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CHAPTER XVII.

Having now, we think, conclusively proved,
not only that tubercular consumption is
not incurable, but that the Red Sulphur water
affords the best chances for cure or relief, we
feel it incumbent upon us to make a few observations
on the treatment of that disease.

We have always been of the opinion that
too much practice has been the great error of
the profession, in their attempt to counteract
its progress. Gentlemen of the Sangrado
family, yielding too readily to the specious
theories of Broussais and others, seem to think
that while there is an ounce of blood in the
body, they must continue to cup, and leech, and
phlebotomize their unfortunate patient, when,
in fact, it is for want of blood, and from the
defective quality of what he has, his life is
ebbing away to its kindred earth, as the tide
returns to the bosom of the ocean. We do
not say that this is so in all cases; but we


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maintain that the vast majority of cases of tubercular
consumption are dependent on constitutional
debility,
and that, if you imprudently
add to this condition by untimely
depletion, you at once prostrate those vital
powers which otherwise might have made
some struggle against the enemy. Do we
then deny the utility of depletion altogether?
By no means. If there be a congested state
of the blood-vessels, or any other indication
absolutely demanding blood-letting, it should
not be delayed. We are not arguing against
a cautious and judicious depletion, but we
protest against the practice of some physicians
in sticking their lancet, upon all and every occasion,
into their unfortunate patients.

The attention should first be directed to the
cause of the patient's condition, and to the removal
or modification of that cause. Nature
having a horror of dissolution, struggles to
maintain herself against the foe; a feather
thrown into the balance for or against her,
may decide her fate. Oh what a responsibility
rests upon him who undertakes to correct
her aberrations, and lead her back to the way
she should go! It is not to be denied that


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tuberculous or calculous deposits in the lungs
produce inflammation, and that sometimes it
is so serious as to demand depleting remedies;
but here we should stop, else we throw open
the gates that otherwise may have opposed
some resistance, however feeble, to the assailant.
It is agreed by all, that in the early stages
of chronic consumption a change to country
air is proper. Now it is evident, that if any location
combines all the advantages of a good
climate with an agent whose power in this
disease has been well ascertained, it affords all
the chances which a change of residence can
offer.

In an early part of this work, we took occasion
to give our own experience of the climate
of the mountains of Virginia; and we here repeat,
it cannot be surpassed from the 1st of
June to the 15th November. In some cases
of asthma it is unsuited, on account of its elevation;
but, sheltered as it is from the northeasterly
winds of our sea-board, it scarcely
feels the equinoctial tempests, and the air is
always pure, balmy, and invigorating.

We have already given our views of the species
of diet which generally suits those who


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use mineral waters. At this Spring, there can
be no doubt that an act of imprudence in diet
may be more detrimental than at any other.
Itself a sedative, if, under its use, the invalid
gorges himself with a stimulating diet, it is
disturbed in its operations, and from being
originally a sedative, may, by abuse, be converted
into a stimulant. In the first stage,
mild farinacious diet is that pointed out by
nature; in the latter stages more nutriment,
and sometimes even a stimulant, is admissible.
The use of the Red Sulphur water, as we have
recommended it, under the best circumstances
of judicious management, suitable exercise,
prudence in diet, and a residence during the
winter in a mild climate, may, under Providence,
restore many interesting persons to
usefulness and their friends.

While some have been sceptical as to the
value of the Red Sulphur water in tubercular
consumption, others seem desirous to make the
impression that it is good for nothing else.

Now we think we have already demonstrated,
not only that it is valuable in consumption,
but that, acting on the human system
not as a specific, but on great general


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principles, it is equally available in all cases
of subacute inflammation and irritable condition
of the system, whether produced by morbid
function or organic lesion of some organ.
That man, therefore, who acknowledges its
value in diseases of the chest, and refuses his
confidence in kindred diseases, can have but
a faint idea of the nice physiological relations
of the human body, of the pathological changes
and complications induced by abnormal function,
or of the influences exerted by remedial
agents in restoring the balances that had more
or less varied from the healthy standard. We
shall conclude our notice of this water by
taking a cursory view of the more important
diseases to which it is applicable, and shall
then leave its reputation to the great arbiter
of all such questions—public opinion.

Laryngitis may be divided into acute and
chronic. The former does not fall within the
scope of our design in writing this work; but
as we think we can make a useful suggestion
in this formidable disease, we will be excused
for occupying the attention of the reader for a
short time.

Acute Laryngitis usually commences with


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inflammation of the tonsils, and of the fauces
generally, and is ushered in by chills and
fevers; inflammation progresses rapidly, and
unless relief is quickly obtained the patient
lapses into the asthenic stage, and the painful
scene soon closes. Now if the patient is seen
whilst depletion is yet admissible, how may it
be effected with the greatest chances of success?
The mode of operation we shall suggest
is so obviously the proper one, that it is
matter of surprise it has not been in general
use for centuries in this and other acute inflammations
of the fauces, such as tonsilitis, &c.
Yet except the few physicians we have informed
of the operation, and shown how to
perform it, we have known of no solitary instance
in which it has been practised in this
country. The operation we refer to is bleeding
the sublingual vein. Not only in acute
laryngitis, but more especially in putrid sore
throat, have we seen instantaneous relief from
this operation.

The operation is thus performed: Place the
patient in a chair in a reclining posture, seize
the tip of his tongue by the medium of a towel,
strike the vein with a spring lancet, and the


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operation is over. Now, on account of the
muscular contractibility of the tongue, it will
not bleed, unless we use warm water, which
must therefore be sipped and spat out, and
with it the blood will flow freely for any
length of time you please. The temperature
of the water had better be about 112°. If you
desire to stop it, you have but to substitute
cold water instead of warm. If one bleeding
does not suffice, the opposite vein can be
treated in like manner. Now it will strike
every man of common sense at once, that this
operation possesses vast advantage over that
by leeches, cupping, or general blood-letting.
It immediately relieves the congested vessels
in contact with the inflamed part, and enables
the salivary and other glands to perform their
functions. It can be performed at all times,
and in every place, and by every one who can
recognize the vein. No time need be lost in
town or country, for the moment the alarm
arises it can be resorted to. In putrid sore
throat, we will pledge our lives, that if performed
early, and followed by an emetic
and brisk purgative, and an antiseptic gargle,
say 12 grains chlorate of soda to a half-pint

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of water, the life of the patient will be
secure.

The only difficulty in performing the operation
is with infants. With children of four
years old we have succeeded, as follows: We
apply a powerful mustard plaster to the throat,
and when it stings severely, we make a bargain
with the child to take it off, provided he
will put out his tongue and permit us to perform
the operation—he promises, and we remove
the plaster, with the understanding that
if he breaks his promise we again put it on.
We soothe the irritated surface by cooling
applications, gain the child's confidence, and
he thrusts out his little tongue without hesitation.
In order to gargle in such a case, we
use an ivory pipe terminating in a perforated
bulb, fitted to a pint syringe, and placing the
child on the knee of its nurse, with the head
inclining forward, we inject the gargle, and
completely cleanse the mouth and fauces of
the child. And this we repeat according to
the urgency of the case. We also repeat
emetics of ipecac once in six hours, until the
danger is over.

Sometimes, in chronic laryngitis, the acute


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form supervenes, and then this operation is
available. In inflammation of the tongue itself,
of the tonsils or epiglottis, it may be used
with advantage, and we would practise it also
in the early stage of croup, for the very obvious
purpose of restoring the normal secretion
of the glands and mucous membrane.

Chronic laryngitis may range from simple
inflammation to ulceration of the mucous
membrane, cartilages, and vocal ligaments,
and even to the destruction of these parts. It
sometimes attends tubercular disease of the
lungs, and sometimes the larynx itself is the
original seat of deposition of tubercles. The
prognosis is of course dependent on the mildness
or intensity of the disease, and on the
constitutional ability to resist its progress.
The Red Sulphur water will be found a
powerful auxiliary in this disease. We have
witnessed many most interesting recoveries
by the use of this water, in apparently very
bad cases. It seems, from the following interesting
extract from MM. Trosseau & Belloc,
the distinguished authors of a prize essay
on Laryngeal Phthisis, &c., before the Royal
Academy of France, that the waters of Bonnes


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and Cauterets, in the Pyrenees, are also celebrated
for the cure of this disease.

"Sulphur; Sulphurous Mineral Waters.
—Many physicians, chiefly those who have
embraced the opinions of the new French
school, consider as almost fabulous the cases
of cure reported by Borden and many others,
effected by the waters of Bonnes and Cauterets.
But they who have studied the effects of the
Pyrenean waters upon the spot, they who
have often sent to them their patients evidently
attacked with pulmonary tubercles, will acknowledge
the admirable cures which have
been annually effected by this powerful means.
Therefore we should never neglect the use of
Sulphurous Mineral Waters, whether natural
or artificial, in the treatment of various forms
of laryngeal phthisis. Although secondary,
they may, unaided, effect a cure in the early
stages of the disease. We select the following
case from a host of others.

"Mr. D., captain of artillery, thirty-four
years old, was born of tuberculous parents.
His voice is rather grave, and not very strong,
except in the high notes. He attended balls
and soirées, and was much in the world for


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three months, when he perceived that his voice
was hoarse, and complete aphonia soon followed.
There was no expectoration or pain
in the larynx, and the general health continued
excellent, only he was greatly fatigued
by the severe efforts that were necessary to
make himself understood. There was nothing
to induce a suspicion of disease in his lungs, he
had never had hæmoptysis, catarrh, or angina.
He used as a gargle, one ounce of alum to a
pound of water, for a fortnight, without amendment.
Milk diet was then prescribed, with
some advantage; to this was added one bottle
of Bonnes waters per day. This soon effected
an improvement, and a complete cure at the
end of two months."

We see from the foregoing extract, that
scepticism is not confined to the physicians
of this country: it is, indeed, the natural result
of medical research and experience, for
no man can appreciate the difficulties of a
science so well as he who has encountered
them. But while, on the one hand, the physician
should be slow to believe, on the other,
he should not lapse into absolute incredulity.
To him may be applied with propriety the


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general maxim so elegantly expressed by the
Latin poet:

Est modus in rebus; sunt certi denique fines,
Quos ultra citraque nequit consistere rectum.

We have ourselves lived long enough to
have observed that valuable hints may be
gathered from the very haunts of ignorance.
Utility is not only the mother of justice and
equity, but also, and more especially, of invention.
We doubt not many "old women" in
the interior of our country have cured diseases
by some simple infusion or decoction,
that would have resisted all the science of
Broussais. Had man continued to live in his
original simplicity, the trade of the druggist
would not be so profitable as it is at this time.
We firmly believe that the Almighty has sent
no disease to afflict his creatures, for the cure
of which he has not appointed some remedy,
subject, however, to that immutable law which
has allotted to man a certain amount of vital
power which he cannot exceed, but which he
may be deprived of by some disturbing force
from without, or by the misapplication of
agents intended as remedial.

Bronchitis.—Acute bronchitis, (Herbert


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Mayo,) inflammation (ordinarily following
cold in the head) of the lining membrane of
the trachea and bronchi, which become red
and slightly thickened, sometimes softer than
natural, attended with a sense of dryness or
roughness behind the sternum, and extending
into one or both lungs; cough at first dry, soon
accompanied by a serous expectoration, which
is saltish, and slightly glutinous, but not distinguishable
from the saliva with which it is
intermixed. As the disease advances, the expectoration
becomes thicker and more yellow,
and is mingled with particles of an opaque
whitish colour; by degrees the whole becomes
opaque, of a pale yellow or slightly greenish
hue, viscid, inclosing air-bubbles, tasteless or
somewhat saltish, and occasionally marked
with dots or small specks of blood. When
the sputæ are very large, they frequently leave
after expectoration a dull pain about the root
of the bronchi, indicating the place whence
they have been detached. The cough occurs
in fits, on waking, after a meal, and on lying
down to rest.

Chronic Bronchitis.—The expectoration
sometimes precisely similar to that of the latter


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stage of the acute, but most commonly less
glutinous, more opaque, and nearly puriform.
Occasionally it is of a dirty-grayish or greenish
hue, from an admixture of the black pulmonary
matter. It is usually inodorous; but
sometimes becomes more or less fetid, and assumes
the smell as well as the other physical
qualities of the different kinds of pus. This
disease frequently follows acute bronchitis,
and is liable to persist, with remission, for
years.

During the remission, the appetite and
strength return; but the patient commonly
loses a little flesh, and remains paler than
usual. During repose there is no oppression
on the chest, but exercise soon brings on dyspnœa.
The complaint remits in the summer,
and returns in the winter, frequently attended
with fever. In some rare cases, hectic fever
comes on, with rapid emaciation, and the disease
terminates fatally, with all the usual
symptoms of phthisis pulmonalis. In fact,
the most perfect similarity exists between the
two diseases as far as regards the expectoration,
the emaciation, and all the other general
symptoms.


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Such are the characteristics of a disease
which is becoming every year more prevalent
in our variable climate, and which has assumed
vast importance, not only on account of
its frequency, but also on account of the evils
which a continued impediment to respiration
may cause, by producing congestion of the
lungs and heart, and organic disease of the
latter. This disease, when not the accompaniment
of pulmonary phthisis, is usually
manageable by proper treatment, and early
removal to a mild climate. The waters of
the Red Sulphur seldom fail to relieve it, by
removing the irritated condition of the membrane,
and restoring a healthy secretion, and
by imparting tone to the constitution. When
this disease is attended with suffocative secretions,
producing periodically great distress of
respiration, much benefit will be derived, according
to our own experience, in occasional
emetics of ipecac.

Having directed no supper to be taken,
cause the patient to drink from half a pint
to a pint of warm water, then give 15 to 20
grains of ipecac. At bed-time give a tumbler
or two of Sulphur water. This treatment,


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in many cases, may be repeated every
48 hours with advantage. We have found
emetics used in this manner also valuable in
many cases of tubercular disease of the lungs.
Nothing prostrates the bodily powers more
rapidly than the constant attempt to expectorate,
and indeed the hectic fever and sweats
are greatly aggravated by this cause.

Our advice to a person afflicted with bronchitis
would be to visit the Red Sulphur about
the 15th of June, and use the water until towards
the close of the Indian Summer, (say
1st to 15th November,) and travelling thence
southwards, on horseback if possible, spend
the winter and spring in Cuba.

Most invalids from the northern States return
too soon, and proceed directly home.
Now this is wrong; they should land at the
southern extremity of the Union, and advance
homeward according to the natural progress
of the season. It is evident that a sudden
transition from the climate of Cuba to that of
Massachusetts is imprudent, and if made before
the summer fairly sets in, may be hazardous;
whereas there would be little danger in
arriving in New-Orleans in April, and thence


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travelling northward, so as to find somewhat
of the same temperature in one's progress.

Chronic Pleurisy and Pneumonia.—We
designed to say something on these and other
affections of the organs of respiration, but we
find we have already exceeded our limits, and
we do not know that it would be attended with
any practical good. Suffice it to say, that the
Red Sulphur water is a highly important agent
in these diseases, and that, by improving the
general health, it increases the power of the
absorbents in removing the effusions.