It is asserted, on good authority, that there always are in England, 78,000 cases of consumption, and that the yearly death-rate of this fell disease alone is 39,000! Consumption more frequently shows itself between the ages of fourteen and twenty-one: after then, the liability to the disease gradually diminishes, until, at the age of forty-five, it becomes comparatively rare. Boys are more prone to this complaint than girls. Some of the most important symptoms of pulmonary consumption are indicated by the stethoscope; but, as I am addressing a mother, it would, of course, be quite out of place to treat of such signs in Conversations of this kind. The symptoms it might be well for a parent to recognise, in order that she may seek aid early, I will presently describe. It is perfectly hopeless to expect to cure consumption unless advice be sought at the onset, as the only effectual good in this disease is to be done at first.
It might be well to state that consumption creeps on insidiously. One of the earliest symptoms of this dreadful scourge is a slight, dry, short cough, attended with tickling and irritation at the top of the throat. This cough generally occurs in the morning; but, after some time, comes on at night, and gradually throughout the day and the night. Frequently during the early stage of the disease a slight spitting of blood occurs. Now, this is a most dangerous symptom; indeed, I may go so far as to say that, as a rule, it is almost a sure sign that the patient is in the first stage of a consumption.
There is usually hoarseness, not constant, but coming on if the patient be tired, or towards the evening; there is also a sense of lassitude and depression, shortness of breath, a feeling of being quickly wearied—more especially on the slightest exertion. The hair of a consumptive person usually falls off, and what little remains is weak and poor; the joints of the fingers become enlarged, or clubbed as it is sometimes called; the patient loses flesh, and, after some time, night sweats make their appearance: then we may know that hectic fever has commenced.
Hectic begins with chilliness, which is soon followed by flushings of the face, and by burning heat of the hands and the feet, especially of the palms and the soles. This is soon succeeded by perspirations. The patient has generally, during the day, two decided paroxysms of hectic fever—the one at noon, which lasts above five hours; the other in the evening, which is more severe, and ends in violent perspirations, which perspirations continue the whole night through. He may, during the day, have several attacks of hectic flushes of the face, especially after eating; at one moment he complains of being too hot, and rushes to the cool air; the next moment he is too cold, and almost scorches himself by sitting too near the fire. Whenever the circumscribed hectic flush is on the cheek, it looks as though the cheek had been painted with vermilion, then is the time when the palms of the hands are burning hot. Crabbe, in the following lines, graphically describes the hectic flush:—
"When his thin cheek assumed a deadly hue,
And all the rose to one small spot withdrew:
They call'd it hectic; 'twas a fiery flush,
More fix'd and deeper than the maiden blush."
The expectoration at first is merely mucus, but after a time it assumes a characteristic appearance; it has a roundish, flocculent, woolly form, each portion of phlegm keeping, as it were, distinct; and if the expectoration be stirred in water, it has a milk-like appearance. The patient is commonly harassed by frequent bowel complaints, which rob him of what little strength he has left. The feet and ankles swell. The perspiration, as before remarked, comes on in the evening, continues all night—more especially towards morning, and while the patient is asleep; during the time he is awake, even at night, he seldom sweats much. The thrush generally shows itself towards the close of the disease, attacking the tongue, the tonsils, and the soft palate, and is a sure harbinger of approaching death. Emaciation rapidly sets in.
If we consider the immense engines of destruction at work-viz., the-colliquative (melting) sweats, the violent bowel complaints, the vital parts that are affected, the harassing cough, the profuse expectoration, the hectic fever, the distressing exertion of struggling to breathe—we cannot be surprised that "consumption had hung out her red flag of no surrender," and that death soon closes the scene. In girls, provided they have been previously regular, menstruation gradually declines, and then entirely disappears.
370. What are the causes of consumption?
The predisposing causes of consumption are the tuberculous habit of body, hereditary predisposition, narrow or contracted chest, deformed spine, delicacy of constitution, bad and scanty diet, or food containing but little nourishment, impure air, close in-door confinement in schools, in shops, and in factories, ill-ventilated apartments, dissipation, late hours, over-taxing with book-learning the growing brain, thus producing debility, want of proper out-door exercises and amusements, tight lacing; indeed, anything and everything, that either will debilitate the constitution, or will interfere with, or will impede, the proper action of the lungs, will be the predisposing causes of this fearful and lamentable disease.
An ill, poor, and insufficient diet is the mother of many diseases, and especially of consumption: "Whatsoever was the father of a disease, an ill diet was the mother."