Pulmonary Consumption, or Phthisis pulmonalis, a wasting of the lungs, attended with fever, cough, and expectoration of matter : it is one of the most fatal disorders to which mankind is subject, and therefore requires our most serious attention; as it frequently originates from the most trivial causes.

Persons, who possess what is termed a natural disposition for this malady, generally have a flat, compressed, or otherwise deformed chest; a long, thin neck;-the shoulders sharp-pointed : the teeth are uncommonly white, and not subject to decay.—Two periods in life are said to be particularly obnoxious to phthisis ; namely, the first, from the eighteenth to the twenty-fifth; and the second, between the thirty-third and thirty-eighth year. It has farther been observed, that men are more liable to it than females, and that it occurs less frequently in the West Indies than in Europe.

The following are the principal symptoms which indicate this malady : after a previous complaint in the chest, pains are felt under the breast-bone; shivering, succeeded by heat; the voice becomes shrill; a cough ensues, that gradually increases, particularly on lying down, so as to interrupt the rest; the patient finds himself most at ease on the diseased side. The expectoration at first generally resembles mucus, but afterwards becomes frothy matter streaked with blood : the pulse is rather feverish. Such is the, first, ox inflammatory sage

If these symptoms are not timely relieved, they become extremely aggravated ; the expectorated matter assumes a yellow, green, and brown colour; and is particularly offensive in the morning; the cough and pains increase; the symptoms of Hectic Fever (which see), appear regularly twice a day; the palms of the handss burn after taking meals; the cheeks are of a glowing red ; the body and strength decline. Such are the characteristic signs of the second, ox suppurative period.

In the third, or last stage, all these symptoms are more violent ; the bones project in every part of the body; the temples appear ho low; low; the fare presents a very unhealthy appearance; the eyes sink deep within their sockers ; the nose becomes pointed ; the hair falls off; and the nails curve inwardly. Night-sweats, particularly about the head and chest, together with debilitating offensive loosenesses, now make their appearance. The hands and feet swell; the speech is progressively weakened, till death closes the scene, in most cases, with a gentle tainting. One circumstance is remarkable, that the unhappy sufferer, even at the summit of the disease, always flatters himself with hopes of recovery.

Causes :—Whatever may affect, the organs of respiration, in such a manner as to produce inflammation, for instance, arsenical and Other noxious fumes; the injudicious treatment of catarrhs, and other complaints of the chest; the improper use of astringents, etc. ; after blood-spitting, foreign substances fall into the windpipe (whence stone - masons, miners, hair-dressers, and grinders, are frequent victims to this fatal disease); suppression of habitual evacuations; inordinate, passions; sudden change from heat to cold. It has often been questioned, whether consumption be. hereditary or contagious ; but a superficial observation of the ravages in certain families, would soon resolve any doubt on these points.

The danger attending pulmonary consumption, is such as to leave little or no hope of recovering alter the second stage has once commenced : where it proceeds from an hereditary disposition, it proves incurable. If it originate from suppressed evacuation-, of blood; or the repulsion of cutaneous erup-No. XII.—vol. 1ll.

tions.we may, by a judicious treatment, still flatter ourselves with a favourable issue. The duration of the disease varies according to the difference of constitution, cause and treatment, so that it may extend to twelve months, and even two or three years.

The Cure must be adapted to the cause, stage of the disease, and difference of the season ; but the following may be admitted as general, rules : All irritants and astringents (such as acids, etc.) ought to be avoided, and emollient medicines administered ; the diet must be chiefly, and during the fever entirely, of the vegetable kind, light and nourishing. The utmost temperance is necessary, not to stimulate the blood, and thus increase the hectic fever.—Blisters applied to the back and sides, and other topical applications for deriving the fluids, are highly beneficial in the first stage, but less so in the sequel. All irritating remedies are to be avoided in the inflammatory stage, such as bark, the heating gums, etc.; on the contrary, recourse should be had to gentle evacuations, particularly by small doses of ipecacuanha, so as to produce long-continued nausea. If the inflammation subside, some gentle solvents, such as sal-ammoniac, the Iceland Liverwort (p. 117), with sea air and a voyage, will be found eminently serviceable ; though the latter cannot be supposed to act otherwise than as an emetic: it ought however to be performed in the warm season. Gentle pedestrian exercise is preferable to that on. horseback ; the latter requiring too great an exertion ; but, in cases of extreme weakness, a carriage will be preferable. Should these modes of-G g ex ercise be found inadmissible, recourse may be had to swinging, with benefit to the patient. It is likewise necessary that the atmosphere be mild and pure; hence physicians have been induced to adopt a variety of expedients to answer this purpose. Dr. Bergius, in Sweden, and his followers in France and Britain, recommend a residence in a cow-house, which has uniformly relieved the patient, particularly during the cold seasons. The inhalation of factitious airs, which of late years has acquired some celebrity, can prove of advantage only in the first and second stages.

From a retrospect of the whole, it is evident, that we can flatter ourselves but with small hopes of recovery, after this melancholy disease is once confirmed in the constitution: and how futile are all the various specifics, and other remedies, the bane and disgrace to mankind ! The principal point will consequently always remain, to avoid all those causes, that may affect the lungs, and which we have already specified under the heads of Catarrh, and Cough.