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tient finds himself overpowered, when his attention is not occupied by some among his various fixed or flying pains; the extremes of cold and heat through which he is carried by the daily returns of hectic; the sweats in which his repose by night drenches him; the breathlessness on motion or without motion, arising by degrees to a sense of drowning, and terminating in actual drowning, when there is no longer strength to bring up the fluids secreted in the chest ; the disorder in the bowels, towards the last always threatening, and finally unrestrainable, while it cuts off those indulgencies which the very thirst it creates or aggravates impatiently demands;-these are but a part of the torments under which the physician, during his transient visit, in an immense majority of instances, sees the consumptive labouring. And what are the few minutes of a physician's call, compared to the whole twenty-four hours, lengthened out as they often are to the tenants of the sick chamber, by pain and incapability of amusement on one side, and by tender concern on the other?'
On the subject of climate, as tending to produce phthisis, we meet with many curious and important observations. Dr. Beddoes had conceived, from information, that this disease is little known in the West Indies, but that the Creole women must be liable to it when they come to England. His opinion is confirmed in a letter from Mr. Bryan Edwards, the ingeni ous historian of the West Indies. In Portugal, Dr. B. tells us, consumptions are frequent; and at Lisbon, it is a common expedient to send patients to the other side of the Tagus.' In Italy, phthisis is very common; and the Island of Madeira does not appear, from our author's facts, to be an eligible residence for consumptive patients.
Our curiosity was much excited by the subject of one of Dr. Beddoes's divisions; the Classes Exempt from consumption. We feel some doubt whether his facts be conclusive in establishing these privileged orders, but the hints are highly deserving of attention; not only with reference to the subject of phthisis, but as they shew the advantage which might result from a complete history of the diseases concomitant on particular arts and professions.
In a letter from Dr. Withering written in 1793, which he allowed me to publish, it is remarked that "the only classes of men he had yet observed exempt from the disease (consumption), are butchers and makers of catgut. They both pass much of their time amidst the stench of dead animal matters, the latter very much so; the former live chiefly on animal food, and are much exposed to the inclemencies of the seasons, whilst the latter live as other manufac turers, and work under cover in close and rather warm buildings. These persons are always sleek, often fat, and the rosy bloom of health adorns their cheeks." (Letters from Dr. Withering, and others, to Dr. Beddoes. Johnson, 1793-).
Concerning catgut makers no subsequent information has reached me; but I have since heard soap boilers claim a similar privilege. In the case of the numerous tribe of butchers, the fact, if true, could, I thought, without difficulty be ascertained. The following is the result of my attempts to ascertain it.-I requested a gentleman accustomed to the butchers of Bristol, to examine them generally concerning the healthfulness of their calling, and by no means to put his questions so as to prompt a negative regarding consumption. The notes he took ran literally thus.
"July, 1797, S, has been in business nine years-never had but two persons in that time employed in the slaughter-house, both of them always in health; live on beef steaks, mutton-chops and other meat as often and as much as they please; drink large quantity of malt-liquor, seldom spirits.
"G-, thirteen years in business, Lord bless you, Sir die of a cough! why I never heard of such a thing; every one knows that the "smell of meat" keeps off infection. Why, my husband has often taken sheep into gentlemen's bed-chambers; and if you will read, you will find when the plague was here, all the but chers escaped-never knew any of our men a moment ill.'
, a well-informed man; had a man die about ten months ago of a consumption, coughed exceedingly; got his illness by straining himself in carrying quantities of beef, and then he took to spirits and drank them most excessively he died certainly of a consumption:' worked little in the slaughter-house after this accident. Wages 5s. per week, and every thing found them; plenty of beef and mutton at all times of the day. I am sure the breath of the beasts is good, no people are so free from disorders as we are.'
"B, thirty years in business, docs not recollect any man dying in his service. He has had three or four apprentices at a time; they live well; eat hot meat for breakfast, broth and onions; knew a boy die next door in the slaughter-house, but in consequence of ill usage; he never had any thing the matter with himself.
"B, fourteen years in trade. I never heard of a man dying of a consumption who was a butcher. After a sheep is dead, it is very wholesome to swallow the steam, the smell of meat keeps us from disorders.'
"M, twenty five years in trade, had a son nineteen years of age die of consumption, he did not attend to the business but to the farm; never had any one die who worked for him. Has now same men who have been many years with him, and never ill a moment; drink very hard. Sad drunken beasts all of them.' Knew the man well alluded to by F. he had a shocking cough, and was always drinking drams.
"I find there are about five hundred persons here employed in the trade. I have examined a number of inferior butchers whose answers I have not sent:-they tally so exactly with those of the best informed."
Several other evidences are produced, tending to the same general conclusion.
It seems an objection, however, on the price pneumatic pathology, to the opinion that butchers are served from phthisis by inhaling hydro-carbonat ga, ironine animals which they dismember, (p. 40, 41,) that the plexion of these men is said to be ruddy, and their habit of body vigorous. This would rather bespeak a considerable degree of oxygenation.
From the accounts given, in the Statistical Reports of Scotland, of the habits of living among the fishwomen in the neighbourhood of Edinburgh, Dr Beddoes was led to suppose that they were less liable to consumption than some other classes of people. On inquiry, he found reason to believe that this is the case; and that they consume a larger proportion of animal food than their neighbours. The report of Mr. Kilgour, Surgeon in Musselburgh, deserves to be inserted without abridgment.
"I have (says Mr. Kilgour) just now before me your letter, enquiring if pulmonary consumption be a disease to which people fol lowing the fishing trade are more or less subject than others. After a practice of thirteen years in this place, I can with confidence say, that it is a very rare complaint among them, and scrophula, supposed to be so much connected with it, is hardly with them ever known, although with others a very general disease here. From being subject to violent and laborious exercise, to frequent heats and sudden cools of the body, with much exposure to wetness and moisture in stormy weather, these people (the fishermen) are peculiarly liable to pneumonic inflammation, catarrh, rheumatism, and cholic; and although both pneumonic inflammation, and catarrh, are strong exciting causes of consumption in those predisposed to it, yet in almost no instance have I found this to happen with them. What I have now said concerning the occasional causes of their diseases, refers principally to the men of this class of people, when following their business at sea; but the women are subject to the same complaints from other circumstances attending their trade. In order to sell the fish their husbands have caught, they in cold, warm, wet, or dry weather, carry from this place to Edinburgh an immensely heavy load of them on their backs, with a celerity which is astonishing; and upon this occasion a general race takes place, in order first to gain the market for the highest price; and this violent exercise at all seasons of the year, necessarily produces all the diseases arising from cold. From these frequent colds, their old people are peculiarly liable to that increased afflux of fluids to the lungs, which so generally takes place in advanced age; and they, upon being peculiarly exposed and taking cold, frequently die of peripneumonia notha. This, I cannot help observing, most frequently happens to their women. In some very few instances, I have seen such old people, who had long laboured under this catarrhus senilis, have all the characteristic symptoms of phthisis pulmonalis, viz. exquisitely formed hectic fever, and purulent expectoration, some considerable time before their death:
Beddoes's Essay on Consumptions."
b such cases are very rare. I wish here to have had it in my power 277 to have given you an account of the state of the lungs from dissection, but the liberty of inspecting the bodies being denied me, I canLike all other people of a similar rank of life, who have gains from their labour, they live well, but I do not believe they use in their food a great deal of fish, of which being excellent judges, great they chuse principally the lightest and most delicate. While they do not eat a great number of fish, they live freely upon butcher's meat, and indulge after their meals in drinking copiously of porter, the more generous ales, and spirituous liquors; indeed were they not to live well, it is impossible they could support the fatigue they undergo. From this manner of living it is easy to be seen the habit of body, and the strong predisposition it must induce to peripneu monia potha, so frequently fatal to them in advanced life.”
Sailors and watermen are added to this class by Dr. Beddoes; and Dr. Withering suggests that stable-boys and grooms are little subject to consumption. that dragoons are exempt from this disease, in a remarkable We have reason to believe degree; and we mention this class more readily, because the fact can be easily ascertained by applying to regimental surgeons. To the constant, gentle exercise on horseback, to which heavy troops are accustomed, a great share of the vention must be attributed, if the assertion should be established. The exercise of rowing may also contribute to preprevent the disease in watermen.- We think that Dr. Beddoes has not insisted sufficiently on those contractions of the chest, which are sometimes the result of aukward habits, as much as of general disease; and which may be prevented or corrected in the first instance, by proper muscular exertion.
The result of Dr. B.'s investigations on this subject is that, the persons most free from consumption are precisely those who eat most animal food. Their healthfulness is undoubtedly not to be imputed to this circumstance alone: but it is to be presumed that their substantial diet has its share in determining their personal condition.' (P. 112.) He therefore advises that, where habitual weakness or the history of the family furnishes reason for apprehending consumption, children should be encouraged to use animal food freely. The plan of bringing them up on milk and vegetables is censured as disposing them to scrophula and phthisis. The necessity of exercise, as a preventive, is strongly and justly inculcated; and this part of the book, including the remarks on the influence of prevailing modes of education on health, deserves the serious attention of all who can choose respecting the method of rearing their children.-On the subject of dress and habitations, the example of the Dutch is quoted, to prove that we should be less affected by changes of temperature, if we used
warmer cloathing, and more airy and temperate rooms. The use of flannel is particularly recommended. Much admonition is certainly wanted respecting the dress of the ladies. For persons subject to cold feet, Dr. Beddoes advises a tin footwarmer but we believe that a more effectual method of removing this uneasy sensation will be found in repeated friction. with dry flour of mustard, till a gentle glow is produced on the surface. This practice might be extended, if necessary, to the whole external skin.
In tracing the connection of phthisis with scrophula, Dr. B. produces some observations by Mr. Bowles, to shew the great similarity subsisting between tubercles of the lungs and scrophulous mesenteric glands, in all the stages of their affection.
The frequent use of the blood-warm-bath is enjoined as a preventive of phthisis, and many striking facts are brought forwards to enforce the recommendation. We shall extract two experiments from the very interesting series related by Dr. Marcard; which we beg leave to point out to the attention of our medical readers.
A very striking diminution of the pulse was observed in a child of seven years and a quarter, who lay in a hopeless state of stupor and convulsion, and actually died in sixteen hours after. The pulse could not be accurately counted without the greatest difficulty. In every five seconds, there were more than 16 pulsations; in a minute, therefore, about 200. The child was put into a bath at 93°, because the thermometer, under his armpit, rose no higher, and the tempe rature seemed perfectly agreeable to his feelings, as he was perfectly quiet in the bath. In half an hour the pulse was sensibly slower, and more distinct; and in an hour, the author could count 140 strokes in a minute. It had therefore, in this time, fallen 60 strokes in the minute.
A lady whom her physicians had declared to be hectic, because her pulse was quick, and her flesh wasted, consulted the author. Her pulse, he says, was always 100-106, and occasionally rose to 120 and above, at which time she felt extremely ill. The slightest movement produced this quickness of the pulse, without the feelings of extreme illness.
Before the first immersion, the pulse was 120. The water was heated to 94°, and in half an hour the pulse had not lowered above one or two strokes. That evening and the next morning, it was 96; Dr. Marcard had never found it so low before.
"Before the second bathing, the pulse was 120, and in the bath 122. At first I imputed something to dread of the bath; but the effect conated, though I reduced the bath to go. The pulse was almost always quicker the day of bathing. On the whole it was slower, but always quicker in the bath. After the twelfth bathing, it was constantly at 94° out of the bath; but the thirteenth time of