We come now to speak of a disease which in our ever-changing climate is constantly scattering its seeds over the land, gathering its victims alike among the poor and lowly, the sons and daughters of toil, and the gay votaries of fashion, the lovers of luxurious ease, and the mighty throng which ever crowd the various paths of dissipation. Consumption, ghastly messenger of death, how many cheeks have paled as thou with stealthy footsteps and almost noiseless tread hast glided into the sanctuary of their home; how many young mothers hast thou laid in an early tomb; how many bright golden links, uniting hearts in fond affection, severed with thy corroding touch; how many barks freighted with the wealth of genius, of beauty, of deep and holy love, have gone down into the dark ocean of death at thy bidding!

To move on, day after day, week after week, and perhaps month after month, your friends feeling that with each revolving sun the hectic flush is growing brighter, the step more feeble, the form more attenuated, and the stern and perhaps unwelcome truth at length forcing itself upon your own mind, for the victim is too often buoyed up with a delusive hope, and the last to awake to his real situation, that the sands in your hour-glass are fast running out, that death is drawing you on, slowly it may be, yet with a strength, you cannot resist, to his cold embrace, into that dim and shadowy spirit world, where Ms power ends, and the roar of time's waves is never heard - this is consumption.

In another chapter it has been necessary for me to refer to the causes of this disease, and to urge the importance of watching for its first stealthy footsteps, and thus guarding against its entrance, or eradicating it before it has become so deeply planted as to defy control.

I have spoken of it in the chapter on the causes and prevention of disease, as the result of hereditary taint, slow perhaps in its progress, as the sequele of other diseases, as produced by dissipation, exposure to sudden changes of temperature, imprudence in living and dress, and various other causes.

Diagnosis

The incipient stage of consumption can he cured, and even where it is hereditary, I am strongly inclined to believe, that by means of proper physical, moral, and mental training, a proper education of the whole system in childhood, in very many cases at least, the children may escape the doom of the parents. I say that consumption in its incipient stage may be cured, but beware how you allow it to fasten its fangs deep in the system, how you disregard the slight hacking cough, the growing sensation of languor, the weakness of the chest, the increasing flush on the check, and those other symptoms which perhaps at first may be easily removed, but which, disregarded, are like the easy gentle motion of the boat gliding along the outer circle of the maelstrom, the victim unconscious of danger, until, rushing on with increased rapidity he is startled, when, alas, too late, by the roaring vortex below.

The general symptoms of phthisis are, cough, dyspnoea, expectoration, haemoptysis, night-sweats and wasting, hectic fever, hoarseness, or loss of voice, diarrhoea, and various other symptoms, marking the different stages of the disease.

Cough is one of the earliest symptoms. It is at first generally slight and dry, occurring particularly on getting into the bed at night, on getting up in the morning, or after any unusual exertion. It soon becomes more troublesome, and is attended with more or less expectoration. Haemoptysis, another symptom is a kind of expectoration; the expectoration of blood. This is a common symptom, but I have already spoken of it under a separate head. As the disease progresses, the patient is troubled with shortness of breath after but very little exertion, and particularly on going up-stairs or ascending even a slight eminence.

Hectic fever gradually steals on. The patient may in the evening feel chilly, and at night flushed and hot, the skin, particularly the hands and feet, dry and burning, followed during sleep and towards morning by profuse and exhausting perspiration. This perspiration is generally more copious on the upper part of the body, the chest and head, and almost invariably comes on during sleep, the patient on awakening often finding himself drenched.

Diarrhoea is another very common symptom, more frequently, however occurring during the latter part of the disease, and rapidly prostrating the strength of the patient. The voice sometimes for months is almost entirely extinct, the patient grows weaker and weaker, until at length he glides almost without a struggle into the arms of death. Or perhaps for a time the unpleasant symptoms may abate, the strength begin to return, and brightening hope whisper to the soul promises of returning health, when the blow falls and all is over. In tubercular consumption, the tubercles may exist for years without disturbing the health, when by proper treatment they can be removed, but at length they soften and produce ulceration. The rapid form of consumption, which is frequently seen among the young, and after debilitating diseases, is rightly called galloping consumption., for its course is short.

In tuberculous persons, syphilitic, and eruptive diseases, there is often a transfer of the disease from external organs to the lungs, developing a consumption, which speedily carries off the patient.

Treatment

The treatment of this disease in all its stages covers so broad a field as to render it not only impossible but unnecessary to go into the particulars here, as the skill and care of a judicious physician are necessary in its treatment. For the appropriate remedies in the incipient stage, consult "cough" "inflammation of the lungs" dec. In the more advanced stages, among the prominent remedies are, Arsenic, Stan., Merc, Phos., Calc., Carb.-v., Hepar-s., Kal.-oarb., Nit.-ac, and Iodine.

Aconite and Belladonna are more particularly indicated in the congestive variety or when there is sore throat, glandular swelling with heat and fever.

Dose

One drop, or twelve globules, in a glass half full of water, a teaspoonful every two hours until a change. See also congestion of the chest.

Calcarea-carb. Cough as if produced constant cough, dry and exhausting, with pain in the chest. Offensive brown expectoration mixed with pus; cough with lumpy purulent greenish or yellow expectoration; stitches in the side of the chest on coughing, breathing or moving about; chill with thirst; diarrhoea alternating with constipation, perspiration on the chest at night; chill with thirst.

Dose

Six globules morning and night, until a change.

Phosphorus. A valuable remedy; for the indications see Cough and Pneumonia.

Stannum. Constant tendency to cough with sensation of mucus in the chest. Violent fatiguing cough, at times dry, at others moist; cough with greenish or yellowish expectoration of a sweetish or saltish taste. Pains all over the chest; oppression and difficulty in speaking; sense of suffocation.

Dose

Same as Aconite.

Duet And Regimen

Cleanliness, fresh air, and as even a temperature as possible, are of course essential. Often simply a change of air, going from a cold to a warmer or more temperate climate will be sufficient to arrest a disease which seemed almost hopeless. In selecting the food, the wishes and feelings of the patient should be consulted, taking care, however, that while the food is as nourishing as may be, it is as little stimulating as possible.