutes. Iodine Inhalation. — Take Iodine and Iodide of Potassium, of each 6 grains. " Distilled Water heated to 125° F. 5| ounces. " Alcohol 2 drams. Mix. Take of this solution from one to six drams ; (commence with one) and add to it 30 or 40 drops of the saturated tincture of conium ; place the whole in the inhaler and inhale for 20, 30 or 40 minuter. The inhaler should be immersed in water of the temperature of 130° F. during the inhalation; otherwise the fumes of the iodme and conium would not be thrown off in suf- ficient quantities, as the temperature of the liquid in the inhaler would sink below that required to generate them. In confirmed consumption, it is best to begin with half a dram of the solution of iodine, and 10 drops of the tincture of conium, and repeat the inhalation three times daily. Each case demands the adapt- ing judgment of the medical practitioner. CONSUMPTION BE CURED? 95 Treatment of Symptoms. — ^The author does not doctor the symptoms of consumption much ; still, it is sometimes necessary, to check profuse perspiration and diarrhea, to allay cough, relieve pain, and attend to other distressing symptoms. He will, therefore, subjoin a few remarks upon these topics. Cough. — ^This is usually the first, most common, and an exceedingly distressing symptom. It would be improper to check it entirely, it being an efibrt of nature to eject foreign matter from the lungs and bronchise ; but it sometimes prevails when nothing is expectorated, and only fatigues and distresses the patient. It also causes irritation in the throat, soreness in the chest, and prevents sleep, and may be relieved by suitable cough mixtures. I employ mixtures of wild cherry, salts of morphise, squills, mucilage, and demulcents. Expectoration. — When it proceeds from soften- ing tubercle, or from the secretion of pus, it should not be checked ; but when it proceeds from a highly vascular and irritated mucous membrane, it may be regulated by ammoniacum. Hemorrhage. — When slight, needs no attention ; it often relieves congestion ; but, if it is alarming, the patient can take salt into the mouth and swallow it as fast as possible, not waiting for it to dissolve ; turpentine, acetate of lead, kino and tannin, com- bined w^ith a small portion of ipecac, are also useful in hemorrhage. Pain in the Chest. — Slight pains are soon re- lieved by the application of a suitable counter-irritant liniment ; nothing more is requisite or proper. But if the pain is caused by tubercle, or perforation of the pleura, it is proper to apply cups, friction, or dry cups. Night Sweats. — They are very distressing and 96 HOW CAN PULMONARY exhausting, and require special attention. The in- dications are, to stimulate the skin, increase the tone of the muscles, and impart vigor to the system. The former indication is fulfilled by friction over the whole person, sponging with allum and warm brandy, vinegar, alcohol, whisky, &c., and the hot bath; rendered exciting by the addition of mustard, alco- hol, or salt. The latter^ by the use of tonics ; the aromatic sulphuric acid, ten drops to a wine-glass of water, three or four times daily, is, perhaps, the best internal remedy in such cases. Cold bathing and friction are very valuable auxiliaries. The in- ternal administration of astringents has been recom- mended, but I do not approve the practice. Frequent Pulse. — In attempting to throw oif the disease, nature quickens the action of her forces ; it may, therefore, be questioned, whether it is good practice to diminish the increased action of the heart, whereby nature is doing her utmost to hasten the circulation of the blood through the lungs, to get it purified, and charged with vitality, and then to convey it through the morbid tissues of the body. If she should get immoderate and over-excited in her endeavors, she might cause an injurious reaction, and must then be controlled. For this purpose, wild cherry bark, digitalis, and black snake root, are the best adapted. Diarrhea. — This is an exceedingly important symptom, but one which does not usually occur until the disease is far advanced. A milk diet, with a little lime water added, when the patient's strength will permit it, should be instituted. JSTitrate of sil- ver, acetate of lead and opium, with a small portion of ipecacuanha, are the best medicines that can be employed. Debility. — The best mode of relieving all of the symptoms of consumption is, to institute that course CONSUMPTION BE CrEED ? 97 of treatment which will eradicate the disease ; re- move the cause, and its effects will disappear, as a consequence. All of the laws of hygiene, including dietetics, are applicable to the treatment of debility. Suitable mineral and vegetable tonics can be em- ployed as coadjutants. There are other symptoms which the author does not deem it advisable to prescribe for in this place ; they are cessation of menstruation, delirium, nervous- ness, falling of the hair, emaciation^ difficulty of breathing, hectic, &c.j &c. DISEASES OF THE THROAT, OR AIE PASSAGES, &c. Enlarged Toksils. — l^j clironic irritation or in- flammation, frequent colds and acute inflammations, the tonsils — especially in scrofulous children and adults — become hypertroj^hied, (thickened or enlarg- ed) — and if this state of things is permitted to go on for some time, the voice becomes husky or hoarse, the patient will experience great diiliculty in swal- lowing, and when he takes cold will croak and wheeze excessively. Treatment. — Scarrifications, and applications of strong astringent solutions, applications of the ni- trate of silver in substance or in solution ; tincture of iodine, &c. All of these measures failing, the ligature or knife must be resorted to, and the en- larged tonsils removed. Acute inflammations of the tonsils frequently result in supj^uration ; the disease is then called quinsy. Elongated Uvula. — ^The uvula, by many called the palate, is a small rounded process, hanging from the middle of the soft palate. From frequent in- flammations caused mostly by colds, there is often a fibrinous infiltration into the cellular tissue of this organ, by which it is gradually elongated, causing, DISEASES OF THE THEOAT. 99 in many instances, nearly all of the symptoms — ex- cept the physical — of consumption ; as cough, quick pulse, hectic, purulent and bloody expectoration, and emaciation. In some cases it causes frequent nausea, vomiting, and true jjulmonary consumption. Treatment. — Astringent and stimulating gargles and caustic applications, with constitutional reme- dies, will in slight and recent cases often restore the organ to its proper dimensions ; but if the case is of longstanding, the uvula becomes permanently thick- ened and elongated, and it is then beyond the con- trol of these remedies, and must be excised — cut off. This is an extremely simple operation, and en- tirely unattended with danger, subsequent inconve- nience or injury to the voice, and should by no means be delayed, on account of the mischievous and dangerous consequences which are sure to fol- low, if the enlarged and indurated organ is suffered to remain. Laryngitis . — CynancJie Laryngea. — ^The^ larynx — as it is defined in the glossary — is the top of the windpipe, including the organs of voice. The la- rynx is also called the vocal box; it is endowed with the most exquisite sensibility, and with a very complicated and curious muscular aj^paratus, which is set in motion in speaking and singing. Laryngi- tis consists of an inflammation of the parts compos- ing that organ, especially of the mucous covering of the laryngeal cartilages and epigiotis. This inflam- mation frequently extends to the posterior fauces, the velum palati, and tonsils, and may be either acute or chronic. If it is acute, it is termed acute laryngitis ; if chronic, chronic laryngitis. Acute Laryngitis. — Syrroptoms. The patient com- p>lains of sore throat, he is restless and anxious, the velum, uvula, and fauces generally, are quite red, there is a difficulty of deglutition — swallowing — diffi- 100 DISEASES OF THE THEOAT. culty of breathing, hoarseness, loss of voice, the face is flushed, the skin hot and dry, and the pulse hard. If relief is not obtained the patient soon be- comes strangled and dies. Treatment.—EsiYlj bleeding ; counter-irritation on the sternum, purging, cupping the back of the neck, and in the advanced stages a surgical opera- tion are the means which were formerly, and are still to a great extent relied upon in this terrible disease. Chronio Laryngitis. — The larynx is very liable to chronic inflammation, ulceration, thickening of the membrane, and death of its cartilages. Con- sumptive patients are peculiarly liable to these forms of disease. Symptoms. — The symptoms of chronic laryngitis are, hoarseness, loss of voice, cough, and many of the melancholy symptoms of consumption. Treatment. — ^To^Dical applications of the solution of nitrate of silver and iodine, gargles, nitrate of sil- ver in powder, mixed with pulverized sugar, counter- irritants, regulation of the stomach and liver, and a long list of simple remedies addressed to the general health, are among the most valuable means at our command in this inveterate disease. All of the preventive means recommended in the third part of this work are also indisiDcnsable to its successful treatment. Tkachitis. — Croiqy. — Cynanche Trachealis. — The trachea or windpipe is the canal through which the air moves in its passage to and from the lungs. It is compossd of rings of fibro-cartihige, fibrous membrane, mucous membrane, glands, and muscu- lar fibres. Its upper part is called the larynx ; from the larynx it extends down as far as the fourth or fifth vertebrae of the back, where it divides into two branches, which are the right and left bronchial tubes. Inflammations of the mucous lining of this tube are DISEASES OF THE THROAT. 101 termed trachitis^ croup^ cynancTie^ trachecdis. The croup of children usually attacks them between the third and thirteenth year ; one attack greatly en- hances the liability of its recurrence. It commences with cough, sneezing, hoarseness, and other symptoms of a cold. It is often attended with spasms of the mus- cles of the trachea and larynx, and the formation of a pseudo or false membrane. It is a very dangerous disease, and is frequently fatal in a very short space of time. The treatment should be prompt, decisive, and energetic. The remedy relied upon by the best authorities of the present day, is large and repeated doses of calomel, of which as much as five or six grains are given at once to quite young children, and repeated every two or three hours, until there is a discharge of bilious matter, the criterion of its having taken effect ; emetics, bleeding, blisters, and rubefacients are also employed with decided advan- tage. If these means fail, and suffocation follows, an operation termed tracheotomy is necessary, Washington died of cynanche trachealis. The CJironio Form. — The trachea is frequently the seat of chronic inflammation, which may have originated in the bronchial tubes, and thence extend upwards to that organ ; or in the larynx, and extend- ed downwards ; or it may originate in the trachea itself. The trachea is more or less involved in chronic inflammations of the bronchial tubes and larynx. This form of the disease requires pretty much the same treatment as chronic bronchitis. Clergyman's Sore Throat. — ^This is thought, by many of the profession, to be a disease of recent ori- gin, and peculiar to the clergy ; but its attacks are entirely indiscriminate. Much has been written to establish its identity, and to prove it to be a disease of the glandular follicles of the mucous membrane, rather than of the membrane itself; in short, to es- 102 DISEASES OF THE THKOAT. tablisb. for it a separate name — follicular laryngitis. Its seat is in the back part of tlie mouth and larynx ; it may consist of simple inflammation or ulceration, or of tubercular deposition. It seldom exists alone, but is consecutive to laryngitis, bronchitis, &c. The disease is characterized by absence of cough, hoarse- ness, weakness of the voice, v^eariness in the throat, and an increased secretion of mucus. The nitrate of silver, directly applied, has been represented to be a specific in this disease ; but ex- perience has shovrn that it is not so ; it is a palliative, and, in moderation, a useful a^Dplication. But, to esta- blish a lasting cure, it is necessary to correct those vices of the constitution and habits of life which brought on the difficulty. They are the same which bring on consumption, and, therefore, do not require to be repeated here. Clergymen are very sedentary, often dyspeptic and costive, weak, delicate, and ner- vous, subjected to the inhalation of much impure air, to great anxiety and excitement, and to laborious mental and attentive duties, quite enough to render them liable to a host of maladies, and especially to throat diseases. The treatment of this disease is plain, straightforward and easy, and although it baffles the skill of those who attempt to drug it to death, still it is easily and perfectly cured by proper treatment. Many suffer with it for years, take me- dicine enough to supply an army during a campaign, and grow worse all the time. It has been my for- tune to treat a vast man}^ cases, and I can say with confidence, that I do not know a more curable or manageable disease. Catahrji.—A €07)1771071 Cold. — Catarrh is not pro- perly a disease, but the term is used to designate an increased flow of mucus, caused by a slightly in- creased vascularity and afflux of fluids to a mucus membrane. It is commonly the result of a cold, BEONCHITIS. 103 broiaglit on by sudden atmospheric changes or ex- posure. Catarrh always accompanies slight inflam- mations of the mncous linings of the air passages, nostrils, posterior nares, or any part of the passage from the nose to the mouth, and is present in measles, fevers, small-pox, worms, and dentition. "When confined to the head or nostrils, it is termed coryza. If confined to the larynx, it constitutes laryngitis ; if to the trachea, trachitis ; to the bron- chial tubes, bronchitis ; to the intestines, diarrhea, &c. 'No question is more frequently asked in w^inter than, " "What will cure a cold ?" The answer is — • always take it in time, fast upon dry bread, rice, and black tea, for one day ; use gentle purgations ; take a pill of opium at night, and a sudorific — something to excite a perspiration — a copious draught of hot chamomile or horehound tea, is quite an appropriate one. Sometimes colds are epidemic ; they are then called influenza. When catarrh becomes chronic, the above treatment will not sufiice. Topical appli- cations of the nitrate of silver, and, in many cases, other and varied direct applications are necessary, in connection with alterative and other constitutional remedies. Robust health, attainable by temperance, long continued exercise in the open air, bathing, and attention to other laws already spoken of, will most effectually protect the system against colds. Bronchitis. — The author considers this term ap- plicable to every case of inflammation of the mucous membrane lining the bronchial tubes, without referen- ce to grade or locality, notwithstanding the restriction which some authors place upon it, making it appli- cable to the higher grades of inflammation only. A reference to the anatomical plate accompanying the article on anatomy and physiology, will enable the general reader to distinguish the precise location of bronchitis. The disease is often complicated with 104: BRONCHITIS. laryngitis, trachitis, pulmonary tubercle, pleurisy, congestion and inflammation of the lungs, pulmo- nary cancer, or morbid dilatation of the tube itself. Great care is necessary on the part of the practi- tioner to enable him to distinguish between dilatation of the bronchige and a vomica — cavity in the lung. Causes. — Cold is without doubt the most frequent cause of bronchitis, particularly when applied to some one part of the body, as the feet, or back of the neck ; inhalation of irritating pow^lers, heated air, acrid gases or vapors, epidemic influence, &c. It sometimes attends hooping-cough, asthma, measles, typhoid fever, and scarlet fever. Syinjytoms. — It usually commences with symp- toms of a common cold, either in the nostrils or in the throat, hoarseness, cough, expectoration, slight soreness in the chest, sore throat, quick pulse, head- ache, furred tongue, and other symptoms of fever ; and as the disease proceeds, expectoration of a transparent ropy mucus, mixed sometimes with blood ; the expectoration subsequently becomes opaque and white, and Anally yellow or greenish. Treatment. — In the acute form, bleeding, saline cathartics, antimonials, counter-irritation, vegetable orfarinaceous diet, and demulcent drinks, as infusion of slippery elm, solution of gum arable, and flaxseed tea. In the chronic form, great patience, perseverance, and attention, are requisite to effect a cure, as the disease is sometimes inveterate, and endures for years, defying treatment. J. H., Esq., having suffer- ed for five years with chronic bronchitis, and having during that time been under the care of several eminent physicians, and tried many modes of treat- ment, is now cured ; snatched, under Providence, from despair and the grave. In giving the treat- ment for this form of bronchitis, it will suffice to DISEASES OF TUB THROAT. 105 refer to that wliicli tlie author adopted in the case of J. H., and which he has found equally successful in other cases. In the first place, he prevailed upon him to follow exactly every direction which is laid down in the third part of this work, for the preven- tion of consumption, improvement of the general health, &c. ; employed counter-irritants, shoulder- braces, inhalations and the inhaling tube ; but gave very little medicine, and that only to meet certain indications. The author thinks it absolutely impossible, to cure chronic bronchitis with drugs alone ; the strictest regimen is necessary. Of course, there are indications in each case which require suitable medicines, but medication without regimen, will not avail in this obstinate malady. Common or Incipient Sore Throat. — This com- plaint is so common, and its causes so well under- stood, that much need not be said to enlio^hten the reader ujDon the subject. Women are more exempt from throat diseases than men, as they wear much less covering about the neck, which becomes, like the face, capable of resisting inclemencies and vicissi- tudes of the weather. Causes. — Wet or damp feet, colds, deranged stomach, &c. The symptoms are known to all. Treatment. — The treatment which the author prescribes for this affection, and which he has found to cure readily in most cases, is the following : he orders a light, farinaceous diet, a simple gargle of alum and water, or of cayenne pepper and water ; to take half an ounce of the sulphate of magnesia on going to bed, and to employ a wet towel bound round the neck, on retiring, which is to be worn all night. Cold bathing, and strict attention to other hygienic measures, will effectually fortify every per- son against its attacks. 6 106 ASTHMA. ASTHMA. This is a paroxysmal disease, characterized by difficulty of breatliing, and accompanied by wheez- ing, constriction of the cliest, and congh ; and terminates generally in expectoration. It most fre- quently attacks the aged ; infancy and youth being comparatively exempt. The paroxysms usually come on in the night. The disease is supposed by most writers to consist of a morbid dilatation of the air cells of the lungs or emphysema of the lungs. The pneuniogastric nerve, and the muscles of the larynx are without doubt frequently implicated. ISTot less than twelve kinds of asthma are minutely described by nosologists. It is to be treated by venesection — in plethoric cases — and by narcotics, antispasmodics and diaphoretics.' The lobelia inflata, given in the form of a saturated tincture of the leaves, in doses of from 3ss. to 3ij., is the most effectual remedy known to the profession at the present day. JSTo disease calls for stricter hygienic regulations ; I refer to temperance in diet, regular exercise, regular sleep, residence in a salubrious locality, &c., &c. H15ART DISEASES. 107 HEAET DISEASES. To tlie great mass of mankind, tlie diseases of this organ are obscure, and must ever remain so. They are also a great stumbling block to many physicians. The only modes of detecting them with certainty, is by means of auscultation, pulsation, inspection, and percussion ; which have already been enlarged upon in the fourth part of this Yolume. The diseases of the heart are not to be reached by domestic remedies ; patients, therefore, laboring under these affections, must seek the counsel of the skillful, experienced, and scientific physician. Diseases of this organ are very dangerous, and were formerly considered uni- formly fatal. There are certain morbid conditions of the system which induce them, but which are entirely curable, if treated properly and in season. Diseases of the heart were formerly thought to be rare, but they are now known to be very common. 108 PNEUMONIA. p^^umo:nia. The term pneumonia is now universally applied to that disease of the lungs, which consists merely of inflammation of their spongy textm^e or paren- chj^ma. It is likely to be confounded with phthisis, bronchitis, pleurisy, or pulmonary oedema. It is a very dangerous disease ; least dangerous in children, more so in middle life, and extremely so in the aged. Causes. — Sudden exposure to cold, when the per- son is in a perspiration, vicissitudes of the weather, excessive speaking or singing, violence, drunken- ness, and the suppression of habitual discharges. It sometimes occurs after great surgical operations, and frequently accompanies small pox, erysipelas, rheumatism, gout, and other diseases. Symjytoras. — The expectoration or sputum, is vis- cid and of a rusty tinge, (this may be set down as a pathognomonic symptom,) cough, difficulty of breathing, shivering, pain in the chest, and fever. Treatment. — Bleeding is universally resorted to, and should be followed by a thorough evacuation of the bowels, by means of calomel and jalap, or the compound cathartic pill, or the infusion of sen- na with the sulphate of magnesia. Recourse must be had to expectorants, mucilaginous drinks, ano- dynes, &c. Antimonium tartarizatum, in large and often repeated dcses, is considered by many eminent practitioners to be almost a specific in pneumonia. Others place entire reliance upon the mild chloride of mercury. Blisters are of very doubtful advan- tage ; a repetition of the general bleeding, and the topical extraction of blood, by means of cups, is good practice. The disease is far too grave and energetic to be managed by domestic treatment. PLEUEIST. 109 PLEUKISY.— Syx.— PZ^wnV25. An inflammation oftlieplem'a — delicate mem- brane lining the cavity of the chest and investing the lungs — it may be either acute or chronic. It chieflv attacks those of a vigorous constitution and plethoric habit. It is caused by colds, principally, but may be occasioned by any cause which gives rise to inflammations in other parts of the system. Symptoms. — Acute pain in the side, which is in- creased by a full insj^iration, flushed face, short breath, hot sldn, rigors, fever, difllculty of lying upon the affected side, hard, strong, frequent and vibrating pulse, nausea and cough. If blood, is drawn, it exhibits the buffy coat. . Treatment. — Large and repeated bleedings from the arm, leeches or cupping glasses over the seat of pain, blisters, purgatives, diaphoretics, and a perfect antiphlogistic regimen. The Chronic Torrti — principally attacks the aged and dissipated; it is usually fatal, bronchitis generally supervening to assist in the destruction of the patient ; the symptoms are very obscure. Leeching and counter-irritation forms the -most suitable treatment. Adhesions of the pleura to the walls of the chest, thickening of the pleura, hydro thorax, or water in the cavity of the chest, &c., &c., are likely to follow either form of the disease. 110 PKESEEVATION OF THE VOICE. PKESEEYATIOl^ A'NB IMPEOYEMENT OF THE YOICE. The author is frequently consulted by gentlemen belonging to the various professions, which require them to speak in public, by teachers, singers, auc- tioneers, &c. ; some wishing to recover the use of their voices, and others wishing to strengthen and improve them. J^ot every Swede, nor every beauti- ous maid of Erin, nor every Anglo-American, can have the voice of the nightingale; but all voices are susceptible of vast improvement, whether they are natural, or much impaired by disease. The best mode of improving a healthy, natural voice, is by exercising it properly after good models ; to improve the symmetr}^ of the neck and chest, by wearing shoulder braces, and using an inhaling tube; by gym- nastics, and vigorous exercise in the open air. The best mode of preserving the voice, is not to exercise it inordinately ; to give it sufficient rest, to avoid the inhalation of all impure air, mist and fogs, dust and gases ; to have singing and speaking apart- ments well ventilated ; to pay particular attention to the teeth ; to fortify the throat and bronchige against colds and hoarseness, by cold bathing and friction ; in short, to keep the whole system in perfect health. Loss OF YoicE. — This affection often results from sudden colds, and in such cases is generally soon cured by mild laxatives, hot foot-baths and copious draughts of the infusion of hoarhound on going to bed. When it results from chronic laryngitis or protracted colds, it is much more difficult to cure, and often entirely silences the patient for weeks, and PRESERVATION OF THE VOICE. Ill even months. Sometimes it is occasioned by lead poison ; it must then be treated by the proto-chlo- ride of hydrargyrum, by stimulating gargles, and topical applications ; as a solution of the nitrate of silver, to the internal surface of the larynx, as prac- ticed by M. Trousseau. These measures are also applicable in all cases where the loss or modification of the voice is dependent upon debility of the mus- cles of the larynx. The voice should never be used - — in singing or speaking in public — immediately after eating. Many jDublic speakers contract the ungraceful habit of drinking, or wetting the throat while speaking ; this injures the voice. Some pub- lic singers have codes upon diet, with strict refer- ence to the quality of their voices ; these are appli- cable, just so far as they recommend abstinence from stimulating food and drinks, and moderation in the quantity of healthy food to be taken. Toba- oo-chewing, snuff-taking, and smoking, materially mjure the voice. Sometimes strong and sudden emotions, as of joy, fright, and anger, will entirely suspend it ; in such cases, it will retm^n upon a re- sumption of the equilibrinm of the nervous system. The voice is very much injured by frequent and neglected colds, tonsilitis, lengthened uvula, laryngi- tis, trachitis, bronchitis, consumption, constipation, falling of the bowels, a bent jDosition, immoderate venery, dissipation^ (fee, &a 112 CONSTIPATION. cokstipatio:n". Syn. — Costiveness. — Irregular Bowels. From mechanical impediment, diminished con- tractility, or susceptibility of the muscular coatings of the intestines, to tlie usual alvine stimuli, or a deficiency of these stimuli, from habit, &c. ; the stools often become less frequent or less in quantity than in health. Sym2?to7ns. — In the author's opinion, every person in health, has at least one passage from the bowels every twenty-four hours, and consequently people who habitually go a longer time, suffer from con- stipation. To controvert this doctrine, instances are urged upon our notice, of people who are accustomed to but one j^assage every two, or three and even six days, and still are said to suffer no apparent dis- advantage. A close scrutiny, however, into such cases, always dete'cts consequent derangements. The evacuations may be quite regular in the period of their recurrence, and still entirely insufficient in quantity. The faeces are usually dry, hard and knotted into lumps, causing straining and painful distention of the anus at the stool. !Not unfrequent- ly the patient passes also a bloody mucus. The faeces are sometimes quite black, and sometimes of a light clay color. Flatulence, distention of the ab- domen, colic pains, nausea and headache finish the list of common symjDtoms. Effects. — These are legion ; among the most re- markable are irritation, inflammation, ulceration, and gangrene of the bowels, impediments to the co:n^stipation. 113 circulation, congestions, contamination of the blood, weakness of the intellect, heart diseases, throat diseases, bronchitis, consumption, dyspepsia, drowsi- ness, depression of spirits, fever, vertigo, headache, difficulty of breathing, pains in the loins and limbs, liver and kidney diseases ; stone in the bladder, flushed face, furred tongue, prolapsus of the anus, bleeding from the rectum, piles, fistula in ano, ca- tarrh of the bladder, strangury, diarrhea, dysentery, colic, leucorrhoea, amenorrhoea, dysmenorrhoea, men- orrbagia, falling of the bowels and consequent failing of the "svomb ; foul breath, sick-headache, unpleasant exhalation from the skin, pimples on the face, opacity and discoloration of the skin, bleeding at the nose, paralysis, epilepsy, apoplexy, hysteria, melan- choly and insanity, are first only, in the list of effects and diseases established by constipation. Some of these diseases often take an independent existence, and last long after the cause is removed. Treatment. — Regular solicitations of nature at a stated hour, suitable exercise, change of air and scene, relaxation from study, bathing, and friction U-pon the skin, kneading of the bo w^ els ; regular habits, change and regulation of the diet, suitable medicines, and an abdominal supporter. By these means I have never found much difficulty in curing completely the most obstinate cases. In most in- stances I find that the use of the abdominal supporter alone, speedily accomplishes the object. If there is any one subject connected Tvith health, Tvhich more than another recjuires the studious attention of man- kind, and which is most of all neglected, it is that of Constipation of the Bowels ; probably the most fruitful of all causes of disease, especially in women. Ko consumptive need hope for an alleviation of symptoms, or a cure, who permits his system to suffer from the effects of constipation. 114 DYSPEPSIA. DYSPEPSIA. This is a very common disease ; it consists of indigestion, dependent npon chronic irritation, in- flammation or atony of the stomach or the conti- guous intestines. It is known by pain in the re- gion of the stomach, directly after eating; vomit- ing, acrid eructations, heartburn, pyrosis, want of ap- petite, transient distensions of the stomach, and some- times costiveness or diarrhea. The nervous system is often much affected in dyspepsia ; thus we have headache, palpitations of the heart, dimness of vis- ion, partial deafness and despondency. People of sedentary habits are most subject to attacks of the disease, but it also frecpently attacks from other causes than a sedentary life, as from colds, bad diet, fast eating, over eating, eating be- tween meals, grief, &c. It may also attend organic affections, cancer, &c. Perhaps no invalid suffers more or enjoys less than the confirmed dyspeptic. He awakes in the morning, not only unrefreshed and unrestored by sleep, l3ut feeling infinitely worse than when he retired ; his whole system is deranged, and an uni- versal feeling of misery is the conseqnence ; he is drowsy, fatigued and averse to risiug. His tongue is covered with a thick, yellow or grayish coat, his mouth is dry and tastes disgustingly. After each meal he has pain, waterbrash, or acid eructations ; sometimes feels a little better and then much worse. He enjoys nothing ; neither the pleasures of the table, society nor amusements ; he has no refreshing sleep, DYSPEPSIA. 115 but is haunted by distressing dreams, and turns and tumbles about in his bed, vainly endeavoring to find rest. He feels as though he would give worlds for oblivion ; he is often tormented with the most dia- bolical desire to commit some gross outrage ; and, in short, he is utterly miserable. The treatment consists in restoring tone to the affected organs, invigoration of the general system, obviating the causes, and relieving symptoms. For these indications, careful diet, regular exercise in the open air, rest, sleep at regular hours, attention to the bowels, bathing and friction are the most applicable. We must meet the atony by vegetable tonics, dis- ordered secretion by rdilcl mercurials, laxatives, and antacids ; and the inflammation by leeches, saline cathartics, and abstinence. I have devoted much attention to this disease, and am gratified in being able to cure it in a short time. .iij jvir i,eil[ .voire ££ inoib-'id D ^Si^jLVl ji(i'r] .ajavo FEMALE DISEASES. It would not com- port with the design of this work, for the anthor to write upon all of the diseases to which women are par- ticularly liable ; he has therefore noticed those only which are the most common, and which tend most to destroy the general health, and thus assist in laying the founda- tion of consumption. The diseases noticed are mostly lesions of functions and vital lesions ; lesions of Perfect symmetry and health. form, situatiou, devel- opment, and reproduction are not referred to. Under the two former heads, the author classes hysteria, nymphomania, retention of the menses, change of life, hysteralgia, a-naphroclisia, mastodynia, false preg- nancy, inertia of the womb, chlorosis, hypersemia, hydrometra, menorrhagia, physometra ; amenor- rhoea, dysmenorrhoea, phlegmon, oedema, varix, cysts, fibrous' and sanguine tumors of the labia, ery- FEMALE DISEASES. 117 sipelas, prurigo, fuDgns of the nymphse, ulcers and excrescences of the vulva ; carcinoma of the clitoris and meatus urinarius, acute and chronic vaginitis, whites, uterine phlebitis, acute and chronic metritis ; ulceration, excoriation, cancer, putrescence, dropsy, and softening of the womb ; cancer of the breast, me- trorrhagia, fibrous tumors, polypus, calculus, hydatids, sanguine and lymphatic concretions in the substance of the womb, scirrhus, or cancer ; tumor and dropsy of the ovary. The above comprise only about one- fourth of the lesions incident to females, and the author presumes that the fatigue of going over the above lengthy fragment, will give sufficient distaste to induce his fair readers to join him in declaring, that the subject is quite too broad and elaborate for any but a medical mind. It is well for every lady to know all that she can find time to learn of herself, anatomically, physiologically, and pathologically ; for which she is referred to the various text books which cluster in bright constellations about our science. My fair readers must not place too broad an interpretation upon these remarks. I refer, of course, only to such knowledge as is every day ne- cessary in female hygiene. Our ideas of delicacy might be startled, were we to meet with a lady who knew too much of herself. 118 FALLING OF THE WOMB. FALLma OF THE WOMB. S YN. — Prolapsics Uteri. — Hystero^tosis, I HAYE made some remarks "upon falling of the womb, in the chapter on Abdominal Supporters, but as I have broached the subject of female dis- eases, it will be expected that this frequent and afflicting maladj will be spoken of in a separate article. Opinions of medical men are somewhat at variance upon the cause or causes of prolapsus uteri ; some contend that it arises from loss of tone of the parts ; others say that relaxation of the ligaments of the womb is the sole cause, while others contend that relaxation of the vagina alone is quite sufficient. M. Lisfranc thinks the disease or displacement is almost always produced by engorgement of the womb ; in this opinion he is supported by many eminent medical writers. At least, one gentleman who has given the profession his incidental opinion, says, that prolapsus uteri is caused by a softening, loss of contractility, or relaxation of the pelvic muscles. The author thinks that relaxation of the abdominal muscles and consequent gravitation of the viscera, with relaxation of the peritoneal expan- sions, constitute, in the majority of cases, the prin- cipal causes of falling of the womb. There are, of course, besides these, predisposing and occasional causes ; as frequent pregnancy, emaciation, abusus coitus, tumors upon the womb, an unnatural capa- city of the pelvis or vagina, leucorrhcea, tight lac- ing, violent exertion, abortion, rising too soon after parturition, engorgement of the uterus, &c., &c. FALLING OF THE WOMB-. 119 Treatment. — The first indication is, replacement of the organ ; the second, to keep it in its proper position. For the fulfillment of the first indication, the lady must rely upon the manipulations of her physician or nurse. The abdominal supporter shonld be immediately adjusted, and suitable hygienic directions, and medicines given. The often mooted, but still unsettled question'now arises. Should a pessary be employed ? Being my- self of the opinion that more mischief has accrued from the use of j^essaries than benefit, arising no doubt in many instances from its being employed when nothing of the kind was indicated, from choos- ing a bad instrument, from neglect to extract and cleanse it at proper intervals, &c., &c., any argu- ment which I might institute upon the subject, based, as such argument must be, upon anatomy, physiology, and pathology, would perhaps but cover the objections to the instrument, and necessarily lead the reader into a labyrinth where more medical jargon than, to her plain common sense, would pertain. I shall therefore but mention some of the evil conseqnences which have, in repeated instances, followed the employment of the instrument. All pessaries are liable to be coated with calcareous in- crustations, and nearly all are liable to corrode and decoi 'ipose. They never fail to excite irritation, and, from their pressure, impede the functions of all the pelvic organs — defecation, urination, menstruation, &c., &c. They frequently cause change of texture, and purulent vegetations which sometimes complete- ly fill the vagina ; also strangulation of the womb, j^ain, engorgement, injury to the walls of the vagina, perforation of the rectum and bladder; vesico-vaginal fistulas, mortification, ulceration, sloughing, com- plete loss of the vagina, fatal peritonitis, cancer of the womb, &c., &c. It is probable that the French 120 FALLING OF THE WOMB. surgeons have tested the utility of the pessary more thoroughly than the surgeons of any other people ; and they, nearly all, speak disparagingly of it. Among whom I can say positively, that Dupuytren, Grenier, Colombat, Mauriceau, and Lisfranc, have recorded their testimony against it. As the abdo- minal supporter entirely obviates the necessity of employing a pessary, I am of the opinion that the former instrument will, finally, entirely supersede the apparent necessity which, to some, seems at times to exist for its use. LECrCOERHCEA, &C. 121 LEUCOERHCEA. Stn. — Whites. — Fluor Albtcs. — Uterine Catarrh. — Fleurs Blanches. This frequent and distressing disease is known by a secretion of whitish mucus from the lining membrane of the womb or vagina of women. The discharge is sometimes very profuse, and is at- tended with a pain in the back and loins, smarting during urination, want of appetite, loss of flesh, pale- ness, lassitude, nervousness, and dejection. In cases where the discharge is very acrid, it will contaminate, giving rise to symptoms resembling those of vene- real. If the case is of long standing, fever, diffi- culty of breathing, palpitations of the heart, faint- ings, and swellings of the lower extremities often ensue. Causes. — Laxity of the parts concerned, general debility, poor diet, use and abuse of tea ; profuse evacuations, immoderate ilowings of the menses, immoderate coition, difficult and tedious labors, frequent miscarriages, falling of the bowels uj)on the womb, use and abuse of spices, w^arm baths, chalk, purgatives, emmenagogues, foot-stoves, and coffiee ; debility and inflammations of the womb and vagina. Treatment. — It must be treated by general hy- gienic means ; as gentle exercise, pure air, a light, full, nutritious diet, attention to bathing, avoidance of excitement, rest, abstinence from coition, and per- fect regularity in all the habits. By astringent washes, suitable tonics, (as of metallic iron, gentian, columbo, cinchona, myrrh, &c.,) anti-leucorrhoeal troches of copaiba, suppositiories, and above all, an abdominal 122 LEUCOEEHCeA, &C. supporter. I can generally cure the whites, in a short time, with a supporter, suitable tonics and injections. In some cases I have found the suppor- ter alone sufficient. Pomme warmly recommends baths of a temperature of 90® F., emollient fomen- tations, and diluents. The disease should at once be cured at any cost, as it ruins the constitution and drags the woman to her grave. AMENOEKHCEA. 123 AMEKOEKHCEA. This afFection may be defined to be an obstruc- tion or suppression of the monthly turns or menses, from causes other than pregnancy or advanced age. If it occurs in a young lady, who has not menstru- ated at the time when it would be expected from her age that she should, the difficulty is termed Emansio ineiisiiiin. If it is a morbid cessation with one with whom the periods have been previously established, it is termed Suppressio onensium. Causes. — General debility, sedentary habits, im- proper diet, plethora, fatigue, vivid emotions, colds, improper use of aperient medicines, haemorrhage, a burn or blister, consumption, scrofula, inflamma- tions, false membranes, form, development, &c, &c. Treat-inent. — If occurring in a young unmarried lady, it is to be treated as chlorosis. {See chlorosis) A resort to general principles is quite indispensable in the treatment of this affection ; we must first as- certain the exact cause of amenorrhcea, which cause should be removed, and other indications carefully attended to. If the disease proceeds from plethora, we must adopt means to diminish the exuberance and richness of the blood, and the other fluids by means of suitable purges, low diet, and sometimes by bleeding. If it is caused by a sudden cold, we should prescribe warm, stimulating drinks, as infu- sion of mint, elder flowers, balm, &c. The author might pursue the subject of the treatment of amen- orrhcea to great length, as it requires a very nice discrimination, and scrutiny into each individual case, before the proper treatment can be laid down. The advice of the intelligent and careful physician is therefore indispensable. 124: DTSMENOREHCEA.. DYSMENOEEIICEA. This term signifies menstruation forced, or accom- panied by uterine pains, pains in the back, loins, and lower part of the abdomen, and often bj nervous and hysterical symptoms. Causes. — Plethora, nervous irritability, and many of the causes which ]3roduce amenorrhoea. Bymjptoms. — The discharge is usuall}^ slight ; there are pains in the loins, back, groins, thighs, and hypo- gastric region; more or less anxiety, lassitude, sleep- lessness, irritability, itching, and often a sense of constriction in the throat. Treatment. — If the disease — or rather the painful exercise of a function — proceeds from plethora, there are frequently pieces of false membrane and blood in the discharge, and it must be treated by antiphlo- gistic means ; as leeches to the anus, frequent, mild, saline purges, nitre, &c. Other cases are relieved by warm baths, warm hi]3 baths, anodynes, diapho- retics, acetate of ammonia, narcotic injections, vege- table diet, and emollient drinks. The itching can be relieved by injections of an infusion of poppy heads with a mucilage of marshmallows. CHLOROSIS. 125 CHLOKOSIS. Syn. — The Green Sickness. This disease attacks principally young unmarried ladies, at about the age of puberty. It is character- ized by a slightly greeu and yellow tint of the skin, and loss of red tinge, pale lips, absence of perspira- tion, bloated face, universal debility, fatigue, languor, melancholy, loss of tone in the digestive organs, acidity in the stomach, flatulency, constijDation, per- verted taste, palpitations of the heart, weak back, pains in the loins, and flaccidity of the whole person ; quick pulse, oedematous swellings of the feet, many symptoms of hysteria, unusually pale and scanty ca- tamenia, and finally a total suppression. Causes. — The disease arises from a deficiency of blood globules, caused by premature and rapid growth, feeble constitution, suppression of the men- ses, frequent haemorrhages, onanism, celibacy, cap- tivity, sadness, grief, melancholy, disappointment; living in secluded, dark, damp situations, as in cel- lars, narrow streets, mines, deej) and sombre vallies and woods ; bad diet, drinking vinegar, eating clay, sealing-wax, pickles, cloves, lemons, chalk, slate- pencils, green fruit, rose leaves, &c. ; and finally, a sedentary and voluptuous life, all cause the nervous debility, and deficiency of red blood globules upon which deficiency the disease depends. Treatment. — Daily exercise in the open air, cold bathing, exemption from study, liglit.^full diet, riding on horseback, travelling, agreeable company, atten- tion to the bowels and catamenia, proper use of flan- nel, moderate use of wine and tonic medicines. The mineral waters of Pyrmont, Yichy, and Spa, are highly recommended by French writers. 126 BARRENNESS. B A E K E ]Sr I^ E S S . Stn. — Sterility. Sterility may depend npoii tlie male or female, and may arise from malformation ; but, in tlie great majority of cases, it is caused by debility of tbe sexual organs. This debility is caused in men by dissipation, excesses, strictures, &c., and in women by the diseases peculiar to their sex ; but especially by disordered menstruation, chlorosis, and whites. The treatment is easily adapted by the intelligent phy- sician, and generally soon effective. It is of the last importance that a medical adviser should be per- fectly educated upon the subject of physical incom- petency in either sex, and of barrenness or sterility, as they are both usually within the reach of suitable remedies ; mere mediocrity in medical science, is quite incompetent to either emergency. HYGIENE OF WOMEN. 127 HYGIENE OF W0ME:N^. "Women have tempestuous and dangerous periods to pass, diseases and pains to endure, and physio- logical changes to encounter, which are peculiar to their sex, and which may be said to be superadded to those usually incident to humanity. There are then, hygienic precepts, which belong to the sex alone ; and it is the author's pm'pose to refer to them briefly in this ai*ticle. We must begin at that period when the divine light of womanhood first sheds its beau- tiful rays as precursors upon the fragile form of childhood. As this age — the age of puberty — ap- proaches, the tender young girl should receive spe- cial attention from her mother or governess, and be instructed by either respecting those changes which mark this brilliant epoch in her existence. Pear, shame and mischief, often arise from the mistaken silence of mothers upon these important subjects. At the crises of the irruption of the menses, the young woman — for woman she now is — should not be subjected to that strict physical and mental dis- cipline and training, which at seasonable times is so necessary to fit her for the exalted place she is des- tined to occupy upon the stage of existence. Re- laxation from severe study is necessary, that the powers of her system may come to her assistance in the performance of a new, and at the outset — ex- tremely difiicuit function. If she must study, let her cultivate the higher branches, avoiding romance ; as 128 HYGIENE OF WOMEIT. History, Geography, Rhetoric, ISTatural Philosophy, &c. Or, if she is of a dull, cold, phlegmatic and indifferent temperament, the opposite is indicated; and she should see company, attend concerts, read a little, chaste romance — if such can be found — and cultivate music, drawing, dancing, painting and other light accomplishments. Her diet should con- sist of light, nutritive and easily digested food ; as rice, milk, farinaceous substances, a very little ani- mal food, fresh fish and well cooked and healthy vegetables. Her drink should not be stimulant, but tonic ; as a little wine and water, or porter and water or chocolate. She should abjure coffee, tea and spirits. Let not Cupid be permitted to flutter his wings in her atmosphere at this period, but ra- ther permit Minerva and Diana to preside over her thoughts, occupations and aspirations. If difficul- ties or delay in the fulfillment of her functions arise, she must, of course — through her mother — receive the counsel of her physician. During the menstrual flow, the woman, what- ever her asre mav be, should abstain from the use of purgatives, emetics, bleedings, baths and exciting emotions. She should avoid washing in very cold water, she should avoid company, balls, parties and public assemblies. She should take no exciting food or drink, and especially avoid exposure to damp and cold. She should avoid foot-stoves ; and at all times, clothe and protect herself with the strictest propriety. If the discharge should at any time be too abun- dant, she must repose herself in the recumbent po- sition, take very little food, abstain from warm drinks, and substitute cold barley water, rice or toast water, lemonade, &c. If she meets with sudden and premature sup- pressions, she must also seek rest, apply warmth to HYGIENE OF WOMEN. 129 the hips and thighs, aud drink hot balm tea, for the purpose of recalling the necessary evacuation. From the age of puberty to that of perfect wo- manhood, a host of new thoughts, scruples, impres- sions and sentiments have possession of her bosom ; during this season of expansion, we leave her to her mother, in whom we must also confide during the periods of " coming oiit^'' company, romance, love, courtship and marriage. She is now a wife ! — now impressed with the proud consciousness that she lives for a new being, whom she is to call her child ! During the season of gestation she must maintain the most perfect composure and placidity, cultivate the highest and noblest sentiments, and pursue em- ployments and 23leasures calculated to preserve her- self in perfect health, and stamp her offspring with qualities as nearly as possible approaching perfec- tion. During the nursing and rearing of her chil- dren, we leave her to her happiness and solemn duties. But, as the scene draws toward a close, as dark clouds begin to gather round her, whose lining is of purple, and whose glittering edges are now bound with black, and under which rages the shat- tering and detracting storm which, is to usher in her days of placidity and decay, we again olfer our guidance. The " change of life^^ affords, perhaps, a less flattering prospect for the future ; still, when not disastrous, it is not without its pure joys and happy anticipations. She must now renounce the court of Yenus, cultivate the complacent affections, and re- joice in her rising and risen offspring. At this pe- riod, the woman must renounce drugs as far as pos- sible, and seek to correct her various disorders by regimen and the simplest medical means. In her case, the heroic medication is not applicable ; she must avoid drastic purges, emetics, blisters, seatons, and, as far as possible, great surgical operations, 130 HYGIENE OF WOMEN. LigM bleedings, enemata, leeches, baths, tonics, sup- positories, anodynes, anti-spasmodics, &c., are, how- ever, sometimes requisite in combating the unpleas- ant symptoms incident to the " cTiangeP Women have smaller lungs, are of a more fra- gile texture and constitution, remain more in-doors, and are more subject to consumption, constipation, &c., &c., than men ; greater caution on their part is therefore requisite, not only in respect to diet, but to all of the hygienic rules which we have adverted to. We would say to ladies, seek for beauty in health, cleanliness and composure ; abjure powders, paints, medicated soaps, perfumes, hair-dyes, depilatories, cosmetics, vinegars, washes, and all of those false appliances, which have not real utility to recommend them. Purity and beauty of complexion cannot be obtained by cosmetics, such as pearl-powder, rouge, medicated soaps, &c. ; all of which injure the skhi very materially. They are attainable only through firm and perfect health, upon which they absolutely depend. Those, therefore, who desire to possess a clear, transj^arent, and beautiful complexion, should seek for it through the proper means, rejecting every preparation which is urged upon their attention, under the pretence that it will remove pimples, tan, moth, and freckles. The only reliable cosmetic is pure water. If the reader wishes more particular directions upon this subject, she is referred to the hygienic j)i'inciples laid down in the third part of this work. VARIETIES. 131 YAEIETIES. De. Rush thought the Germans kept off con- sumption by singing so much. An Epitaph — " Died of thin shoes, January, 1830." A saying in Rome — " Where the sun enters, the physician never does." BCouses with southern exposures are most healthy. Parents, examine school rooms before sending your children to school ; these rooms should be above ground, dry, large, well lighted, well ven- tilated, in a healthy neighborhood, and not over- crowded with scholars. Do not sleep in a basement room, or on the first floor. Do not indulge in excesses of temper ; they ruin health and make man prematurely old. Do not wear abdominal supporters or shoulder braces in bed, unless you are constantly confined to it. Invalids should always choose a physician in whom they can place the most implicit confidence, as confidence assists materially in performing a cure. If you wish to avoid consumption, become a disciplinarian, keep a bridle upon your passions, and especially avoid intemperance in exhausting indulgences. Constipation is a most dangerous enemy to health. Do not sleep in crowded apartments. Retire early and rise early ; a long morning is worth more than a long evening. 132 VARIETIES. Spend a part of each day in amnsements. The influence of the mind, or of the imagination, over disease is astonishing, but well substantiated ; ask the homeopathist his secret, and if he answers you truly, you will realise its extent. The influence of diet and regimen over disease are truly wonderful ; ask the hydropathist his secret, and then you will realise that. The effects of medicines upon the animal econo- my are susceptible of satisfactory demonstration ; study materia medica and general therapeutics ; make critical observations in practice, and then you will be convinced of facts of great moment. Even physicians sometimes oppose different me- chanical remedies ; such as abdominal supporters, shoulder-braces, inhaling tubes, &c., &c. {excepting^ perhaps, some favorite of their own), and will attempt to give learned and incomprehensible reasons for their disapproval. While poor human nature remains as it is, scrutiny into motives is often quite allowable. It is perfectly a]3parent to a thinking mind, that while neither pill, poAvder, plaster nor vo- luntary care, can restore lost symmetry, suitable mechanical remedies will. If, then, loss of sym- metry will occasion disease, are not these means, in many cases, the first to be relied upon as preventives as well as remedies ? Eat slowly, and masticate your food thoroughly. Do not take much liquid with your meals. Rise from the table with an apj)etite. Eat no hot bread, no veal, no sausages, no pickles. Let your repast be full, so as to distend the sto- mach perfectl}^. Do not eat just before going to bed, or between meals. Do not take your tea, puddings, &c., &c., too hot. Take your meals at regular and stated hours. VARIETIES. 133 Do not cover your head with the sheet or quilt, while in bed. Do not study at night. Avoid sick rooms as much as possible. Keep your feet warm and dry, your head cool, and your heart at rest. Avoid the inhalation of coal and other deleterious gases, dust, smoke from matches, &c. Do not neglect your teeth ; brush them night and morning. Always use a toothpick after eating. If you accidentally get wet, by being caught in a shower, strip, use a flesh brush, and j)uton dry cloth- ing immediately. Avoid sitting in damp shoes or boots. Avoid currents of air. Medicines will not cure disease, but may assist nature to do so. The mind as often requires a physician as the body. Do not study or think too much ; the mind re- quires rest as well as the body. The robust and healthy are not nervous, irritable, or distressingly susceptible. To become robust and healthy, exercise in the open air, eschew liquors, tea and tobacco ; maintain a good conscience toward God and man, and eat temperately of plain, substantial food. S'early all diseases come from intemperance of some sort, and want of exercise. I cannot refrain from addressing a few words to the young physician. I have been in your situation, and can sympathise with you in your trials, hopes, and fears. I have toiled and waited, sought favor from the great and powerful, and received an abun- dance of promises, wliich were oftentimes never ful- filled. I would say to you, court no favor from those 13i VARIETIES. whose interest it is to keep yon in obscurity. If God has given yon talents, nnite to them industry, per-, severance, polished manners, true benevolence, close attention to your profession, and faithfulness to your patients, l^ever stoop from the dignity of your ta- lents, education, and deserts, and you can rest as- sured that a generous and discerning people are sure to find you out, and soon place you in the position you are fitted to maintain. SHODLDER-BKACES. 135 SIIOULDEE-BRACES. All invalids, authors, editors, public speakers, singers, students, schol- ars, accountants, clerks, artists, seamstresses, me- chanics ; all people of se- dentary habits, and all who have acquired the habit of stooping, and all round-shouldered people and consumptives should wear shoulder-braces. Shoulder-braces are very much worn by the elegant and stately offi- cers and soldiery of Eu- ^A rope ; a round-shoulder- ^ j ed or stooping grenadier would have been an ano- / maly in ^Napoleon's old s, s^uard, sufficient to have t^ I' ^ 1^-^P caused that pertinaceous \\ "i r^ hero no little disquie- tude. Heretofore, shoulder-braces have been very little worn in this country, and this fact arose wholly from Shoulder- Brace. 136 SHOULDEK-BEACES. our not having had good paterns ; those commonly offered being made by milliners, corset-makers, and instrument-makers, who, knowing little or nothing of anatomy, of course their bearings are wrong, and they cut nnder the arm, cause the blood to settle in the hands, are stiff, hard, inelastic and uncomfort- able ; incase the person nnnecessarily, cover and heat the spine, will not keep in place, and confine and compress the waist ; in fine, their objections so far over-balance their ntility, that those who purchase them are soon obliged to lay them aside. Wishing to nse shoulder-braces extensively in his practice, and not being able to find any perfectly free from these objections, the author has invented a brace which he esteems very highly, as it unites every advantage ; it is light, elastic, and elegant ; it affords no additional covering to the spine, and fits neatly, so as not to wear or interfere with the set of the clothing. A glance at the accompanying plate will give the reader an idea of its form. Those prepared for gentlemen have attachments which entirely supersede the necessity for wearing sus- penders. They form a perfect suspender shoulder- brace. ATMOSPHERIC INHALING TUBES. 137 ATMOSPHEEIC INHALIXG TUBES, AXD EXPANSION OF THE CHEST. Atmospheric Inhaling Tube, These tubes are designed to assist in our endea- vors to expand the lungs, open and iullj inflate their folded or closed air cells, and enlarge the chest, so as to give ample room for the constant action of the lungs and heart, and increase the capacity of the former for the consumption of air; to detach the mucus from the lining mucous membrane, so as to permit the free egress of carbonic acid from the blood, and favor the ingress of oxygen. Animal energy, animal electricity, nervous energy, or ani- mal contractility or excitability, (the reader may take his choice of terms,) is derived from the air by respiration, and therefore depends — in intensity or amount — upon the quantity of pure air consumed. The quantity of air consumed, depends, of course, upon the capacity and action of the lungs, upon the action of the heart and arteries, and on the perfec- tion of contact between the blood in the lungs and the air. Men are stronger than women, and why? Because they possess larger chests, larger luno^s, and consume more air; from which the lungs and blood elaborate, manufacture or extract oxygen, electricity or nervous energy, and which gives to the muscular 138 ATMOSPHERIC INHALING TUBES. system contractility or irritability ; in other words, power to act. The blood — or a constituent of the blood — is the vehicle which conveys this power from the lungs to the brain, and other parts of the nervous system, and to the muscular system. Animal action, therefore, depends entirely upon electricity, or oxygen, or a principle derive^ from atmospheric air. If this principle is entirely withheld, action ceases, and death immediately ensues. If it be partly withheld, as is the case with people afflicted with catarrh of tlie lungs, with the sedentary; w^ith those confined to heated and impure apartments ; wdth those whose lungs, from habits of stooj^ing or tio;ht lacino\ wearino- tio'ht clothino;, or from loss of symmetry, have been compressed and their air cells closed, folded, or collapsed, the power of action is diminished ; debility and effeminacy follow, and in their train, disease creeps insidiously into dif- ferent organs of the system. Proper inhaling tubes, not only assist nature in opening and expanding the air cells, but they attenuate, or make thin the pari- etes or cell walls, both preventing curing and conges- tions and thickening of these walls. Tuherdes can- Qiot form in the lungs^ vntJwut this congestion and thickening. So long^ therefrre^ as the lungs are Jcejpt expanded^ the walls of the cells kept thin andj congestions prevented^ we can with perfect confidence and safety defy tubercles and consumption. And further, cold in the system — by which I mean the absence of caloric — heat — is a great provocative of consumption ; it is therefore requisite to keep up the natural fires of the system, not only to keep the enemy at bay, but to expel him when he has once gained an ascendency. These fires are kept con- stantly burning within us, and are fed by the carbon which is contained in our food, and the oxygen which we breathe into our system through the lungs ; these ATMOSPHERIC INHALING TUBES. 139 two principles meet in every part of the system, and their contact canses their immediate combustion, and the evolvement of heat ; this heat is the natu- ral warmth of the body. It follows, then, that when the lungs are diseased or collapsed, the amount of air inhaled, and oxygen therefrom extracted, is dimi- nished, and the fires get low ; this accoimts for the constant chill which consumptives so much complain of. If the amount of food is diminished, of course less carbon is supplied, and the result would be iden- tical. This is proved by the fact of our getting chillv if v/e 2;o too lono^ without food : who has not exj)erienced the fortifying effects -of a hearty break- ftist against the cold ? Men drink brandy and other liquors to keep the cold out ; and in imputing this efiect they are quite right ; for liquors contain an. excess of carbon, and cause the systemic fires to flash up afresh for a while, but the evil is, that they so soon die down, and require more fuel ; while the carbon from a good dinner will burn six or seven hours, imparting a genial and substantial warmth to the system. Of course it will be plain to every per- son, that the colder the weather, and the more we expose ourseh^es, the more food we require to keep us warm. It is quite plain, also, that the inhaling tube which expands the lungs, and increases their capacity for air, from w^hich oxygen is extracted, is also of inestimable service in this particular. The wdiole rationale, modus operandi, and philosophy of inhaling tubes may be derived from the above, if studied carefully and understandingly. The intel- ligent reader will at once perceive and advocate their utility and employment. They must be used under proper restrictions. People who have heart diseases, and those inclined to apoplexy or giddi- ness, sliould use them with the greatest caution. 140 ABDOMINAL SUPFOETEBS* ABDOMIKAL SUPPOETEES. FALLmG OF THE BOWELS. Abdominal Supporter. The author knowing that many people do not perfectly nnderstand the indications which call for the employment of these instruments, the indica- tions which they answer, or the purposes which they subserve, the rationale of their action, and what a perfect supporter should be, wliat it should not be, and tiow it should act, will give his readers — as perspicuously as possible — the necessary informa- tion. To do this fully, may involve some slight re- petition of remarks which have been made while other topics were under consideration ; these are un- avoidable in a work of this character. Two men may meet, though they may be travelling on entirely different or separate roads — for roads unavoidably cross each other. From various causes, the abdominal muscles or ABDOMINAL SUPPORTERS. 14l belts, wliich cover the front part of the abdomen and pelvis, and which assist in holding the contents of the abdomen in their proper places, loose their con- tractility and become relaxed — stretched — permit- ting the abdominal viscera to gravitate — fall — down- wards and outwards. This loss of symmetry — dis- placement — occasions the displacement of other or- gans and is a fruitful cause of disease. It causes constipation, ruptures, dyspeptic symptoms, pains in the back, abdomen, stomach, heart, chest and shoulders ; weakness of the chest, a sinking, drag- ging, hollow feeling about the stomach ; liver and kidney complaints, piles, diarrhea, seminal weak- ness, barrenness, and all female diseases ; as pro- lapsus uteri — falling of the womb — fluor albus — whites — &c., &c. The intestines and peritoneum — lining membrane of the abdomen — fall upon the womb and press it out of place ; otherwise this organ would seldom be prolajDsed. The liver, stomach, and spleen being situated above the intestines and being partly held in position by them, of course participate in their gravitating or falling movement. These in their turn, affording in health, partial support to the diaphragm, lungs, (fee, j)ermit — in cases of falling of the bowels — the parts which also aid in holding them in position, to be put upon an nnnatural stretch ; and thus the whole system is, by loss of symmetry, deranged in action and involved slowly and insi- diously in disease. Abdominal Supporters are designed to supply that support to the abdomen and its contents which the abdominal muscles, in their relaxed and debili- tated condition, cannot give, and to restore to these muscles their contractility, strength, and tone. To answer these ends they must be of the right con- struction and fit the person absolutely. They should not press upon the spine or cover it so as to heat it. 14r2 ABDOMINAL SUPPORTERS. They should be very light, of sufficient power to sustain the incumbent viscera, perfectly adapted to the anatomy of the pelvis, of a construction which will not interfere with the clothing, locomotion, or the patient's comfort : should adapt themselves to the motion of the person while walking ; should possess graduating power ; should press upward and inward on each side of the low^er part of the abdo- men, between the two hip bones ; should not be im- movably joined in front, for many reasons / should not press in the middle of the abdomen over the bladder ; should be durable and not too expensive. The author thinks his supporters exactl}^ answer the above descriptioii ; they give the most perfect satis- faction to his numerous patients, and meet with the entire approbation of his ]3rofessional brethren. They are readily convertable into supporter trusses, which, in the author's opinion, are the only instru- ments applicable in certain forms of hernia — rupture. In some forms of hernia, a supporter truss is quite inapplicable ; to meet such cases the author has in- vented a truss which has a wide range of application, and which in many cases effects radical and perma- nent cures. Abdominal supporters are applicable in nearly all cases of diseased lungs ; absolutely indispensable in consumption, and in female complaints, and of infinite service in dyspepsia^ constipation, chronic diarrhea, piles, liver, kidney and heart diseases ; weak chest, weak back, loss of appetite, loss of voice, corpulency, cancer of the stomach, &c., (fee. Ladies during pregnancy and after confinement find great benefit from their employment ; and people whose occupation obliges them to remain during a great part of the day in the upright position, as clerks in stores, and others, find them invaluable. They are readily and easily applied, and worn with perfect ABDOMINAL SLU'POKTEES. 143 comfort ; the two pads connected by the lacer, arc worn in front, between the two hip bones or ilii, and just above the cross bone or pubis. The two steel springs pass up nearly or quite to the waist, and round the person ; the four round pads attached to the posterior end of the springs take their position two on each side of the sj)ine, upon the large mus- cles of the back — the latissimus dorsi — and the other two in the gluteal region, upon the gluteus maximus. Small leather straps are attached to these pads, which are to be fastened across from one to the other, after the instrument has been adjusted. Some physicians, even some who enjoy good pro- fessional reputations, and which reputations are, in most respects, w^ell deserved, persist in advising, pjre- scribing, and applying, almost indiscriminately, the pessary ; a practice fully as repugnant to science as it possibly can be to the feelings of the most delicate lady; and which is as useless and injurious in most cases, as it is repugnant. I^o one man can be great in everything ! nor perhaps in many things ; every man has his hobby, and this very hobby is often his weak point. Some physicians make hobbies of pessaries ; and though they may be superior men, in some respects, in this — science and nature deplore their weakness. But, it may be asked, " Will not a j)essary hold up the womb?" certainly it will, and it will do more ; it will both hold up the womb and the weight of the intestines and peritoneum, which fall upon it and press it down. The intelligent reader will at once concede, that the only ration?J procedure in such a case, would be to lift the ab- dominal viscera, intestines, &c., off from the womb ; suppose tliem% in their proper place, and permit the womb,with its powerful ligaments, to find the position wliich nature assigned it, and there remain, ^o relaxation of its ligaments, r.or of the soft parts 144 ABDOMINAL SUPPORTERS, which help to hold the womb in position, would ever cause it to fall. I contend that gravitation of the abdominal viscera is the only cause, in ninety-nine cases in every hundred, of falling of the womb; and consequently, the only rational treatment consists in the application of a suitable abdominal supporter. It has been my happiness to cure so many ladies of this distressing complaint with this instrument alone, who had in vain sought relief from other sources, that on this point I am impatient of contradiction. I do employ pessaries, in some cases for a short time, but I iirst lift and support the superincumbent weight of the contents of the abdomen, by means of an abdominal supporter, and keep my patient a short time in the recumbent position, which is usually sufficient to effect a cure ; but, there are cases in which the womb has been prolapsed for a great length of time, where pessaries worn for a short period, materially assist in attaining our object. But the instrument should never be used until the patient, has a supporter adjusted, ortherwise the difficulty is increased by making the womb support the bowels. This latter course is a frequent cause of cancer of the womb. It is contended by some gentlemen in the pro- fession, that abdominal supporters give no sup- port to the womb, in cases of falling down or out of that organ. It is quite true, they do not give the least support to the womb. But they do infinitely nnore and hetter ', they lift from that organ the weight of the intestines and peritoneum, which fall upon it, and push it out of position ; (otherwise falling of the womb would seldom occur.) Supporters thus enable nature to restore the organ to its j)roper position, and keep it there. In its natural and healthy state, it is a very small organ, not weighing, in most instances, more than from one ounce and a half to three ounces. ABDOMINAL SUPPORTERS. 145 and can never, by its own weight, overcome the re- sistence of parts which nature designed should hold it in position. The so-called supporters, Avhich are mere lacing belts, without steel springs and proper pads are absolutely and positively worse than use- less, as many ladies daily testify who have tried them. The same remarks are applicable to many which are constructed with sj^rings and pads. The springs of which, instead of rising over the hips as they should do, to answer the indications, pass round the hi^^s, and merely press the contents of the abdomen back upon the spine, whereas they should be lifted upward and inward ; the displacement being always downward and outward. It is quite a difficult task to make a good drawing of an abdo- minal supporter, and still more difficult to obtain from a drawing a satisfactory knowledge of the instrument. The accoirjDanying cut is quite faulty. To see the instrument itself, is the only reliable mode of judging of its advantages. 146 PILES. PILES. Syn. — HcemorrJioids. — Fici Condylomata. Piles are tumors, usually of a violent color, whicK form within and without the sphincter ani, but most- ly on the mucous and cellular coat of the rectum within the sphincter ; they are also sometimes found in and around the genital organs of Avomen. These tumors are usually of a spongy nature ; but they are sometimes dry, hard or fleshy, vascular or erec- tile, and when compressed by the sphincter ani, they are exquisitely sensible. They are produced by the dilitation or stretching of the hsemorrhoidal veins ; also, by the formation of cysts from the cellular coat of the rectum. Piles may be arranged under the distinctive appellations of hlind.^ hleeding^ mucous^ and excrescential. They are hlind when they are altogether internal, and consist of nothing more than varicose — enlarged — veins, with slight thickening of the internal membra^ne of the intestine. JBleeding^ when, from excoriation caused by constriction, stric- ture, or some incidental violence, they are attended by hsemorrhage. Mucous^ when the mucous follicles of the rectum are abraded, scraped or galled, and pour out mucus. Excrescential^ when they form fleshy excrescenses, either internal or external to the sphincter. Causes. — The sedentary are most subject to j)iles; and constijpation of the howels., is by far the most PILES. 147 prominent and frequent cause. Tlie other causes are, pregnancy, straining at stool, severe exercise on horseback, plethora of the blood vessels, congestion or torpidity of the liver, the suppression of habitual discharges, and hereditary predisposition ; frequent use of aloetic purges, suppositories, and injections ; 1 ong continuance in the erect posture, passage of hard or acrid fcecal mat':er, venereal excesses, and inflammations. Symptoms. — Difficult and painftd defecation, an insupportable stinging or burning pain, and distress- ing sensation about the anus after the stool, uneasi- ness and pains in the back and loins, inability to stand, sit, or exercise ; ill health, costiveness, de- pression of spirits, &c., &c. Treatment. — Surgeons usually assert, that all medication in piles is merely palliative ; and that the Itnife and the ligature are the ^?2Z?/ radical means of cure. This is not my belief, nor is it my exj^eri- ence. I am as certain, as I am of any fact of which my mind takes cognizance, that the piles are easily, readily and radically cured by scientific medication, and proper regimen. In causes of bleeding piles of long standing, in patients who are predisposed to consumption, pulmonary hsemorrhage, apoplexy, &c., it would not be proper, nor safe to institute at once a radical treatment ; because, the system, having accustomed itself to the discharge, and the increased elaboration of blood to supply the waste, would be- come over-charged, and the result would probably be unfavorable. The means at our command for the cure of piles, are, removal of the causes, rest in the horizontal po- sition, spare diet, the internal administration of the balsam copaibEe, issues, leeches, poultices, astringent injections, and injections of cold water; mild laxa- tives, general blood-letting, the use of the anguen- 14:8 PILES. turn gallge compositum, also the extracts of strarao- nium and belladonna; opium ointments, external sponging with cold water, alterative pills, bougies, astringents given by the month, and the avoidance of all highly seasoned food, liquors and coffee. In all cases of rigid constriction of the sphincter ani, I find that the employment of fine, smooth bougies, of different sizes, is indispensable to a radical cure. The disease is very common, and is probably productive of more real suffering and inconvenience, than attends any malady incident to patients who keep about, and are not considered sick. Many young people and women, from shame and motives of delicacy, suffer for months and years, a secret agony, which can only be realized by themselves. This is wholly unnecessary ; they should, at the very com- mencement of this disease, place confidence in a physician, possessed of a high tone of character, and the requisite skill to relieve them, and freely confide to him their afflictions. If the disease is permitted to become chronic, and is still neglected, or only treated by the common palliatives, it is like- ly to assume a severe form at any moment ; and finally to become so grave, as to require a surgical operation of the severest character, and which most people, and especially young and delicate fe- males, shrink from with indescribable fear, shame and horror 1 EUPTUEE. 149 RUPTUEE. Syn. — Hernia, Common hernia consists of a protrusion of some part of an intestine, or of some of the other abdomi- nal viscera, covered by a portion of the lining mem- brane of the abdominal cavity, called the peritoneum, through the natural apertures, or ajDertures formed by violence, in the muscular or tendinous walls of the abdomen, forming a kind of sack. The hernial tumors most frequently make their appearance iu the groin ; but they also occur at the naval, on the upper part of the thigh, on almost any part of the anterior portion of the abdomen ; at the labia pu- dendi, in the scrotum, &c., &c. There are many kinds of hernia, which are designated by appella- tions indicative of the contents of the hernial sack, and of the location of the tumor ; these distinctions are instituted for the convenience of the profession, and are not pertinent to the author's present pur- pose. It has been estimated that as many as one-eighth of the individuals composing the human family, have a rupture ; but it is my impression that the es- timate comprises far too large a proportion. Causes. — The predisposing causes are, an heredi- tary conformation, and an unnatural laxity of the tissues about the abdominal rings, &c. The direct 150 RUPTURE. causes are, violent muscular exertions of any kind, as jumping, running, lifting, playing upon wind in- struments, crying, parturition, retching while vomit- ing, sudden contractions of the muscles while falling, or endeavouring to save one'self from falling, severe exercise on horseback, and long continuance in the upright position, &c., &c. Treatment. — Reducible hernia is now universally treated by the adjustment of a truss ; these instru- ments vary in their construction, with the inventive genius of many physicians, and a host of surgical- instrument makers. A physician is the only suitable person to apply them, as he best understands the anatomy of the parts, and the indications which present in different cases. A good truss, properly fitted at an early period, will cu7''e the rupture ; but, as they are usually worn, they but serve to relieve and save the patient from violent symptoms, by keeping the tumor partially reduced. On the first accession of hernia, the patient should wear a truss that will cause a slight inflammation about the ring or hernial orifice ; whereby coagulable lymph is thrown out, and the ruptured tissues thereby agglu- tinated. I do not find much difficulty in radically curing ruptures with the trusses with which I furnish my patients ; they are constructed with steel springs, which are galvanized to prevent their rusting, and furnished with pads, which are moveable, and sus- ceptible of being perfectly adapted to the require- ments of different cases. They are covered with leather, are light, elastic, comfortable ; and do not at all interfere v/ith the clothing, or impede walking or any other exercise. Strangulated hernia is exceedingly dangerous, and if not reduced within a few days, necessarily causes death. The proper and most effectual means of' procuring a reduction are, a surgical operation, EUPTURE. 151 by whicli the aperture is enlarged so as to permit the return of the sack; tobacco injections, which produce relaxation of the abdominal belts and parts about the ring or aperture, and by taxis ; by which is understood, the manipulations of the physician in endeavoring to return the protruding viscus. Infants are frequently ruptured at the naval ; they are easily and readily cured by the adjustment of a suitable umbilical truss. CARD TO IKVALIDS. In all cases of disease of the lungs, heart and throat, it is imperative that the patient should have his chest, &c., examined by a physician skilled in auscultation and j)ercussion ; but as such opportu- nities are not always within the reach of the patient, the author suggests that any who are thus situated, should write him as clear and perfect an account as possible of their indisposition, stating also, their ages, occupations, habits, &c., <&c,, upon the receipt of which, he will study their cases carefully, and write back his opinion, free of charge. A prompt answer will be returned. To insure attention, all letters must, of course, be post-paid. Answers to the following questions, together with the invalid's own account (or his or her friend's ac- count) of the case will greatly assist in making out clearly what the disease is, which must be the first step toward successful treatment. First, please to give name, residence, age and occupation. State wiiere born and reared ; whether married or single ; strong or delicate constitution ; lean or fieshy ; erect or stoop -shouldered ; color of hair and eyes, and what complexion. CAP.D TO INVALIDS. 153 Questions. — How long have yon been ill? are you in indigent or easy circumstances ? are you from a consumptive family ? what relations have you lost by consumption ? have you any skin disease ? do you cough ? do you expectorate or spit up ? if so, what is the appearance of the expectoration ? have you ever coughed up blood ? do you sweat at night ? have you diarrhea? are you costive? have you piles? have you pain in the chest, side or in any part ? are you emaciated ? have you sore throat ? short breath or difficulty of breathing ? are you hoarse ? is your voice weak ? is your uvula — palate — elongated ? are you nervous ? are your feet habitually cold ? have you any fever? have you had any chills? is your appetite good ? does your food agree with you ? have you falling of the bowels ? have you a w^eak, hollow feeling in the breast or stomach ? have you a feeling of weight in the chest ? have you any uri- nary disease ? If a lady ; are you married ? how many children have you had ? what is the age of the youngest ? how many miscarriages have you had ? have you always had a good getting up after confine- ment? have you any female complaints, such as falling of the womb, whites, or dysmenorrhoea, &c. ? are you regular ? have you always nursed your children ? A prompt answer will be returned. CASES. The reader is presented with a few cases, wMch are reported to evidence the truth of the position which I have taken in regard to the curability of consumption in its first stage, and often in its second and third stages, and of throat diseases in every stage. I have selected the cases of a few people of the highest respectability, who, of course, are not willing to have their names published in full to the world as invalids. I have therefore used their ini- tials in most cases. I have had a dread of swelling this work with matter which might not command the attention of my readers, and have therefore made but few reports, and those as brief as is. prac- ticable. I am, however, permitted to refer the afflic- ted who call on me, to many of my patients, whom it has been my delight and good fortune to benefit. A CASE OF CONSUMPTION IN THE SECOND STAGE, WHICH YIELDED TO TREATMENT. Mr. S. D., of Chesnut Hill, Pa., aged forty-five, consulted me on the seventh of June, 1850. Mr. D. had lost two brothers by consumption, and had been ill himself for sixteen months. His disease com- CASES. 155 menced, as lie informed me, with a violent cold and pleurisy ; these were succeeded by a dull pain in the left side of his chest, violent cough, copious j^urulent expectoration, night sw^eats, extreme emaciation, nervousness and irritability of temper, debility and distressing lassitude. On examining his lungs, aus- cultation revealed sounds which plainly indicated tubercles in his right lung, in a state of softening. His left lung was also slightly affected. A peculiar- ity in his case was, that w^hile he had felt the most pain on the left side, his right lung was the most diseased. He informed me that he had taken of all the different lauded nostrums of the day ; none of which, of course, gave him the least relief, but in his opinion did him much injury. His pulse had been constantly at one hundred. I had no hope of curing him and offered him palliatim medicines ; these he at once rejected, and said that he wished to 'be^ and must le^ cured! When I find such determi- nation in a patient, however bad his case may be, I am immediately excited to attempt a cure ; I ac- cordingly put a shoulder-brace and supporter upon him, gave him an inhaling tube, and suitable medi- cines and directions. During the first few weeks, scarcely any change was discernable in his disease ; but, on the twenty-fourth of July, when he came to town for the sixth time to see me, there was an evi- dent mitigation in his symptoms ; he was encouraged and continued to use his remedies. During the month of August, he suffered from an attack of inflam- mation of the spleen, which required active and prompt treatment, but his consumptive symptoms continued to mend ; on the twenty-sixth of August, his cough had entirely left him ; his pulse was down to eighty, his expectoration was but slight, he had gained flesh, and was in high spirits. Sept. 4th. He called, vastly improved in health.^ 156 CASES. looks, and strength. He informed me that he was in his usual flesh, having gained twenty-five pounds, and had not the slightest cough. On again apply- ing my ear to his chest, I was astonished to find that his lungs gave everywhere the natural vesicular murmur, which is indicative of the perfect health of those organs. This gentleman's determination, con- fidence, and indefatigable perseverance in the use of his remedies, has, with the blessings of a kind Pro- vidence on the means prescribed, completely tri- umphed over an almost hopeless sickness. It is to be hoped, that his noble and triumphant example will encourage the desponding invalid. During the subsequent winter, I received a letter from him, in which he informed me, with the deep- est expressions of gratitude, that he was in excellent health. CASE OF CONSUMPTION. Miss p. Y., of Edgemont township, Delaware County, Pa., aged 25, came to the city to consult me respecting her health, on the 19th of June, 1850. Miss Y. had not been well since she left her boarding- school, more than six years before. She complained to me of debility, headache, palpitation of the heart, difiiculty in breathing, short breath, pain in the chest, constriction across the chest, a feeling of weight in the chest, violent cough and expectoration, fever, night sweats, and great emaciation. Her father, who accompanied her, told me, confidentially, that disappointment and grief, he thought, had been active agents in ruining her health. I found her lungs extensively diseased, her pulse 112 ; in fact, I looked U2:)on the case to be almost hopeless ; but she CASES. 157 seized upon the means of recovering lier health with so much hope and earnestness, and followed my di- rections with such joyful precision, that it almost seemed to me that her " faith made her whole." On the third of July she came in to see me, accompanied by a younger sister, also my patient. Every symp- tom was relieved ; her pulse down to 96. She came to town again, on the 12th of the same month. She was still improving ; pulse down to 86. She com- plained of other symptoms, which I prescribed for. July 2Tth. She called again very much improved ; pulse only YO — her natural pulse. She was every way better. She had no cough, no night sweats, no pain, no difficulty of breathing, very slight expecto- ration, no bad feelings about the chest, and appeared confident of attaining a speedy and perfect cure. August 'Tth. Her father called on me to-day for remedies for a younger daughter, and says that Miss P., the subject of this report, is in perfect health. I employed, in this case, my abdominal supporter, shoulder-brace, inhaling tube, and the medicines which are prepared under my own immediate super- vision. I am myself greatly astonished at her speedy restoration. The reader is presented with the following note from her parents, subsequently received. Edgemont toivnsJiip, Pa., August 20, 1850. Dk. Pottee, Dear Sir: As our daughter, Phoebe, has not been to town, for some weeks, to consult thee, we thought it best to write and inform thee of the rea- son. Sir, she is well! and needs no physician. From the moment that she commenced using thy remedies she began to mend, much to the astonishment and 158 CASES. joy of ourselves and of all our friends and acquaint- ances ; some of whom, Laving waited to see the re- sult in our daughter's case, are convinced that thee can cure consumption, and will, no doubt, soon con- sult thee. We intend to have Phoebe continue her remedies for some time, to avoid a relapse. With great confidence in thy superior skill in lung diseases, and many thanks for the interest which thee has manifested in our daughter's case, we remain thy friends, Reuben Yaenall. A CASE or INCIPIENT CONSUMPTION. On the 13th of ]N"ovember, 1849, I was consulted by Mrs. E. B., vocalist, of Philadelphia, aged 26. She was born in Ireland, and brought up in England. She is the mother of two children ; had lost her mo- ther and a brother by consumption. She had been four years ill, with a constant hacking cough, bloody expectoration, night sweats, hoarseness, an aching and exhausted feeling in the throat after speaking or singing ; diarrhea, and pain in the chest. I pre- scribed an abdominal supporter, inhaling tube, shoulder-brace, diarrhea pills, counter-irritant, lung syrup, &c., &c., and the result has been most satis- factory. 'Nov. 23d. She coughed less, and was free from fever. On examining her fauces and throat, I found them sympathetically affected, and applied nit. ar- gent, in solution. Dec. 2. She had just had a spell of raising blood. I advised the application of four cups to the back, to refrain from meats, all stimulating food, hot drinks, &c., and gave her a prescription. Dec. 5. The haemorrhage had ceased, her cough CASES. 159 grew less and less. I again cauterized the fauces and larynx freely. March 10th. She has had a sick child, the care of which has retarded her recovery. Her child subse- quently died. April 25th. She now began to improve rapidly, and to feel greatly encouraged. June 1st. She still improved, and began to regain her flesh ; she had no night sweats, and scarcely any cough. She went to Long Island for the benefit of change of air and scene. July 20th. She visited me, and reported herself almost well. She had no cough, no pain in her chest, and but a slight expectoration ; she had grown quite fleshy, and was perfectly confident of attaining a complete cm^e. September 10th. Her health is now perfectly re- established. She is in full flesh, quite as strong as she ever was in her life, and has the complexion of the lily and the rose. In short, she is a perfect pic- ture of health. A CASE or INCIPIENT CONSUMPTION, COMPLICATED WITH CHKONIC BEONCHITIS, AND LARYNGITIS. Miss C. E., of Philadelphia, a gifted and inter- esting young lady, and sister to Mr. R., whose case I have reported, commenced using remedies under my directions early in E'ovember, 1849. Her dis- ease, complicated as it was, proved very obstinate ; but the subjoined note will show her progress. Her disease had been pronounced incurable. Philadelpliia, December SOih, 1849. De. J. H. POTTEE, Z^ea/r Sir : I cannot refrain from expressing to you my gratitude, and that of my mother, brother and sisters, and friends, for your instrumentality — 160 CASES. under Providence — in the almost complete restora- tion of my health. It is now abont one year since I was taken ill. I had an almost constant cough, exj)ectoration, distressing dejection, constant hoarse- ness, emaciation, pain in my chest, night sweats, sore throat, and in fact every symptom of consump- tion. Before I called on you (at the solicitation of mother,) I had been from time to time under the care of several physicians, but received no benefit from their treatment. I had entirely given up all hopes of recovering my health, and thought only of death as the agent of my deliverance from sick- ness. About two months since I called at your of- fice, had my chest examined, and commenced u]3on your treatment ; I began to improve immediately and raj^idly. I am now nearly or quite well. I am in fine spirits, have scarcely any cough, am recoA^er- ing my flesh, and believe, that a new lease of my life has been accorded to me. Yery truly and respect- fully yours. C. E. On the 9th of November, 1850, I received a let- ter from her, in which she said : " Respecting my own health, I have no cause to complain, but much to be grateful for. I have been very well all this fall." Speaking of her younger brother whom I had treat- ed for a sudden and dangerous heermorrhage of the lungs, she said : " My brother seems now in good health ; I think this information will please you." And S23eaking of a lady and daughter who had been under my care, for throat disease, lepgthened uvula, &c., she said : " Mrs. Buchannan and her daughter, are both perfectly well, and send their respects to " you." CASES. 161 CASE OF ME. N. B. T., C)F CHARLESTON, SOUTH CAROLINA. On tlie 9tli of December, 184:9, this gentleman first consulted me. At that time he had every symp. torn of a rapid decline ; his mother died of consump- tion. He had a distressing cough, which almost en- tirely deprived him of rest at night ; a copious ex- pectoration of pus, mixed with mucus, excessive weakening night sweats, hoarseness, sore throat, a feeling ol tightness across the chest, cold, damp feet, emaciation, debility, and other symptoms of con- sumption, lie was under my care for several months, used my remedies with great precision, and improv- ed wonderfully and rapidly. On the Tth day of August, 1850, I received the following note from him, which I take the liberty of inserting. My Dear Sir : In answer to your note inquiring about my health, at this time, I am thankful to have it in my power to say, that I now consider myself completely restored ; I do not cough at all. I have no sore throat, no hoarseness, no expectoration, no night sweats ; I have recovered my flesh, and in a great measure my strength. In short, I am now quite well, and attend constantly to my business; though I continue to use your remedies — as they do me no harm — for the purpose of avoiding a return of my former distressing cough, night sweats, &c. 1 dread consumption more than all other diseases, and I therefore do all that you recommend to be done for its prevention ; which I am confident im- proves my general health, and adds to my strength. I believe that your practice is the only rational and effective one in cases of consumption, bronchitis, and throat diseases, and that you have saved me from a dreaded and lingering sickness, and from death. With gratitude, &c., your friend, ]^. B. T. To J. II Poller, M. Z>., New York. 162 CASES. A CASE OF CONSUMPTIOIT IN THE SECOND STA&E, PEOBA- BLY BEYOND THE KEACH OF REMEDIES. Mr. C. B., of Philadelpliia, carpenter, aged 26, consulted me on the fifth of December. He had been some weeks a patient in the Pennsylvania Hospital, under the care of Dr. Wood ; had also been some months nnder the care of Dr. Samnel Jackson, both gentlemen deservedly eminent in the profession. Auscultation and percussion revealed, extensive disease of his lungs. He had a constant cough, hoarseness, night sweats, pain in the chest, emaciation, hectic fever and extreme debility. He was under my care until the twelfth of February, during which time I tried every means in my power to break up his disease, but my efforts only availed as palliatives. I had advised a sea voyage as a last resort, and he sailed to-day, Feb. 12th, 1850, for Eu- rope. This unfortunate gentleman was constantly de- jected, his mind being filled with the most gloomy ai^prehensions, differing thus from most people who are in the advanced stages ; a circumstance which militated greatly against successful medication, and which induced me to recommend change of scene. CASE OF CIIBONIC LAETNGITIS, WHICH CAME UNDER MY CARE IN THE FALL OF 1849. This gentleman, Mr. J. F., complained to me that he had " bronchitis, or clergyman's sore throat." He presented the usual symptoms of chronic laryn- gitis ; hoarseness, almost complete loss of voice, cough, expectoration, &c. He procured remedies from me and went to the country to attend exclu- sively to his health. I applied a solution of the ni- CASES. 163 trate of silver to the internal surface of the epiglotis, to the glotis and larynx, on several occasions when he came to town for remedies. His recovery was perfect in three months. He has remained well up to this time, September 30th, 1 850. A CASE OF COMPLETE LOSS OF VOICE. Mr. Edward Kirby of Baltimore, Maryland, came on and consulted me in May, of the past year, on account of an affection of the larynx, which had resulted in complete loss of voice. He remained a few weeks in the city and used remedies under my directions, which completely cured his throat. His voice gradually returned to him. It was weak and husky at first, but ultimately became as strong and clear as it ever had been, and he returned home in perfect health. A CASE OF SPINAL DEBILITY, COMPLICATED WITH MANY ALAKMING SYMPTOMS. This lady had been given up to die, and was pro- nounced, by not less than three eminent physicians, to be in the last stages of the worst form of pulmo- nary consumption. On the 23d of October, 184:9, 1 was waited upon by Mrs. B., and requested to call and see her daugh- ter, Mrs. E. Y., a widow, nineteen years of age, of remarkable personal beauty, and the mother of one child, aged three years. She was married at fifteen. Her mother informed me that, since the birth of her child, a daughter, she had never been well ; that she 164 CASES. had been, for the preceding two years, constantly confined to her bed, not being able to turn or move her limbs without assistance. It was thought by all that she was in consumption, and that her right lung was completely consumed. I found the patient suf- fering from the following serious disorders. Debility of the spine, complete paralysis of the lower limbs, an alarming constipation — her bow^els not being moved oftener than once in from ten to fourteen days — cough and expectoration, falling of the womb, whites, dyspepsia, headache, inflamed eyes, &c., &c., a com]3lication that, for extent and severity, is rarely met with. Her lungs were sound, perfectly. Eeing requested to undertake the case, I commenced adapting remedies, wdth but a distant hope of suc- cess. j^ovember 15th. Her eyes were well, and her bowels more regular. IS^ovember 20tlj. She had improved in strength, had a better appetite, and was regaining her flesh. She was in fine spirits, and seemed confident of a speedy return to health. December 2d. At this time she sat up from two to three hours daily. She was a good patient ; she took her remedies regularly. December 11th. She had continued to improve. March 1st, 1850. Was rapidly recovering ; sat up all day. June 1st. She stood upon her feet, and walked the floor with assistance. July 20th. She is in fine health, and walks out daily. She can walk nearly across the city without much fatigue, considers her health perfectly esta- blished, and is training her hopes for a bright future. She has been under my care for about ten months. The change and recovery are astonishing, truly, and can only be realized by those who are acquainted with the case, and have watched its progress. OASES. 165 1^0 confidence, in a medical adviser, it seems to me, could exceed that with which this lady honored me daring the long months that she was under my care. At each visit, the distressed lady exclaimed^ in answer to my inquiries respecting her health, " Oh, I am much better. Doctor ! I know you will cure me ; I am sure of it, and I tell ma so a dozen times a day." And she did get well ! and is now in perfect health. September 29tli, 1851. How much merit should be attached, in this lady's case, to remedies, regimen, and attention, and how much to her wonderful buoyancy of spirits, lively hope, and confidence in my feeble powers, I leave to the reader to decide for himself. She tells her friends that these words are engraved upon her heart, " Cured by Dr. Potter." A CASE OF CAKCEE OF THE STOMACH, ILLFSTKATING THE UTILITY OF THE ABDOMINAL SUPPOETEE. Mr. H. consulted me in December, 1849, and complained of distressing symptoms about the re- gions of the stomach and chest, which had continued for a great length of time, in spite of all remedial efforts. After a strict examination, I made up my mind that his case was one of cancer of the stomach ; but, as neither himself, his wife, family physician, or friends susj^ected such to be the case, and knowing the disease to be fatal in spite of all science, I deter- mined, in his case, not to create any alarm by letting him know my diagnosis, but to try the effect of my abdominal supporter. I prescribed the instrument, which was immediately applied and adjusted by myself. I also prescribed some appropriate medi- cines. His improvement was so sudden and so j)er- manent, that I began to doubt my own opinion of 166 CASES. his case. Matters went on thus for eight months ; during which time he enjo_yed ahnost, as he said, uninterrupted health. In July, 1850, he left off his supporter for a short time, and all of his former bad symptoms returned. He sent for me, and I advised him to resume his supporter immediately; he in- formed me that he had done so. But it was too late ; violent symptoms supervened, his family physician was also called in ; at the solicitation of his friends, a consultation was held with eminent talent, but all to no purpose ; he sank in a few days. An examina- tion of his stomach being made, post mortem, cancer of the stomach was revealed, and decided to be the cause of death. It will be seen by the above, that through the agency of the supporter, this gentleman's life was, in all probability, prolonged for many months. Had he not, unadvisedly, left it off, under the impression that his disease was cured, perhaps the writing of this report had been postponed to a much later date. CASE OF LENGTHENED UVULA, OR PALATE. Mr. J. D. S. was advised to consult me by Dr. D. He complained of a distressing cough, which he informed me that he had suffered with for four years. I examined his lungs and found them sound. On questioning him further, I ascertained that he had no expectoration, no fever, no night sweats, no pain in the chest, no feeling of weight or constriction about the chest, no chills, no emaciation ; but was in absolute health, with the one exception of cough. I now suspected lengthened uvula ; and on examination, found that organ enlarged to the extent of one full inch, and hanging some distance down his throat ; CASES. 167 tliis occasioned the tickling and cougL ; the fauces and throat were somewhat irritated. I advised him to' have his uvula truncated, (cut off) ; he consented, and I immediately performed the operation, leaving him an uvula or palate of nearly the natural di- mensions. The operation has proved completely successful. As soon as I succeeded by proper re- medies in allaying the irritation about his fauces and throat, which had been kept up by the elongated uvula, his cough ceased entirely, and has not since returned. He suffered no inconvenience from the operation, nor was he sensible of the slightest change in his voice at the time, but it subsequently became clearer and stronger. Many eminent surgeons ad- vise, in cases of the above description, that the uvula be entirely cut off; I see no reason for not leaving enough to represent an organ of natural dimensions ; such has been my practice, and I have found that success has attended it ; and that a second operation has rarely been necessary, where suitable medication was subsequently employed. A CASE OF TUBEKCULAE CONSUMPTIOl^" IIS. THE THIRD STAGE. In March, 1850, I was waited upon by Mrs. W., from Woodbury, ifew Jersey, near Philadelphia. She came to consult with me respecting her husband, a merchant, whom she informed me had been alarm- ingly ill for several months ; and that she was under the impression that he was in consumj)tion, but that she was wholly uncertain as to the true nature of his disease, as his physicians had entirely disagreed in their opinion of his case ; adding, that they had ne- glected him, and that he had been for three months 168 CASES. at a time without any physician. After describing his case to me as fully as she could, she requested ray opinion of it. 'No physician is justified in giv- ing opinions without seeing the patient, except, of course, such opinion as he may be able to base on the representations made to him. I told Mrs. W. that her husband was undoubtedly very ill, and, so far as I was enabled to judge of his case from her repre- sentations, his disease was bronchitis. This did not satisfy her; she was determined to ascertain the exact state of the case, if it were practicable, and requested me to visit her husband in Woodbury, and institute a critical examination of his chest, &c., &c., and, if possible to tell her precisely how her hus- band was effected, and exactly what she was to ex- pect. I accordingly visited him. 1 found him to be about thirty-eight years of age, tall, broad shoul- dered and thin chested, and reduced to a mere skele- ton ; entirely imable to leave his room, and present- ing the appearance of a man who had been dead for some days. He coughed and raised constantly. The pathological sounds of his lungs were so audible that a common listener could not mistake them, even at some distance from his person. I made a hasty ex- amination of his lungs, and quitted the apartment as speedily as possible, knowing that death was upon him, and that his last struggle might take place at any moment; and, to say the truth, I feared he might die while I was in his room, or in the house, a circumstance which I did not wish should trans- pire. His devoted wife followed me to the parlor, and placed herself in the attitude of one expecting to hear an important ulthnatum. I asked her if she wished me to give her my true and candid opinion of Mr. W.'s case. She replied that she invited me CASES. 169 to Woodbury to make an examination of lier hus- band's case, not to keep the facts a secret, but for the purpose of being satisfied, and requested me to tell the precise facts as I found them, and mj opinion of his chance of recovery. I replied that Mr. W. was in the very last stages of pulmonary consumption ; that he could not possibly get well, but was likely to die at any moment ; and that I should not be astonished if she found him expiring on her return to his apartment. She thanked me for my candor, but wished still to cling to some hope. I assured her, that, in my opinion, there was none. She then requested me to try to cure him, and resolved on procuring my remedies. She did so ; she came to the city in three days, and was full of hope that her husband would be spared to her, as she thought that his health had greatly improved. In four days more he died. She subsequently ex- tolled my remedies, and regretted that she had not procured them before ; adding, that she believed, had she done so, her husband would have been cured. This case illustrates the necessity of employing counsel at the very commencement of a disease, who is known to be capacitated to tell what the disease is, and whose attention to, and interest in the subject, will enable him to institute that treatment which will be most likely to restore the patient to health. MISCELLANEOUS FORMULJE. MEDICATED BATHS, DIET FOK INVALIDS, ANTIDOTES, &C. Salt-"W"atek Bath. — Dissolve six pounds of rock-salt in twentj-five gallons of water. Aleaxine Bath. — Take five ounces of the sub- carbonate of potash, and stir it into thirt j-five gal- lons of water. Sea-Watee Bath. — Dissolve nine pounds of sea- salt, and four pounds of crystallized chloride of mag- nesia, in thirty-five gallons of water. Sulphur Bath. — Dissolve six ounces of the sul- phuret of potassa, in twelve ounces of muriatic acid ; mix the whole with thirty-five gallons of water. The temperatm-e of this bath should be 90° F. The Bareges Bath. — Take of carbonate of soda, chloride of sodium, and crystallized sulphuret of sodium, of each two ounces, dissolve in twelve ounces of pure water, and mix the solution, with thirty gallons of the same fluid. Iodine Bath. — Place two drachms of iodine, and four drachms of the iodide of potassium in a pint of water, and when dissolved, pour the solution into a bath containing fifty gallons of water. The tub for this bath must be of wood, and be covered FOEMULJ^:, &c. 171 while the patient is immersed, to prevent the fmnes from rising, and irritating the fauces and throat. The face and hands need not be immersed, as this bath will slightly color the skin ; the color, however, soon disappears. ISTiTRo-MijEiATic Acid Bath. — Take of muriatic acid, three ounces, nitric acid, two ounces, water, five ounces, mix ; three ounces of this dilute acid is to be added to each gallon of water in the bath. Place the feet in the bath for fifteen minutes, and in the mean time, sponge the rest of the person — with the exception of the face, neck and hands — frequent- ly. The bath-tub should be of wood. Mtjriatio Acid Bath. — Add from four to six ounces of the muriatic acid, to thirty-five gallons of water. Let the tub be of wood. NiTKic Acid Bath. — Add six ounces of nitric acid, to thirty-five gallons of water. Let the tub be of wood. "Waem Bath. — The temperature of the water should range from 90*^ to 100° F. Hot Bath. — The water should be as hot as the patient can bear with comfort ; from 100° to 150°F. The Ems Bath. — Dissolve twelve ounces (Troy) of the bi-carbonate of soda, two ounces of common salt, and two ounces of the sulphate of iron, in thirty-five gallons of pure water of the temperature of 85° F. This makes a bath similar to the Ems waters in Germany, which have the reputation of curing consumption. To MAKE Cakeigeen Jellt. — Take Carrigeen moss, 3 ounces,'^ water, 2 quarts, boil it down to half a pint, strain and add sugar, 4 ounces, flavor 1Y2 FORMULA, , patient vomits, or if mustard is more con- venient, give a teaspoonful instead of the 20 grains of ipecac ; as soon as the patient vomits, give him strong coffee, dash water into his face, and worry FORMULA, &C. 175 him in some way till the doctor comes. Do not let him remain quiet for a moment ; keep him walking, or, if he cannot walk, shake him or whip him con- stantly. Yegetable Poisons. — As nux vomica, tobacco, stramonium, atropa belladonna, colchicum, digitalis, cocculus indicus, North American. " Poe's writings are distinguished for vigoious and minute analysis, and the skiU with which he has employed the sti'ange fascination of mystery and terror. 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" The style is the farthest possible remove from pedantiy and dullness, every page teems with delightful matter, and the whole is thoroughly furnished with grace and beauty, as well as truth. One giving himself over to its fascinating charms, might read- ily beheve himself fast on to the borders, if not in the very midst of fairy land." — Roches- ter Daily Democrat. " We have in this work deep philosophy and an endless flow of humor, and lessons Bet before us, drawn from ants, beetles, and butterflies, which we might do well to pon- der. We can think of nothing more calculated to delight the passing hour than the beautiful delineations we find in these three volumes." — Christian Intelligencer. " The whole insect world is represented in these volumes, many of them disguised so as to present what politicians would call a compromise between a human and an insect We cordially commend these volumes to the attention of our readerB."— Boston Museum. "A book elegant enough for the centre table, witty enough for after dinner, and wise enough for the study and the school-room. One of the beautiful lessons of this work is the kindly view it takes of nature. Nothing is made in vain, not only, but nothing is made ugly or repulsive. A charm is throwrf around every object, and life suifused through all, suggestive of the Creator's goodness and wisdom." — N. Y. Evangelist. " WTiat a monument is here raised to that wonderful, tiny race, so often disregarded, but which nevertheless amply repays the care we may bestow in studying their pecu- liarities. The interest of the reader of these volumes is well sustained by the humor and sprightliness of the writer." — Zioji's Herald. " It is a beautiful specimen of book-making. The character of the contents may be already known to our readers from the long and very favorable attention they have re- ceived from the English reviewers. The illustrations are at once grotesque and signifi- cant." — Boston Post. " The book is one of especial beauty and utility, and we heartily thank the publisher for his enterprise in putting it within the reach of American readers. It is worthy of a place in every family hbrary. Elegantly illustrated and humorously yet chastely writ- ten, it is calculated to amuse aad instruct all classes of readers." — Com. Advertiser. NOTICES OF KPISODES OF INSECT LIFE. "A more charming book, fresh with tho fragrance of tho country air and musical with the rustle of insect wings, is not likely to be seen often. In the clearaese of its type, the beauty of the illustrations, and tiie whole manner of its presentment, the " Episodes" fairly gives the huiral to its tasteful and enterprising publisher." — Lit. World. " There is a moral, we may say a religious lesson, inculcated in every chapter of thia book." — Watchman and JRfJlcctor. " The style is easy, flowing, natural, and happy. The ideas arc such that the reader will arise from their perusal, a ' wiser and a better man.' " — Courant. "We defy any one to rise from its perusal, without thanking the book for many new ideas, added to one's previous stock of information, as well as feeling better and more kindly disposed, for the lessons of humanity and benevolence it teaches." — Bost. Courier. " A most attractive work to all ages, for while it is amusing and playful in its language, it is replete with valuable information. It might be called Science made pleasure, or Fact made fanciful. A finer specimen of typography is rarely seen, and we commend it to all those who would see in nature constant illustrations of the power and goodness of its great Creator."— Newark Daily Advertiser. " Wonderfully beautiful, graceful, and entertaining. Children can read it with un- derstanding, and be enraptured by it ; and this is no small thing to say of a work not especially intended for juveniles." — Ontario Repository. " By a happy combination of taste and knowledge — science and poetry, with anec- dote and description, the naturalist and the mere 'reader for amusement are equally gratified. It is a book for the library, — and just the thing as a companion for a journey, or the winter evening fireside. It is well adapted for "the sick-chamber too, and the weary invalid as he reads may fancy that he smells again the sweet fragrance of spring flowers, and listens to the hum of a bright summer's day ; and, not lea^t of all, the ten- dency of these beautiful volumes, is to elevate our conceptions of the grandeur and love cf the Almighty Creator." — Old Colony Memorial. "This is a work of rare and varied beauties. It is beautiful within and without; beautiful in conception and in execution ; beautiful as it comes from the hands of the author, the engraver, the printer and the binder." — Albany Argus. "This is one of the most tasteful books of the season, very entertaining and amusing, and at the same time the work ot an accomplished naturalist." — Christian Register. " The author has availed himself not only of the greater abundance of material which the summer months supply, but also of the brighter hues atforded by the summer sun- shine, for the enrichment of his glowing descriptions, which become gorgeous while i-eflecting a parti-colored glory that eclipses the splendor of Solomon." — Journ. of Com, No work published during the year, has received so extensive and favorable notices from the British Quarterlies and Newspapers as the Episodes of Insect Life, A few are here given as specimens of the whole. " The whole pile of Natural History — fable, poetry, theory, and fact — is stuck over with quaint apothegms and shrewd maxims deduced, for the benefit of man, from the contemplation of such tiny monitors as gnats and moths. Altogether, the book is curi- ous and interesting, quaint and clever, genial and well-informed." — Morning Chronicle, "We have seldom been in company with so entertaining a guide to the Insect World." — AthencEum. " Rich veins of humor in a groundwork of solid, yet entertaining information. Al- though lightness and amusement can find subject-matter in every page, the under cur- rent of the " Episodes" is substance and accurate infoi"mation." — Ladies' Newspaper. " A history of many of the more remarkable tribes and species, with a graphic and imaginative coloring, often equally original and happy, and accompanied both by accu- rate figures of species, and ingenious fanciful vignettes." — Annual Address of the Presi- dent of the Entomological Society. "This second series of "Episodes" is even more delightful than its predecessor. Never have entomological lessons been given in a happier strain. Young and old, wise and simple, grave and gay, can not turn over its pages without deriving pleasure and information." — Sun. "The headpiece illustrations of each chapter are beautiful plates of the insects under description in all their stages, capitally grouped, and with a scenic background full of playful fancy ; while the tailpieces form a series of quaint vignettes, some of which are especially clever." — Atlas. "The book includes solid instruction as well as genial and captivating mirth. The icientific knowledge of tho writer is thoroughly rcMible.— Examiner. MEN AND WOMEN OF THE EIGHTEENTH CENTURY. By ARSENE HOUSSAYE. With Beautifully-Engraved Portraits of Louis XV. and Made, de Pompadour. In Two Volumes, l2mo., Cloth — Price $2.50. DUFRESXY. FONTENELLE MARIVAUX. PIRON. CO NTE NTS. LOUIS XV. GREUZE. BOUCHER. THE VAXLOOS. THE ABBE PREVOST. LANTARA. GENTIL-BERNARD. WATTEAU. FLORIAN. LA MOTTE. BOUFFLERS. DEHLE. DIDEROT. ABBE TRUBLET. GRETRY. BUFFON. CARDINAL DE BERNIS. CREBILLON THE GAY. MARIE ANTOINETTE. MADE DE POMPADOUR. VADE. MLLE CAMARGO. MLLE CLAIRON. MAD. DE LAPOPELINIERE SOPHIE A.RNOULD. CREBILLON THE TRAGIC. MLLE GUIMARD. RIVEROL. DORAT. THREE PAGES IN THE LIFE OF DANCOURT. A PROMENADE IN THE PALAIS-ROYAL. LE CHEVALIER DE LA CLOS. "A series of pleasantly desultory papers — neither history, biography* criticism, nor romance, but compounded of all four: always lively and graceful, and often sparkling with esprit, that subtle essence which may be so much better illustrated than defined. M. Houssaye's aim in these sketch- es — for evidently he had an aim beyond the one he alleges of pastime for his leisure hours — seems to have been to discourse of persons rather cele- brated than known, whose names and works are familiar to all, but with whose characters and histories few are much acquainted. To the mass of readers, his book will have the charm of freshness ; the student and the man of letters, who have already drunk at the springs whence M. Houssaye has derived his inspiration and materials, will pardon any lack of novelty for the sake of the spirit and originality of the treatment." — Blackwood. IS PRESS, PHILOSOPHERS AND ACTRESSES. BY THE SAME AUTHOR. C DUE DATE i V ! i Printed in USA 3// \Ssz ^P^c C // Crista n. n "■im^j^