Consumption: (phthisis) its nature and treatment

Introduction

A quarter of a century since, the writer of this work prepared a Treatise on Pulmonary Consumption, but the result was so unsatisfactory (he was then an old systemist) that he put the work aside.

Ill health, in 1857, arising from overwork and the anxieties connected with the treatment of disease, necessitated rest.

The writer went to Yarmouth, returning to town for three days in each week to attend to urgent cases of disease.

Any one who knows the character of railway travelling from Yarmouth at times when the Express train cannot be used, will recognise the almost insupportable tediousness of the journey. The irritation caused by this tedium determined the writer to occupy himself during the journey. To read continuously while travelling on railways is bad both for the eyes and the head, and to talk was, in. the state the writer then was, too exciting. What then was to be done ? To think one is obliged, at least while awake, and therefore why not think out a book. This he realized in the journeys to and from Yarmouth.

The plan adopted was to take the works which were needed for reference, selecting large typed editions, and to mark thereon the points of interest ; and then, when the train stopped, as most frequently it did, to write down any thoughts, and to record the iy INTRODUCTION.

pages containing references illustrative of these thoughts. In this way the skeleton of the work now before the reader was completed. During the winter and the spring the author added to the work and wrote it out.

In the autumn of 1858, overwork again necessitated repose, and the writer went to the seaside. He adopted the same plan, and revised the whole work while journeying.

To remove every obscurity from and to abbreviate as much as possible the woi-k, the writer transcribed it a third time, employing as far as he could the phraseology not of technical science but of society.

He has subsequently had it copied by another, knowing that the most effective mode to discover mistakes and inefficient and inexact writing is to read one's work dressed in another's handwriting.

A physician's holiday may be regarded as not a very fit time to bring forth a book ; but this is certain, that had not the book been written under the circumstances stated, it could not have been written under the interruptions connected with professional duties, which occupy the writer from eight in the morning to seven and sometimes later in the evening. As to the value of the book itself, thus given birth to, the reader is the party to judge. The Index of the work and the Preface will give some idea how far the work has claims on the public attention.

89 Great Russell Street, Nov. 21, 1859.

Preface

a. One fundamental idea pervading this work is, Fundamental that Phthisis, more especially that connected with work, the

pt n iiT77 existence of

the presence of diseased parts, called tubercles, in the » cachexia. lung tissue, can be developed only when there exists in the individual a special unhealthy habit, a cachexia (%<x%og, kakos, bad ; and sfys, eksis, habit).

And this fundamental idea is in this work developed Fundamental

1 idea, to what

to the extent of demonstrating, that the phthisical ^j nt devel " cachexia is not single, but is multiform, and that each cachexia has distinctive characters, and that these distinctive cachexias must be recognised and medicinally met, in order that Phthisis, thereupon resulting and therewith connected, may be treated scientifically.

b. A second fundamental idea, one indeed which Second

fundamental

grows out of the first, is, that in order to effect a cure idea ' £** for

o ' ] cure, the spe-

of the cough, the expectoration, the hectic fever, the ^^e e ^f night - sweats, the emaciation, the rapid pulse, the ^f t nised and hurried breathing, and other symptoms, so generally present in Phthisis, the special cachexia in connexion with which all these symptoms develop themselves, must be recognised in all their particulars ; and, further, that any attempt to remove these symptoms,

A

VI PREFACE.

except by curing the cachexias, will be as inefficient as is the procedure of the mere surgeon, who presumes that, in removing the fluid in a dropsy, he cures the disease on which the dropsical effusion depends, fundamental c - ^ ^ Ir ^ fundamental idea is, that it is only by b ea t'h t e h know- :r tne knowledge of the effects of medicines on healthy '^effects individuals,* that the medicine corresponding to each curTctn'be 8 cachexia, with which the phthisical condition is associated, can be discovered, and the cachexia cured ; cure how the cure resulting in the obedience to and in the

resulting in # # m

theappiication effective carrying out of the homoeopathic law, —

of the law, JO r

Similia simili- LlKES ARE CURED BY LlKES,

bus curantur. '

Similia similibus curantur; the whole of these circumstances requiring that, for the cure of each case of Phthisis, a medicine should be given which has itself, as its pathogenesis, the power of producing an aggregate of medicinal effects similar to the symptoms of and to the states connected with each phthisical cachexia. Homceopathy,f therefore, as presenting both

* These effects are designated by Hahnemann as the pure effects, because obtained by experiments on persons, unmodified by disease ; effects designated also as pathogenetic (•m0os, pathos, suffering, and yivtTiKos, genetikos, begotten), because the knowledge of these was obtained by the sufferings, which were caused or produced in Hahnemann and his disciples, during a series of years, in experiments on themselves with medicines, in order to learn their effects. And yet this noble man and his followers, who pained themselves for the world's benefit, are designated by a vulgar herd of medical journalists and medical men as fraudulent.

f Persons find fault with the terms used by homceopathists. With ignorance and conceit (the two states attend each other), they sneeringly describe the term " homoeopathy" as new fangled, whereas it is so old as to have a place in the original Bible, where it occurs twice: in Acts, chapter xiv., verse 15, ofcoiairxfas, homoiopathes, translated "we are men of like passions : " also, in James, chapter v., verse 17, "a man subject to tike passions," cftaurxfa; , homoiopathes. Perhaps, when known as thus occurring, the word will no longer be sneered at ; or at least, if it be, the ignorance and the conceit of the sneerers will be manifested less obtrusively.

PREFACE.

the necessary knowledge of medicines and the law regulating the application of that knowledge, affords the only scientific basis on which the curative, scientific i. e. the therapeutic (diguTeia,, therapeia, cure) application of medicines for the cure of Phthisis can be built.

d. A fourth fundamental idea which obtains a Fourth manifestation in these pages is, that previous to the idea, the development of a case of Phthisis, a debility of the a debility of lung tissue must, in addition to the cachexia, be in- tissue. duced by some injurious agency. It is true that the

very cachexia, itself a debility, may be a source of debility ; but there are conditions of debility inde- conditions pendent thereof, these being induced by other causes, ° e ' lty ' which ultimately affect both the tubercular formation itself and the parts in the lung tissue adjacent to the tubercular formation.

e. No claim to genius is made in putting forth these views : —

" Genius, in any inquiry into nature, must act a Duty of subordinate part ; its duty is to arrange, not to fabri- ee " cate ; but the dogma is held and acted upon, that, if a man is capable of communicating anything in connexion with a subject, the capacity constitutes his right to communicate." — (Tyrrell)

f. It may be, that he may exhibit his capacity in

a way different from that which many will recognise, Mode of but this will not render less either the capacity or the 2 capadtf. right to communicate; since, though it is true regarding the multitude, " we think according to nature, speak according to precept, and act according to custom " (Tyrrell) ; yet a mode of thinking different from via

PREFACE.

Further justification of the views advanced in the great mortality of Phthisis.

Young physicians think thpy can cure Consumption.

Work of Dr. Sanders.

the prevalent mode may be true, and, being true, will be, yea must be, useful.

g. A further justification of this putting forth the views embodied in this work is found in the fact, that Phthisis still causes one-fourth of the mortality of Great Britain ; and consequently an attempt, if made on rational grounds, to cure the disease, and thereby to diminish this mortality, must be a duty.

h. In the face of this great mortality from Phthisis, may not the question be put, and put rightly, " Is not the test of twenty-three centuries of barren investigation, of mere medical romance, with scarcely a ray of light to guide our steps, sufficient ground for further inquiry ?" — (Tyrrell.) Or, "Are we to sit down in despair, bowing to the dogma so frequently proclaimed, Consumption is incurable ? "

i. It is allowed that almost all young physicians think that they can cure consumption. Thirty-one years since, at a time when the writer commenced his active professional career, he thought this. Well does he remember how strongly the conviction gained hold of his mind, when his friend, Captain Cargill of Edinburgh (now Superintendent of the Assembly at Otago, New Zealand, and who has been for some years a stanch homoeopathist — what changes a few years can make!) — brought before his notice "A Treatise on Pulmonary Consumption, in which a new View of the Principles of its Treatment is supported by Original Observations in every Period of the Disease, by James Sanders, M.D., 1808." How diligently and hopefully, in obedience to this conviction, did the writer proceed, employing inhalation, and more especially inhalation

PREFACE. IX

of the vapour of an infusion of digitalis, and using milk simply, and milk in which kidney suet (a dietetic means recommended by Hippocrates De Internis Affectionibus) had, in conformity with ancient usage (a kind of imperfect adumbration of the cod liver oil practice), been boiled, &c.

j. Phthisis, however, was too strong. The writer realized in regard to the effective treatment of Phthisis, what Melancthon found in regard to the cure of man's Meiancthon'»

remarks.

moral diseases, that " Old Adam was too strong for young Melancthon."*

h. Some cases of Phthisis the writer cured bv anti- Phthisis

* cured by

monium tartaricum ; but these, it is likely, were cases antimoninm

' ' J ' tartaricum.

of pulmonary catarrh, and not of tubercular Phthisis ; the medicine named being, when prepared according to the homoeopathic formula, and given, when thus prepared, in infinitesimal quantities, useful in some forms of this disease.

I. What Bayle states as his experience, very nearly represents the experience of the writer in relation to The experi-

. • -, ■ • • i ence of Bayla

the treatment of Phthisis during the time he employed compared

m ° L J with that of

the old system means. Bayle, in his work, " Researches the author. on Pulmonary Phthisis" translated by Barrow (Liverpool, 1815), writes thus: —

* When Melancthon had recognised the Scripture truth, bo beautifully embodied by Cowper in the lines,

" Legible only by the light they give,

Stand the soul-quickening words, Believe and Live,"

he was so filled with gratitude and love to the Great Father of All, as to feel that all he had to do was to proclaim to his fellow -men these truths, and they would embrace them. He laboured hard in the diffusion of these truths, but with little result ; he expressed his experience in the acknowledgment to Luther, his co-worker, that " Old Adam was too strong for young Melancthon."

Extract from Bayle.

Important practical matter is presented.

X PREFACE.

" Whenever I have found the lungs perfectly sound in those whom I thought phthisical, but who had died of accidental disease, I found I had erred in the diagnosis, and that I had taken for species of Phthisis peculiar cases of other affections of the chest. I have the less difficulty in confessing this mistake, from having often cured phthisical cases in the first years of my practice, though I now sincerely acknowledge that I have not cured any since I have more perfectly discovered the nature of Phthisis. I have, however, sometimes palliated the symptoms, and even suspended the progress of the disease; and I have also cured many with severe cough and puriform expectoration who were clearly in a state of hectic fever and incipient wasting (marasmus)."

m. Whatever may be the result in regard to the cure of Phthisis in connexion with the views put forth in these pages, it is believed that therein much important practical matter is presented, — matter which will be of some service both to the profession and to the public, more especially to those of the public who are predisposed to phthisical affections : To the former, in making the way to the cure of Phthisis more clear ; to the latter, in showing how the phthisical tendency can be, if not removed, kept in abeyance.

n.

It may be useful to detail the incidents which led to the writing of this work.

During the Medical Session of 1856-7, the writer gave a course of sixty lectures on the Homoeopathic

PREFACE. XI

Materia Medica* One of the students who attended T A e wri ' e f

states what

these lectures was attacked with inflammation of the \f^ e lungs. When the inflammation was cured by homoeo- the work "

* The subjoined Syllabus is that of the lectures given : as the first course of lectures on Practical Homoeopathy delivered in Great Britain, the record has somewhat of a historical character.

Dr. Epps commenced a course of sixty lectures on the Homoeopathic Materia Medica, on Monday, Nov. 24, 1856. Medical men and students wishing to attend these lectures can obtain tickets of admission and particulars of S. R. Bardouleau, Esq., honorary secretary, No. 13, Rochester Road, Camden Road, London.

Syllabus. — Lectures 1 and 2 will embrace the pathogenesis of Aconite. The rationale of its curative action in relation to inflammatory fever and inflammations will be unfolded, and the special powers of this medicine explained and illustrated.

Lectures 3 and i will embrace the pathogenesis of Belladonna. The rationale of its curative action in relation to diseases of the cerebrum and of the skin, in connexion with enlargement of certain portions of the glandular system, will be considered, and the special powers of this medicine will be explained and illustrated. The points of analogy and of difference between aconite and belladonna will be worked out.

Lectures 5 and 6 will embrace the pathogenesis of Bryonia. The rationale of its curative action in connexion with diseases of the lungs and the pleura will be considered, and the special relationships and powers of this medicine will be explained and illustrated. The points of analogy and of difference between bryonia, aconite, and belladonna will be worked out.

Lectures 7, 8, and 9, will embrace the pathogenesis of Pulsatilla. In connexion with these lectures, the rationale of the curative action of pulsatilla in connexion with gastric and intestinal diseases, and also with the deviations presented in connexion with the monthly period, will be considered, and the special powers and relationships of this medicine will be explained and illustrated. Points of analogy and of difference between pulsatilla and the medicines previously considered will be brought forward.

Lectures 10 and 11 will embrace the pathogenesis of Nux. In connexion with this medicine, the rationale of its curative action in connexion with diseases of the gastric, intestinal, and rectal systems will be considered, and the special relationships and powers of this medicine will be worked out. The points of analogy and of difference between this medicine and pulsatilla will be brought forward and illustrated.

Lectures 12 and 13 will embrace the pathogenesis of Ltcopodium. The rationale of its curative action in relation to diseases of the urinary organs, in connexion with the gastric and intestinal system, will be considered, and the special relationships and powers of this medicine will be fully detailed. The analogies and points of difference between lycopodium, nux, and pulsatilla will be illustrated.

Xll PREFACE.

pathic means, the patient's progress towards health was delayed. On this account the development of

Lectures 14, 15, and 16, will embrace the pathogenesis of Sulphur. This valuable medicine, and the rationale of the extensive range of action of this medicine in connexion with jysora and its effects, will be considered.

Lectures 17, 18, 19, 20, 21, 22, 23, 24, 25, and 26, will embrace a group of medicines which have a relationship to the urinary and genital organs; this group consisting of Cantharis, Causticum, Cannabis, Clematis, Thuya, and Tr. Acris. The rationale of the general action of these medicines on these systems will be given, and the special relationships of each will be detailed and illustrated.

Lectures 27, 28, 29, 30, 31, 32, 33, and 34, will comprise a group of medicines which have a special action on the female genital si/stem ; a group consisting of Secale, Sabina, Crocus, and Apis. The special characteristics of each medicine will appear in the examination of the pathogenesis of each.

Lectures 35 and 36 will embrace the consideration of Sepia, and the relationships of this medicine to certain diseased conditions of the uterus and rectum, together with other relationships which an examination of its pathogenesis will present, will be considered and illustrated.

Lectures 37 and 38 will embrace the consideration of Spigelia and Dioitalis, and the relationships which the pathogenesis of these medicines establish as existing between certain diseases of the heart and these remedies.

Lectures 39, 40, 41, 42, 43, and 44, will embrace a group of medicines, between which and the bony tissues, and the investments of the bony tissues, a curative relationship is established by their pathogenesis. This group comprises Aurum, Acidum Nitricum, AssAFCETrDA, Mezereon, and Euta.

The action of homoeopathic medicines in connexion with the secondary forms of Syphilis will here be noticed, and the points of analogy and of difference of each medicine of the group will be worked out.

Lectures 45, 46, 47, 48, 49, and 50, will embrace a group of medicines which have a relationship to the diseased conditions associated with the development of abscesses and of ulcers. This group consists of Hepar Sulphuris, Silicea, and Kali Carboxicuh, and the peculiarities of each will be illustrated pathogenetically and clinically.

Lectures 51 and 52 will embrace the consideration of Calcarea, and the rationale of its action in connexion with the peculiar cachectic state of the body, which causes enlargements and tubercular formations and their development, will be explained. The points of analogy and of difference between it and kali earbonicum will be worked out.

Lectures 53, 54, 55, 56, 57, and 58, will embrace a group of medicines that have a curative relationship in connexion with the diseased states developable in mucous membranes and the glandular tissues, connected more particularly with the digestive system. This group will comprise Lachesis, Acidum I'HOsrHORicuM, Acidum Muriaticum, Arsenicum, Mercurius, Mercurius Corrosivus.

Lectures 59 and 60 will embrace some general remarks on Cocculus, Colocyithis, Dropera, and other medicines.

PREFACE. Xlll

Phthisis was inferred by the writer. To satisfy the minds of some influential members of the patient's family, the opinion of Dr. Elliotson was sought by them in reference to the correctness of the opinion held by the writer. Dr. Elliotson declared the case to be one Dr - Elliotson'.

opinion on

of marked Phthisis, and that nothing could be done, f,Jj^? f except to take cod liver oil, to go into the country, and to let the patient have what he liked, i. e. to go to his execution. The patient remained under the writer's care, and is now (January 1859) alive and comparatively well, although no cod liver oil has been administered, and none but homoeopathic medicines have been used, and these only in infinitesimal doses.

o. Disgusted by the indiscriminate, the empirical administration of cod liver oil (for not a week passes without the writer seeing some unfortunate, who, by the waste of time in taking this oil, has lost the best chances of cure, by passing the period when the Phthisis was most certainly curable), the writer was Writer's ob-

servation on

determined to try, if, by substituting for this cod liver cod liver oil. oil delusion a scientific treatment, he might be able to hasten the end of that which keeps itself alive only by advertisements in every daily, weekly, and monthly journal, this advertising developing a trade which causes, in one year, a quantity of oil to be presented to the public greater than all the cod fish taken from the ocean can supply. To the supporters of this empirical employment of the oil, the remarks of Dr. Remarks of

V l J , Dr. Sanders

Sanders in reference to the unscientific character oionthe

' treatment of

the treatment of Phthisis, practised in his day, apply : Phthisis.

" Here, in Phthisis, every one has some favourite remedy, which he prescribes without regard to age,

Xiv PREFACE.

sex, peculiarity of constitution, or period of the disease." — {Preface, p. vi., lib. cit.)

p. Having thus determined, the writer looked at his note books, and turned to the works in his library.

Tyrreii's a In the latter, he found a work entitled " Con-

work on ■* '

consumption. ST j M p TI0Nj ichy so fatal ? What are the Means by which it can be prevented in those predisposed to it, and its progress arrested in those attacked with it ? By John Tyrrell." *

This work was now (August 1857) read, and the writer's estimation of it will be seen by the numerous quotations therefrom in the following pages.

Dr. Bayie's r . Another work, to which reference is often made,

work on

Pulmonary j s the volume of Dr. Bayle, entitled " Researches on

Phthisis. J '

Pulmonary Phthisis."

This work demands attention, originating, as it did, in an experience gained by the history and the examination after death of 900 individuals who had died of Phthisis.

s. To Dr. Sanders's work, after a neglect by the writer extending to nearly thirty j'ears, attention was given, and many quotations in this work therefrom have been, the writer believes, beneficially made.

* On the titlepage of this book was written: " Paid for the book 4s., July 10, 1835." What a, sadness does this express ! This John Tyrrell was, no doubt, some man of talent, but impoverished, who sought bread by disposing of his book. The following letter has been received from Mr Renshaw, the publisher of the work, the writer having applied to him for any information he could afford of John Tyrrell.—" 356, Strand, July 14, 1858. Dear Sir,— I regret that I can recollect nothing about John Tyrrell beyond the fact, that he was introduced to me by Dr. Spillan, who had known him a long time. I am also pretty sure he told me Mr. Tyrrell was not in the medical profession, but was a veterinary surgeon. Yours faithfully, Heney Renshaw."

book noticed.

PREFACE. XV

t. The labours of Laennec and of Louis, in con- works of nexion with this disease, will be found recognised in tfSj the following pages. ■* of othe "-

u. Some reference will be made to the laborious work of Dr. Walshe, entitled " A Practical Treatise on the Lungs, Heart, and Aorta, including the Principles of Physical Diagnosis, 1854."

This work, full of the most varied and the most Dr - waishev. exact information in reference to the physical signs of these diseases, is, in regard to the cure of the diseases described, meagre, — a circumstance which, when viewed in connexion with the powerful cerebral organization and the untiring industry of Dr. Walshe, admits of explanation only by the fact, that, as yet, Dr. Walshe has not applied his mind to the investigation of the homoeopathic law and of the homoeopathic pathogenesy: a direction of mind much to be desired, for Dr. Walshe will, if studying them, be sure to become a convert : that is, if he has not foolishly committed himself against homoeopathy by any unwise expression of opinion ; which, if so, to preserve his consistency, he must uphold.*

w. It will be found that, in remarking on the works

* A work, entitled " On Consumption: its Nature, Symptoms, and Treatment, by E. P. Cotton, M.D., 2d Edition, 1858," came under the writer's notice after he had twice written this work. The work is creditable to Dr. Cotton : although containing little new, it presents many useful facts and some reasoning aboye the average. Some extracts have been embodied during the third transcript of the present volume, chiefly because the views put forth may be regarded as expressive of the opinions of a considerable number of the old system medical profession, Dr. Cotton's work having been originally presented to the world as an Essay, to which was awarded the Fothergillian Gold Medal by the Medical Society of London.

Reference will be made to a work on Consumption by Dr. Gardner, which presents some novel views.

XVI PREFACE.

of men of talent and research, referred to in the following pages, the writer exercises his liberty to detect errors ; he recognising the truth taught by Johnson : Truth " If there is any writer, whose genius can embellish

Dr. Johnson, impropriety, can make error venerable, his works are

the proper subjects of critical inquisition." The spirit x. The spirit in which such inquisition is to be

influence made is thus detailed by Sanders :

" I have occasionally used freedom with great and venerable names, but never with any intention to diminish their lustre : if, indeed, assisted and guided by the light they afford, I have sometimes discerned their imperfections, I would no more presume to blame them, than to blame the glorious sun, because, by his rays, I was enabled to discern the spots on his disk."— (Lib. cit.)

To gain for practical use this high state of mind, it is essential to have realized what is thus described by one who has afforded to the writer, and to multitudes beside, some of his and their highest intellectual enr>r. Brown's joyment. The writer refers to the work of Dr. Thomas of the Human Brown on the "Philosophy of the Human Mind.' 1 ''* In that work he thus writes :

" There is a philosophic spirit which is far more valuable than any limited acquirements of philosophy ; and the cultivation of which, therefore, is the most precious advantage that can be derived from the lessons and studies of many academic years, — a spirit which is quick to pursue whatever is within the reach of human intellect, but which is not less quick to

* To the honour of the phrenologists, it is to be stated, that they were the first who brought Dr. Thomas Brown's work into extensive circulation.

PREFACE. XV11

discern the bounds that limit every human inquiry, Quotation and which therefore, in seeking much, seeks only what man may learn : — which knows how to distinguish what is just in itself from what is merely accredited by illustrious names, adopting a truth which no one has sanctioned, and rejecting an error of which all approve, with the same calmness as if no judgment were opposed to its own ; but which, at the same time, alive, with congenial feeling, to every intellectual excellence, and candid to the weakness from which no excellence is wholly privileged, can dissent and confute without triumph, as it admires without envy; applauding gladly whatever is worthy of applause in a rival system, and venerating the very genius which it demonstrates to have erred."

v In conclusion : The quotations made by a writer concluding

J . matter.

from other writers generally express the writer's own experience. It might be more foodful to one's vanity to put down one's own experience in one's own words ; still there is a virtuous because a self-denying gratification in making use of the observations of Motives for others. It is a kind of fealty offered to the beneficial activity of the minds of those who have gone before ; a dutiful testimony to the fact, that one owes some of his mental wealth to labourers who have ceased to labour, — a corroborative recognition of the truth, that all accurate and honest observers agree on points which are recognisable, and which have been recognised, a grateful acknowledgment of the value of

recorded experience, and more especially of the arts of writing and printing, which enable us in this, the

XV111 PREFACE.

nineteenth century, to communicate with Hippocrates, with Galen, and with others :

" To sit and hold converse with the mighty dead, Sages of ancient times, as gods revered, As gods beneficent, that blessed mankind With arts and arms, and humanized the world."

Add to these motives, that derived from the fact, that views put forth, when sanctioned by both ancient and modern experience, are likely to take a deeper hold on the public mind ; and thus, when the views are true, the public will, when these views are thus recommended, more readily recognise them, and gain the benefit from their reception.

The plan of this work is the following : —