Controlling the milk supply so as to insure the purity of this food, and isolation of the phthisical patient are the two means of a specific kind indicated by pathological research in the sphere of prevention.
By appropriate measures a cure may pretty surely be brought about in at least twenty per cent of all cases. The prognosis is guided, not so much by the extent of the mischief, but by the intrinsic resistance of the individual. The mean duration of cure is at least two and a half years.
The patient should be removed from all debilitating conditions. He should get a maximum of direct sunlight. Direct sunlight is one of the most powerful agents in destroying the tubercle bacillus. Rabbits inoculated with tuberculosis, if confined in a dark, damp place without sunlight and fresh air, rapidly succumb, while others, treated in the same way, but allowed to run wild, either recover or show very slight lesions. It is the same in human tuberculosis. A patient confined to the house-particularly in the close, overheated, stuffy dwellings of the poor-is in a position analogous to that of a rabbit confined to a hutch in the cellar; whereas a patient living in the fresh air and sunlight for the greater part of the day has chances comparable to those of the rabbit running wild. Stress is laid on direct sunlight. The effect of sunlight on tuberculosis other than pulmonary is extra-ordinary. The passage of sunlight through glass robs it of a varying amount of the all important active rays. This is well- evidenced by the difference in rapidity with which sensitised photographic paper prints when exposed to direct daylight as compared with that which first passes through the window pane.
The patient should be constantly bathed in fresh air, but exposure to wind should be avoided. In cases of pulmonary delicacy and even of incipient disease, removal from urban conditions to an open sea, moorland, or mountain air life will in most instances restore health.
Cold is better than heat, and undue moisture is to be shunned.
The regulation of rest and exercise is the fundamental thing in the treatment of tuberculosis. There should be rest for the diseased part, both physical and functional. Hence the difficulty of treating tubercle in parts like the lung or bladder, which do not have complete physical or functional rest.
It is of the utmost importance that fatigue should be avoided; this not only wears out the defensive forces, but is usually accompanied by excessive auto inoculation, the first sign of which is loss of appetite. Exertion pushed to the point of undue fatigue is the commonest cause, both of initiation and relapse.
The diet should be a generous one of ordinary food, with a slight excess of fatty things. The aim is not to make the patient fat, but gradually to increase the weight. Care must be taken not to pus the amount of food beyond the limits of the digestive capacity. The stuffing system is now discarded. Meals should be at considerable intervals to give the stomach sufficient rest.
Sanatorium treatment is merely a convenient and expressive term for the form of treatment which has been worked out at certain institutions known as sanatoria. It does not imply that treatment should necessarily be carried out at an institution. The sanatorium is not to complete cures of phthisis but to educate the patient in the methods and reasons by which cure is to be compassed. For this purpose perhaps a residence of three months may suffice. (See also Section on Tuberculosis of Lungs.)
TREATMENT. – A dose of one of the following medicines may be given once or twice daily, as exerting a favourable influence over the cachexia. As it is often desirable to persevere with one remedy for a long period, it is necessary occasionally to suspend its use for a few days, then to administer a dose or two of an intercurrent medicine, such as Sulphur; and again, after waiting a few days, to resume the former remedy. The most useful remedies are – Calc-C., Sulphur, Iodium, Ferrum, Phosphorus, Arsenicum, and Mercurius
Calcarea. – Is well adapted to those constitutions in which the digestion and assimilation of food does not lead to the formation of good blood and healthy tissues; there is an impoverished, or, on the other hand, a stout, soft, and pale appearance, notwithstanding that a sufficient supply of good food is taken. It is indicated in the cases of enlarged and hard abdomen, so frequently met with in children with a tuberculous tendency. Other indications for this remedy are-a want of firmness of the bones, slow or difficult dentition, glandular swellings, extreme sensitiveness to cold and damp, and, in females, too frequent and profuse period.
Sulphur. – Unhealthy skin; Ophthalmia of children; humid eruptions behind, or purulent discharge from the ears; swelling of the axillary glands, tonsils, nose or upper lip; swelling of the knee, hip or other joints; defective nutrition; colicky pains, mucous discharges, etc.
Phosphorus. – Especially suitable to tall slender persons with fair skin, blonde or red hair. Frequently and easily disordered lungs with a short, dry cough, pain or soreness of the chest, shortness of breath, tendency to diarrhoea or perspiration and general feebleness of constitution.
Arsenicum. – This is one of the most important remedial agents in tuberculosis, when debility is very marked, and the patient has frequent and exhausting discharge from the bowels, sallow complexion, extreme restlessness, thirst and emaciation. The Iodide of Arsenic is also especially valuable in tuberculous affections.
Mercurius-Iod, and Silicea are suitable adjuncts in many cases.
Ferrum-Iodium – Is of great value in the anaemic, impoverished, and cachectic conditions so common in tuberculosis, arising from imperfect assimilation of food.
Aurum. – Chiefly indicated in affections of the bones, and in cases improperly dosed with Mercury. Mental depression. Forum and China are deserving of attention in like cases.
Belladonna. – Head symptoms preponderate. Sudden onset, and as sudden disappearance of symptoms.
Silicea. – Ulcers with callous edges, fistulous ulcers, Scald- head, Otorrhoea; affections of the bones. It may follow Calcarea, especially in disease of the bones.
Mercurius. – Glandular inflammations with much swelling, redness and the pains worse at night in bed, particularly when the glands of the neck are swollen and painful, and there are affections of the eyes; copious saliva; disagreeable taste, and frequent and unhealthy-looking stools; profuse perspiration with most complaints.
Sepia. – Females with menstrual irregularities, corrosive leucorrhoea, unclear skin, yellow saddle across upper part of cheeks and nose and yellow spots on face, etc.
Iodine. – Enlargement of the glands; tuberculous inflammation of the knee; rough, dry, skin; enlarged mesenteric glands, and tender abdomen; emaciated appearance, with hectic. A chronic diarrhoea is well met by this remedy.
Phyto., K-Hydriod., Bary-Carb., Hepar sulph., Staphysagria, or other remedies may be required.
THE INDIGESTION. – In order to correct the derangements of the digestive tract – choice may be made from the following short list of remedies-
Nux Vomica. – Indigestion with flatulence, heartburn, acid eructations, and Constipation or irregular action of the bowels. It is specially indicated in patients of dark complexion, sallow skin, of sedentary habits, or who suffer much from mental fatigue or anxiety.
Pulsatilla. – Adapted to that form of indigestion in which fat, an important constituent of a mixed diet, is distasteful, or not taken without derangement of the mucous membranes. Pulsatilla is generally more suitable for light-complexioned persons, and where there exists a tendency to diarrhoea rather than to constipation from gastric disturbance; otherwise the indications are much the same as for Nux V.
Calcarea Carb. – In addition to the indications before pointed out, this remedy is useful in obstinate acid eructations not cured by Nux V. or Pulsatilla, and when a debilitating relaxation of the bowels is present.
Mercurius. – Faulty action of the liver, shown in yellowish skin and conjunctivae, mental depression, anorexia, etc.
K.-Bich., Bryonia, Ant.-c., or Carbo Veg., may likewise be of service in some cases. See Secale on Dyspepsia.
Cold-liver oil, as a supplemental article of diet, is an agent possessing such remarkable and well-known properties of arresting general or local emaciation as not to require further recommendation here. It may be given in almost any case in which a patient is losing flesh, in teaspoonful doses, two or three times a day, commencing even with half a teaspoonful, if it be found at first to disagree.
Bathing, both in fresh and salt water, is invaluable as a means of promoting a healthy action of the skin, and to imparting tone to the whole system. but it must not be indulged in indiscriminately. The patient should never feel chilly after a bath, should never take a bath when fatigued, or before being called upon make an exertion.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."