A repetition of colds, and thereby an increase of the disease, will be prevented by wearing flannel next to the skin in winter, and muslin in the summer, either in the form of a shirt or a waistcoat: where these are objected to, a piece of flannel, or of soft sheepskin, should be worn next to the breast. They not only prevent colds, but frequently remove chronic pains from that part of the body.
5. Artificial evacuations, by means of BLISTERS and ISSUES. I suspect the usefulness of these remedies to be chiefly confined to the inflammatory and hectic states of consumption. In the typhus state, the system is too weak to sustain the discharges of either of them. Fresh blisters should be preferred to such as are perpetual, and the issues, to be useful, should be large. They are supposed to afford relief by diverting a preternatural secretion and excretion of mucus or pus from the lungs, to an artificial emunctory in a less vital part of the body. Blisters do most service when the disease arises from repelled eruptions, and when they are applied between the shoulders, and the upper and internal parts of the arms. When it arises from rheumatism and gout, the blisters should be applied to the joints, and such other external parts of the body as had been previously affected by those diseases.
6. Certain FUMIGATIONS and VAPOURS. An accidental cure of a pulmonary affection by the smoke of rosin, in a man who bottled liquors, raised for a while the credit of fumigations. I have tried them, but without much permanent effect. I think I have seen the pain in the breast relieved by receiving the vapour from a mixture of equal parts of tar, bran, and boiling water into the lungs. The sulphureous and saline air of Stabiæ, between Mount Vesuvius and the Mediterranean Sea, and the effluvia of the pine forests of Lybia, were supposed, in ancient times, to be powerful remedies in consumptive complaints; but it is probable, the exercise used in travelling to those countries, contributed chiefly to the cures which were ascribed to foreign matters acting upon the lungs.
7. Lozenges, SYRUPS, and DEMULCENT TEAS. These are too common and too numerous to be mentioned.
8. Opiates. It is a mistake in practice, founded upon a partial knowledge of the qualities of opium, to administer it only at night, or to suppose that its effects in composing a cough depend upon its inducing sleep. It should be given in small doses during the day, as well as in larger ones at night. The dose should be proportioned to the degrees of action in the arterial system. The less this action, the more opium may be taken with safety and advantage.
9. Different positions of the body have been found to be more or less favourable to the abatement of the cough. These positions should be carefully sought for, and the body kept in that which procures the most freedom from coughing. I have heard of an instance in which a cough, which threatened a return of the hæmorrhage from the lungs, was perfectly composed for two weeks, by keeping the patient nearly in one posture in bed; but I have known more cases in which relief from coughing was to be obtained only by an erect posture of the body.
10. Considerable relief will often be obtained from the patient's SLEEPING BETWEEN BLANKETS in winter, and on a MATTRASS[** sic] in summer. The former prevent fresh cold from night sweats; the latter frequently checks them altogether. In cases where a sufficient weight of blankets to keep up an agreeable warmth cannot be borne, without restraining easy and full acts of inspiration, the patient should sleep under a light feather bed, or an eider down coverlet. They both afford more warmth than double or treble their weight of blankets.
However comfortable this mode of producing warmth in bed may be, it does not protect the lungs from the morbid effects of the distant points of temperature of a warm parlour in the day time, and a cold bed-chamber at night. To produce an equable temperature of air at all hours, I have frequently advised my patients, when going to a warm climate was not practicable, to pass their nights as well as days in an open stove room, in which nearly the same degrees of heat were kept up at all hours. I have found this practice, in several cases, a tolerable substitute for a warm climate.
11. The MODERATE use of the lungs, in READING, PUBLIC SPEAKING, LAUGHING, and SINGING. The lungs, when debilitated, derive equal benefit with the limbs, or other parts of the body, from moderate exercise. I have mentioned, in another place[28], several facts which support this opinion. But too much pains cannot be taken to inculcate upon our patients to avoid all excess in the use of the lungs, by long, or loud reading, speaking, or singing, or by sudden and violent bursts of laughter. I shall long lament the death of a female patient, who had discovered many hopeful signs of a recovery from a consumption, who relapsed, and died, in consequence of bursting a blood-vessel in her lungs, by a sudden fit of laughter.