Part 4

We would next make some observations on the different modes of treating pulmonary consumption, that fatal and mysterious disease, which has so long baffled the curative efforts of the most eminent physicians of their day, and it is gratifying to find that a great step towards a rational and successful mode of treatment, based on sound physiological principles, has lately obtained in its case, which mode we hope soon to see generally adopted by the medical profession. The unsuccessful treatment of this disease has hitherto cast a slur on medical science, and it is not to be wondered at that little success should have attended on the orthodox mode of treatment, since recent observation, and matured experience have shown, on physiological principles, that no worse mode could have been devised for curing, nor a surer one adopted for aggravating the disease. This new view of the matter is very ably set forth in Dr. Lane’s work, which we heartily recommend to the perusal of our readers, as a sensible and modest statement of the benefits resulting from Hydropathic treatment in cases of that nature. Dr. Lane looks upon consumption as essentially a blood disease, in which opinion he is confirmed by the first physiologists of the day, and by those physicians who have had most experience in the treatment of that particular disease, Sir James Clarke, Professor Bennet, Dr. Balbyrnie, and others. These physicians concur in confirming the observation of others, to the effect that indigestion or derangement of the stomach and digestive organs, is a universal forerunner of pulmonary consumption, and that without such derangement consumption cannot exist. Consequent on this diseased state of the digestive organs, imperfect blood is assimilated, deficient in its oleaginous elements, and containing an undue amount of albuminous materials; that in consequence of this deficiency of oleaginous elements, the blood is incapable of being converted into true cellular tissue to replace the effete material of the lungs, and the superabundant quantity of albumen has a tendency to exude upon the lungs on their exposure to cold in the form of tubercles, which process is unaccompanied by inflammatory action. These facts are based on long observation and direct chemical analysis of the substance composing the tubercles, which consist of almost pure albumen; and on this theory the wonderful effects of cod liver oil in consumptive cases, and the great emaciation of body which results from the disease are satisfactorily explained. In the one case, the cod liver oil supplies, in a light and digestible form, the oleaginous element in which the blood is deficient; in the other, the system has recourse to the fatty or adipose matter of the body to supply the oleaginous principle. But now the question arises, supposing that indigestion is the universal precursor of consumption, from what does this indigestion and consequent imperfect assimilation of the blood proceed? This question Dr. Lane does not touch upon, but we believe that Dr. Barter, the well-known Hydropathic physician of Blarney, considers that it arises from defective vitality in the blood, caused by deficiency of oxygen in the system, more immediately proceeding from defective capacity of the lungs, and imperfect action of the skin. The skin and lungs, it must be remembered, are supplementary organs; stop the action of either, and death inevitably ensues, and on their perfect or imperfect action, perfect or imperfect health depends. This view of the disease is illustrated by the history of the monkey: in its wild state, the best authorities state, it never gets consumption, but domesticate the animal, so inducing bad action of the lungs, from want of sufficient exercise and wholesome air, and imperfect action of the skin, arising from the same cause, and it usually dies of this disease. These observations equally apply to all cases of scrofulous degeneration, which physicians estimate as carrying off prematurely one-sixth of the whole human family. Of this terrible disease, the scourge of the human race, it is sufficient to observe, that consumption is merely a form of it, and that it is, moreover, hereditary, a fact which would corroborate the opinion of its being a true blood disease.

Having referred to the fact of the lungs and skin being supplementary organs—the principal duty of both being to aerate the blood—it may be interesting to lay before our readers the following extracts from the results of Monsieur Fourcault’s experiments bearing on the subject. These experiments were made with the view of ascertaining the effect of the suppression of transpiration by the skin, in animals, on coating their bodies with an impermeable varnish. The committee of the French Institute thus describes these experiments:—

“The substances which he used were givet-glue, dextrine, pitch, and tar, and several plastic compounds; sometimes the varnish was made to cover the whole of the animal’s body, at other times only a more or less extensive part of it. The accidents which follow this proceeding are more or less complete or incomplete, general or partial. In every case the health of the animals is soon much impaired and their life in danger. Those which have been submitted to those experiments, under our observation, have died in one or two days, and in some cases in a few hours only.

“In the opinion of the committee these experiments are full of interest for the future, * * * * the experiments of M. Fourcault cannot fail to throw a new light upon the physiological and pathological phenomena, depending upon the double function of inhalation and exhalation of the cutaneous system.”

Monsieur Fourcault himself thus writes:—

“The mucous membranes were not the only parts affected by the artificial suppression of the insensible perspiration. We also observed the production of serous effusions in the pericardium, and even in the pleuræ. These effusions thus demonstrate that dropsies are found in the same body as mucous discharges. Several dogs died with paraplegia, and could only drag themselves along on their fore paws; some died atrophied, and their lungs contained miliary tubercules, which appeared to me, from their whiteness and softness, to be of recent formation. It was, therefore, now impossible to doubt the influence of the suppression of the insensible perspiration of the skin upon the changes in the blood, the mucous and serous exudations, and finally, upon the development of local lesions.

“But the results of these experiments differ in toto according as the plastering is partial or general, or as it suspends the action of the skin incompletely or completely. In the first case, the alteration of the blood is not carried so far as to cause the dissolution of its organic elements; it can coagulate, and present, in some few cases, a buffy coat of little consistency, bearing some resemblance to that which is found in inflammatory blood. As to the tissues affected, they, however, appear to me to present the anatomical characteristics of the consequences of local inflammation.

“But when the application of very adhesive substances upon the whole of the body quickly suppresses the cutaneous exhalation, and consequently prevents the action of the air upon the skin, death takes place much more speedily, and appears to be the result of true asphyxia. The breathing of the animals experimented upon, is difficult; they take deep inspirations, in order to inhale a larger quantity of air than usual; their death is violent, and is often accompanied by convulsive movements. On dissection, we find in the veins and the right cavities of the heart, sometimes also in the left, but very rarely in the arteries, a black diffluent blood, forming sometimes into soft and diffluent coagula, and coagulating, very imperfectly, when exposed to atmospherical air. This dissolution of the blood, favours the formation of large ecchymoses and of effusions into the lungs and other organs, the capillary vessels are usually injected;—one can see that the alteration of the blood has been the true cause of the stagnation of the circulation in this order of vessels. * * * * *

“It is important to state that man, in the same way as animals, dies from cutaneous asphyxia when his body is covered by impermeable applications. I shall detail, in another work, the results of my researches upon this subject, and facts which still belong to general history will enter into the province of medicine. Thus, at Florence, when Leo X. was raised to the pontificate, a child was gilt all over, in order to represent the golden age. This unfortunate child soon died, the victim of a physiological experiment of a novel kind. I have gilded, silvered, and tinned several guinea-pigs, and all have died like the child at Florence.”

Monsieur Fourcault, in summing up his researches, remarks as follows:—

“Nasal catarrh, diarrhœa, paralysis, marasmus, convulsive movements, and finally the phenomena of asphyxia are also the results of the same experiments. Cutaneous asphyxia may cause the death of man and animals; in this affection, the blood presents, in the highest degree, the refrigerant and stupefying qualities of VEINOUS blood.”

The above extracts are our answer to those superficial medical objectors, who would argue that death is not occasioned, in the above instances, by the exclusion of atmospheric air from the system, but by the suppression of poisonous salts secreted in the skin. The effects of the suppression of the most poisonous and irritating of these is well known to the physician, but their phenomena bear no analogy to those presented in the case before us, which exhibits all the symptoms and appearance of true suffocation. If, however, the evidence of these experiments be not sufficient to convince them, that a deficient supply of air, producing suffocating symptoms, was the real cause of death in the above cases, we will be prepared to meet them on a more convenient battle-field, where arguments, which would only prove tedious and unintelligible to the non-professional reader, may be freely adduced in support of our position.

Were it not tedious to multiply instances, many more might be adduced, such as the dangerous stage of small-pox being contemporaneous with the breaking of the pustules, when the surface of the body becomes partially varnished over, and the fact that a scald or burn is dangerous, not in proportion to its depth, but breadth.

Now, if it be conceded that the main cause of consumption, tracing the disease back to its first cause, is to be found in an insufficient supply of oxygen to the system (which certainly the success attendant on the treatment based upon this theory would lead one to suppose), we would beg of our readers seriously to ask themselves how can consumption be cured by drugging, and how can the much required oxygen be supplied to the blood by any proceeding of the kind? We think that the results of such a system afford a conclusive answer to this question; failure marking its course wherever it has been tried. Again, as regards the fashionable remedy of going abroad, how are we likely to get more oxygen supplied to our blood by going abroad than by staying at home? What magic is there in the process? A mild climate may certainly prove less irritating than its native air to a diseased and disordered lung, and the suffering and uneasiness consequent on the irritation may be thereby allayed, but we are not a whit nearer being cured by this device, nor have we, in so doing, properly gone to work to remove the main spring and cause of the disease.

Let our readers bear in mind the following aphorism of Dr. Hall: “Close bed rooms make the graves of multitudes;” let them recollect that impure blood is the origin of consumption, and that impure air causes impure blood.

Carrying out these principles, in curing consumption, Dr. Barter would use all means to place the system in a favourable condition to receive a full supply of oxygen, first, by a direct inhalation of a mixture of oxygen and atmospheric air through the lungs; secondly, by enjoining a large amount of active exercise in the open air, when practicable, and sleeping at night with open windows; and thirdly, by inducing a healthy action of the skin, and consequent supply, through it, of oxygen to the blood, by the intervention of the Turkish bath. This mode of treatment has, we believe, proved most successful, whilst the old mode of treatment, of which it is the very antipodes, viz., keeping the patient in a heated and impure atmosphere, swathing him with flannels, dosing him with prussic acid, and applying a respirator to the mouth, has proved most unsuccessful and fatal. How it could ever have entered into the brain of a physician to recommend the use of a respirator, as a cure for consumption, we are at a loss to imagine, as a more ingenious mode of shutting out the pure atmosphere, essential to our existence, and exchanging it for one loaded with carbonic acid (thus aggravating the disease which it seeks to cure), could not possibly be devised. Man, in a state of health, requires pure air as a condition of his existence; and can it be supposed that, in a state of disease, he will be able, more successfully, to resist the effects of poison on his system than when in a state of health? Will he, in a state of disease, be strengthened and improved by the loss of that, on a due supply of which, when well, the continuance of his health and strength would depend? Does the experience of our readers furnish them with a single case of recovery from consumption caused by the use of a respirator, or does it not, on the contrary, furnish them, in every case where it has been resorted to, with instances of the bad effects attendant upon its use?

In support of the view taken by Dr. Barter, we would observe, that narrow and contracted lungs, an impure atmosphere, uncleanly habits, sedentary occupation, indulgence in alcoholic liquors, and over eating, all directly tend to the overloading of the blood with carbon, and they are also the most constant causes of consumption. But the success attending this treatment is the argument which will have most weight with the public, and cause its adoption by the profession at large. When this takes place we shall not have consumptive patients sent abroad to seek restoration of their health—

“To Nice, where more native persons die of consumption than in any English town of equal population—to Madeira, where no local disease is more prevalent than consumption—to Malta, where one-third of the deaths amongst our troops are caused by consumption—to Naples, whose hospitals record a mortality, from consumption, of one in two and one-third of the patients—nor, finally, to Florence, where pneumonia is said to be marked by a suffocating character, and a rapid progress towards its final stage. Sir James Clarke has assailed with much force the doctrine, that change of climate is beneficial in cases of consumption. M. Carriere, a French physician, has written strongly against it. Dr. Burgess, an eminent Scotch physician, also contends that climate has little or nothing to do with the cure of consumption, and that if it had, the curative effects would be produced through the skin and not the lungs, by opening the pores, and promoting a better aeration of the blood.”

With respect to the administering of prussic acid, to lower the pulse in consumption, we cannot TOO STRONGLY reprobate this mistaken practice. Do physicians, when prescribing this poison, ever reflect that this elevation of the pulse, which they employ themselves so sedulously to lower, is an effort of nature to supply more oxygen to the system by an increased action of the lungs, and that the more the lungs are injured by disease, the greater is this compensating effort of nature: just as a blacksmith must work a small or defective bellows more rapidly than a large one, to keep his fire going. If this be the case, the destructive effects of prussic acid will at once be evident, since by it all the powers of the system become reduced, and nature’s efforts at self-relief most mischievously obstructed. The feverish action of the pulse is, in itself, of no moment; it is only as a symptom of derangement in the system that it becomes alarming; it is nature telling us that something is wrong by the very action which she is establishing to cure it. What then must be thought of a practice which silences the tell-tale pulse, stops the voice of nature, and checks her curative efforts, without attempting to cure the disorder; doing immense mischief, whilst it effects no good? The fact is, the only reduction of the pulse which is worth a farthing, is that which follows naturally from removing the cause of its elevation, viz., a want of oxygen in the system. That the supplying of this want has the effect of lowering the consumptive pulse, without the assistance of prussic acid, is abundantly proved by the rapid fall of the pulse produced by the Turkish bath,—a result most satisfactory to the physiologist, as evidencing the soundness of the theory which prescribes it as a remedy.

Having referred to the erroneous practice of swathing consumptive patients in flannel, it may not be out of place here to make a few observations on the origin of caloric in the animal system, and the office of clothing in relation to it.

The only true source of caloric in animals, is that produced by the chemical combination of oxygen with the carbon and other oxidizable products of their system. Every cause which quickens and exalts this chemical action increases the animal heat, whilst every interfering cause produces cold and chilliness. It is in this way that drinking cold water, or taking exercise in the open air, increases the warmth of the body, by producing a healthy waste of the system, and so stimulating the chemical combustion within it. Clothing, it should be recollected, has merely the effect of retaining animal heat and preventing its dissipation, but it cannot, in the slightest degree, create it: if, therefore, any thing occurs to interfere with that action, by which heat can alone be generated, all the clothes in the world will fail to warm us. How little these facts are reflected on, is shown by the excessive and injurious amount of clothing worn by delicate persons, which defeats the very object they are intended to effect. These facts also explain the apparent paradox of patients who, previous to undergoing the water system, complain of chilliness when smothered with clothing, but who afterwards are enabled to wear very light clothing, without any feeling of their former chilliness. On this subject Dr. Gully observes:—

“Should, however, the reader desire to learn the most effectual way of destroying the power of generating animal heat, let him pursue the plan which so many shivering patients who come to Malvern have followed. Let him drink spirits and wine, eat condiments, swallow purgatives, and especially mercurials, take a ‘course of iodine,’ and, as an occasional interlude, lose a little blood, and we stake our reputation that he will shiver to his heart’s content, and find himself many degrees lower in the scale of Fahrenheit than cold water, cool air, early rising, and exercise can possibly make him.”

Before leaving this subject, we would entreat our readers seriously to consider the observations we have addressed to them, and the facts which we have adduced in support of the mode of treatment which we have advocated. The subject is one of serious moment, since, on this disease being rightly understood, the lives of millions of our countrymen depend. If a rational mode of treatment be adopted, its fearful ravages may be successfully encountered and stayed, but if not, the gaunt spectre will stalk as hitherto, unchecked through the length and breadth of our island, dealing death to millions of its sons.

With regard to water drinking, an important part of the Hydropathic process, and against which much prejudice exists, the following extracts from the pen of the justly celebrated Allopathic physician, Sir Henry Holland, will not, we hope, be considered out of place. In his work styled “Medical Notes and Reflections,” treating of “Diluents,” he thus writes:

“Though there may seem little reason for considering these as a separate class of remedies, yet I doubt whether the principles of treatment implied in the name is sufficiently regarded in modern practice. On the Continent, indeed, the use of diluents is much more extensive than in England; and, under the form of mineral waters especially, makes up in some countries a considerable part of general practice. But putting aside all question as to mineral ingredients in water, the consideration more expressly occurs, to what extent and with what effects this great diluent, the only one which really concerns the animal economy, may be introduced into the system as a remedy? Looking at the definite proportion which, in a healthy state, exists in all parts of the body between the aqueous, saline, and animal ingredients—at the various organs destined, directly or indirectly, to regulate the proportion—and at the morbid results, occurring whenever it is materially altered—we must admit the question as one very important in the animal economy, and having various relation to the causes and treatment of disease. Keeping in mind then this reference to the use of water as an internal remedy, diluents may be viewed under three conditions of probable usefulness:—First, the mere mechanical effect of quantity of liquid in diluting and washing away matters, excrementitious or noxious, from the alimentary canal;—secondly, their influence in modifying certain morbid conditions of the blood;—and thirdly, their effect upon various functions of secretion and excretion, and especially upon those of the kidneys and skin * * * The first is an obvious benefit in many cases, and not to be disdained from any notion of its vulgar simplicity. It is certain there are many states of the alimentary canal in which the free use of water at stated times produces good, which cannot be attained by other or stronger remedies. I have often known the action of the bowels to be maintained with regularity for a long period, simply by a tumbler of water, warm or cold, on an empty stomach, in cases where medicine had almost lost its effect, or become a source only of distressing irritation. The advantage of such treatment is still more strongly attested, where the secretions taking place into the intestines, or the products formed there during digestion, become vitiated in kind. Here dilution lessens that irritation to the membranes, which we cannot so readily obviate by other means, and aids in removing the cause from the body with less distress than any other remedy. In some cases, where often and largely used, its effect goes farther in actually altering the state of the secreting surfaces by direct application to them. I mention these circumstances upon experience, having often obtained much good from resorting to them in practice, when stronger medicines and ordinary methods had proved of little avail. Dilution thus used, for example, so as to act on the contents of the bowels, is beneficial in many dyspeptic cases, where it is especially an object to avoid needless irritation to the system. Half-a-pint or more of water taken when fasting, at the temperature most agreeable to the patient, will often be found to give singular relief to his morbid sensations. * * * In reference to the foregoing uses of diluents, it is to be kept in mind that the lining of the alimentary canal is, to all intents, a surface, as well as the skin, pretty nearly equal in extent; exercising some similar functions, with others more appropriate to itself, and capable in many respects of being acted upon in a similar manner. As respects the subject before us, it is both expedient and correct in many cases to regard diluents as acting on this internal surface analogously to liquids on the skin. And I would apply this remark not only to the mechanical effects of the remedy, but also to their use as the medium for conveying cold to internal parts; a point of practice which either the simplicity of the means, or the false alarms besetting it, have hitherto prevented from being duly regarded.”

Again he writes:—

“Without reference, however, to these extreme cases, it must be repeated, that the use of water, simply as a diluent, scarcely receives attention and discrimination enough in our English practice.”

And again:—