Read Ebook: The Atlantic Monthly Volume 11 No. 68 June 1863 A Magazine of Literature Art and Politics by Various

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THE

ATLANTIC MONTHLY.

A MAGAZINE OF LITERATURE, ART, AND POLITICS.

Entered according to Act of Congress, in the year 1863, by TICHNOR AND FIELDS, in the Clerk's Office of the District Court of the District of Massachusetts.

WEAK LUNGS, AND HOW TO MAKE THEM STRONG.

The highest medical authorities of this century have expressed the opinion that tubercular disease of the various tissues is justly chargeable with one-third of the deaths among the youth and adults of the civilized world. The seat of this tubercular disease is, in great part, in the lungs.

Before the taint is localized, it is comparatively easy to remove it. If in regard to most other maladies it may be said that "an ounce of prevention is worth a pound of cure," in reference to tubercular consumption it may be truly declared that an ounce of prevention is worth tons of cure.

Had the talent and time which have been given to the treatment of consumption been bestowed upon its causes and prevention, the percentage of mortality from this dreaded disease would have been greatly reduced.

NATURE OF CONSUMPTION.

Genuine consumption does not originate in a cold, an inflammation, or a hemorrhage, but in tubercles. And these tubercles are only secondary causes. The primary cause is a certain morbid condition of the organism, known as the tubercular or scrofulous diathesis. This morbid condition of the general system is sometimes hereditary, but much more frequently the result of unphysiological habits. Those cases to which our own errors give rise may be prevented, and a large proportion of those who have inherited consumptive taint may by wise hygiene be saved.

Salt rheum appears on the hand. Some ignorant physician says, "It is a disease of the skin." An ointment is applied; the eruption disappears. Soon, perchance, the same scrofulous taint appears in the lungs in the form of tubercles. The doctor cannot get at it there with his ointment, and resorts to inhalation. He is still determined to apply his drug to the local manifestation.

Salt rheum is not a disease of the skin. It is a disease of the system, showing itself at the skin. Consumption is not a disease of the lungs. It is a disease of the system, showing itself in the lungs.

A ship's crew is seized with some fearful malady. They hang out a flag of distress. Another ship passes near the infected vessel. Its captain discovers the flag of distress. A boat's crew is sent to cut it down. The captain turns to his passengers with the triumphant exclamation, "We have saved them! All signs of distress have disappeared!"

A human body is diseased in every part. A flag of distress is hung out in the form of some malady at the surface. Some physician whose thinking is on the surface of things applies an ointment, which compels the malady to go back within the body again. Then he cries, "I have cured him; see, it is all gone!"

It may be said, that, when the disease attacks the lungs, it must be driven from that vital organ at any sacrifice. I reply, if the drug vapors which are inhaled could disperse the tuberculous deposit,--which is impossible,--the tubercle could not be transferred to any other internal organ where it would do less harm. No other internal organ can bear tuberculous deposit or ulceration with less danger to life.

In 1847, two brothers, bank-officers, afflicted with chronic inflammation of the eyes, came under my care. I repeatedly prescribed for them, but their eyes got no better. Indeed, they had little hope of relief; for, during their years of suffering, many physicians had treated them without avail. At length I told them there was no hope but in absence from their business, and such recreation as would elevate the general tone. A few months of hunting, fishing, and enjoyment in the country sufficed to remove the redness and weakness from their eyes. As I have argued, the disease was not one of the eyes, but of the entire system, which had assumed a local expression.

In brief, a local disease is an impossibility. Every disease must be systemic before it can assume any local expression. Or, in other words, every local pathological manifestation is an expression of systemic pathological conditions.

Now what is the practical value of this argument? I reply: So long as people believe bronchitis to be a disease of the throat, or consumption a disease of the lungs, so long will they labor under the hallucination that a cure is to be found in applications to these parts. But when they are convinced that these diseases are local expressions of morbid conditions pervading the whole organism, then whatever will invigorate their general health, as Nature's hygienic agents, will receive their constant and earnest attention.

CAUSES OF CONSUMPTION.

The following fact graphically illustrates the influence of carbonic acid on human life.

A young Frenchman, M. Deal, finding his hopes of cutting a figure in the world rather dubious, resolved to commit suicide; but that he might not leave the world without producing a sensation and flourishing in the newspapers, he resolved to kill himself with carbonic acid. So, shutting himself up in a close room, he succeeded in his purpose, leaving to the world the following account, which was found near his dead body, the next morning.

"I have thought it useful, in the interest of science, to make known the effects of charcoal upon man. I place a lamp, a candle, and a watch on my table, and commence the ceremony.

"It is a quarter past ten. I have just lighted the stove; the charcoal burns feebly.

"Twenty minutes past ten. The pulse is calm, and beats at its usual rate.

"Thirty minutes past ten. A thick vapor gradually fills the room; the candle is nearly extinguished; I begin to feel a violent headache; my eyes fill with tears; I feel a general sense of discomfort; the pulse is agitated.

"Forty minutes past ten. My candle has gone out; the lamp still burns; the veins at my temple throb as if they would burst; I feel very sleepy; I suffer horribly in the stomach; my pulse is at eighty.

"Fifty minutes past ten. I am almost stifled; strange ideas assail me.... I can scarcely breathe.... I shall not go far.... There are symptoms of madness....

"Eleven o'clock. I can scarcely write.... My sight is troubled.... My lamp is going out.... I did not think it would be such agony to die.... Ten...."

Here followed some quite illegible characters. Life had ebbed. The following morning he was found on the floor.

The steamer Londonderry left Liverpool for Sligo, on Friday, December 2d, 1848, with two hundred passengers, mostly emigrants. A storm soon came on. The captain ordered the passengers into the steerage cabin, which was eighteen feet long, eleven wide, and seven high. The hatches were closed, and a tarpaulin fastened over this only entrance to the cabin.

The poor creatures were now condemned to breathe the same air over and over again. Then followed a dreadful scene. The groans of the dying, the curses and shrieks of those not yet in the agonies of death, must have been inconceivably horrible. The struggling mass at length burst open the hatches, and the mate was called to gaze at the fearful spectacle. Seventy-two were already dead, many were dying, their bodies convulsed, the blood starting from their nostrils, eyes, and ears.

It does not appear that the captain designed to suffocate his passengers, but that he was simply ignorant of the fact that air which has passed to and fro in the lungs becomes a deadly poison.

The victims of the Black Hole in Calcutta and of the Steamer Londonderry, with the thousand other instances in which immediate death has resulted from carbonic acid, are terrible examples in the history of human suffering; but these cases are all as nothing, compared with those of the millions who nightly sleep in unventilated rooms, from which they escape with life, but not without serious injury. As a medical man, I have visited thousands of sick persons, and have not found one hundred of them in a pure atmosphere. I have often returned from church seriously doubting whether I had not committed a sin in exposing myself to its poisonous air. There are in our great cities churches costing fifty thousand dollars, in the construction of which not fifty dollars were expended in providing means for ventilation. Ten thousand dollars for ornament, but not ten dollars for pure air! Parlors with furnace-heat and a number of gas-burners are made as close as possible, and a party of ladies and gentlemen spend half the night in them. In 1861 I visited a legislative hall. The legislature was in session. I remained half an hour in the most impure air I ever attempted to breathe. If the laws which emanated from such an atmosphere were good, it is a remarkable instance of the mental and moral rising above a depraved physical. Our school-houses are, some of them, so vile in this respect that I would prefer to have my son remain in utter ignorance of books, rather than breathe, during six hours of every day, so poisonous an atmosphere. Theatres and concert-rooms are so foul that only reckless people can continue to visit them. Twelve hours in a railway-car exhausts one, not because of the sitting, but because of the devitalized air. While crossing the ocean in the Cunard steamer Africa, and again in the Collins steamer Baltic, I was constantly amazed that men who knew enough to construct such noble ships did not know enough to furnish air to the passengers. The distresses of sea-sickness are greatly intensified by the sickening atmosphere which pervades the ship. Were carbonic acid black, what a contrast would be presented between the air of our hotels and their elaborate ornamentation!

It is hardly necessary to say that every place I have mentioned might be cheaply and completely ventilated.

Consumption originates in the tubercular diathesis. This diathesis is produced by those agencies which deprave the blood and waste vitality. Of these agencies none is so universal and potent as impure air. When we consider, that, besides mingling momentarily with the blood of the entire system, it is in direct and constant contact with every part of the lungs, we cannot fail to infer that foul air must play a most important part in that local expression of the tubercular taint known as pulmonary consumption.

The author of an excellent work on consumption declares,--

"Wholesome air is equally essential with wholesome food; hence it is that crowding individuals together in close, ill-ventilated apartments, as is often the case in boarding-schools, manufactories, and work-houses, is extremely prejudicial, both as a predisposing and exciting cause of tubercular disease."

The great Baudeloque considers impure air the only real cause of scrofula, other causes assisting. He thinks that no scrofula could be developed without this cause, whatever others might be in operation.

To drink from the same tumbler, to eat from the same plate, to wear the same under-clothes, to wash in the same water, even with the cleanest of friends, would offend most people. But these are as alabaster whiteness and absolute purity, compared with the common practice of crowding into unventilated rooms, and thus sucking into the innermost parts of our vital organs the foulest secretions from each other's skins and lungs. I wish it were possible for these vile exhalations to be imbued with some dark color, if but temporarily. Then decency would join with reason in demanding a pure atmosphere.

NIGHT AIR.

Consumptives, and all invalids, and indeed persons in health, are cautioned to avoid the night air. Do those who offer this advice forget that there is no other air at night but "night air"? Certainly we cannot breathe day air during the night. Do they mean that we should shut ourselves up in air-tight rooms, and breathe over and over again, through half the twenty-four hours, the atmosphere we have already poisoned? We have only the choice between night air pure and night air poisoned with the exhalations from our skins and lungs, perhaps from lungs already diseased. A writer pertinently speaks on this point after the following fashion:--

"Man acts strangely. Although a current of fresh air is the very life of his lungs, he seems indefatigable in the exercise of his inventive powers to deprive himself of this heavenly blessing. Thus, he carefully closes his bed-chamber against its entrance, and prefers that his lungs should receive the mixed effluvia from his cellar and larder, and from a patent little modern aquarius, in lieu of it. Why should man be so terrified at the admission of night air into any of his apartments? It is Nature's ever-flowing current, and never carries the destroying angel with it. See how soundly the delicate little wren and tender robin sleep under its full and immediate influence, and how fresh and vigorous and joyous they rise amid the surrounding dew-drops of the morning. Although exposed all night long to the heaven, their lungs are never out of order; and this we know by daily repetition of the song. Look at the new-born hare, without any nest to go to. It lives and thrives and becomes strong and playful under the unmitigated inclemency of the falling dews of night. I have a turkey full eight years old that has not passed a single night in shelter. He roosts in a cherry-tree, and is in primest health the year through. Three fowls, preferring this to the warm perches in the hen-house, took up their quarters with him early in October, and have never gone to any other roosting-place. The cow and the horse sleep safely on the ground, and the roebuck lies down to rest on the dewy mountain-top. I myself can sleep all night long, bareheaded, under the full moon's watery beams, without any fear of danger, and pass the day in wet shoes without catching cold. Coughs and colds are generally caught in the transition from an over-heated room to a cold apartment; but there would be no danger in this movement, if ventilation were properly attended to,--a precaution little thought of nowadays."

Dr. James Blake advises the consumptive to join with several friends, procure horses and wagons, and set off upon a long journey, sleeping in the open air, no matter what the weather. He seems to think this the only way in which it is possible to induce the consumptive to sleep in the fresh air. Doctor Jackson gives the case of a consumptive young man who was cured by sleeping in the open air on a hay-stack. This advice and experience do not quite harmonize with the common terror of night air.

No doubt the lives of thousands would be saved by destroying their houses, and compelling them to sleep in the open air;--not because houses are inevitable evils, but because they are so badly used. Windows are barred and closed, as if to keep out assassins; draughts defended against, as if they were bomb-shells; and the furnace heat still more corrupts the air, which has done duty already--to how many lungs, for how many hours?

Let the consumptive thank God for the blessing of a house, but let him use it wisely. How my heart has ached, to see the consumptive patient put away in a bed, behind curtains, in an unventilated room, the doors and windows carefully closed, to shut out the very food for which his lungs and system were famishing!

I do not wonder that Blake, Jackson, and many others have advised an out-door life of the wildest and most exposed sort, to invalids of this class,--but I do wonder that they have not equally insisted upon abundance of air for them, as pure as that of the fields and mountains, in their own homes, and in the midst of friends and comforts.

MOISTURE IN THE ATMOSPHERE.

It is the common belief that a dry atmosphere is most favorable to the consumptive. Many medical authors have advanced this assumption. It is, nevertheless, an error. In the British Isles and in France, outside the cities and manufactories, the mortality from pulmonary diseases is much less than among the agricultural classes of this country. And on the western shores of this continent consumption is comparatively unknown.

A hundred times have my consumptive patients expressed surprise that the wet weather, in which I have insisted they should go out as usual, has not injured them,--that they even breathe more freely than on pleasant days. Of course, I tell them, if the body is well protected, the more moist the air, the more grateful to your lungs.

There is no possible weather which can excuse the consumptive for keeping in-doors. Give him sufficient clothing, protect his feet carefully, and he may go out freely in rain, sleet, snow, and wind. Ignorance of this fact has killed thousands.

That point of temperature at which the moisture of the air first becomes visible is known as the dew-point. According to one authority, the mean dew-point of England, from the first of November to the last of March, is about 35?; that of our Northern States about 16?. Now suppose a house in England is kept at a temperature of 70?, the drying power would there be represented by 35. A house with the same temperature in Albany, for example, would possess a drying power of 54. This great contrast in the atmosphere of the two countries is strikingly illustrated by the difference between the plump body and smooth skin of the Englishman, and the lean, juiceless body, and dry, cracked skin of the Yankee. It is also shown by the well-known difference in the influence of house-heat upon furniture. Our chairs and sofas and wood-work warp and shrink, while nothing of the sort occurs in England.

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