CAUSES OF CONSUMPTION.
Sir James Clarke says,—"It may be fairly questioned whether the proportion of cures of confirmed consumption is greater at the present day than in the time of Hippocrates: and although the public may continue to be the dupes of boasting charlatans, I am persuaded that no essential progress has been made or can be made in the cure of consumption, until the disease has been treated upon different principles from what it hitherto has been. If the labor and ingenuity which have been misapplied in fruitless efforts to cure an irremediable condition of the lungs had been rightly directed to the investigation of the causes and nature of tuberculous disease, the subject of our inquiry would have been regarded in a very different light from that in which it is at the present period."
While I shall not attempt a discussion of all the causes of phthisis pulmonalis, I shall, in a brief and familiar way, consider the more obvious sources of this terrible malady, and particularly those which all classes may remove or avoid.
Impure Air a Cause of Consumption.—In discussing the causes of a disease whose principal expression is in the lungs, nothing can be more legitimate than a consideration of the air we breathe. In full respiration, it penetrates every one of the many millions of air-cells.
Dust.—Every species of dust must prove injurious. Workers in those factories where tools are ground and polished soon die of pulmonary disease. The dust of cotton and woollen factories, that of the street, and that which is constantly rising from our carpets, are all mischievous. M. Benoiston found among cotton-spinners the annual mortality from consumption to be 18 in a thousand; among coal-men, 41; among those breathing an atmosphere charged with mineral dust, 30, and with dust from animal matter, as hair, wool, bristles, feathers, 54 per thousand: of these last the greatest mortality was among workers in feathers; least among workers in wool. The average liability to consumption among persons breathing the kinds of dust named was 24 per thousand, or 2.40 per cent. In a community where many flints were made, there was great mortality from consumption, the average length of life being only 19 years.
Gases.—Among the poisonous gases which infest our atmosphere, carbonic acid deserves special consideration. The principal result of all respiration and combustion, it exists in minute quantities everywhere, but when it accumulates to the extent of one or two per cent, it seriously compromises health. I have seen the last half of an eloquent sermon entirely lost upon the congregation; carbonic acid had so accumulated that it operated like a moderate dose of opium. No peroration would arouse them. Nothing but open windows could start life's currents. In lectures before lyceums, I often have a quarrel with the managers about ventilation. There is, even among the more intelligent, a strange indifference to the subject.
The following fact graphically illustrates the influence of carbonic acid on human life.
A young Frenchman, M. Deal, finding his hopes of cutting a figure in the world rather dubious, resolved to commit suicide; but that he might not leave the world without producing a sensation and flourishing in the newspapers, he resolved to kill himself with carbonic acid. So, shutting himself up in a close room, he succeeded in his purpose, leaving to the world the following account, which was found near his dead body, the next morning.
"I have thought it useful, in the interest of science, to make known the effects of charcoal upon man. I place a lamp, a candle, and a watch on my table, and commence the ceremony.
"It is a quarter past ten. I have just lighted the stove; the charcoal burns feebly.
"Twenty minutes past ten. The pulse is calm, and beats at its usual rate.
"Thirty minutes past ten. A thick vapor gradually fills the room; the candle is nearly extinguished; I begin to feel a violent headache; my eyes fill with tears; I feel a general sense of discomfort; the pulse is agitated.
"Forty minutes past ten. My candle has gone out; the lamp still burns; the veins at my temple throb as if they would burst; I feel very sleepy; I suffer horribly in the stomach; my pulse is at eighty.
"Fifty minutes past ten. I am almost stifled; strange ideas assail me.... I can scarcely breathe.... I shall not go far.... There are symptoms of madness....
"Eleven o'clock. I can scarcely write.... My sight is troubled.... My lamp is going out.... I did not think it would be such agony to die.... Ten...."
Here followed some quite illegible characters. Life had ebbed. The following morning he was found on the floor.
The steamer Londonderry left Liverpool for Sligo, on Friday, December 2d, 1848, with two hundred passengers, mostly emigrants. A storm soon came on. The captain ordered the passengers into the steerage cabin, which was eighteen feet long, eleven wide, and seven high. The hatches were closed, and a tarpaulin fastened over this only entrance to the cabin.
The poor creatures were now condemned to breathe the same air over and over again. Then followed a dreadful scene. The groans of the dying, the curses and shrieks of those not yet in the agonies of death, must have been inconceivably horrible. The struggling mass at length burst open the hatches, and the mate was called to gaze at the fearful spectacle. Seventy-two were already dead, many were dying, their bodies convulsed, the blood starting from their nostrils, eyes, and ears.
It does not appear that the captain designed to suffocate his passengers, but that he was simply ignorant of the fact that air which has passed to and fro in the lungs becomes a deadly poison.
The victims of the Black Hole in Calcutta and of the Steamer Londonderry, with the thousand other instances in which immediate death has resulted from carbonic acid, are terrible examples in the history of human suffering; but these cases are all as nothing, compared with those of the millions who nightly sleep in unventilated rooms, from which they escape with life, but not without serious injury. As a medical man, I have visited thousands of sick persons, and have not found one hundred of them in a pure atmosphere. I have often returned from church seriously doubting whether I had not committed a sin in exposing myself to its poisonous air. There are in our great cities churches costing fifty thousand dollars, in the construction of which not fifty dollars were expended in providing means for ventilation. Ten thousand dollars for ornament, but not ten dollars for pure air! Parlors with furnace-heat and a number of gas-burners (each of which consumes as much oxygen as several men) are made as close as possible, and a party of ladies and gentlemen spend half the night in them. In 1861 I visited a legislative hall. The legislature was in session. I remained half an hour in the most impure air I ever attempted to breathe. If the laws which emanated from such an atmosphere were good, it is a remarkable instance of the mental and moral rising above a depraved physical. Our school-houses are, some of them, so vile in this respect that I would prefer to have my son remain in utter ignorance of books, rather than breathe, during six hours of every day, so poisonous an atmosphere. Theatres and concert-rooms are so foul that only reckless people can continue to visit them. Twelve hours in a railway-car exhausts one, not because of the sitting, but because of the devitalized air. While crossing the ocean in the Cunard steamer Africa, and again in the Collins steamer Baltic, I was constantly amazed that men who knew enough to construct such noble ships did not know enough to furnish air to the passengers. The distresses of sea-sickness are greatly intensified by the sickening atmosphere which pervades the ship. Were carbonic acid black, what a contrast would be presented between the air of our hotels and their elaborate ornamentation!
It is hardly necessary to say that every place I have mentioned might be cheaply and completely ventilated.
Consumption originates in the tubercular diathesis. This diathesis is produced by those agencies which deprave the blood and waste vitality. Of these agencies none is so universal and potent as impure air. When we consider, that, besides mingling momentarily with the blood of the entire system, it is in direct and constant contact with every part of the lungs, we cannot fail to infer that foul air must play a most important part in that local expression of the tubercular taint known as pulmonary consumption.
The author of an excellent work on consumption declares,—
"Wholesome air is equally essential with wholesome food; hence it is that crowding individuals together in close, ill-ventilated apartments, as is often the case in boarding-schools, manufactories, and work-houses, is extremely prejudicial, both as a predisposing and exciting cause of tubercular disease."
The great Baudeloque considers impure air the only real cause of scrofula, other causes assisting. He thinks that no scrofula could be developed without this cause, whatever others might be in operation.
An English writer who was physician to the Princess Victoria says,—"There can be no doubt that the confined air of gloomy alleys, manufactories, work-houses, and schools, and of our nurseries and very sitting-rooms, is a powerful means of augmenting the hereditary predisposition to scrofula, and of inducing such a disposition de novo."
To drink from the same tumbler, to eat from the same plate, to wear the same under-clothes, to wash in the same water, even with the cleanest of friends, would offend most people. But these are as alabaster whiteness and absolute purity, compared with the common practice of crowding into unventilated rooms, and thus sucking into the innermost parts of our vital organs the foulest secretions from each other's skins and lungs. I wish it were possible for these vile exhalations to be imbued with some dark color, if but temporarily. Then decency would join with reason in demanding a pure atmosphere.