MEDICINE. 



27 



of all the plan* that hare been presented to the 

 public. Indeed to those who havewitneaaed the condition 

 to which the lungs are reduced, after they have ex- 

 the ravages of thi* complaint, it can excite 

 no sornnie that all attempts at core should be entirely 

 unavailing, and must impress the mind with the full 

 conviction that it can only be in the very earliest **** 

 that any relief is to be obtained from the interposition 



1 -ine. It is therefore to the prerentKm of Phthisis 



than to its cvre that we are to direct our efforts, 

 if it can be accomplished, must depend upon 

 avoiding the exciting CSUSBS, especially cold and mois- 

 ture, and still more, by using every means for fortify- 

 ing the body against their influence. Warm clothing 

 and airy rooms, moderate exercise, regularity in diet 

 and in all the habiti of life, may do much in preventing 

 the extreme susceptibility to catarrh, but for those 

 whose situation will admit of it, and who are disposed 

 to make so great a sacrifice, the removal to a warmer 

 and more settled climate, is the only effectual preven- 

 tative How far this i* to be advised when the disease 

 has actually eatablidwd itself, or whet stage of Phthisis 

 admits of a chance of cure by Una means, is a question 



1 ? _t_ . fc^^l .I.ICj^Hl* *** 1 1 iiiil mmA tf\ 



nil BJUJBUJ It l BinumBrj '' SB9UUJ t" BUI 'I' . BUB UU r' 



is no point concerning which s pfsctitiutier feels a more 



jyimtiit (ititv !m|X'M-<i tijviii Inni Tfi in t<> |ir< ri-tnvi tin- 



doom of his patient to be hie vocable, by discouraging 

 his removal, or to subject him to a more painful fair, )>y 

 MfMuTVtin nifn frotn tnf comfort** o4T ntc oonw UK! tit*? 



flttfll* MUM OV nH iriCTWl*, WIUMHrt IHtXpCrt OV TtOtf 



In the earlier stages of Phthisis, or where the disease is 

 nth... i-rmg actually 



CFMt OOlOCt M to psTPvmt or cow 

 and yet this mm* be done in each 

 the strength in as 

 General Mood-letting is 



UBBMU) I* VW.k^ -- -I.J, _ - i. -I ^K^UVBAAA UB*BlV dhAB>UMK 



['.. 1 n :j*T f' .i.v. i\* I M *-i-<injr- (-> WI'M i.*i,'..,'tl , 



we may with sees fcmard employ topical bleeding, if 

 the pam of the cheat sad state of the poise seem 

 uunsut it ***! ^ni nMire blisters which are ncrhaiM the 

 meat powerful remedies that wo possess in this dtasuse. 



We must endeavour to allay the cough by mucflagi- 



?_,, .,_ , . i i __ii ^" . ' 



nous mixtures, to wmen amau quantities or opsuin may 



be added, and we may endeavour to allay the fever by 



away 



if 



for us to sooth the termination of life, by diminishing, I'rwtit*. 

 as far ai lies in our power, the various sources of un- """ nr~ 

 easiness that from time to time rise up to distress the 

 patient. Every candid practitioner will confess, thit, 

 beyond this, he can have no expectation of obtaining 

 the least relief from the aid of medicine ; and it is a 

 duty which he owes to himself no less than to his pa- 

 tient, to refuse his consent to any of those experiments, 

 which, with whatever pretensions they may be sup- 

 ported, must be regarded as the offspring either of de- 

 Luion or of empiricum. 



SKCT. VI. Rac/utit. Rickets. 



Another disease, which, like Phthisis, is supposed to Rachitis. 

 be nearly allied to Scrofula, if not to be a mere modi- 

 fication of it, ii Rickets. It would seem to have first 

 made its appearance in modern times, for it is too re- 

 markable in Its symptoms to have been overlooked ; 

 and there is probably some reason to believe that it is 

 not now so frequent as it was half a century ago. It 

 is essentially a disease of the bones, in which th.y in- 

 crease in bulk, and at the tame time lose their firmness, 

 so as not to bear the weight of the parts attached to 

 them without being bent out of their natural form. It 

 makes its firat appearance at an early age, and conti- 

 nues until about the period of puberty. During this 

 interval the patient suffers from the immediate effects of 

 the distortion that i* produced in various parts of the 

 body, as well as from irregularity in the different or- 

 ganic functions, and especially in those of the digestive 

 organs, so as to induce a great degree of emaciation 

 and debility, which not unfrequently affect the mental 

 as well as the corporeal faculties, and ultimately pro- 

 ceed to a fatal termination. When the disease assume* 

 a lees acute form, the powers of the constitution finally 

 overcome the violence of the disease ; but the deformi- 

 ty of the bones still continue* ; and when it has affected 

 the trunk of the body, it often materially deranges some 

 of tlir function*, and leaves the parts in a state from 

 which they can never afterwards recover themtelves. 

 The cause of RickeU is not yet ascertained ; many of the 

 which tend to induce Scrofula seem also 



i i 

 oMpnoroc 



IP t 'K .u It n , i 



but we must proceed with great 



i of any suhstanot that is intended 

 to act upon the capillaries of the akin, in wnsoqutnce 

 of the tendency to profiue perspiration, which always 

 exists m the latter stages of Phthisis ; the same remark 

 Mil also to the bowels. I low far any benefit i* to 

 ho expected from sedatives is still a 





; 'tar although we apprehend thef can be no doubt 

 of the advantage which is nrraainnaHy derived from 

 digitalis, in certain iniemmaliiiy Mates of the chest, 

 yet we are not disposed to expert much iruro it where 

 the itracture of the long* is affected. A, however, 

 we have no means of ascertaining when thi* criiu has 

 actually occurred, a cautious eutployment of digitalis 

 my be generally admiible ; but it hmild alway* be 

 given in mall dote*, and we think it may be assumed 

 as a general principle, that if no benefit be obtained 

 from Mnall dosti of this medicine, we arr not to hope 

 fir any advantage by increasing the quantity, on the 

 coulmj, we should expect that its deleterious opera- 

 tion would be induced with ill it* tr*in of distressing 

 consequences. When the hectic ii fully retscHsbed, 

 nothing n to be attempted but the palliative treatment, 

 and for thi we Bust rater to the remark* that we have 

 already offered on the subject It only now remain* 



to favour the appearance of Rickets ; but we are dispo- 

 sed to regard them as distinct complaints, because we 

 do not perceive that the symptoms are necessarily con- 

 nected together ; but, on the contrary, that they com- 

 monly attack certain individuals separately, and are not 

 convertible into each other. The affection is generally 

 thought to be hereditary, yet the tendency is not so ob- 

 vious in this case as in Scrofula, or in Phthisis ; and we 

 perpetually observe examples, where s single member 

 of a family is diseased without any other suffering from 

 it. The proximate cause of Rickets appears to be a 

 change in the physical and chemical constitution of the 

 bones, the animal matter which enters into their com- 

 position being probably in a morbid state, and the earthy 

 matter either deficient in quantity, or altogether want- 

 ing ; but in what way thee changes are effected, or 

 how they follow from the exciting cause, we are alto- 

 gether unable to explain. 



We have very little to offer respecting the cure of TrMtasmt. 

 Rickets more than that we must adopt every means 

 which lies in our power for removing the supposed ex- 

 citing causes, and for promoting the general health. 

 The disease seldom exhibits any inflammatory symp- 

 tom*, so as to render bleeding necessary ; but the de- 

 rangement of the digestive organs, and the torpor of 

 the alimentary canal, make purgative! an essential part 



