Pulmonary disease

“ Sedentary habits of life, accompanied with hard study, and too intense application of mind, predispose literary men to Consumption. Loud public speaking, blowing on wind instruments, glass blowing and other circumstances requiring a laborious and continued action of the lungs, produce the same effect. Any one of these causes may frequently exist without injury, but their combined action seldom fails to produce pulmonary disease. ”

“ I infer that the pulmonary consumption is a disease of the whole system from its analogy with several other diseases, which, though accompanied by local affections, are obviously produced by a morbid state of the whole system.
The rheumatism, the gout, the measles, small-pox, the different species of cynanche, all furnish examples of the connection of local affections with a general disease; but the APOPLEXY, and the PNEUMONY, furnish the most striking analogies of local affection, succeeding a general disease of the system in the pulmonary consumption. ”

“ Nature of the Disease. It is an error to suppose that the disease under consideration is confined to the lungs. "Pulmonary Consumption," as has been remarked, "is but a fragment of a great constitutional malady." The lungs are merely the stage where it plays its most conspicuous part. Every part of the system is more or less involved, every vital operation more or less deranged; especially is the nutritive function vitiated and imperfect. The circulation is also involved in the general morbid condition. ”

“ More and more attention is being directed toward the latter factors and the rôle they play in respiratory infections. Many different factors open the pulmonary portal for organisms and, in this way, terminate by a serious respiratory inflammatory complication what otherwise might have been a relatively mild disease. ”

“ I come now to say a few words upon those palliative remedies which are alike proper in every state of the pulmonary consumption.
The first remedy under this head is a DRY SITUATION. A damp air, whether breathed in a room, or out of doors, is generally hurtful in every form of this disease. A kitchen, or a bed-room, below the level of the ground, has often produced, and never fails to increase, a pulmonary consumption. I have often observed a peculiar paleness (the first symptom of general debility) to show itself very early in the faces of persons who work or sleep in cellar kitchens or shops. ”

“ Pneumonia is not unfrequently an exciting cause of Phthisis. Like catarrh, its frequent repetition is more dangerous than a single attack. Pneumonia may indeed act merely as a predisposing cause of Consumption, by leaving the lungs in a debilitated and irritable condition, favourable to the production of that disease; but it is an exciting cause, when in consequence of inflammation of the lungs, suppuration follows, and vomica or empyema is the consequence. This shews the close analogy between Phthisis Pulmonalis and ordinary Pneumonia. ”

“ Secondary Consumption has also been induced by some other preceeding diseases, such as Scurvy and Syphilis, and requires the attention of the Physician, to the primary disease rather than to the affection of the Lungs.
In the treatment of Pulmonary Consumption, arising from any of these or analogous causes, our attention is first called to the removal of the primary source of the disease. If it be Chlorosis, remedies, calculated to cure that malady, must be prescribed. If profuse evacuations are the cause, all the means in our power, must be employed in restraining [Pg 65] those evacuations. ”

“ The force of so much authority with the evidence adduced, constrains us to admit the communicability of Consumption by contagion. But if this agent has any effect, its action must be extremely limited, and extend no farther than to those previously predisposed to the disease. For daily examples without number occur of the constant attendants upon those labouring under Phthisis remaining perfectly free from that malady.
Violence done to the lungs by blows or other injuries of the chest, has in some instances, excited Consumption. ”

“ One not very strong, or unable powerfully to resist conditions unfavorable to health, and with a predisposition to lung disease, will be sure, sooner or later, by partial lung starvation and blood poisoning, to develop pulmonary consumption. The lack of what is so abundant and so cheap—good, pure air—is unquestionably the one great cause of this terrible disease.—BLACK'S Ten Laws of Health. ”

“ The predisposing causes of this complaint are too numerous herein to detail, but the disease generally commences by a cold, taken in the winter season, which brings on at first a common cough, that from neglect settles on the lungs. The lungs become gradually and increasingly obstructed, inflamed, and ulcerated; a slow fever attends the latter stages of the disorder, when the case imports the existence of considerable danger. Those of a delicate structure and weakly habits, between the ages of 16 and 25, are most liable to this disease. ”

“ In forming a judgment in respect of the prognosis, the amount of the pulmonary affection is less to be considered than the symptoms which relate to the progressive tendency of the disease and to its tolerance by the system. An unfavorable prognosis, however, is to be based on the existence of an amount of the pulmonary affection sufficient to compromise the respiratory function, as shown by notable increase of the frequency of the respirations and by dyspnoea. ”

“ In other cases of pneumonia we get a certain amount of serous effusion into the pleura; and sometimes, especially in children, the pneumonia is followed by the development of an empyema. Pleurisy with effusion is also frequently a complication of valvular heart disease and dilatation of the heart, and in such cases is often associated with the formation of superficial pulmonary infarcts. It is also seen in many other diseases of the lungs. For instance, in chronic pulmonary phthisis pleuritic adhesion's over various parts of the lungs are the rule ”

“ Spitting of blood from the lungs seems in most instances to depend on the presence of tubercular phthisis, or on an inherent constitutional tendency to this disease; and any accidental excitement, as that from cold or undue exposure to atmospherical vicissitudes, may hurry on cases of pulmonary hæmorrhage to a fatal termination. Suckling, in particular, is known to be apt to occasion spitting of blood, which, if not cured in time, usually ends in those symptoms which characterise consumption of the lungs. ”

“ Alexander McAldowie has considered the much-debated question whether pulmonary consumption is an infectious disease in the light of his own infirmary and private practice. lie is of the opinion that it is infectious, although it is not so frequently communicated by infection as it would be were the lungs less well protected than they are against the access of germs. ”

“ Great Triumph.—The universal success of Wells’ Throat and Lung Balsam, in Consumption, Coughs, Bronchitis, Asthma and Pulmonary diseases, is attracting notice throughout the country. It is without question a remarkable preparation, and has given abundant evidences of peculiar efficacy in controlling Pulmonary diseases. Cures of severest forms of long standing throat and lung affections reported every day. ”

“ Since the symptoms progress gradually, COPD patients may not even realize in the early stages that they have the disease. Over the years, as the lung damage continues, breathing becomes increasingly difficult. ”

“ DIAGNOSIS.—The principal diseases from which acute inflammation of any part of the bronchial mucous membrane needs to be differentiated are pneumonia, pleurisy, laryngitis, tracheitis, and asthma, while it is still more important to keep a clear line of diagnosis between the chronic grades of bronchial inflammation and the earlier stages of pulmonary phthisis and of emphysema. ”

“ When we consider the size and peculiar construction of the lungs, their perpetual motion, the chemical process going on in them, and their exposure to the action of contaminated air, or sudden changes in its temperature, it can be no matter of surprise that Pulmonary Complaints are so frequent; and the lungs, not possessing the same natural powers of removing diseased structure, or of mutation as other parts of the body, we may account for their fatal termination from the want of application of proper auxiliaries, as counteractives. ”

“ It is remarkable how many of our disease-enemies appear to have a preference for the lung as a point of attack. In the language of Old Man Means in "The Hoosier Schoolmaster," the lung is "their fav'rit holt." Our deadliest diseases are lung diseases, headed by consumption, seconded by pneumonia, and followed by bronchitis, asthma, etc.; together, they manage to account for one-fourth to one-third of all the deaths that occur in a community, young or old. No other great organ or system of the body is responsible for more than half such a mortality. ”

“ The predisposing and occasional causes of pulmonary phthisis are all the preceding causes of pulmonick hemorrhage; hereditary; scrophulous tubercles; suppuration in the lungs, and not with laudable pus; calculi in the lungs; consequence of pulmonick inflammation and suppuration, of small pox, measles, hooping cough, rickets; and of various acute and chronic diseases; venereal, icterick; chlorosis; worms; rheumatism; chronic asthma; internal abscesses and ulcers; catarrh and neglected colds; sudden suppression of perspiration, especially when the body is heated ”

“ So serious are the disturbances of the circulation all over the body by these spasmodic suffocation-fits, that rupture of small blood-vessels may occur in the eyes, the brain, in the lungs, and on the surface of the skin. The heart becomes distended, and if originally weakened may be seriously dilated or overstrained; the lungs become congested and inflamed, and any of the [Pg 265] numerous accidental germs which may be present will set up a broncho-pneumonia, which is the commonest cause of death in this disease, as in measles. ”

“ There is ample evidence that primary lesions appear not only in the skin and nasal mucosa, but also in the bronchia, intestines, and other parts. Much time and ink have been wasted in attempts to prove that pulmonary lesions are always secondary, and doubtless many are so, but the cases in which the lesions are confined to the bronchia or parenchyma, and the many parallel cases of direct infection of the lungs by other diseases (tuberculosis, lung plague, contagious pneumonia, influenza, etc.,) furnish conclusive enough evidence that the germ may be inhaled and colonize this part first. ”

“ Even primary diseases of the lungs often exist with peculiar violence, or continue for many years without inducing a consumption. I have never known but one instance of the whooping-cough ending in consumption, and all our books of medicine contain records of the asthma continuing for twenty and thirty years without terminating in that disease. The reason in both cases, must be ascribed to those two original diseases of the lungs not being accompanied by general debility. ”

“ All pulmonic patients will, while taking counsel of some physician, do well to remember that their cases rest largely in their own hands; indeed, more depends on their own care of themselves than on the efficacy of any system of medicine. Lung disease is usually of a most flattering character, and its influence on the mind differs from that of any other, in that the patient is lulled into a serene and hopeful condition. ”

“ When death occurs it is usually directly due to heart failure; in some cases it is caused by asphyxia, owing to the great amount of exudation into the lung tissue, rendering its further function impossible.
Complications.—The pulmonary complications of infectious pneumonia are secondary inflammatory or necrotic changes in the lungs themselves. Suppuration at times takes place in the bronchi and may extend to the lung tissue. In this case mucous râles develop which are most distinctly heard over the trachea and on the sides of the chest directly behind the shoulders. ”

“ Violent and serious as are the changes in the lung, it is very seldom that death comes by interference with the breathing space. In fact, while regarded as a lung disease, we are now coming to recognize that the actual cause of death in fatal cases is the overwhelming of the heart by the toxins or poisons poured into the circulation from the affected lung. The mode of treatment is, therefore, to support the strength of the patient in every way, and measures directed to the affected lung are assuming less and less importance in our arsenal of remedies. ”

“ But with regard to the treatment of acute pneumonia I regard the following axioms as fully established, viz.:—
1. The great end of medical practice is to remove the consolidation of the lungs and restore those organs to their natural condition as rapidly as possible.
2662. To this end everything that diminishes vital strength should be avoided, and nutrients administered as early as possible, to favour the cell transformation necessary for removing the exudation from the lungs.
3. There is no relation between the violence of the symptoms or force of the pulse and the fatality of the disease. ”

“ This will soon reduce the inflammation and effect a cure.
PNEUMONIA, Sometimes called Lung Fever, is an acute inflammation of the lungs, usually caused by a cold, and commencing with a chill and feverish symptoms. At first there is a dry cough and what is known as the brick dust sputum, and in the advanced stages a peculiar dark tint in the cheeks, known as the mahogany flush. The breathing becomes very hurried, rising as high as forty respirations per minute. It is an exceedingly rapid and frequently fatal form of disease. ”