Medical Inquiries and Observations, Vol. 2: The Second Edition, Revised and Enlarged by the Author — John Shaqi
Medical Inquiries and Observations, Vol. 2: The Second Edition, Revised and Enlarged by the AuthorRush, Benjamin
Science
Medical Inquiries and Observations, Vol. 2: The Second Edition, Revised and Enlarged by the Author
Rush, Benjamin
Medicine; Yellow fever -- Pennsylvania -- Philadelphia
7. I grant that cutaneous humours, and the matter of old sores, when
repelled, or suddenly healed, have in some cases fallen upon the lungs,
and produced consumption. But I believe, in every case where this has
happened, the consumption was preceded by general debility, or that it
was not induced, until the whole system had been previously debilitated
by a tedious and distressing cough.
If the reasonings founded upon the facts which have been mentioned be
just, then it follows,
III. That the abscess, cough, tubercles, ulcers, and purulent or bloody
discharges which occur in the pulmonary consumption, are the _effects_,
and not the _causes_ of the disease; and, that all attempts to cure
it, by inquiring after tubercles and ulcers, or into the quality of
the discharges from the lungs, are as fruitless as an attempt would be
to discover the causes or cure of dropsies, by an examination of the
qualities of collections of water, or to find out the causes and cure of
fevers, by the quantity or quality of the discharges which take place
in those diseases from the kidneys and skin. It is to be lamented, that
it is not in pulmonary consumption only, that the effects of a disease
have been mistaken for its cause. Water in the brain, a membrane in
the trachea, and a preternatural secretion of bile, have been accused
of producing hydrocephalus internus, cynanche trachealis, and bilious
fever, whereas we now know they are the _effects_ of those diseases
only, in the successive order in which each of them has been mentioned.
It is high time to harness the steeds which drag the car of medicine
before, instead of behind it. The earth, in our science, has stood
still long enough. Let us at last believe, it revolves round its sun.
I admit that the cough, tubercles, and ulcers, after they are formed,
increase the danger of a consumption, by becoming new causes of stimulus
to the system, but in this they are upon a footing with the water,
the membrane, and the bile that have been alluded to, which, though
they constitute no part of the diseases that produce them, frequently
induce symptoms, and a termination of them, wholly unconnected with the
original disease.
The tendency of general debility to produce a disease of the lungs
appears in many cases, as well as in the pulmonary consumption. Dr. Lind
tells us, that the last stage of the jail fever was often marked by a
cough. I have seldom been disappointed in looking for a cough and a
copious excretion of mucus and phlegm after the 14th or 15th days of the
slow nervous fever. Two cases of hypochondriasis under my care, ended
in fatal diseases of the lungs. The debility of old age is generally
accompanied by a troublesome cough, and the debility which precedes
death, generally discovers its last symptoms in the lungs. Hence most
people die with what are called the _rattles_. They are produced by a
sudden and copious effusion of mucus in the bronchial vessels of the
lungs.
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