vn THE CURE OF CONSUMPTION 65 



a condition sometimes set up by the use of bark or other 

 astringent tonics. 1 



CONSUMPTION. THE CLIMATE OF LONDON 



Fothergill wrote several papers on the cure of consumption, 

 the outcome of a large experience. His first purpose is to 

 enter his protest against the abuse of balsams such as copaiba, 

 tolu and benzoin, then much prescribed for this disorder. 

 Their use in embalming may have led people to infer that they 

 had efficacy in preserving the living also from corruption and 

 decay. They may be good, he allows, in cold serous habits 

 in advanced age, and they may have antiseptic efficacy against 

 purulent ulceration, but (and here he disagrees with Fuller) 

 their heating and acrid qualities are improper when inflamma- 

 tory signs are present. He traces the clinical signs of chronic 

 phthisis, not omitting the patient's " nails bending over the 

 ends of his fingers," and points out that its victims are many 

 of them marked by " excellences both of body and mind," 

 which would have made them conspicuous ornaments of 

 humanity. Treatment, he says, is chiefly of use at the 

 beginning. Influenced by a theory that the quantity of blood 

 passing through the lungs should be moderated, he advises 

 limiting solid food, and gives no meat nor fermented liquors, 

 preferring milk, or where this disagrees, whey ; the addition 

 of rum or brandy has done much mischief. He lays stress 

 on general regimen ; the avoidance of anxiety, fatigue and 

 dissipation ; the keeping of regular hours, with moderate 

 exercise ; horse-riding, which was Sydenham's prime remedy, 

 is useful within limitations. 



As regards drug treatment he condemns such mischievous 

 nostrums as " Godfrey's Cordial " and " Bateman's Drops." 

 He thinks that bark, indicated as it is by the symptoms of an 

 intermittent hectic, is too freely used, but he finds it valuable 

 in certain classes of cases. The Elixir of Vitriol (aromatic 

 sulphuric acid) combined with tincture of roses is good in the 

 later stages of the complaint. He has also tried in some 

 cases the antiseptic effect of inhaling the vapour from boiling 

 brine in the salt-works. Repeated small bleedings are useful 



1 On Painful Constipation from Indurated Faces, an anonymous paper 

 read 1768. Med. Obs. & Inq. iv. 123 ; Works, ii. 99. The local examination 

 and the treatment mechanical removal by the finger, or by the aid of a 

 tallow candle was carried out by the apothecary or his servant at the request 

 of the physician. 



F 



