5. Dyspnoea. – Arsenicum, Ant.-t., Nit.-Strych.
6. Hectic fever, night sweats, Diarrhoea, etc. – Ac.-Phosphorus, China, Hepar sulph., Sambucus, Stann.
7. Various Symptoms. – Kreas. (sympathetic vomiting); Gelsemium (sleeplessness); Phyto., K.-Hydriod., K.-Bich., K.-Carb., Calcarea- C., Spigelia, Ac.-Sulph., Mercurius-Cor.; etc.
LEADING INDICATIONS.- Calcarea carb.-Imperfect digestion and assimilation of food; obstinate acid eructations; relaxed bowels; enlarged glands; sensitiveness to cold and damp; fatigue after slight exertion; Cough; gradual emaciation; and, in females, too frequent and profuse menstruation, or Leucorrhoea.
Phosphorus. – In confirmed, as well as incipient Consumption, especially in girls of a delicate constitution; with frequent, dry, short Cough, so constant as to lead to exhaustion of strength; or moist Cough with greenish foetid expectoration from an Abscess in the lungs; shortness of breath; tendency to Diarrhoea or perspiration; emaciation; pain and soreness of the chest; less of appetite; dry or hot skin; small and quick pulse, etc.
Iodium. – Consumption associated with glandular affections- enlargement or atrophy-diarrhoea from mesenteric disease, and inability to digest fat, laryngeal or tracheal symptoms. Either large appetite or none.
Ferrum. – Anaemia, Diarrhoea, oedema of the lower extremities, emaciation. Ferrum is required in most cases for the constitutional and condition.
Pulsatilla. – This drug is adapted to that form of Indigestion in which fat, an important constituent of a mixed diet, is distasteful, and is not taken without more or less derangement of the mucous membranes.
Lycopodium. – Useful if the chest symptoms are associated with chronic indigestion-intestinal flatulence, Constipation, etc.; also in chronic Pneumonia.
Hyoscyamus. – Night-cough, especially when the cough commences or is aggravated on lying down.
Bryonia. – Tearing dry Cough, as if the chest or the head would burst by the effort; stitching pains in the sides, catching the breath; dyspnoea.
Drosera. – Severe spasmodic Cough, causing frequent discharges of blood. Pain in chest on coughing causing patient to hold his side.
Arsenicum. – Tightness of the chest; oppressed breathing, aggravated by lying down; chilliness in the chest; or soreness and burning from coughing; exhausting Diarrhoea; rapid emaciation; depression of spirits. Arsenicum is valuable in all stages of the disease, and especially in the last.
Hepar Sulph. – Tubercular persons, in the early stage. The chief symptoms are – hoarse, rough, or weak voice, hollow Cough, with expectoration of mucus, sometimes of blood; dyspnoea, especially on lying down; night sweats; pain after the smallest quantity of food; clay coloured or greenish stools.
Sulphur. – Valuable for the constitutional condition; also as an intercurrent remedy throughout the disease.
Nux Juglans. – Tubercle of the lungs, swollen glands, hardness of abdomen, etc. See also Pneumonia, Cough, Haemoptysis, etc. Besides these remedies Tuberculin in some form should be used. It is made from the tubercle bacillus and acts in the manner of a vaccine. It must be given in occasional doses and the repetition of the dose is a matter for most careful and individual attention. It is best avoided in high potencies in acute conditions. Potencies can be used, or one or other of the Tuberculins injected. Rosenbach’s Tuberculin is a valuable form.
Inhalation (see Secale 32) is often a useful method for administering such remedies as Iodine, Kreasote, Aconite, Bryonia, Hyoscyamus, Belladonna, Ipecacuanha, Sulphurous Acid, etc., especially when the throat and large bronchial tubes are involved. Apart from medicines, the simple vapour of hot water is of great utility; it soothes the inflamed mucous membrane, and assists in detaching mucous from the air-passages.
GENERAL MEASURES. – To describe in detail the general treatment of consumptive patients were to write a treatise on hygiene; we shall therefore only mention several of the most important points.
1. Nutritious Food. – The diet should be nourishing, digestible and sufficiently abundant; including animal food twice or thrice a day; fish, especially oysters, good home-made bread, not less than one day old; puddings of arrowroot, rice, sago, or tapioca, with milk; various kinds of green vegetables and mealy potatoes; good milk, eggs raw or beaten up with a little milk; alcohol is best avoided as a rule. Pork should be avoided; also veal; pastry; and all articles that give rise to irritability of the stomach, nausea, eructations, or any other symptoms of Indigestion.
Cod-liver oil must be considered as an item of food, and a very important one; and properly administered may be expected to be productive of the happiest results. If, as is occasionally the case, cod-liver oil disagree with the stomach, the author has found Cream or Maltine of great value as a substitute, though it is inferior.
Koumiss has the reputation of being curative. Cough mixtures, lozenges, etc., should be avoided.
2. Clothing. – This should be sufficiently warm to maintain a vigorous cutaneous circulation; the extremities especially should be kept warm, to obviate Congestion in the chest or abdomen. Silk and wool or linen mesh underclothing is valuable. The great rule is to have the patient warm enough to be comfortable but not over-loaded with clothes. Especially too many bed-clothes must be avoided. There is no better way of dealing with night sweats than to diminish the weight of bed-clothes. In sanatoria they are rarely seen.
3. Bathing and friction of the skin. – Except in confirmed cases, bathing is generally beneficial; even sea-bathing may often recommended. But on no account should the patient bathe when exhausted by fatigue, or when the body is cooling after perspiration. When sea-bathing is not admissible, sponging the chest and back with water to which sea-salt has been added, can generally be borne and enjoyed; and when it is followed by a general glow, it is a most valuable aid in promoting the capillary circulation. Under all circumstances, vigorous friction should immediately follow the bath, as reaction is thus rendered more complete. In cases in which patients are prevented from taking exercise, friction by means of bath-sheets or flesh- gloves is the more indispensable. Bathing must be regarded as injurious if after a brief immersion the surface remains cold, numb, and pale, in spite of the use of good friction, or if the patient is more sensitive to cold after a bath. In such cases, warm salt-baths are recommended.
4. Exercise. – Next to diet, the unrestrained exercise of the muscles and lungs in the pure open air is of the greatest importance. The more fully the lungs are judiciously used, the more is their capacity nursed; and conversely, the less they are used and expanded, the more useless are they likely to become, if not absolutely diseased. Under a judicious system of training, an undeveloped man, even although he may be feeble, narrow- chested, and sickly, may yet become active, full-chested, and healthy. It is therefore within the power of the medical officer to direct the physical training of young persons, so that the apparently sickly and the short winded may in time to developed into the wiry and active young man, long in wind, sound in body, and lithe of limb; a result which, however, can only be attained by judicious feeding, careful exercise throughout the development of the body, and by the gradual nursing of the breathing powers (Aitken). The guide to the regulation of exercise is the thermometer as used in open air sanatoria. Any patient in whom tuberculosis of the lungs is diagnosed should at first be allowed to exercise but slow steady walking, if possible, with occasional ascents of gentle slopes, but all done so slowly as not to make the patient get out of breath; and the limit of distance should be that which does not cause the temperature to rise beyond 100* Fahr., taken immediately after the exercise. If the temperature exceeds 100* then the walking distance must be shortened If it does not exceed 100* then gradually the distance may be lengthened always checking the result with the thermometer. When a distance of eight or ten miles can be traversed without dangerous reaction, other forms of exercise can be cautiously attempted especially out of doors occupations, such as gardening. After a time even heavy digging is permissible. Always the thermometer should be used to measure the reaction.
If possible, exercise should be so taken as to bring all the muscles into moderate and agreeable action, and with the body in an erect posture. Walking exercise secures these conditions to a certain extent; but riding on horse-back has the advantage of permitting the patient to breath a large amount of fresh air, while it does not occasion fatigue or great difficulty of breathing. When a patient can walk and garden without fatigue, other forms of exercise may be tried. Golf is often permissible and croquet or bowels among games. Gymnastics require much caution in their application.
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."