An inaugural dissertation on pulmonary consumptionDelafield, Edward
History
An inaugural dissertation on pulmonary consumption
Delafield, Edward
Tuberculosis
Emetics are a powerful remedy in the treatment of Phthisis. They not
only promote expectoration, and relieve the distressing cough in the
first stage of the disease, but by their general relaxing effects
upon the system, are useful in reducing inflammatory action. The use
of this remedy, however, should not in general be commenced until
blood-letting has been premised; otherwise in plethoric habits, full
vomiting might induce hæmoptysis. Practitioners have differed very
much in the choice of emetics proper in this disease. The antimonial
preparations and ipecacuanha, as acting more generally upon the system
in reducing excitement, and from their good effects in other febrile
diseases, appear to be the most proper. But in the last stage of
Consumption, where our object is to relieve the pulmonary symptoms,
without debilitating the patient, the sulphates of zinc and copper are
preferable.
Emetics are not only useful when exhibited for the purpose of full
vomiting, but medicines of the same class given as diaphorectics are
also proper. With this view the various preparations of antimony are in
use. Small doses of the Antimonial powder combined with calomel have
been found, perhaps, one of the best sudorifics that can be employed,
and as such are frequently useful in Phthisis. No medicine is superior
to this combination in reducing inflammatory action; and it frequently
has a better effect by proving both emetic and purgative.
As a sudorific, warm bathing may be very useful, and is an agreeable
remedy in the inflammatory stage of Phthisis. As the warm bath is
useful in relaxing the surface of the body generally; in a similar
manner inhaling warm air, by means of Mudge’s apparatus, relaxes the
inflamed membrane of the bronchiæ, and acts as a fomentation there,
with the same good effect as is produced by warmth and moisture upon
any other inflamed surface of the body. This remedy gives great relief
in the cough and hoarseness so distressing in Phthisis Pulmonalis.
With the same view of counteracting inflammation, cathartics may be
prescribed. As in other febrile diseases, so in Phthisis, the bowels
are frequently torpid, and require the frequent use of aperient
medicines. Saline and mercurial cathartics, possessing the greatest
power in diminishing excitement, are perhaps the most proper in this
disease. But as it is an object not to induce too much debility, the
use of drastic purgatives should be avoided as much as possible, and be
confined to the earliest periods of the disease. During its advanced
stage, the bowels should be kept open by mild laxatives and enemata,
which tend least to debilitate the patient.
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