Treating Phthisis With Iodine (Iodum)

Chronic congestive conditions of lung following on acute inflammations are usually connected with the scrofulous diathesis - pneumonic phthisis especially. In such cases, benefit may be obtained from iodine preparations. I prefer the tincture; but the iodide of iron, or the iodide of ammonium, is useful, according to the case.

In the more acute form of tubercular phthisis, when the patient suffers from loss of flesh, quick pulse, high temperature, pain, cough, dyspnoea, and nocturnal sweatings, the tincture, given every four hours, and inhaled, as well as applied locally over the chest, offers a chance of arresting or ameliorating the disease. In some cases under my care, this treatment appeared to check the disease.

In tubercular phthisis, in the absence of acute symptoms, I have seen benefit from iodine and iodides, but have sometimes noticed haemoptysis following their use, and therefore recommend caution in cases disposed to hemorrhage.

Earlier observers - Chevallier, Elliotson, Bardsley, and others - thought iodine really curative in consumption. It can certainly lessen pulmonary induration and modify the irritative conditions of the bronchial mucous membrane and the character of expectoration; in fact, I have seen most symptoms improve under its use, but this must be supplemented by hygiene and generous living. Dr. Cotton's experience at Brompton Hospital was not so favorable: weight was seldom gained under iodide of potassium - generally diminished; dyspepsia was sometimes induced; usually, no definite effect could be traced (Medical Times, ii., 1859). Dr. Julius Pollock, on the other hand, found the remedy very serviceable, and his patients gained weight under its use.

I have noted most benefit in cases of chronic phthisis, and especially when a syphilitic taint existed. Dr. B. W. Foster suggests that it acts by stimulation of the pancreas, thus promoting assimilation of fatty food, and Claude Bernard proved its elimination by that gland. Iodine inhalations in phthisis have proved of great value in my experience, exerting a disinfectant, and to some extent a resolvent action. It is important to guard against soreness of mouth and undue irritation of the air-passages during their use.

Treating Phthisis With Chlorine (Chlorum)

The literature of forty years ago contains many cases of phthisis treated apparently with benefit, both in France and this country, by inhalation of chlorine.

Elliotson recorded some advantage from it, and I remember Sir James Simpson speaking well of the method, and pointing out that bleachers did not usually get phthisis, and that the air of bleaching works was found to cure cough. Further experience has not corroborated the expectations formed, although in cases of offensive and copious expectoration some benefit may be derived from chlorine-inhalation.

In Bronchiectasis and Gangrene of Lung, chlorine-inhalations may certainly give much relief by their stimulant and disinfectant power.

Treating Phthisis With Carbonic Acid (Acidum Carbonicum)

Inhalations of carbonic acid are indicated in certain irritative forms of pulmonary phthisis, as likely to diminish active erethism and slow the progress of destruction (Withering, Beddoes, etc.). The air of stables is said to be beneficial partly for this reason.

Treating Phthisis With Hydrochloric Acid (Acidum Hydrochloricum)

In the early part of this century Dr. Granville published a small treatise "to establish the claims of a new and powerful remedy," and in his second edition (1820) congratulates himself on the conclusive and numerous facts which have proved he was "not indulging in the chimeras of a revery" when he recommended the prussic acid for treating, if not curing, consumption. Being before the days of physical diagnosis, his cases scarcely bear examination, and his peculiar egotistic style jars upon the professional reader; but he may be credited with pointing out the relief often given to the general nervous irritability, the dyspepsia and harrassing cough of phthisical subjects. The exaggerated views entertained both by the eminent Majendie and by Granville as to its powers of checking the disorder and curing asthma, chronic cough, etc., have not been verified by later experience. We can only say that it is a useful palliative for the irritative dry cough, especially in cases when morphia is not suitable, and that with alkalies and calumba it is often serviceable in phthisical dyspepsia.

Treating Phthisis With Sulphurous Acid (Acidum Sulphurosum)

Dr. Dewar has recorded a remarkable case in the person of a groom advanced in phthisis, with emaciation, cough, sweatings, haemoptysis, etc., and apparently in a hopeless condition, who conducted sulphur-fumigations for cattle (v. p. 242), remaining with them in the sheds "with the most wonderful benefit to his own health: within one week the night-sweats had ceased, his cough abated, and expectoration diminished; he gained weight - nearly two stone in four months: is now dependent for his life on one lung only, or nearly so, but with the exception of being somewhat short-winded, looks nearly as strong and as able for ordinary work as before his illness" (Pamphlet: "On the Application of Sulphurous Acid Gas," 1866). He reports four other cases of "chronic phthisis" equally benefited; and Mr. Pairman corroborates his observations; they deserve careful consideration, but up to the present there has been little further trial of the method.

It was thought that the sulphurous spray would be of great service in the relief of phthisical symptoms, but I have not seen lasting or important results from it, though it facilitates expectoration and lessens laryngeal irritation.