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bering to advise caution in respect to quantity. For is a larger quantity of the best adapted nutriment is talien in at once than cata be weli digested, the chyle, so far stom affording that bland and balmy fluid to the blood, that must qualiij it for the ossices os nutrition, commUni cates a marpnesse that deseats our expectation S.It matters very litile, both in this and many other diseases, what quality the food is os, is thequantity likewi se does not correspond to thepowers of digestion. Ι have not the least: doubi but this is likewise your opinion; and that youin rce it in your directions : but that this is thecase with practitioners in generat, may perhapanot be so certain. Under such a siluation as is above described, the methods potnted out seldona fati to abate thes ver and pain, lower the pulse, and ease respiration ; the dis charge then becomes thicher, and the cough, instead of being violent and conti nuat, jus t comes On When a quantity of Well-digested phlegm soliciis iis dis charge, and step by
mend the ulmost discretion in respect to their condust. A violent cold, a debauch, long con finement in populo as Cities, and other similarcauses, will soon bring bacti the sanae symptonas, whicli, is frequently repeated or neglected, bringon a more formidabie distemper, from whicli is the patient recOvers, he Will have much to attribute to the abili ty of his physician.
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In the further progress of this distemper, medicines of a different classi are found of advantage : the barii, elixi r of vitriol, Brisol and other Walers, a total abstinence frona animal food, and other methods of treat ing consumptive diseases, have their uses. Should you thinii these re- marks not ianworthy Os your notice, I mali en-deavour to collect sicli further rem artis as have occurred to me on this subjeci, and submit themto Four consideration. I am, &c.
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TREAT MENT of CONSUMPTIONS To the Medicat Society in London.
IN the last volume of your ObservationS, FOUwero pleased to admit me remariis ora theti se of resinous medicines, employed in the cureos pulmonary consumptions , and which seemed, in my opinion, to be rather injurious than usefui. I ta e the liberty to lay besore you some furtherrem artis on the treatinent of this dis ease; rather proposing to myself the prevention of harm, than contributing much to the cure of this verydangerous malady.
Medicat Observations and Inquiries, vol. v. p. 3 anno 177si These Esiays, though inserted in disserent volumes of the Medicat Observations and Inquiries, are here collected together ; the date of each Essay is annexed to the respective paper. Eduor.
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It was there pretiy strongly Urged, and can not weli be too osten repeated, that is this dis ease has continued illi the lungs are affected toa certain degree, ali hope of a cure is vatia ; adou bisul, and osten inori lived truce, is ali thalari Can promisse.
In this paper, I mean to subrisit to yotir donsideration, an d, is you do not dis approve them, to that of the Public, some reflections on themore capital medicines employed in the cure of this distemper the bark elixir of vitriol
repeated bleedings vesicatories; not omittingBristot water, and change of air and climate; exerci se; with sicli other observations relative tothis subjeci as have occurred to me.
than to propagate Wrong notions respecting the treaiment of diseases; as they may chance tolead the lese experienced to a precipi ce with his patient, Where one of them may lose his life and the other his repUtation. of late years the barii has been given se generally, and in cases so remote Dona those in whichit was first used as a specific, Ι mean intermittents of every species, that it is not to be wondered at, that it is osten confided ita, as a dernier resori, in the pulmonary hectic. The apparently regular paroxytas of an inter
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Trearment of Consumpti II. I Imittent, so conspicuous in certain stages of this disse ase regular cold fiis, succeeded by greapheat, followed by copious sweais a cessation Osevery Violent symptoto ensu ing, naturalty draWthe attention of the praetitioner to a remedy,
hicli, under like appearances, had amor led themost beneficiat relies The bark has been pushed, in this stage of the
distemper, in too many instances, With as much Vigour as is necessary to conquer the most ge-nUine autumnal intermittent tili both the pa- ient and prescriber Were weary of the processi
the patient Ioathing the remedy, and the pre striber finding it ineffectu al. But this is not the worst: the bark is so farsrom curing the hestic arising frona distemperediungs, that, according to the best of my observatioin, it not Only takes up that time, whicli might probably have been beller employed in the Use of other medicines, but, sor the most pari, it aggravates the disse ase beyonii remedy. I have seen the bark given in almost every state of the phthisis pulmonalis, even in the first commen ement, whilst the bi east was in patia,
the cough dry and harsh, the pulse qui cli and
hard, and the heat considerabie. What was the conseqUence frequently an haemopusis, and alliis worst attendanis ; Ulcereii lungs, purUlent
spitiing, colliquation, and de ath. Ι have seen it given in most of the subsequent stages, osten indeed With less appearance of injury, but at least without benefit. There
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There are two causes of consumptions, whichosten produce such a similarity of synaptoms tothe genuine phthssis, as somelimes to have led me to malle use of the bai k in apparent tenden-cies to a genuine pulmonary consumption, Withadvantage; and I thinii they may not impro- perly claim some attention frona practitioners. One of the causes is, the suci ling of childi enlonger than is conssistent with the mother's abi lily. This case occurs not soldom, among themiddling and lower classe of semales of natural lytender and delicate constitutions. Prompted by maternat son iness, or a Wim to discli arge a dutythey thinii they owe to their ostspring, and semetimes by narrom CircUmstances, they givethe breast to the child illi their own strennii is in patred : in such a state of wealiness, sonarsight colli brings on a Cough; this is increased gradu ally, tili it brings On the appearance, at len th the reality, of the genuine pulmonaryconsumption: here the bark given early, in mo derate doses, and merely as a tonic remedy, is osten os excellent Use. Many, Ι am satisfied, ithas retrieved frona deplorable situ attons; and under such circumstances a prUdent trial maysas ely be made. Another cause is, any weahening dis charge,
Phat the barit is, sor the most pari, Os use in these cases, When the ltangs not in flamed, is
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Trea ment of Consumptioni. 1 3
indubitable; and is they are so affected, and notbeyond a certain degree, it is also essicacious in preventing the progress of this malady. In phthisical complainis, succeeding such
siluations, a prudent trial of the baia seems nece stary. Smali doses of the decoction, giveneither atone, or joined With thesaline mixture, Orsuch other additions as the prescriber may thini Proper, may be given: but is the breatli be- comes more tight and opprefled, the cough dry, the pulse more quick and bard, and especialty is Light transitory pains or stitches about the Ihoraxare more frequently complained os, a persever- ance in the use of the bark will in creasse the disteasse: and is such should be the appearances, in the progress of consumptions, or arising from What cause s ever, is the bark is ac compani edwith such est edis, it will be prudent to desist si ona iis use. IC on the other hand, no pain, tighiness, oroppression, is Perceived, and a manis est abalement of the sympto nas appears, it Will be rightto proce ed. But the exhibiting of this meditacine requires a dispassionate observer; and who ever wisties to malle trial of it, ought neither togive it in the early inflammatory state of this distemper ; nor continue iis use in any subsequent part of iis progressi, is it produces the esse chs above mentione l. By iis tonic virtu es it Will Osten enable natureto conquer many dissiculties. I have siden it os use in promoting expectoration, Where stren th
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fixed ones, and increasses them With ait their consequences, I have been a Witnesse too osten, to admit of the least doubi, in a Variety of Cases. It would be trespasting too much On yOUr Pa tience, to descend more minutely into the his eand abuse of this medicine, or the mode os exhibiting it; suffice it to say, that sor the most paremuch harm or great good may be expected Domit, and consequently too Close an attention cannot weli be paid to iis operations by the pre scriber. THE elixi r of vitriol is osten exhibited in consumptive cases, and may claim a Consideration in this placu, and the more so as it seems tobe frequently used with not lesse impropriety thanthe bark.Ρerhaps a single faet has contributed to raisethe credit of this medicine in phthisical cases, inithout much regard to the state of the diseasse, to a very injurious extent. It is said that a per son took, by mistake, in a very advanced state ofa consumption, at one dose, half an ounce of the elixi r of vitriol, inste ad of twenty-five drops,
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Medicines, it is well known, that are highlyproper in one stage of a diseasse, are equalty de trimental in another. I have seen the elixir of Vitriol, in a competent dose, given in the inflammatory part of this distemper, While the pulse Was qui ch and hard, the breathing dissiculi, the Cough frequent, Willi much heat, and very littieeXpectoration ; the ellect Was, an increasse ofeVery symptom; a spitiing of blood, and ali iis
In the lalter stages of this dis asse, When a generat tenden cy to putrefaction talies place, it cools and checlis this tendency ; it restrains thecolli quative sweais, and, is the lungs are not injured passo repair, it is a very useful auxiliary. The composition, however, of this medicine, may, perhaps, be found sonaewhat exceptionablefor the pui posses intended; the minerat acidcombined with spices, may seem to be the least eligibie. It is true, that aromati cs are thoughtto possesse an antlseptic virtve; but where the putrescen Ce proceeds frona matter continuallymixed with the blood from brohen vesteis, eVerything irritating seems to be fori, id len. Perhapsthe diritus vitrioli, in the tincture of roles, or in any other proper Vehicle, may be the most: suit- able method os exhibiting the minerat acid insuch diseases. Probably, there are very seW medicines Whichilo not Undergo a considerable change in the L. II. L mach
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mach and ossices of digestion; so that ne ther the supposed contractile tonic powers of thebark, nor the antiseptic acid of the elixir, penetrates those recesses Whicli are intended by the prescriber to receive their essicacy. I suspectiliat much good or harm is done by these medicines in the present case, by affecting the irri table paris of the stomach and first passages; and by this means I apprehend the bark of tener contributes to produce the symptotos We have com- plained os, than by iis action on the lungs, theseat of the diseasse. Is we increasse sor a time theton ic force of the heari, and consequently the greater flow of blood through the lungs, we are increassing the malady for which we prescribe it, let the manner of effecting this be what it
The action os allum, When a litile of it is dissolved in the mouth, may perhaps lead to explain this matter. It soon occasions a Lind of thriti through the whole habit ; by whicli it may perhaps contribute to suppressi hemorrhages, tocure obstinate tertians, and produce other salutary ericis, by acting upon the solids only; and the minerat acid in the elixir may, in like man-ner, so affect the organs of taste, and the nerves of the first pasTages, as probably to operate aspowerfulty in suppressing immoderate evacuations, by this means, as by any Other We can