An inaugural dissertation on pulmonary consumptionDelafield, Edward
History
An inaugural dissertation on pulmonary consumption
Delafield, Edward
Tuberculosis
From this statement it appears, that the number of deaths from
Consumption has gradually increased. The average proportion during the
period mentioned, is as 1 to 4.36. Nearly one fourth of all those who
die in this city are destroyed by this fatal disease.
These facts prove indeed that the power of medicine has little control
over so destructive a malady. But it should not therefore paralyse our
exertions. From what has been done already, in improving our knowledge
of its nature and treatment, a hope may be indulged that consumption
may one day, like many other maladies formerly deemed incurable, be
placed no longer among that number.
INAUGURAL DISSERTATION
ON
PULMONARY CONSUMPTION.
The term Phthisis, or Consumption, in its broadest sense, is applied
to all those diseases, in which the system sinks under a gradual
waste of the powers of life. These diseases may be divided into two
great classes--1. That form of Consumption in which the lungs are
unaffected.--2. Phthisis Pulmonalis, properly so called, where the
lungs are the seat of the disease.
Under the first class are included,
1. Atrophia, or Consumption from want of nourishment, or excessive
evacuations, but without hectic fever; excluding all those forms of
disease produced by immoderate evacuations, in which the lungs become
affected.
2. Tabes, accompanied with hectic fever, frequently attended with
disease of the mesenteric glands, and produced most commonly by
scrophula.
The second class, Phthisis Pulmonalis, to the consideration of which
this essay will be more immediately confined, may be also subdivided
into,
1. Primary, where the lungs are the original seat of the disease, and
as a consequence, the general system becomes affected.
2. Secondary, where the system being first reduced by any debilitating
cause, the lungs become secondarily affected, as a symptom of the
general disease.
These two forms of Consumption, although somewhat similar in their
symptoms, yet proceed from opposite causes, and require opposite
treatment. The one is a disease of pure inflammation; the other of
unmixed debility. In the one, an active antiphlogistic treatment is
necessary; in the other, the system requires all the support, which
tonics and good nourishment can afford.
Phthisis Pulmonalis is thus defined by Dr. Cullen, “_Corporis
emaciatio et debilitas, cum tussi, febre hectica, et expectoratione
purulenta_.” This definition is peculiarly incorrect, because it leads
us to neglect, the first stage of the disease; if the symptoms of an
Incipient Phthisis were stated to us, and we were asked, what was the
disease, from this definition we would be perfectly at a loss for an
answer. Except the cough, none of the symptoms there stated are to be
found in the first stage of Consumption. And yet that is as truly a
part of it, and of as much importance to the practitioner, as the last
stage, which alone is included in Cullen’s definition.[3]
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