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Consumption best treated by warm stimulating climate in winter,
Definitions—Illustrations of degrees—Galloping Consumption—Acute Tuberculosis—Scrofulous Pneumonia—More chronic and limited forms—Progress of the disease—Power of Medicine—Unity but not uniformity of Phthisis.
The Disease, too well known to the public, as well as to the medical profession, as Pulmonary Consumption, is characterised by the symptoms, persistent cough, expectoration of opaque matter, sometimes of blood; a progressive loss of flesh, breath, and strength; often hectic fever, night sweats, and diarrhoea; and the common tendency of the disease is to a wasting of the body and a dedine of its powers, down to its termination in death.
Pathologically considered, pulmonary consumption is characterised by certain changes in the textures of the lungs, consisting chiefly of consobdations, granular or diffused, which irritate their functions and clog their structures, and which proceed to further changes, of degeneration, disintegration, and excavation of some parts, and of induration and contraction of others—all tending to a disorganisation of the lungs, and a wasting away of the flesh and blood of the body.
It is this tendency to degeneration and destruction, which stamps the consuming character of the disease; and the more strongly this tendency is manifested, the more irresistible and rapid will it be in its fatal course. In certain cases the disease is so acute and extensive as to carry off the patient in a few weeks or months. In others it is more limited and slow, and may not destroy life for five, ten, twenty, or more years. In the former cases medicine has little or no control over the disease; decay and death invade the frame so overwhelmingly, that there is neither sufficient power in nature to resist them, nor time for art to aid that power. One of the most vital organs of the body becomes suddenly invaded by a disease, changing its structure, obstructing its functions, and spreading through it the seeds of further decay, which not only in the organ itself, but by the blood and lymphatics, diffuse its destructive influence through the whole system.
Let us briefly sketch the two most terrible forms of the disease.
A man of middle age is attacked with fever, with pungent heat of the body, cough, viscid expectoration, extreme oppression, and overwhelming weakness, resembling that of continued fever; and the likeness sometimes appears also in the coated or dry brown tongue, sordes on the teeth, and occasional delirium. The vesicular breathsound is superseded everywhere by bronchial rhonchi and mixed crepitation. On percussion, the chest is dull nowhere, but less clear in the posterior than in the front parts. This case might be supposed to be one of universal capillary bronchitis, with general pulmonary congestion. So it is; but this is not all. In spite of blisters and other remedies, the breathing remains short and difficult; the pulse becomes more rapid and feeble; the lips, cheeks, and nails become livid; clammy sweats break out, and the patient dies in the third or fourth week from his first attack. The lungs are found congested, and the bronchi loaded with viscid mucus; but more than this, innu