The expectoration at first is merely mucus, but after a time it assumes a characteristic appearance; it has a roundish, flocculent, wooly 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, 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.”
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.
I should be particular in his clothing, taking especial care to keep his chest and feet warm. If he did not already wear flannel waistcoats, let it be winter or summer, I should recommend him immediately to do so; if it be winter, I should advise him also to take to flannel drawers. The feet must be carefully attended to; they ought to be kept both warm and dry, the slightest dampness of either shoes or stockings should cause them to be immediately changed. If a boy, he ought to wear double-breasted waistcoats; if a girl, high dresses.
The diet must be nutritious and generous; he should be encouraged to eat plentifully of beef and mutton. There is nothing better for breakfast, where it agrees, than milk; indeed, it may be frequently made to agree by previously boiling it. Good home-brewed ale or sound porter ought, in moderation, to be taken. Wine and spirits must on no account be allowed. I caution parents in this particular, as many have an idea that wine, in such cases, is strengthening, and that rum and milk is a good thing either to cure or to prevent a cough!