Advice to a wife and mother in two parts

by Pye Henry Chavasse

There is usually hoarseness, not constant, but coming on if the patient be tired, or toward the evening; there is also a sense of lassitude and depression, shortness of breathing, 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 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 about 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.

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 toward 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 toward 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.

362. What are the causes of Consumption?

The predisposing causes of consumption are the scrofulous 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, overtaxing 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.”

The most common exciting causes of consumption are slighted colds, neglected inflammation of the chest, long continuance of influenza, sleeping in damp beds, allowing wet clothes to dry on the body, unhealthy employments—such as needle grinding, pearl-button making, etc.

363. Supposing a youth to have spitting of blood, what precautions would you take to prevent it from ending in Consumption?

I should let his health be the first consideration; I should throw books to the winds; if he be at school, I should advise you to take him away; if he be in trade, I should cancel his indentures; if he be in the town, I should send him to a sheltered healthy spot in the country, or to the south coast; as, for instance, either to St. Leonards-on-Sea, or to Torquay.