Treating Phthisis - Chronic Bronchitis With Lime (Calcium)

In the early stages of phthisical anaemia and debility, especially in excitable florid persons with tendency to headache and dyspepsia, also when in later stages profuse sweating, or expectoration, or diarrhoea is present, or when the menses are frequent or profuse, the carbonate or phosphates of lime often exert a good influence in lessening such discharges and in improving strength; even when actual softening has occurred and cavities formed, I have given these salts with the object of assisting cretaceous degeneration, and often with benefit. Lime well supplements cod-liver oil, and the two remedies may be suitably combined, since they form an emulsion readily taken by children- 1 1/2 parts of lime-water to 1 of cod-liver oil is perhaps the best proportion (Medical Times, i., 1862, p. 399). Van den Corput, a Belgian physician, though praising this combination, recommends rather the chloride flavored with anise or such proportions of lime-water, etc., as will make a solid jelly ("jecoro-calcaire savon"), which is still better taken (Medical Times, ii., 1870, p. 624); it has not, however, come much into use in this country. Cod-liver oil does not mix well with syrup of lacto-phosphates, and is liable to become rancid when in contact with it. At a hospital in Moscow excellent results were obtained in the treatment of phthisis by freshly calcined bone.

The hypophosphites of lime were introduced as the best compound for the treatment of phthisis, owing their value in part to the base, and in part to the hypophosphorous acid contained. The rather extravagant praise which was bestowed upon them has not been supported by the majority of the profession, and opinions are still divided as to their real powers. I believe myself that they are sometimes of much service. Ra-buteau remarks that as hypophosphites raise animal temperature, the phosphates would seem more rational remedies for phthisis; that dogs never have phthisis (?), probably because they eat so much bone; also that phosphates are commonly in excess in the urine of the phthisical, and therefore to supply them artificially is reasonable. Charters has lately published illustrations of their value in night-sweats (Lancet, i., 1876), and Gugot has made a similar observation (Husemann). Mr. Pidduck specially praises the iodide of calcium in struma and phthisis; it is tasteless, non-irritant, readily decomposed, but not readily producing iodism (Medical Times, i., 1858). Dr. Sawyer states that he has seen, in chronic phthisis, better results from calcium chloride than from other medicines, hypophosphites of lime and soda included. He recommends 10 gr. of the chloride with 1 dr. of water and of glycerin, to be taken in milk after meals, and finds this often "check night-sweats, increase weight, and dry up pulmonary lesion" (British Medical Journal, i., 1880).

In chronic bronchitis, I have frequently seen lime-water, and also carbonate of lime, act well in diminishing profuse expectoration and troublesome cough; it should be given internally, and the lime-water applied locally by an atomizer.

In Gangrene of the Lung, Dr. Graves advised the chloride with opium.

Treating Phthisis - Chronic Bronchitis With Lead (Plumbum)

At one time, acetate of lead was thought valuable in consumption, and it may relieve some of the symptoms, such as profuse sweating, expectoration, and diarrhoea, but the cases said to be cured by it were probably of chronic bronchitis, with excessive secretion. M. Beau has, however, written comparatively lately to advocate again the advantages of lead treatment in phthisis, recommending the carbonate in gradually increasing doses (Lancet, ii., 1861). He founded his practice upon some cases of phthisis which recovered after working in lead-factories, and concludes that a moderate degree of lead-poisoning is antagonistic to the malady - but such an opinion is not generally accepted. I need scarcely say that other physicians condemn the use of lead salts in phthisis "as worse than useless" (Medical Times, i., 1860, p. 435). The truth probably lies between the two extremes, but a decided objection to any continued use of the drug is its impairment of appetite.