Consumption Curable: Observations on the Treatment of Pulmonary Diseases

by Henry Congreve

It has appeared from the calculations of an eminent Physician, that the annual mortality from diseased lungs throughout Great Britain, amounts to one hundred and forty thousand, and that from this class of disorders more than one third expire from Pulmonary Consumption. When we consider the size and peculiar construction of the lungs, their perpetual motion, the chemical process going on in them, and their exposure to the action of contaminated air, or sudden changes in its temperature, it can be no matter of surprise that Pulmonary Complaints are so frequent; and the lungs, not possessing the same natural powers of removing diseased structure, or of mutation as other parts of the body, we may account for their fatal termination from the want of application of proper auxiliaries, as counteractives. Various and contradictory are the opinions of medical men, as to the hectic fever, which is symptomatic of the disorder, being a primary disease, and some absurd notions have been advanced in support of their statements. The recapitulation of these opinions will not, however, interest the afflicted, or casual reader. One proof of the discrepance of their statements on the origin of this disease, must, however, be advanced: Dr. Young considers that, “the want of proper nourishment is the most frequent cause of Consumption.” If so, it may be inquired, how does it happen that the disease most frequently occurs in the families of the opulent? Dr. Lambe, a man of equal experience, fearlessly asserts, “that an excessive use of animal food is among the most prominent and prevalent procuring causes of the disease,” and consequently recommends a vegetable diet. Surely, it may be observed, these contradictory opinions are not likely to increase the confidence of the public in the healing art.

It has been said, and is generally believed, that Consumptions are incurable. This fact cannot be established. Moreover, the doctrine involves the most fearful consequences; for cases, which in themselves are hopeful, are rendered hopeless from the neglect of proper means, from the groundless apprehensions that no medicines can succeed, and death inevitably ensues. The patient afflicted with cough, expectoration, shortness of breath, and other pectoral symptoms, is calmly consigned to the slow ravages of hectic fever and Consumption. After a few weeks or months of suffering, he dies: this is regarded only as a matter of course. An inspection takes place—the lungs are found studded with tubercles, and an ulcer of more or less extent in some part of them. The pathologist immediately asks, in significant triumph, what possible good could medicines have done in such a case? by what mode of treatment could an organ so diseased have been restored? But another case occurs, the invalid complains precisely of the same symptoms: he has cough, expectoration, wheezing in the chest, and difficulty in breathing—he gradually falls away in flesh, and the hectic fever increases. Palliatives are resorted to, as in the former case, not to cure, which is considered impossible, but simply to alleviate his suffering—he also dies. On inspection, the lungs are found generally sound; no tubercles are discovered; but there is found to be an ulcerated spot of more or less extent in the bronchial membrane. We are forthwith informed, that an ulcerated or thickened condition of the bronchial membrane, with purulent secretion, is a fatal disorder, even although the lungs are otherwise perfectly sound: that in fact, in this case, as there was no difference in the symptoms from the former, and none in the result, so there could have been none made in the method of treatment—that remedies were alike unavailing in both.

Without under-estimating the importance of morbid anatomy, we must observe, that when it is carried to the unwarrantable length of introducing such paralysing and disheartening scepticism into medical science, it is productive of extensive and serious practical evils that counterbalance the benefits which would otherwise result from it. Hundreds, nay, thousands of cases of death are day by day occurring, exactly as above described. Indeed, it is a well-established fact, that in this country alone, the annual number of deaths by pulmonary consumption greatly exceeds 50,000.

When it is considered, further, that in every individual case of the above solemn catalogue of deaths in disease, medical skill has been resorted to, and found unavailing; the practitioner is reluctantly constrained to pronounce every similar case as equally hopeless, and beyond the power of remedies to cure. This is manifestly a fallacious mode of reasoning, leading to an erroneous conclusion.

Before we concede to the morbid anatomist, that an ulcerated or diseased lung is necessarily incurable, we demand, by what direct method can that assertion be proved, that tubercles, once existing in the lungs, cannot possibly be absorbed during life, and the healthy texture again restored? This point cannot be incontrovertibly demonstrated: who then can limit the powers of the living texture in self-restoration? The conclusion, that ulceration of the lungs is incapable of restoration, is founded only upon indirect induction, and amounts, in fact, to nothing but conjecture. There is but one way of disproving the inference that Pulmonary Consumption is incurable, and that is by an appeal to facts. If it can be established that in cases, where, from the attendant symptoms the same reasons have existed for inferring disorders of the lungs to exist, as in the case of those who die; yet that these invalids have, under a judicious mode of treatment, gradually lost these serious symptoms, and have at length recovered—an argument is made out, not only in favour of the possibility of cure in this disease, but positively that it is curable in most of its stages, by adopting those remedies which assist nature in throwing off the diseased matter, healing the injured surface by the application of balsamics and restoratives, possessing the power of new creating, in the lieu of diseased surface, living and healthy structure—so long, we again repeat, as a solitary case of cure has been effected (and there are many) under the most unpromising circumstances, philosophy and humanity alike oppose the practice of abandoning to its fate any case in which there is at least a hope of cure.

Those who allege that Pulmonary Consumption is incurable, from the results obtained by inspections after dissolution, can substantiate no claim to depreciate the efficacy of remedial agents, until they supply us with unequivocal symptoms, whereby we may determine between cases which are and which are not curable. It is mere trifling to assert that all medical means in the cure of the diseased were unavailing, and that the disorder was incurable. This is sufficiently apparent to need that information. But, what we require is, a certain criterion during the life of the patient, to form our judgment between the curable cases, and those which are pronounced incurable; which we must possess before we can admit the necessity of despair in a solitary case. No morbid anatomist has hitherto supplied us with that indispensable information: and the most we can extort from them on the subject is, that in the event of the death of the subject who exhibited certain symptoms of consumption, the disease was necessarily incurable: and the cause assigned is—ulceration in the lungs! But, in the case of recovery of a patient who has experienced similar symptoms, we are informed that there could have been no affection of the vital organs: but, no proof is offered by way of demonstration.

The cases which do terminate fatally are, doubtless, very numerous; and, therefore, the natural conviction deduced from that circumstance is, that wherever diseased lungs make their appearance, all hope of recovery is extinct, and the patient has no alternative but to prepare himself for his exit. Yet, none can deny that recoveries have been effected under the most fearful circumstances, even when solid masses of tubercle have been ejected, or spat up, by which the character of the disease has been most decisive. By reckoning some diseases incurable, and others as past the period of cure, physicians only enact a law of negligence to exempt their own ignorance from discredit and infamy in the eyes of posterity.

It is deplorable that physicians, who have shocked the constitutions of their patients with opium and mercury, never have discovered the mode of effecting a cure. They admit that the fatal issue of this disease they may retard, but cannot avert; and as to their remedies, they have no established mode of treatment; and with respect to their opinions on the origin of the disease, means of arresting it, or palliatives, but few of their number agree; and in ninety-nine cases out of every hundred, they are compelled to abandon the patient to his fate.

It is well known, that those who move in the higher circle of life are frequently the subjects of this obstinate and fatal disorder. Each family has its medical attendant actively engaged when any serious symptom of this disease appears. Patient after patient sinks into an untimely grave, under their united efforts; and the disease is generally pronounced by them of a fatal character. If then, in such extremities, remedial means are discovered which will not only mitigate, but in almost every instance cure the complaint under which the subject labours, such means are entitled to the highest commendation.

As this disorder, like several others, does and will sometimes terminate fatally, in spite of our every effort and means to control it, it is wise to adopt precautionary measures to prevent its approach. The delicate, and those who are susceptible of colds, should avoid exposures to draughts as much as possible, and the change from heated apartments to cold atmospheric air. On the first appearance of cough, they should have immediate recourse to the Balsam before recommended, to deterge the lungs from the obstructing matter—which matter impedes a free respiration, irritates and occasions cough, and ultimately produces the disease. When the disease has further advanced, the Balsam may be regularly taken in the dose of a tea-spoonful, three or four times in the day, mixed with honey (dissolved by heat, and separated from the wax to which it is often combined). The patient must avoid all indigestible meat, and take nutritious broths, jellies, &c., and refrain from spirituous liquors, as he would from a poison. He ought to take gentle and moderate exercise in the early part of the day, when the weather will permit. Whenever a disposition to constipation arises, it should be obviated by the occasional use of mild laxatives, and a salutary relaxation must on no account be checked.