Therapeutics of tuberculosis : or pulmonary consumption / by Wm. H. Burt. / Title Contents

Title Contents


Page  3 - Title Page

THERAPEUTICS OF TUBERCULOSIS OH PULMONARY CONSUMPTION. BY WM. H. BURT, M.D. OF CHICAGO, ILLINOIS, AUTHOR OF " CHARACTERISTIC MATERIA MEDICA," A MONOGRAPH ON "POLYPORUS OFFICINALIS, POLYPORUS PIIICOLA, USTILAGO MADIS, AND CHINCHONA OFFICINALIS." BOERICKE & TAFEL, NEW YORK AND PHILADELPHIA; IIENRY TURNER & CO., OF LONDON, 77 FLEET STREET. 1876.

Page  4

Copyright, BOERICKE & TAFEL, 1876. LAKE SHORE PRESS, ROUSES POINT, N. Y.

Page  5

on JOHN MEYHOFFER, M.D., OF NICE, IN CONSIDERATION OF THE GREAT BENEFIT DERIVED FROM YOUR LABORS FOUND IN YOUR TREATISE ON CHRONIC DISEASES OF THE ORGANS OF RESPIRATION, I WOULD MOST RESPECTFULLY DEDICATE TO YOU THIS MY HUMBLE EFFORT, WITH GRATITUDE. THE AUTHOR.

Page  7

INTRODUCTORY. TUBERCULOSIS OR PULMONARY CONSUMPTION. It is estimated that more than one-eighth of the entire mortality of the human family is due to the fatal ravages of tuberculosis. It is, therefore, not only the most frequent of constitutional, but also the most common of all diseases. With these facts before the physician, it behoves him to make its treatment a life study. Tuberculous matter is an unorganized material, characterized by a soft, cheesy, pale or yellowish gray colored substanc

Page  8

8 INTRODUCTORY. self, believing that in so doing it would greatly aid the practitioner in successfully combating its fatal ravages. They are the following,1. General atonic condition of the body. 2. Emaciation. 3. Debility. 4. Heamoptysis. 5. Cough. 6. Asthma. 7. Hectic fever. 8. Night Sweats. 9. Aphthae. 10. Diarrhcea. 11. Pain. 12. Bed-sores. The pathology of the disease has been entirely omitted, it being so fully written up in our works on pathology, which are in the hand

Page  9

MEDICAL TREATMENT. 9 Medical Treatment.-Before giving the indications for our r'emedies, it will not only be interesting, but practical, to note down the remedies used in our standard works for this formidable disease. Dr. B. Baehr, in his science of Therapeutics uses forty remedies, namely: Aconite, Cannabis, Kali carb., Pulsatilla, Alumina, China, Kali nit., Plumbum, Arnica, Cuprum, Kreosote, Phos. acid, Belladonna, Causticum, Ledum

Page  10

10 PULMONARY CONSUMPTION. Dr. C. H. G. Jahr, in his "Forty Years Practice," gives thirty-three remedies, but he doubts the virtues of the last ten, as indicated in his work: Aconite, Ferrum, Lachesis, Rhus tox., Bromine, Hepar sulph.,l Mercury, Sulphur, Belladonna, Iodine, Nux vom., Spongia, Bryonia, Ipecac, Nitric acid, Silicea, Calc. carb., Kali carb., Phosphoric acid Stannum, Carbo veg., Kali hyd., Phosphorus, Sambu

Page  11

MEDICAL TREATMENT. 11 Dr. Epps, in his work on "Consumption,":gives thirty~seven remedies, viz: Aconite, Causticum, Ignatia, Phosphorus, Arnica, Cantharis, Kali carb., Pulsatilla, Arsenicum, Clematis, Lycopodium, Quinine, Asafcetida, Cinnamon, Lachesis, Rhus tox., Belladonna, Cod-liver oil, Ledum, Sulphur, Bryonia, Graphites, Mercurius sol., Spongia, Baryta carb., Hepar sulph., Nux vomica, Sepia, Calc. carb., Ilelleborus

Page  12

12 PULMONARY CONSUMPTION. Dr. Richard Hughes, in his "Therapeutics," gives seventeen remedies, viz: Arsenicum, Hyoscyamus, Kreosote, Phosphorus, Calc. carb., Iodine, Lycopodium, Stannum, China, Ipecac., Pulsatilla, Spongia, Drosera, Kali carb., Phos. acid, Sulphur. Dr. A. Charge, in his "Traitement Homceopathique, des Maladies des organes de la Respiration," in the section "Phthisic Pulmonaire, " gives forty-two remedies, and fifteen "Medi

Page  13

MEDICAL TREATMENT. 13 great confidence in, the balance has given him but little satisfaction; they are the following. The truly reliable remedies are: Calcaria carb., China sulph., Kali carb., Natrum m., China, Hepar sulph., Mercury, Silicea, Cod-liver oil, Iodine, Phosphorus, Sulphur. MINOR REMEDIES. Aconite, Conium, Lachesis, Sepia, Apis m., Hyoscyamus, Lycopodium, Stramonium, Arsenicum, Ignatia, Nux vomica, Thuya, Belladonna, Kal

Page  14

14 PULMONARY CONSUMPTION. at once get a true idea of the class of remedies that should be given to arrest it, their grand centre of action must be on the same tissues. This gives us a large number of well tried remedies that will really cure this frightful destroyer. Of course, every remedy in the materia medica will be more or less useful for incidental symptoms, but the grand curative ones must be those having a specific action upon the great vegetative nervous system. Dr. Frost,

Page  15

MEDICAL TREATMENT. 15 which is sometimes mistaken and unavailingly treated for spinal disease. The ganglionic system contains all the hereditary elements of health and disease, which latter may be considered as latent till they begin to be transmitted to some of the organizations which this system supplies. It is believed that the germs of the hereditary dyscrasia, latent in the sympathetic ganglia, may be discovered in the form of minute tubercles in the involuntary organs, in

Page  16

16 PULMONARY CONSUMPTION. met by employing the muscles in such a manner that while they are made to act with more or less force, no greater demand shall be made upon the nervous system than can be easily and healthfully responded to." "-The first thing to be attended to and never to be lost sight of for a moment, is the circulation of the blood. Feebleness of the heart's action, imperfect respiration, poor quality and small quantity of blood, and especially want of affinity between

Page  17

MEDICAL TREATMENT. 17 apparatus is so simple that the most fragile woman, if she can but stand up, can use it with perfect safety. From six weeks to two months exercise, spending each day, ten or twelve minutes in Health-lift exercise, will give her not only a strong muscular system, but health. Consumptives who have been treated by the health-lift have uniformly found their health and strength daily improved, cough and expectoration diminished, appetite improved, pulse slower

Page  18

18 PULMONARY CONSUMPTION. laxed. It will be seen that in this way the spinal column is kept perfectly straight, there being no lateral twist or contortion, as in lifting with a cross-bar between the legs, which is the usual mode as practiced in the gymnasium. RULES FOR THE USE OF THE HEALTH-LIFT. I. —Exercise should be taken usually in the forenoon, about three hours after breakfast.-The reason for this involves the physiological law that exercise of function increases the supply of

Page  19

MEDICAL TREATMENT. 19 1 V.-Avoid competition, and do not strive to see how much you can lift. USUAL EFFECTS PRODUCED BY THE HEALTH-LIFT. Following the exercise most commonly, is a tingling glow over the whole surface of the body, with a sense of buoyancy and vigor which prompts one to want to do something-the exercise seems to have been entirely insufficient-there is a temptation to strike out from the shoulder, to seize the heavy dumb-bells, or " skin the cat " on the suspended

Page  20

20 PULMONARY CONSUMPTION. days, and some absolutely need to lift heavy every day. Temperament, occupation, inherent vitality, etc., etc., all must be taken into consideration. No rule can be laid down for any given case, even by the most experienced. From fifty to eighty pounds will frequently tax the strength of the patient at first, but in the course of three or six weeks, three or four hundred pounds can be lifted with ease. From ten to twelve minutes [ealth-lift exercise once

Page  21

EMACIATION AND DEBILITY. 21 flabby muscles, hair dry and the digested food to blood and tissue looking like tow. Exceedingly does not proceed as it should, we sensitive to the least cold air, have obstructions " intumescence which seems to go through and through him. Feet cold and in the lymphatic and glandular sysdamp continually, as if he had tems, dyscrasial affections of memon cold, damp stockings. branous structures, of all the white Walking produces great fa- structu

Page  22

22 PULMONARY CONSUMPTION. up the oxygen supplied to them in the lungs; and the carbonaceous compounds thus unconsumed, deposit themselves in the form of fat. If this direct action on the corpuscles be granted, many of the phenomena of arsenical poisoning become explicable. No wonder that the blood is black and non-coagulable, resembling that of malignant fever and cholera. Petechial effusions frequently occur, and the chronic poisoning takes the form of a profound This remedy wi

Page  23

EMACIATION AND DEBILITY. 23 disappeared under its use; and a diminution of the functional energy of the ovaries makes it probable that those are similarly affected." The most marked effects of Iodine are: "Over-excitement of the whole nervous system; ebullition of the blood and pulsations over the whole body, increased by every effort; trembling, tottering gait; great debility, atrophy; extreme emaciation; general edema; pulse accelerated, hard and small; hectic fever; variable

Page  24

24 PULMONARY CONSUMPTION. a watery, exhaustive diarrhoea, or much gastric irritability: the tongue is red at the tip and sides; nausea and more or less vomiting. SILICEA.-Emaciation ac LICA.-Emaciation ac In enaciation and debility where companied with more or less suppuration going on in the there are organic changes taking lungs. Profuse night-sweats. place, especially suppuration, it has Much perspiration about the an extraordinary control over the head and chest, especial

Page  25

IODIDE OF POTASSIUM. 25 exhaustive hsemorrhages, long with much acidity of the stomach. lasting, congestive headaches. Anaemia with excessive debility Excessive sensitiveness of the from loss of vital fluids. Most of skin, with much irritability and sadness. The least draft the symptoms of China are aggraof air causes great suffering. vated in the evening and at night. Its great action is to cause debility of the trophic nervous system. Debility is to the nervous system

Page  26

26 PULMONARY CONSUMPTION. STANNUM,-Great weak_ The cases that will be cured by ness of the chest, the least exer- this remedy, will have great prostration puts himallout of breath, tion of the whole cerebro-spinal annot answer questions, there is such debility all centering i nervous system, the most of which the chest; reading aloud, seems to centre in the chest. coughing, or the effort to ex- With the emaciation and debility pectorate produces great weak- the patient is

Page  27

IODIDE OF POTASSIUM. 27 Chronic uterine haemorrhages, that seem to get almost well, and then return again and again. Menses thick and black, and so acrid as to make the vulva and legs sore. The child has great voracity, watches eagerly for everything it sees. Emaciation and debility, with hoarseness and roughness in the throat, and much mucus in the chest. Great dyspncea, shortness of breath and oppression of breathing, Asthma at night. Tearing pains in the outer parts of the

Page  28

28 PUMONARY CONSUMPTION. LYCOPODIUM.- Great In emaciation and debility, where quantities of red sand in the Lycopodium is indicated there will urine. Much pain in the back be found many dyspeptic symptoms previous to urinating, relieved present with an immense accumulaas soon as the urine begins to tion of gas in the stomach and bowflow. Constant sense of satiety. Great accumulation of flatus els, the stomach is often acid, and in the stomach and abdomen, the least quantity of f

Page  29

OLEUM JECORIS ASELLI. 29 Most of the symptoms are aggravated after dinner. I now use the hypophosphorous zincum, with better results than in the metallic form. Oleum Jecoris Aselli.-Cod-liver oil. This is obtained from the liver of the common cod; the process is thus described by Dr. Garrod: "The livers are collected daily, so that no trace of decomposition may have occurred; carefully examined, so as to remove all traces of blood and impurity, and to separate any inferior li

Page  30

30 PULMONARY CONSUMPTION. a large number of other valuable remedies, and it is nonsensical to think they do not act medicinally. Our preparations of the same remedies in which we all have such unbounded confidence, contain far less medicine of each one of the ingredients, at the 30th and 200th attenuation, than the oil. We would like to see the chemist who could give the amount of iodine, the 30th or 200th centesimal attenuation contain to the grain or ounce. We are certain that the

Page  31

OLEUM JECORIS ASELLI. 31 a healthier aspect, colliquative diarrhoea and sweats cease; the natural secretions become more copious, the pulse less frequent. It is difficult to comprehend how it can produce such marvellous manifold salutary effects." (Through the vegetative nervous system it produces these marvellous effects). " When we remember that in a teaspoonful of oil we are administering a dose of Iodine equal to a drop and a half of its 3d decimal dilution, and that we are

Page  32

32 PULMONARY CONSUMPTION. with that of many of my professional friends, is at least quite as strong as any that can be adduced in favor of the brown or impure kind of oil, and it does seem absurd to recommend the exhibition of the remedy in its offensive form, when the pure, fresh oil has been proved to be at least equally efficacious." To get the full benefit of the oil, its use must be persevered in for at least several months, and some patients will find it their staff of life,

Page  33

OLEUM JECORIS ASELLI. 33 part of a moderator to the metamorphosis of nitrogenous substances. On the other hand, that part of the oleagenous matter which has not furnished its share towards the production of animal heat by combustion, does so by its accumulation under the cutaneous surface, or enters as a necessary element into the formation of cells. It is thus evident that Cod-liver oil can only be of service when the destructive nutritive process prevails over the constructive

Page  34

34 PULMONARY CONSUMPTION. (5.) That it increases weight in favorable cases with singular speed, and out of all proportion to the actual quantity taken; that hence it must in some unknown way save waste, and render food more readily assimilable. (6.) That it sometimes fails to increase weight. (7.) That in the great majority of cases where it fails to increase weight, it does little good in other ways. (8.) That it does not relieve dyspncea out of proportion with other symptoms. (9.)

Page  35

CAUTION-EXHIBTTION. 35 (17) That it often disagrees, when the liver is enlarged and probably fatty. (18.) That weight may be increased by it, the cough and expectoration diminish, night sweating cease, the strength which has been failing remain stationary under the use of the oil, and yet the local disease be all the while advancing. "Singular proof," says Dr. Walshe, "of the nutritive power of the agent," and, we may add, of its inefficiency as a medicine. "This admirable exhau

Page  36

36 PULMONARY CONSUMPTION. general tone; this is best accomplished when active morbid processes and local irritation have subsided, for then the system isina condition to appropriate a larger amount of nourishment."-DR. RUDDOCK. Exhibition.-Many people and even children have no trouble in taking Cod-oil, in fact Cod-liver oil is taken better by children than by grown people; but, with some the sweetest oil is taken with great difficulty; those who are so sensitive, should take it i

Page  37

EXHIBITION. 37 scarcely tasted. The proper proportion is two to four tablespoonfuls of the oil to one pound of dough. Patients to whom we have recommended this method of taking the oil assure us that while pleasant and digestible, it is as efficacious taken in this as in any other way.' " Small pieces of ice in each dose of oil also render it almost tasteless." "' Its assimilation is promoted, and its beneficial action greatly enhanced, by the addition of ten drops of the fi

Page  38

38 PULMONARY CONSUMPTION. once very distasteful and nauseating, that of a young lady whose health fail d repeatedly whenever she lived in New Bedford (near salt water), and gained on her going west to Illinois." G. F. Matthes. New -England Medical Gazette, vol. 6, p. 6. I have tested the fumes of I he oil as given above, and am pleased with its action. Inhaling the fumes all night during sleep, will be found of much value in the first stages of phthisis. Latest Modification of t

Page  39

KOUMISS OCR MILK WINE. 39 long time, and is rather agreeable to the taste. If need be, pyrophosphate of iron can be added, or strychnine, or Fowler's Solution. We have used it especially in hysteria and allied affections, and in organic diseases of the nervous system it is also valuable. Consumptives frequently take it in preference to Cod-liver oil. As Cod-liver oil has a somewhat unpalatable name, it is sometimes better, in prescribing for nervous patients, to call this the pho

Page  40

40 PULMONARY CONSUMPTION. emaciation is a marked feature, with most marvelous effects; in fact with such success, that scrofula, and consumption are almost unknown to them, and travellers from all parts of Europe, suffering with phthisis, go into their country to submit themselves to a course of Koumiss, many of whom have returned in perfect health. The success in phthisis has been so great that the imperial government of Russia has established, and supports institutions devoted to

Page  41

KOUMISS OR MILK WINE. 41 my friend, A. Arend, Esq., of 521 W. Madison street, Chicago, the following method to prepare new Koumiss from the old. Mr. Arend is the only chemist, I believe, in the United States, that has really succeeded in making good Koumiss, and he experimented one year before he considered himself qualified to make a good article of the Milk-wine. It is made with such difficulty that it requires the nicest manipulation and most careful attention to all the mino

Page  42

4 2 PULMONARY CONSUMPTION. phosphate of lime and 30 grains of mixed chlorides of sodium and potassium. The physical and chemical characteristics of Koumiss render it an aid upon which the physician can rely with great confidence, for the treatment of extreme debility, and all the phases of impending marasmus." Koumiss not only contains a large proportion of lactic acid, which is a prime constituent of the gastric juice, but holds the casein in that state of vitality which gives it t

Page  43

EXTRACT OF MALT. 43 but a small quantity, for instance a wine glass full, should be taken at once, and this quantity frequently repeated, until as much as one-half or one quart bottle is consumed in a day. As the patient grows stronger and accustomed to this new diet, he will learn to relish the Koumiss and he will be able to take one-half, or one gobletful, or more at a time, and as much as two or three quarts in a day." Infants may be fed on Koumiss exclusively, and they soon

Page  44

44 PULMONARY CONSUMPTION. of causing many to use the nourishing beverage to the great benefit of many suffering invalids, I will refer the reader to larger works devoted wholly to Koumiss. Having seen its salutary effects in my practice, I am anxious that every physician should give his patients the benefit of this fermenting milk. EXTRACT OF MALT. The extract of Malt is a most valuable auxiliary in the treatment of phthisis, bronchitis, scrofula, dyspepsia and general debility. Pro

Page  45

HEEMOPTYSIS. 45 changes are going on in the lungs that will eventually result in fatal tuberculosis. Passive heemoptysis is more intractable than active haemorrhage. When the hbemorrhage comes from the lung tissue itself, the symptoms are more violent, and may prove suddenly fatal. The principal remedies for hwemoptysis and pneumnorrhagia are Aconite, Veratrum viride, Hamamelis, Millefolium, Ipecacuanha, Phosphorus, Ferrum, Arnica, China, Belladonna, Pulsatilla, Crocus, Tr

Page  46

46 PULMONARY CONSUMPTION. it is not so useful. In active hemorrhages from the lungs, this remedy only has to be given to be appreciated. HAMAMELIS.-Especially In hmemoptysis this is well nigh called for in nervous, passive a specific. No remedy has given us hsemorrhages, the blood is e, the bloodissuch prompt and satisfactory redark and comes into the mouth such prompt and satisfactory rewithout any effort, like a warm sufts, in active or passive venous current out of the chest

Page  47

H}EMOPTYSIS. 47 were ascending in the throat, gradually increasing in intensity until blood is raised." Spitting of blood, with violent palpitation of the heart and much excitement, accompanied with a feeling of great oppression of the chest, active haemorrhages from deep ulcerations in the lungs. IPECACUANHA. — Hemor- For acute hkemorrhages, no remrhages from all the orifices of edy is used more frequently than the body, with great and long continued nauswith grea, aom

Page  48

48 PULMONARY CONSUMPTION. difficulty. Fatty degeneration whole organism, have been overof the liver, with much jaun- looked for a long time. In numerous dice. Strong sexual desire, or impotence from sexual cases of poisoning by means of Phosabuse. Tightness across the phorus-matches, and by Phoschest, with dry cough, or rusty phorus-paste, the changes in the spots raised with great difficul- blood are too conspicuous to remain ty. Hard, teasing, dry cough, unnoticed any long