Practical letters on the nature, causes, and cure of catarrh, sore throat, bronchitis, asthma, and consumption, with cases

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Med

Preface

TO

THE FIFTH EDITION,

With a Statement of English Cases.

— * —

In the month of August 1864, the first impression of Dr. Hunter’s Letters was issued in England. Since that date four editions, of one thousand copies each, have appeared, and the last is now exhausted. His publishers require and urge the publication of a fifth edition, numerically larger. Such demand renders pertinent some enquiry as to the reason of so remarkable an instance of public favour.

Having been long familiar with these writings, and cognisant of their success in America, as well as the progress of their reception in this country, it is with much satisfaction that I venture to append my testi-

P KEF ACE TO THE FIFTII EDITION.

mony to tlieir merit, even at the risk of trenching on the domain of the reviewer.

In all the published criticisms of these letters which I have had the opportunity of seeing, even in such as were opposed to the views they enunciate, the simplicity of diction, the terse vigour of description, the close reasoning they display — in short, their intelligibility, have been the subject of just commendation and complimentary remark. There can be no doubt that this facile style of composition has proved a great source of attraction for the general reader, to whom technicality of language, how7ever elegantly expressed, is always a serious obstruction in the pursuit of knowledge. The graphic pictures drawn of the inception, symptoms, and progress of the several diseases treated of in these letters, powerfully arouse the interest and arrest the attention of the reader. We receive daily evidence of this truthfulness of portraiture in the language of applicants for advice — ‘ You have so clearly and exactly described my

symptoms and condition in Letter , that I can

say nothing more about my ailment.’ Who will say that this is hot a great boon to the invalid, thus spared much of the apprehension and difficulty which often attend the ordeal of a professional investigation ?

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Preface To The Fifth Edition

I am quite aware of, and not indifferent to, the objection sometimes raised against such popular expositions of disease, namely, that they are calculated to awaken the apprehensions of the nervous reader. But it seems to me that the fallacy of such objection cannot escape the discrimination of any intelligent person. A characteristic feature of the present century is the irresistible tendency to popularise ancient mysteries, to reject useless formalities, and to bring into play whatever is practical and useful ; to enable men to judge for themselves, not by appealing to their credulity , but to their reason and common sense. Every circumstance and action of life have been influenced and recast by the practical discoveries of modern science ; commerce and trade, travel, social intercourse, international communication, scientific research, popular education, have all been carried forward towards a larger and more complete development. Life is a pmdical matter, not a mere theory. Life is a personal matter, not a mere proxy. And

the man or woman who lives and learns not, lives to little purpose.

Health is unquestionably a matter of the first importance to every one. It is as practical and as personal as life. It may be called the art of living •

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PREFACE TO THE FIFTH EDITION.

or, we may dignify it further as the science of life. If life therefore is valuable — if its objects are desirable, if its preservation be a matter of serious solicitude, can there be more interesting topics to bring under public notice than the principles of health, and the nature and causes of its antagonistic condition, disease ? Whose province is it to do this ? Surely it is at once the prerogative and the duty of the physician. And how can he better sustain this honourable responsibility and discharge this contingent obligation, than by explaining in familiar language the nature, origin, causes, progress and phenomena of disease, and the means of preventing, alleviating, or subduing it ?

That this sentiment, long entertained by the mass of right thinking people, has at length begun to influence the professional mind, is forcibly illustrated by the following passages in an editorial comment of the ‘ Lancet,’ September 20 (pages 378-9): ‘Medicine has every reason to court the investigation of men of sense and education. They love to be appealed to in plain clear language. Mystery is magnificent only to the ignorant and uneducated. The man who studies to use it is by that fact under suspicion of incompetency or quackislmess.’ ‘ The best medical writers and the most distinguished practitioners are vi

PREFACE TO THE FIFTH EDITION.

remarkable for tbe clearness of their diction, and for the constant avoidance of latinised terms when they can be dispensed with. Many a man would cease to write nonsense if he would begin by writing plain English. This is useful for medical men writing for each other ; it is most desirable when they are writing or speaking ivords which are to be scanned by non-medical persons.''

We believe in the faith which is engendered, as well as the power which is gained by knowledge. We know from experience, that the public justly appreciates every effort made to impart to it information on subjects of which it has been heretofore kept in helpless ignorance ; and that while people profit by the lessons taught them in matters of vital importance to their health, they do not fail to recognise the advantage of trusting themselves, for direction and management, to those who are duly qualified to undertake so great a responsibility.

It is not only to the manner in which the subject is put before the reader, that the popularity of these letters can be attributed. Much is due also to the nature of the subject itself. To quote the writer’s words, ‘ Consumption is not only the most common and most fatal disease known to our race, but it is

PREFACE TO THE FIFTH EDITION.

also probably the one least understood ’ — by those especially for whose information these letters were written. Now, whatever opinions may be entertained, or expressed, on the particular views propounded by the author as to the causes of pulmonary consumption, no one can gainsay the accuracy of his statements as to the phenomena which precede the development of the disease and the signs which mark its progress. The importance of the subject is heightened also by the discussion of the possibility of curing this formidable malady. It is a lamentable commentary on the faithlessness exhibited by medical men in the resources of their art, to affirm that with the majority of them the conviction still obtains, that no choice is left to us but to adopt a palliative course of treatment. Almost every recent professional treatise on the subject contains the records of instances of spontaneous or natural cure of the disease. This information is obtained from a more careful interpretation of the evidence afforded by after-death examinations. Shall we then wilfully neglect the lessons taught us so palpably by Nature herself ? Nay, rather let us endeavour to understand these lessons aright. Let us seek to imitate the processes she adopts, to aid the efforts she makes, and turn to viii

Preface To Ti1e Fifth Edition

advantage, by the light she vouchsafes, the means placed at our command by the results of research and experience.

It is in this portion of his work that the writer of these letters, opens up a wide field of fruitful enquiry, and holds forth a reasonable and comforting hope of efficient aid to those who are the victims of pulmonary diseases. He proves by the testimony of those who are universally and justly regarded as the most illustrious authorities in the profession, how inefficacious the system of stomachic medication hitherto pursued has proved to be, in arresting the destructive progress of these diseases, and he points to this defective system as affording an explanation of the common belief of their incurability. He proposes another mode of admistering medicinal agents, by which, taking advantage of the natural act of respiration, these can be safely and effectively drawn into the lungs through the natural channels, by proper preparation, suitable apparatus and due precautions, and thus made to act directly upon the diseased organs, and through their agency on the blood itself, thus combining immediate local action with a general constitutional effect.

It would be as futile to say that such a proposition

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PBEFACE TO TIIE FIFTH EDITION.

has not encountered opposition, as it would have been unreasonable to expect that it should not be assailed. The arguments which, from time to time, have been put forward against it, have been successfully combated in other writings by Dr. Hunter, and all obstruction to the general employment of inhalation, as a systematised method of treatment, springing from this opposition is gradually being removed. As evidence of this assertion, I quote again from the * Lancet’ of September 23 (page 350). After referring to the investigation made by ‘the most renowned authorities,’ under the prestige of the Academie cle Mededne in Paris, c to ascertain by very minute experiments whether fine spray reaches the lungs or not,’ the article goes on to state, ‘ It is a well-known fact that these experiments answered the question affirmatively and indisputably. Very soon, indeed, in different countries, cases were published which had for a long time resisted treatment by internal remedies, but which had been speedily cured by means of inhalation. It cannot be denied that a new era in the treatment of diseases of the pharynx, larynx, trachea, and the lungs began with the invention of Sales-Greron. Since then the employment of the apparatus has become more general, and it is x

PREFACE TO THE FIFTH EDITION.

probable that it will ultimately be in the hands of every medical man, and of every patient labouring under a disease to which the treatment by inhalation is applicable.’

But there is a difficulty we encounter in this country now, as we formerly did in America, which springs from ignorance of the true character and method of employment of inhalation, among those who, being the subjects of pulmonary disease, would gladly avail themselves of this means of treatment, if fully informed on these points. At page 31, Letter V., the reader will find an explanation which will satisfy this want of information ; but there are one or two other points of misapprehension on the subject to which I will incidentally here refer. Some seem to suppose, that as practised by us, it is a mere adaptation of Bamadge’s inhaling tube for the exercise and expansion of the chest and lungs. With this instrument atmospheric air alone is employed, and considerable exertion is required to use it properly. Whereas we employ a variety of apparatus, adapted to the requirements of the several cases under treatment, requiring little or no effort beyond the ordinary act of breathing, and we mingle with the air medicinal substances, rendered respirable by phar-

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Preface To Tiie Fifth Edition

maceutic process, and presented in the gaseous form, as dry or moist vapours, and as spray. Thus exhibited, medicines are deprived of many of the disagreeable concomitants which attend their administration by the stomach. Not a few think that in order to avail themselves of this mode of treatment, they must do so at the sacrifice of an absence from home and its comforts, and a consequent increased pecuniary outlay. This is altogether unnecessary; the treatment of chronic disease of the pulmonary organs by this method, can be directed and carried on quite satisfactorily, without the constant supervision of the physician. Some of the most gratifying cases as to result have been thus treated by us entirely by correspondence, on statements of the history and condition of the patient given by themselves or their ordinary medical attendant.

It has been a fruitful source of experience to me, to have witnessed the result of over two thousand cases of various forms of pulmonary disease, treated by this method of medication. I may be permitted, therefore, without presumption, to say that I confidently regard it as the only effective means at present known to us. The large proportion of these cases were treated in America, and the records of xii

PREFACE TO THE FIFTH EDITION.

many of them already published in these letters are most interesting and conclusive. Exception has been taken to this, although the reason for it must be obvious ; time alone was required to remedy this defect, if such it can fairly be regarded. During the past year, however, our success has been such as to warrant me in appending a few cases taken from the results of our English practice. Several of our patients have voluntarily provided us with statements of their condition at the time they came under treatment. Our notes supply us with the record of others, and we have endeavoured to make such a selection as will illustrate the several forms of disease.

HENRY MELVILLE, M.D.

14 Upper Seymour Street, Portman Square,

London: November I860.

xm preface

TO

THE THIED EDITION.

JT entertained “y doubt of the reception these etters would have received from the English public

When we first presented them to their notice, it would have been removed by the unprecedented fact

at, at the end of six weeks, a Third Edition is demanded by our Publisher.

t grea‘ meri‘ COnSiSt8 “ *heir truthfulness and practical tendency, denuded of all

are, upon the plain principles of reason and common

In no other way can we account for the singular

fascination, they have nnirr n . , mversally created, even in the

md of the Medical Profession, from many „f whom

ents of their practical value. . *

Preface To The Third Edition

We only trust that the invaluable suggestions, so clearly enunciated by the Author, may lead, by their adoption, to a new era in the treatment of pulmonary disease, and that the night of gloomy despair which has so long brooded over their treatment may yet he dispelled by the cheering and life-giving rays of Hope.

J. J. MACGREGOR, M.D.

14 Upper Seymour Street, Portman Square, London: Oct. 24, 1864.

PREFACE

TO

THE PIES T EDITION.

— *

The almost hopeless apathy of the medical Profession, and the despair of the public mind, on the successful treatment of consumption must have aroused the attention of the most casual observer.

This fearful scourge, this insidious foe to the human race, speeds on its fatal course, slaying its tens of thousands annually, notwithstanding the elaborate investigations of the most astute pathologists all over the world.

In vain have such profound observers as Laennec, Andral, Louis, Bayle, Walshe, with a host of others, exhausted their microscopic researches after death, in tracing out the ravages which disease has caused in the delicate organization of the lungs, or trained their ears to discover the minutest aberration from healthy respiration during life.

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PBEFACE TO THE

However science may have profited by those investigations, the great aim of all their labours remains unattained.

The grand object of their pursuit seems as far off as ever, and they all unite in one confession, that they can recommend neither preventive nor cure for consumption.

Having always taken an especial interest in the investigation of pulmonary diseases, — and after an experience of many years, at home and abroad, as well as having read the written testimony of the greatest physicians on the subject, I had fully arrived at the same conclusion, when the writings of Dr. Robert Hunter, of New York, fell into my hands, and new hopes were raised within me by the perusal of his lucid and rational views upon the nature and treatment of this most fatal disease.

This gentleman’s labours I found had been long appreciated, and had procured for him a wideextended fame and an ample fortune in America.

It is, therefore, with real pleasure I am enabled to

FIRST EDITION.

V present his invaluable monograph upon diseases of t-he throat and pulmonary organs to the English public ; feeling convinced that when his enlightened and masterly views of the origin, nature, and, most important of all, treatment of diseases of the lungs (borne out as they are by the numerous cases and indubitable testimony of the press, as well as the medical Profession in America), become known to an unprejudiced and impartial public, the distinguished author will meet the reward he so richly deserves.

The numerous cases introduced by Dr. Hunter, as illustrative of his views and treatment of pulmonary disease, are especially valuable, inasmuch as they each bear a voluntary as well as grateful testimony to the benefit derived from the skill of the physician, and, in many instances, emanate from members either of the press or the medical profession.

JOHN JAMES MACGREGOR, M.D. M.R.C.S.E.

14 Upper Seymour Street, Portman Square, W.

London: August, 1864.

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ENGLISH CASES.

Case I.

This patient was thirty-two years of age, member of a consumptive family, and had for several years suffered from a distressing cough. He ascribes the origin of his illness to a severe cold, contracted by exposure. He was exa-

dtod L 7V Vi m 5> “d f°Und to be

ciated and feeble ; had constant harassing cough with a greenish-yellow expectoration, occasionally tinged with

of the chest, and inability to lie on that side, by which his s was much disturbed ; he had slight hectic daily with pious night-sweating ; his appetite was very bad and

exerti n'; there waf r110” °f s' V °" ‘he ■>«■«-

bronchitis in both lungs. We have “extensive

since^but received the following letter from hL a fewda^s

1 Beaumont Square, Mile End, E. : October 21, 1865.

i riXr“Tt

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ENGLISH CASES.

halation ’ in my particular case, and desire that publicity may be given to my attestation, in the hope that others may thereby be induced to seek so truly wonderful and efficacious a remedy. Two months since I was entirely incapacitated from attending my business, suffering the severest symptoms of consumption — sleepless nights, cold sweats, aching limbs, and hacking cough, with utter loss of appetite. I am now (thankful enough to say) returned to my duties, able to enjoy my food, and entirely a new man.

I am, my dear Sir,

Most respectfully yours,

G. T. Dixon.

Dr. Hunter.

Case II.

Edward Mounsey, Esq., of Uxbridge, 46 years of age, of tall spare frame and sanguine temperament. When about 14 years of age he was attacked by difficulty of breathing while in a hayfield, and for several years after this the disease presented all the characteristics of hay asthma. Gradually, however, the difficulty of breathing became permanent and more severe, and the paroxysmal attacks of spasmodic breathing more frequent and distressing, until these occurred almost daily. For some time before he came under our observation he had been unable to sleep continuously through the night in consequence of these paroxysms. He had also been subject to periodical attacks of acute bronchitis. As the result of this long-continued state of suffering, his general health began to give way, and on September 14, 1864, he consulted Dr. Hunter, and was immediately placed under active treatment by inhalations. At that time there was a constant sense of great oppression of the chest, with short and hurried breathing, a hacking cough

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ENGLISH CASES.

with expectoration of viscid mucus, occasional febrile attacks, loss of flesh and strength, inability to exert himself in the ordinary pursuits of life, frequent loss of sleep, and difficulty in retaining the recumbent position. To use his own words : 1 From the first day of my using the inhalations, my sleeplessness vanished, and has never since returned ; nor have I suffered from my accustomed bronchial attack.’ His improvement has been gradual but uniformly progressive ; he is at the present date (October 1865) stout and healthy in appearance, able to attend to his occupations, breathing comfortably, rarely has a spasmodic attack, which is short in duration. There can be little doubt that he will ultimately get rid of these attacks altogether.

Here we have a disease of more than thirty years’ standing checked in its progress, to the complete relief of suffering and the restoration of the general health.

Case III.

Moredan House, Swindon: September 28, 1865.

Dear Sir, — The only reason I do not give you a frdl account of my case is, that I know you can so much better 'write it than I can.

I do not only give you permission to publish my name, but I shall also be very glad to answer any communications that may be addressed to me respecting it, as I am in fact now doing. Any person that has derived so much benefit from your treatment as I have, would indeed be ungrateful not to do this.

Believe me, dear Sir,

Yours sincerely,

t, _ H. N. Hornby.

Dr. Hunter.

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ENGLISH CASES.

This patient had been suffering for several months from a troublesome hacking cough, with great shortness of breathing, a thick greenish expectoration, pains about the chest, frequent cold chills, daily feverishness, and copious night-sweating. His pulse ranged about one hundred, and was feeble. He had spitting of blood once. There was loss of appetite, with weak digestion ; and his strength was failing rapidly.

September 23, 1864. — On examination of the chest the left lung was found to be the seat of tubercular deposition, and there was extensive bronchitis in both lungs. He was under treatment for four months. From the commencement his system appeared to respond quickly to the action of the remedies employed by inhalation, and his progress towards convalescence was uniform and rapid ; and, as his letter shows, he continues in good health.

Case IV.

Mrs. H. E. Johnson, No. 5 Cornwall Terrace, Colney Hatch, came under treatment October 11, 1864; twenty-eight years of age, of slight frame and feeble constitution ; has been in delicate health for nearly ten years, her ailment having commenced with catarrh, which became chronic, and was followed by coughing. Eighteen months ago her suspicions were first awakened with regard to the state of her lungs.

At the time of examination she had a constant hacking cough in the morning attended by the expectoration of a grey and yellow matter, and sire had hurried breathing, a sense of tightness across the chest, and occasional pains on the left side of the chest. She suffered from frequent cold chills, and slight feverishness daily, with occasional night sweating. She was much emaciated, and her strength was

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ENGLISH CASES.

greatly impaired. There wag a granular and ulcerated condition of the throat and tonsils. The pulse was quick and feeble ; the digestive functions were impaired.

She was immediately placed under active treatment by inhalation, with tonic alterative medicines internally, and appropriate applications to the nose and throat. She persevered steadily during the space of four months, when she discontinued treatment, apparently completely restored to health. In the month of July 1865 she called to say that she was well and had remained so since discontinuing her treatment, and kindly permitted the use of her name and case.

Case V.

Miss H , a lady of highly nervous temperament, of

a consumptive family, had been suffering since July 1863 from general debility and irritating cough. October 21, 1864, she became a patient; there was great emaciation, languor, and debility ; her pulse was 100, and feeble ; there was constant cough (which sometimes occurred in severe paroxysms) with copious thick expectoration of a greenish colour, great shortness of breathing, hectic with night-sweating, and there had been occasional attacks of blood-spitting. Examination of the chest revealed the existence of tubercular deposition, with extensive bronchitis : it was, in fact, a case of chronic consumption. She was put under treatment by inhalation, with appropriate constitutional remedies. She went to Torquay to pass the winter.

December 17th she writes : ‘ I have not spat blood since the first week in November, and I think I have gained flesh a little.’ February 6th, 1865, she writes: ‘My cough has been less frequent since Christmas, and I have had none of the short breathing on first lying down for

*

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ENGLISH CASES.

many weeks.’ March 11th : ‘ I have however gained flesh lately, which looks well, and ever since Christmas the cough, when at its best, has been quieter and less frequent; it has been more troublesome for the last fortnight, in consequence of some mental excitement. The cough-mixture relieves this nervous part of the cough directly, but I have not had recourse to it oftener than I could possibly help. I still feel the pain under the collar-bones after fatigue, but it is not permanent, and never lasts long.’

But it is unnecessary to make further extracts to illustrate the progress of this case. She discontinued treatment after using it for nearly six months. On the 26th of July she writes as follows : ‘ I have just seen my usual medical man, who is considered particularly clever in chest complaints, and I am sure you will be as glad to hear as I am thankful to tell you, that his opinion was a very satisfactory one. First, as regards my improved appearance, betokening a better state of health; and next, as regards my lungs, he stethoscoped me very carefully, and expressed himself much pleased with their better condition, saying “ that he could no longer detect any unhealthy sounds at all-," and with reference to my breathing he used a technical expression which I cannot recollect, but which he said meant that it was like the breathing of a child. At the same time he said that the tubercular deposit was still there, only in a perfectly quiescent state ; “ no activity about the lungs now,” or an expression tantamount to that. I think that towards the winter I should like to see you again, and return to the inhalation or not as you deem advisable. I must add that my cough is still troublesome — the nervous part of it, I suppose. The fact is, these nervous feelings cause so much more discomfort than the actual disease, that I was never aware myself of the improvement which was actually taking place, and which was only shown by the stethoscope.’

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ENGLISH CASES.

Case YI.

Dear Sir, — It affords me much pleasure to inform you that my health still continues good, in fact I do not remember that I was ever stronger in my life.

Having found such great benefit from your skill and the treatment you have employed in my case, I have thought it might prove of value to others if the particulars were made public. I therefore send you a short statement, which you are at liberty to use in any way you may see fit.

In my childhood I suffered from inflammation of the lungs, from which it was thought I should not recover. F or several years in the winter season I had suffered from attacks of bronchitis, with a severe oppression on breathing the smoky atmosphere of London. In the autumn of 1864 1 was attacked with a cough and skin disease, that is an eruption with violent itching. I then visited the Channel Islands for a short time, which restored me for a few weeks ; but in November last I again suffered from severe cough in the morning and during the night. The matter coughed from my lungs was thick and of a greyish-yellow colour. I was very short of breath on every exertion, in fact I could not walk over my farm without being greatly out of breath.

A few days before I came to consult you I spat blood ; my feet were cold, more especially during the night ; my throat was sore, and my sleep greatly disturbed by cough and oppression when resting on my right side.

I commenced the inhalation about November 30, 1864, and persevered regularly for a period of four months, when I discontinued because I considered myself restored to health.

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ENGLISH CASES.

It is now about six months since I discontinued the use of the treatment, and my health is excellent in every respect.

I believe that no other means could have effected my cure, therefore I think it my duty to say so publicly ; I know that such symptoms as I had, especially the spitting of blood, loss of strength, and shortness of breath, could not have existed without something seriously was wrong with the lungs, and I cannot therefore feel too grateful for the means which, under Providence, has brought me safely to my present good health.

I am, Sir,

Yours truly obliged, George Robinson.

R. Hunter, Esq., M.D.

Case TO

Mr. Cockerel, Little Euston, Dunmore, Essex ; fortyseven years of age, a farmer, of small frame and sanguine temperament : he reports his mother as having died from pulmonary disease. For three years previous to his coming under our care he liadbeen suffering from more or less difficulty of breathing, with a sense of tightness, frequently amounting to pain across the chest, accompanied by pains in the limbs, cold feet and hands, headache, and giddiness. He had lost a good deal of flesh and strength, and was always languid and disinclined to exertion ; had slight night-sweating, loss of appetite, and feeble digestion. He was constantly hemming with the desire to clear his throat, but had scarcely any expectoration.

On examination of the chest all the characteristic signs of dry bronchitis, with spasm of the tubes, were found. The case was pronounced to be one of incipient asthma, and he was at once placed under active treatment with appropriate