Terminal illness

“ We need no details to enable all who have watched the progress of disease in the beloved member of a family—and who has been exempted from this anxiety?—to realise how the symptoms of illness, treated at first perhaps lightly, would become more serious, then alarming, until foreboding thoughts of death pained every tender affection ”

“ An incurable disease under the circumstances speedily finds a fatal termination. A patient laid up with a disease, which only admits of a palliative treatment, lives so long as the course of the medical treatment is continued, and will die almost simultaneously with its discontinuance. Just as a prop or a pillar can prevent the collapse of a tumbling edifice, so palliative measures, judiciously applied by a skilful physician, may keep off the inevitable in a disease which knows no radical cure. ”

“ In life-endangering injuries and afflictions the brain and the heart are the organs whose disturbance of function finally ends with death. We can say that in most diseases death takes place through additional development of heart-illness. As regards these science has not by far spoken its last word, but we can say that the clogging up of the blood-vessels of the heart and the destruction of the tender heart-nerves through permanent re-poisoning of the blood is the last cause of death in all chronic diseases. ”

“ The prostration by grief is only equaled by that of violent disease. The blood and all secretions therefrom become so affected that a long time is required to eliminate the morbific matter from the system. If this is not accomplished, [183] lingering illness or death is the final result. This is distinct from sudden death, on the disclosure of some startling news, of grief or joy. The heart in these instances suddenly fails at the nervous shock. Successful labor is always invigorating, while unsuccessful is depressing. ”

“ DEATH. In cases of sudden death interment should be deferred till signs of putrefaction begin to appear, especially when no gradation of disease has preceded, as in cases of apoplexy, hysterics, external injuries, drowning, suffocation, &c. No sooner has breathing apparently ceased, and the visage assumed a ghastly or a death-like hue, than the patient, after his eyes are closed, is too often hurried into a coffin, and the body, scarcely yet cold, is precipitated into the grave. So extremely fallacious are the signs of death that the semblance has been frequently mistaken for the reality. ”

“ Such cases are very rare. The dying person is commonly old, or so worn out by illness as to make death at last no evil. When the illness is shorter, it is usually found that a few hours in the sick room do the work of months of common life, in reconciling the minds of survivors.”
“I am sure that is true,” observed Margaret.
“It is so generally the case that I know no set of circumstances in which I should more confidently reckon on the calmness, forethought, and composure of the persons I have to deal with than in the family of a dying person. ”

“ Death from old age, from natural decay—usually spoken of as death without disease—is most improperly termed by writers an euthanasia. Alas! how far otherwise is the truth! Old age itself is, with the rarest exceptions, exceptions which I have never had the good fortune to meet with anywhere—old age itself is a protracted and terrible disease. ”

“ It first became the expression for the attempt of the physician—originating in human compassion, developed by medical science—to alleviate the end of a dying person by soothing his pain. But then the meaning of the word, and with it the concept of euthanasia, was expanded, and towards the end of the 19th century it meant assistance in dying through an abbreviation of life if the life of the suffering person had lost its value in view of immediate and painful death, or as a result of an incurable disease. ”

“ They have some kind of propitiatory sacrifice however of food and shell money, and whatever prayer they have is made to the spirits of their{31} ancestors. Almost invariably a dying man calls to his father, and we have frequently noticed that when a sick person arrives at this stage of illness, his case is very bad indeed, if not hopeless. ”

“ This purely painless process, this descent by oblivious trance into oblivion, this natural physical death, is the true euthanasia; and it is the duty of those we call physicians to secure for man such good health as shall bear him in activity and happiness onward in his course to this goal. For euthanasia, though it be open to every one born of every race, is not to be had by any save through obedience to those laws which it is the mission of the physician to learn, to teach, and to enforce. Euthanasia is the sequel of health, the happy death engrafted on the perfect life. ”

“ I also had a few people who were beyond help because their vital organs had been so badly damaged that they knew they were dying, and they wanted to die in peace without medical intervention, in a supportive hospice cared for by people who could confront death. ”

“ Tears, wailing, heart-rending death-scenes, the smell of carbolic acid, the cracking of the bones of those seized with cramp, the disgusting symptoms, the incessant tolling of the death-bell, the interment—no, the huddling away—of the dead, for in such cases there is no funeral pomp. All the order of life given up ”

“ Divine Providence hath, therefore, so disposed things that nothing is more uncertain than the hour of death: some die in the womb, some when scarcely born, some in extreme old age, some in the flower of youth, whilst others languish a long time, or die suddenly, or recover from a severe sickness and almost incurable disease; others are only slightly affected, but when they seem secure from death, the disease comes on again, and takes them away. ”

“ Be thankful if they do not become coagulations and produce gangrene, be thankful if they do not reproduce the cancer!
While the patient breathes, we must not lose hope, and however late we be, a judicious examination is never superfluous; at least the cause of death may be known. ”

“ Patients have been admitted suffering from heart disease, aneurism, and cancer, with scarcely a greater amount of melancholy than might be expected to take place in many sane persons at the near and certain prospect of death. ”

“ The violence of the paroxysm often tarns the color of the face into a livid purple, the throbbing of the heart becomes spasmodic, but, when the hopes of the sufferer are almost reduced to the supposed euthanasia of strangulation, the rigor suddenly relaxes, a deep gasp fills the lungs to their very bottom, and a few minutes after the breathing becomes quiet and regular, and only a cold perspiration reminds the patient that he has passed through the chill shadow of death. ”

“ This has probably given rise to the native method of treating this disease—namely, holding a meeting of the patient’s responsible relations, who point out elaborately to him the advantages of life over death, and enquire of him his reasons for hankering after the latter. If in spite of these representations he persists in a course of habitual suicide, he is knocked on the head and thrown into the river; for it is a nuisance to have a person about who is continually hanging himself to the house ridge pole and pulling the roof half off, or requiring a course of sensational rescues from drowning. ”

“ If they die then, they die, like younger people, of disease; and disease is something abnormal. Therefore it is not natural to die at that age. It is only when they are between ninety and a hundred that people die of old age; die, I mean, without suffering from any disease, or showing any special signs of their condition, such as a struggle, death-rattle, convulsion, pallor,—the absence of all which constitutes euthanasia. The natural length of human life is a hundred years ”

“ In Tuesday last he confessed to witness that he had shot himself four times through the chest, and expressed the fear that he had made a bad job of it. He died the following Saturday.
A letter fro the deceased to his brother read as follows: "I have a malignant disease. A sanatorium cure to me would be intolerable. All medical skill can do is at best, palliative. I have been suffering much pain and discomfort. The future must be all pain and sickness, and I should be a burden to myself and nuisance to everybody else. The best thing is to hasten the end. ”

“ Death is supposed to be, in every case, the departure of the spirit from the body, and when the sick person is approaching death the friends and relatives, led by the medicine-man, will often sit around the invalid and sing their petitions to the departing spirit in the hope that it may be led to repent and return to the body. ”

“ It is more so in the coffin than before being placed there. A very sick person who may die begins to be invested with the same awe. Lying in bed by day, the doctor, the silent nurse, the smell of medicines, often suggest that death has begun. ”

“ Gloom, sadness, and despondency depress the vital forces and lead to death. We have seen patients rapidly sinking, who had given up all hope, and were quietly awaiting the coming of death, snatched, as it were, from its grasp, and restored to health, by words of cheer and encouragement. ”

“ The heart, moreover, continues to contract after the lungs have ceased to perform their duty. Death is thus due to apnœa—that is, death beginning at the lungs—and not to syncope. Death in some cases is from neuro-paralysis or nervous apoplexy. In death by shock, which in most cases is instantaneous, both sides of the heart are equally filled. Death, the result of disease, may present all the signs of death from suffocation, and no suspicion may be aroused as to the cause of death from the post-mortem appearances, especially if putrefaction have set in. ”

“ A body is seldom kept longer than one day as, besides the desire to get the dead out of sight, the fear that the disease which caused the death will communicate itself to others of the family causes them to hasten the disposition of it as soon as they are certain that death has actually taken place. ”

“ If he deals only with palliatives, to assuage for a brief period the present suffering, when he can remove the cause, and restore the patient to permanent and perfect health, he is but a quack and an impostor. ”

“ During the next twelve months scarcely less than one hundred thousand persons will die of cancer in this country and a million and a half victims of the disease will breathe their last throughout the world. When we add up all the accidents in industry and transportation, all the wounds in war and civil life, and then add the affections which in one way or another cause mechanical stoppages of processes in the body, for these are the exquisitely painful conditions, it is easy to understand that we need consolation for suffering. ”

“ We are content to encounter the ordinary chances of mortality, let but our children bear the impress of health, and possess the shape of perfect man; but sad and desolating are the reflections that spring from observing in our issue the developments of the evils we have nurtured in ourselves. How many existing beings are there, inhaling the breath of life, in whom every respiration feeds the flame of disease, ignited by those from whose loins they sprung, and is hastening them to a premature tomb. ”

“ They resent the most elementary precautions. If you dare to suggest a post-mortem, they’re up in arms at the idea of ‘cutting poor dear So-and-so up,’ and even if you only ask permission to investigate an obscure disease in the interests of research, they imagine you’re hinting at something unpleasant. Of course, if you let things go, and it turns out afterwards there’s been any jiggery-pokery, the coroner jumps down your throat and the newspapers make a butt of you, and, whichever way it is, you wish you’d never been born. ”

“ To take the case of malignant disease: today the sufferer from carcinoma experiences in spirit, in dread, in foreknowledge, ten times the inevitable anguish of the body; of old such a person would die after great physical pain assuredly, but not after months or years of unspeakable mental agony. And of old the torments of the body might, and often did, become transmuted into the joys of the spirit ”

“ By helping control pain and minimize other symptoms, these men and women bring relief to those who are terminally ill and show them the utmost respect. Hospice care enables many of our citizens to spend their final days in comfort and dignity surrounded by loved ones. This palliative care plays a vital role in our Nation's health care system, and the dedicated work of hospice caregivers helps ensure that our citizens receive the services and support they need. Hospice caregivers also reach out to families and friends to provide guidance and counseling after the loss of a loved one. ”

“ But who is so terrified as the old woman who trips on a rough edge of the carpet and fractures her thigh-bone? How she clings to life! What terrors attend her last few weeks on earth, till merciful pneumonia comes to send her to endless sleep!
I do not remember to have noticed any of that ecstasy which we are told should attend the dying of the saved. Generally, so far as I have observed, the dying man falls asleep some hours or days before he actually dies, and does not wake again. ”

“ If they are rapidly mortal, consciousness will vanish before this discovery; if they result in death later, then it is the same as with other illnesses. All those also who have lost consciousness in water, or from charcoal fumes, or through hanging are well known to say that it happened without pain. And now, finally, the death which is properly in accordance with nature, death from old age, euthanasia, is a gradual vanishing and sinking out of existence in an imperceptible manner. ”