SYMPTOMS.——This disease generally begins with a dry cough, which often continues for some months. If a disposition to vomit after eating be excited by it, there is still greater reason to fear an approaching consumption. The patient complains of a more than usual degree of heat, a pain and oppression of the breast, especially after motion; his spittle is of a saltish taste, and sometimes mixed with blood. He is apt to be sad; his appetite is bad, and his thirst great. There is generally a quick, soft, small pulse; though sometimes the pulse is pretty full, and rather hard. These are the common symptoms of a beginning consumption.
Afterwards the patient begins to spit a greenish, white, or bloody matter. His body is extenuated by the hectic fever, and colliquative sweats, which mutually succeed one another, viz. the one towards night, and the other in the morning. A looseness, and an excessive discharge of urine, are often troublesome symptoms at this time, and greatly weaken the patient. There is a burning heat in the palms of the hands, and the face generally flushes after eating; the fingers become remarkably small, the nails are bent inwards, and the hairs fall off.
At last the swelling of the feet and legs, the total loss of strength, the sinking of the eyes, the difficulty of swallowing, and the coldness of the extremities, shew the immediate approach of death, which however the patient seldom believes to be so near. Such is the usual progress of this fatal disease, which, if not early checked, commonly sets all medicine at defiance.
REGIMEN.——On the first appearance of a consumption, if the patient lives in a large town, or any place where the air is confined, he ought immediately to quit it, and to make choice of a situation in the country, where the air is pure and free. Here he must not remain inactive, but take every day as much exercise as he can bear.
The best method of taking exercise is to ride on horseback, as this gives the body a great deal of motion without much fatigue. Such as cannot bear this kind of exercise, must make use of a carriage. A long journey, as it amuses the mind by a continual change of objects, is greatly preferable to riding the same ground over and over. Care however must be taken to avoid catching cold from wet clothes, damp beds, or the like. The patient ought always to finish his ride in the morning, or at least before dinner; otherwise it will oftener do harm than good.
It is pity those who attend the sick seldom recommend riding in this disease, till the patient is either unable to bear it, or the malady has become incurable. Patients are likewise apt to trifle with everything that is in their own power. They cannot see how one of the common actions of life should prove a remedy in an obstinate disease, and therefore they reject it, while they greedily hunt after relief from medicine, merely because they do not understand it.
Those who have strength and courage to undertake a pretty long voyage, may expect great advantage from it. This, to my knowledge, has frequently cured a consumption after the patient was, to all appearance, far advanced in that disease, and where medicine had proved ineffectual. Hence it is reasonable to conclude, that if a voyage were undertaken in due time, it would seldom fail to perform a cure[[72]].
Such as try this method of cure ought to carry as much fresh provisions along with them as will serve for the whole time they are at sea. As milk is not easily obtained in this situation, they ought to live upon fruits, and the broth of chickens, or other young animals which can be kept alive on board. It is scarce necessary to add, that such voyages should be undertaken, if possible, in the mildest season, and that they ought to be towards a warmer climate[[73]].
Those who have not courage for a long voyage may travel into a more southern climate, as the south of France, Spain, or Portugal; and if they find the air of these countries agree with them, they should continue there, at least till their health be confirmed.
Next to proper air and exercise, we would recommend a due attention to diet. The patient should eat nothing that is either heating or hard of digestion, and his drink must be of a soft and cooling nature. All the diet ought to be calculated to lessen the acrimony of the humours, and to nourish and support the patient. For this purpose he must keep chiefly to the use of vegetables and milk. Milk alone is of more value in this disease than the whole materia medica.