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himself to be quite well, and was unwilling to undergo further treatment; but the stethoscopic signs did not correspond with his views, and I warned him, that, although the cure was progressing, it was not established. Shortly after this he removed from the neighbourhood, and I lost sight of him until August, 1838, when I received a message from him, earnestly requesting to see me, at a distant part of the metropolis. I found him reduced to a mere shadow, in great poverty, in the last stage of pulmonary disease, and evidently sinking fast. It appeared that, upon his former partial restoration, he had pursued a course of dissipation, which had completely destroyed his already impaired constitution, and he had now been confined to his bed for five weeks. Although I could hold out no hope of recovery, I considered it my duty to alleviate as much as possible his painful physical sufferings; and this object (which no degree or severity of disease can justify the practitioner in relaxing his endeavours to effect) was more fully accomplished by sedative inhalations than by any other palliatives I have ever used myself, or seen employed by others.

REMARKS.-I have notes of several incurable cases of pulmonary consumption (for there are, as a matter of course, periods of disease in which every effort of the remedial art must be equally unavailing and unsuccessful), in which the powers of inhalation, in mitigating the symptoms, have been most remarkably displayed. Putting aside, for the moment, the curative effects of inhalation, the incontrovertible fact of its being with certainty capable of lessening the amount of human suffering, must alone be considered sufficient as demanding the most serious attention, and deserving a full and fair trial from the profession.

It is common for poets and novelists to describe Consumption as a disease of little suffering. They paint the victim of it as slowly fading away, placid in mind, without pain of body, and in the fullest and keenest enjoyment of every sense and faculty; like a withering flower gliding

gently down to the grave, diffusing around her as she fades an atmosphere of increasing sweetness. But, alas! poetry (as a contemporary rightly remarks) is not true to life here. There are few diseases more to be dreaded for the sufferings they occasion. In its commencement Consumption is stealthy. It comes on without any warning of its approach, and is generally firmly seated before it is detected at all. Thus far the descriptions of fancy are correct, but afterwards comes a train of complicated miseries which try even the strongest fortitude.

And there is nothing to console the consumptive in the usual treatment of this disease. Remedy after remedy fails to afford even relief. Change of climate only increases his hardship, and in too many instances hastens the fatal issue. The past presents a bleak and dreary prospect, and the experience of the present-if we except the bright promise of inhalation-no hope for the future.

Such is the stern reality of this terrible disease, divested of all fancy. It presents a concentration of bodily and mental suffering to which there is scarce a parallel in the sad catalogue of ills to which our flesh is heir.

CASE VI. BRONCHITIS.-A gentleman, resident in Yorkshire, came up to town for the purpose of consulting me. He was reduced in strength and appearance, and had suffered for a considerable period from cough, attended with great spasmodic difficulty of breathing, which previous treatment had failed in correcting. A stethoscopic examination revealed chronic inflammation of the mucous membrane of the bronchi. The patient immediately commenced antispasmodic and sedative inhalations, and was sufficiently recovered in ten days to return home, and he was very shortly afterwards quite cured. About four months subsequent to this I was much gratified by receiving the following note:-" I have the pleasure of introducing to you the bearer, a friend and neighbour of mine, whom I have recommended to consult you. With regard to myself, I have already intimated that

I am in good health. I have no cough, nor do I expectorate, and I breathe with the wonted ease of youth. In short, all bronchial irritation has ceased; which I solely attribute, under the blessing of God, to having followed your inhaling treatment."

CASE VII. CONSUMPTION.-A married lady from Worcestershire, aged thirty-six, of delicate appearance and scrofulous habit of body, placed herself under my care, by the advice of a medical friend, from whom she had derived little or no benefit. She was greatly emaciated, and complained of much pain and tightness at the chest, with a distressing cough, accompanied with expectoration of purulent matter, occasionally tinged with blood; animal heat 100°; respiration 30; pulse 120; hectic flushes; night perspirations; and stethoscopic signs of a cavity in the superior lobe of the left lung. The cough and other symptoms supervened after an attack of influenza. The treatment comprised inhalations of bromine (a preparation of iodine), nitro-muriatic lotions to the chest, with the internal exhibition of febrifuges, followed up by the ol: jecin: aselli. The lady remained under my treatment for five weeks, and then returned home, both looking and feeling an altered person. She has ever since been quite free from the slightest symptom of pulmonary disease, and her general health has been good.

CASE VIII. CHRONIC COUGH, SIMULATING CONSUMPTION. -A young gentleman, aged twenty, an University student, of pallid and melancholy countenance, and nervous temperament, consulted me for a dry hacking cough, attended with difficulty of breathing on the slightest exertion, derangement of the stomach, and palpitations of the heart; which symptoms had existed, more or less, for two years. He was much emaciated and depressed in mind; his memory and mental faculties were greatly impaired; indeed, he was one of the most pitiable objects I ever beheld. It was believed that he was labouring under pulmonary disease, but the stethoscopic signs did not justify that opinion.

The hidden source of all the disturbance of the health I soon discovered to arise from youthful imprudence-from moral, not natural causes. The cough, and increased action of the heart, were quickly repressed in a most remarkable manner by sedative inhalations, and his general health was perfectly restored by the abandonment of pernicious habits, the aid of vegetable and mineral tonics, change of air, and horse exercise.

REMARKS.-Cases of this painful nature are too frequently presented to my notice. Mysterious in their nature, delicate in their manifestations, and secret in their causes, they too generally escape the observation, or elude the inquiry, of the practitioner; and, in truth, it may be affirmed, as I have elsewhere remarked (on Mental and Nervous Disorders chap. vii.), that too little importance, and far too small an amount of investigation, have been bestowed upon these most grievous and depressing maladies. By the unaccountable neglect which this interesting branch of medical science has experienced at the hands of those who, from previous education, physiological knowledge, and social and moral opportunity, were obviously most fitted for its elucidation, it has been, as it were, forced under the protection of shameless and extortionate empirics, who, from the peculiar delicacy and secrecy under which such subjects have been shrouded, have been enabled to amass wealth, from the threefold miserable victims of debility, ignorance, and rapacity.

In relation to this class of complaints the language of Dr. James Johnson is very explicit: he observes" that the salutary boundaries of indulgence of even virtuous love are so very unconsciously overstepped, as to occasion a range of moral and physical evil in the human race that would startle the most stoical mind, were that range faithfully and accurately delineated: De tantillâ lætitiâ, quanta tristitia; post tantam voluptatem quam gravis miseria!"" (Bern. C. 3. Med.) The investigation cannot be publicly conducted, but it may be privately prosecuted by the medical philosopher;

and though a path but little explored, it will be found to lead, as Dr. Johnson remarks, to "most important conclusions in the development and treatment of many obscure and anomalous diseases."

I may here incidentally observe that physical and moral health are more closely connected than is sometimes supposed. Physical science therefore, revealing to us, as it does, a knowledge of ourselves, should become a part, and a most important part, of education; and this knowledge will effect, as a great pathologist has remarked, a greater improvement in the morals of mankind than all the sermons that ever have been, or ever will be, preached. Physiological ignorance is the most abundant source of our sufferings. Any person accustomed to the sick, must have heard them deplore their ignorance of the necessary consequences of these practices by which their bodily or mental health has been destroyed; and when men shall be deeply convinced that the eternal laws of nature have connected pain and decrepitude with one mode of life, and health and vigour with another, they will avoid the former and adhere to the latter. And as actions are named immoral from their effects, selflove and morality are so far perfectly the same. Nor is this sort of morality likely to terminate in itself; for the acting with consideration and upon principle will extend from the selfish to the social actions, and regulate the whole conduct of life. At present there is beginning to appear in physiology and pathology something like the simplicity and certainty of truth; and in proportion as the laws of animal nature come to be ascertained, the study of them will be gradually esteemed more worthy of general attention, and it will finally prove one of the most popular, as well as the most curious and interesting, branches of philosophy.

CASE IX. CHRONIC COUGH.-A lady of distinguished title, residing near Southampton, consulted me respecting her daughter, aged about nineteen, who had suffered for many months from a constant irritation in the throat, attended

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