RESPIRATION, ITS EFFECTS; MORE ESPECIALLY IN RELATION TO ASIATIC CHOLERA, AND OTHER SINKING DISEASES. BY EMMA WILLARD, » 4 • Author of "A Treatise on the Motive Powers ¦which produce the Circulation of the Blood," and various Historical and Educational Works. NEW-YORK : M UNTINGTON & SAVAGE, No. 216 Pearl-street. • 1849. SYNOPSIS AM) TABLE OF CONTENTS. Note. — The subjects of the following work are essentially two, — certain remarkable facts, and the reasons of those facts. The reasons are before the facts in the order of time and causation : and are, therefore, in this work, placed first, occupying the two first Sections ; but if any reader prefers to reverse the author's method, and peruse the facts first, he can do so by beginning with the third Section. PAGE SECTION I.— Importance of Respiration 7 Its Four Primary Effects— Heat — Circulation— Digestion— Strength ib. New argument to prove that ( 'irculation is an effect of Respiration, derived from collapse of the Lungs, believed to be distended by Steam 6 The Ease of breathing — Cause of — Effects of the vacuum of the Chest on the Circulation of the Blood in the Veins— Cholera confirms the foregoing statements -The heart beats faster, but the blood moves slower — Its action not the cause of circulation 14 Post-mortem examinations confirming the foregoing theory — Arteries empty when vapor or steam condenses 15 SECTION II. — Cholera— Definition— With good breathing no one can have choler — The four primary efl'ect of good breathing all deficient in cholera seasons 16 In what order they fail— State of the liver 17 Color, condition and motion of the blood, all caused by heal 18 Coldness by cholera firsts affects the bottom of the lungs 20 Want OF good biikathing the cause of cholera ib. What good breathing is, and what are its normal conditions 21 Which of these do not fail in cholera seasons. . ib. Which do fail in cholera seasons — Sanitary advice 25 Nature's efforts to keep up mean temperature— Applied to bathing, &c 26 SECTION 111. — O." great importance to have correct views of the force which moves the blood — If it is the heart's action, the circulation not at all in our power — If breathing, it is 29 Last condition of good breathing— must be no obstruction between the oxygen of the air, and the carbon of the venous blood ib. Carbonic acid gas is such an obstruction— proofs 30 Successful experiment to expel it from the lungs in a case of sick-headache. 31 State of the author's mind on the reappearance of cholera 33 Cholera cured, first in the author's own case, by voluntary violent breathing. 34 Second and highly important experiment, when a woman, J. F., is cured in fi.'teen minutes, of an attack of the most fatal description of cholera 36 A third case, of a different bill decided character, cured by the same process 39 2MI CONTENTS. Another case 41 A gentleman cured by hard ridintr — A lady affected by breathing bad air .. 42 Violent artificial breathing may be misapplied ib. Author's manner of investigation, different from others 43 Effects of various curative agents — good— but better to "destroy the worm at the root" 44 Cholera docs not. poison the lungs — Proof 1 — Carbonic acid prevents oxygen gas from giving relicf — Resuscitation — Air-pump for the lungs suggested. 45 Physicians admit that former measures have not been available to the cure of cholera 46 Thesupport of animal life resembles the continuing of a flame ib. SECTION I V. — The authors application to the Smithsonian Institute 48 Its object providentially answered ib. The sudden restoration of Mrs. G., by aeripatky 48-53 Proof afforded by this case that carbonic acid is in the lungs 54 Heat must be internal, not external ib. Proof that the animal organism is uninjured in cholera 55 Comparison of a water mill. ib. Aeripathy, what it is, and what it may become ib. fECTION V. — Cholera cured on principle, is cholera cured whenever IT OCCURS 56 The case of J. F. revim-ed — Her own testimony 56—7 The views of the author respecting cholera have not been anticipated 58 Others have looked to the heart for power to move the blood ib. Deranged Circulation re-acts and threatens to abolish Respiration si) Nothing can meet thin case but violent respiration ib. Case of a man who was scourged to life 60 Aeripathy requires no medicine, or apparatus; and nothing that does can be a cure for a disease so suddenly fatal ib. Causes of very sudden death, and of warmth and revival after death 61 Conclusion Ib - PREFACE. This Essay is the enlargement of an article, originally written for the newspaper press ; and, of course, designed for popular perusal. It was begun in the height of the cholera season. Amidst the wide-spread gloom of sudden and mysterious death, to which all were exposed, it had pleased the Almighty to bless, in a few cases, to sudden restoration, means, which were simple and availtble to all. Conscience moved imperatively, that these ases should be laid before the public, with the principles on which they were conducted, and without which, they would be neither credible nor useful. But to obey the inward monitor, — to take the resolution, to brave the censure "she goes out of her sphere," — then, to execute the design, and to make truths intelligible to the common mind, which, though they have brought CONTENTS. PAGE Another CElse 41 A gentleman cured by hard riding — A lady affected by breathing bad air .. 42 Violent artificial breathing may be misapplied ib. Author's manlier of investigation, different from others 43 Effects of various curative agents — good— but better to " destroy the worm at the root" 44 Cholera does not poison the lungs — Proof — Carbonic acid prevents oxygen gas from giving relicf — Resuscitation — Air-pump for the lungs suggested. 45 Physicians admit that former measures have not been available to the cure of cholera 46 Tlie support of animal life resembles ihe continuing of a flame ib. SECTION [V.— The author's application to the Smithsonian Institute 48 Its object providentially answered ib. The sudden restoration of Mrs. G., by aeripatky 48-53 Proof afforded by this case that carbonic acid is in the lungs 54 Heat must be internal, not external ib. Proof that the animal organism is uninjured in cholera 55 Comparison of a water mill. ib. Aehipath y, what it is, and what it may become ib. SECTION V.— Cholera cured on principle, ts cholera cured whenever IT OCCURS 56 The ca-e of J- F. reviewed — Her own testimony 56-7 The views of the author respecting cholera have not been anticipated 58 Others have looked to the heart for power to move the blood ib. Deranged ( Circulation re-acts and threatens to abolish Respiration 59 Nothing can meet this case bid violent respiration ib. Case of a man who was scourged to life 60 Aeripathy requires no medicine, or apparatus; and nothing that does can be a cure for a disease so suddenly fatal ib. Causes of very sudden death, and o" warmth and revival after death 61 Conclusion '*>. PREFACE. This Essay is the enlargement of an article, originally written for the newspaper press ; and, of course, designed for popular perusal. It was begun in the height of the cholera season. Amidst the wide-spread gloom of sudden and mysterious death, to which all were exposed, it had pleased the Almighty to bless, in a few cases, to sudden restoration, means, which were simple and available to all. Conscience moved imperatively, that these cases should be laid before the public, with the principles on which they were conducted, and without which, they would be neither credible nor useful. But to obey the inward monitor, — to take the resolution, to brave the censure "she goes out of her sphere," — then, to execute the design, and to make truths intelligible to the common mind, which, though they have brought 4 many of the learned to a pause, and are acknowledged by a few, are yet disputed by some, and unknown to others, was a difficult, and an exciting task ; and in a season, when often excitement was death, it was not undertaken without risk, nor executed without suffering. In the meantime, relevant facts accumulated, the mportance of the subject grew upon my mind, the cholera in this region was abating, the Medical Colleges were about to commence their sessions, and I wished o have the article so published, that I could respectfully ay it before their authorities. It was, therefore, delayed, and is now offered in a pamphlet form. But it bears he marks of its original destination ; and this is its apology for a style more didactic, than would have been )ecoining in me, had the learned medical faculty alone >een addressed. But the writer still hopes, that the general public of enlightened men and women, will consider, that their bodies, as well as their souls, their Maker's rights excepted, are their own ; and that they will give these pages a candid and attentive perusal, allowing reason her free scope, unshackled by prejudice or authority. No subject can so intimately concern mankind in respect to 5 their physical well-being, as their " vital breath." And even additional weight will now be given it, if the investigation can be made to throw some rajs of light athwart the dark path of a pestilence, which depopulates cities, and makes nations fast and mourn. RESPIRATION AND ITS EFFECTS. SECTION I. 1. Writers are advised by rhetoricians to choose subjects which come home to men's business and bosoms. Respiration or breathing is of such subjects the very first ; since, to breathe is to live, to cease breathing is to die : to breathe ill is disease and suffering, to breathe perfectly well, with every normal condition of air, of mind, of nerves and physical organism, is health, and vigour, and joyousness. 2. The primary effects of Respiration are, first, animal heat ; second, circulation ; third, digestion; and fourth, strength. That animal heat is produced by a combustion of the carbon in the animal system, kept up by the oxygen which respiration furnishes, was first taught by Lavoisier ; and finally it has been established by Liebig, so conclusively, that it is no longer a contested point. The great naturalist, Cuvier, has proved by an induction, embracing the whole animal creation, that animal heat, digestion, and the degree (not the existence) of vitality, or nervous energy, and consequently strength of body and mind, all depend on the quantity of breathing ; all (except vitality) beginning, and all increasing, diminishing, and finally ceasing, with the great primary function, Respiration. 3. That the circulation of the blood, which is found in this category, following animal heat, and preceding digestion, is actually caused, as we are thus bound to expect, by respiration, operating through animal heat, has been, as we 8 contend, discovered and proved in America. Without invalidating former proofs* we are now about to offer a new argument. The theory, which it is thus intended further to sustain, affirms that the heart's action is not, as has been maintained, for two hundred years, the chief -motive power which causes the blood to circulate ; but that this power is created by an expansion of the volume of the blood, in the lungs, caused by the heat, which is produced by the combustion of the carbon of the venous blood ; there ignited by the in-dwelling spark of life, kindled up by the oxygen perpetually introduced by breathing. In other words, that respiration OPERATING BY ANIMAL HEAT, IS THE CAUSE OF CIRCULATION. 4. The new argument, which we now bring forward in support of this theory, is predicated on facts, established long before Asiatic Cholera was heard of, respecting collapse of the lungs ; and sustained by phenomena attending that state in cholera. Whenever air, either warm or cold, is admitted to the external surface of a lung, that lung collapsesA That is, it falls together, as a closed bladder filled with steam, | would do, on being exposed to the access of a cooling agent ; or, if the steam had been formed in vacuo, on the bladder being exposed to atmospheric pressure. And suppose that any chemist, not knowing by what substance the bladder was distended, should witness its instantaneous collapse, by a cooling agent, or by the admission of atmospheric pressure, — * Those proofs are contained in a " Treatise on the Motive Powers which Produce the Circulation of the Blood," by Emma Willard: Wiley & Putnam, New- York and London, 184 G. See also the author's reply to a critique on the above work, in the New-York Journal of Medicine, March, 1847. t " When a wound is received between the ribs, the aii enters the chest and the lungs fall collapsed." See Bell's Anatomy, vol. 1., p. 400. — " When the breast of a living dog is opened, by taking away the sternum, with the cartilaginous apd as further applying to the lungs, than as distended by steam. So far as solid, or liquid, or gaseous matters fill them, they do not collapse. But so far as they are filled with. 9 would he not know by that token, that it was vapor which had filled it, (and if he knew that water exposed to heat had formed that vapor, that it must be steam :) because nothing else but vapor, — no other substance — no solid — no fluid — no gas would exhibit the phenomenon of sudden collapse. Nothing but vapor or steam would, by such means, instantly have disappeared and left a vacuum, — and that would. It is precisely the nature of steam, a»d is the very property to which it owes its great motive power.* Since, then, the lungs do collapse by these means, it must be vapor or steam which chiefly Jills them, and keeps them in a state of distension. 5. And that vapor must have been formed in the lungs. It could have been formed nowhere else. The arterial system conducts out of the lungs, not into them, and the venous system is filled with blood. 6. This vapor, thus existing in the lungs, is water changed into that expanded state by heat. Steam or vapor is formed in this way and in no other. From what direction comes all this water to the lungs ? From the veins, the only conductors into them, except the trachea, and that allows nothing to enter it but air. Have the veins water in them ? Certainly. It constitutes nearly four-fifths of the substance of the blood, and is its only constituent which can be vaporized. But if some of the water of the blood springs into vapor as it comes to the lungs, then the blood in the lungs boils ; and is the temperature of the lungs up to the boiling point ; Yes, it is, and beyond, when atmospheric pressure is taken off. If the vacuum is perfect it is more than thirty degrees above the boiling point.t Now the lungs are mostly free from atmospheric pressure, but not quite. Since they collapse by the admission of air to their outer surface, whether that air be cold or hot, we know that they are mostly in vacuo, because they are shown by their collapse to have had vapor in them, and * If any other agent than vapor or steam could produce collapse, it would rival steam as a motive power for engines, &c. ; and in the scramble for fortune it would be brought forward to the public. Since none is brought forward, all may conclude that none is known to exist. t If the heat of the lungs is stated at 103° Fahrenheit, and the boiling point of water in vacuo, at 67°, then the blood in the lungs stands at 36 Q above that point. 10 their temperature, unless under this condition, would not have produced it. The structure of the upper part of the body, also indicates that the lungs are mostly in vacuo. 7. But if as we have now shown, steam is generated within the blood in the lungs, then is there produced by the animal heat of respiration, a motive power amply sufficient to circulate the blood. For, we ask, will the blood, under such circumstances, rest in the lungs ? or will it rush forth at a perfectly convenient passage ; the only one, — and expressly prepared to conduct it on a circuit, and on duties, upon which, not only health, but life depends ? The heart's action gives, to the current thus formed, a pulsatory movement, and adds some force. It equalizes the blood's flow ; and above all, it makes the motive power of expansion, what otherwise it would not be, a force available in all necessary and healthful positions.* 8. The phenomena of collapse in cholera, if there were anything wrong in this reasoning, would furnish facts to contradict it ; but on the contrary, they signally confirm it ; for collapse in cholera occurs then, and then only, when the mean temperature of the patient sinks to within the range which this theory woidd lead us to expect, viz. : several degrees below mean temperature, and yet some degrees above the boiling point of water in vacuo. If it occurred without this range it would contradict the theory ; but occurring as it does, within, it confirms it. The more exactly we know at what degree collapse occurs in cholera (and in cyanosis, and asphyxia generallyt) the better we shall understand how perfect is the vacuum in the thorax. Dr. Copland says, that in cholera mean temperature goes down to 86°, which is 12° below mean temperature. Dr. Cartwright avers, that by the thermometer, * This is explained in the author's " Treatise on the Motive Powers which produce the Circulation of the Blood,'' where is also a demonstrative argument to prove, that in animals, designed to have the neck and head carried uppermost, the sanguineous system is right in position, if the motive power be expansion by heat : but wrong if it be impulse, communicated by the heart's action. Since the wisdom of the Creator may not be impugned, this proves that the chief motive power is expansion, and that it it not the heart's action. t <; The great diminution of the volume of the body is remarked by all observers, and it distinguishes the cyanosis of cholera from that of asphyxia generally." — Dr. Bigelow's Translation of M. Tardieu. 11 the mean temperature of the cholera patient is found to diminish 15 or 20 degrees.* Mean temperature is generallyreckoned at 98°, which, minus 20°, is 78° ; and 78° is eleven degrees higher than chemical writers now fix the boiling point of water in vacuo. This is several degrees lower than the ordinary summer temperature of the air, when cholera is most apt to abound. Atmospheric pressure may vary a little on account of difference of form, in different individuals. The vacuum of the thorax is not perfect, because there is an indirect pressure of the atmosphere upon the diaphragm, by means of the direct pressure of the superincumbent air upon the parts of the body below this organ. 9. That the phenomena of collapse in cholera are not prodiiced by a, condensation of air, is proved by the fact, that the mean temperature of the cholera patient, is often below that of the surrounding atmospheric air ; in which case the body ought, so far as any gas contained in it is concerned, rather to swell than to shrink. But collapse of the lungs and other parts of the body does then occur. And what but the condensation of vapor can be the cause ? Dr. Addison says,t that where veins of animals can be observed, they are found to convey blood which holds in connection numerous " colorless cells," (steam bubbles ?) which disappear as they come to the cooled surface, and leave a " clear colorless fluid," (water?) Now, though these " colorless cells" may " appear like air-bubbles," they cannot be so in reality ; for what, in that case, would form the colorless fluid which appeared as they vanished? And air can onry enter veins through wounds, and then it causes death. Such a case is related in the New- York Medical Journal, by Dr. Coolidge. The air entering the venous system through a cut in the jugular vein, had gone on to the lungs, and then the patient died. This air was found close to the lungs, by puncturing, under * See Lee's Copland, article, " Pestilential Cholera," and Cartwrigbt's "Treatise on the Pathology and Treatment of Cholera." Dr. Tardieu quotes from M. Czermack, that below 74^ death was constant. t See Review of Dr. Addison's work on Morphology of the Blood, &c., — N. Y. Med. Journal, Sept., 1847. 12 water, the pulmonary artery, (vein?) then, afterwards, the tubes conducting from the lungs, called the pulmonary veins. Bubbles of air arose from the venous system, but none from the arterial. The only air that can be contained in the body, the lungs having collapsed, must be in the stomach and bowels. But in collapse in cholera, the abdomen, as is described by Dr. Copland and others, is "drawn into folds, 1 ' and crowded " inwards and upwards," no doubt pushed up by the weight of the air, to fill the extensive vacuum caused by the collapse of the lungs. 10. The ease of breathing arises from the suction power created by the vacuum in the chest. The air will naturally flow into the trachea, through the mouth and nose, whenever the opening movement of the ribs will permit — the same as at the nozzle of an extended bellows. This air, with its oxygen, there meets the living texture of the permeable cellular tissue of the lungs, against which lies ihe combustible carbon of the venous blood : combustion ensues, and the expansive springing of water into vapor, will combine with the involuntary compressive movement of the ribs to throw out a portion of the inspired air ; and then to move the ribs expansively, when the air again flows in. 11. And here we would remark, that it is but the smaller portion of the air in the lungs which is changed by any one respiration ; — authors say about one-eighth. This quantity may be diminished or increased by circumstances, and by our own power over a portion of the muscles of respiration. But the most intense straining, continued as long as nature can endure, cannot, we are told, throw out at once more than half the air contained in the lungs. 12. The adaptation of the human frame to the nature of the agent, by which circulation is carried on, affords one of the most striking views of the divine wisdom. For while the lungs, and deep-seated, bone-defended arteries, are in vacuo, the flaccid veins, at and near the surface, are receiving as they need, the full weight of the atmosphere, which must be constantly and powerfully propelling the blood in its return course to the heart and lungs ; and there the pressure of the air being taken 13 bjf, a strong suction power must be created. For, let us consider the nature of a constant pressure of the air upon a tube like india-rubber, rilled with fluid, and arranged with a system of valves conducting one way, and closing at short intervals. Suppose you place that end of the tube where, on account of the valves, the fluid must make its exit, within a constantly exhausted receiver, would it not soon be emptied — unless a force in the rear of the current should be constantly filling k '? So has the current in the human veins a suction power from the vacuum of the thorax ; so are the veins pressed by the atmosphere, and so are they constantly filled by a driving power in the rear of the current; and they continue to be thus filled, until that power stops. Then the capillaries, and the smaller and superficial veins, having the blood pressed from them by the weight of the atmosphere, remain empty, leaving the surface colorless ; while the great uniting branches and trunks within become filled to congestion. If the obstruction is entire, this is death ; if it is partial, it is disease, tending to death. 13. From the diagnosis of cholera, it is evident, that the exterior veins are, even during life, thus emptied. Hence, the ghastly features, " seeming," says Dr. Tardieu,* " as if the veil of death was spread over the face of the choleric before life leaves his body ;" and " after death, the exterior aspect of the body differs little from that of the living 14. Our theory of the motive powers would lead us to expect this result, in case the force which ordinarily sends the blood so rapidly from the lungs, and through the round, smooth, unvalved arteries, should fail ; and we should also expect, that then there would be that pressure upon the blood in the exterior veins, which would be followed by the engorgement with venous blood, of the lungs, right heart, and great vena-cavas, which autopsy actually reveals. "In * See Treatise on Epidemic Cholera, by Ambrose Tardieu, M. D., Physician of the Central Bureau of the Hospitals of Paris,' 1 translated by Samuel Lee Bigelow, M. D.— Boston : Ticknor, Reed & Fields. 14 our last moments," says Haller, "we breathe with difficulty ; the lungs at last collapse, and when they are collapsed, no blood can pass through them, but must accumulate on the right side of the heart."* 15. That the heart's action is not the cause of the circulation, is evident from the foregoing facts, in connection with others long known, respecting diseases where respiration and animal heat fail ; but remarkably brought into notice of late, by some of the symptoms of Asiatic Cholera. Dr. Bigelow thus quotes Magendie in reference to these symptoms : " The pulse, from the early part of the disease, small, depressed, and thread-like, in the algide (cold) stage, wholly disappears. Generally, the left radial pulse disappears a short time before the right, and afterwards the pulse ceases in the larger arteries." " The movements of the heart become accelerated, but lose in force." If the heart's stroke moved the blood, the faster the beat, the more rapid would be the circulation ; but in cholera, as w r e see, the reverse is the case. The movements of the heart accelerate, but even minute by minute the current slackens. This, doubtless, arises from a general law, which observation may make manifest, that whenever the motive power at the lunijs diminishes, nature dictates additional struggles to the heart ; and no doubt the circulation continues a little longer on this account. The heart's motion grows feeble, because the lungs send not the proper quantity of blood to afford it the needed stimulus. The moment they do, as is shown by the phenomena of reaction in cholera, the uninjured heart is ready to take up a full and natural beat. Again, the blood is as a stream circulating in a perpetual tube — in a current returning into itself. Stop the motive power at whatever point it may exist — in advance of that point will be space, and behind it, accumulation. Now, when the blood's current stops, where is the accumulation, and where the space ? The accumulation is in those passages for the blood's current * I make this quotation on the authority of my favorite author, John Bell, having never read Haller. 15 in the rear of the lungs ; and the space is in those leading out from them : the right heart belonging to the first, and the left to the second. This is abundantly proved by all post-mortem examinations ; and Dr. Magendie's observations on the pulse in cholera patients are to the same effect. The left radial pulse disappears before the right. 16. Everything in the examination of the body after death, whether that event occur by cholera, or otherwise, is in accordance with the theory of circulation by respiration ; and, let it be remarked, it furnishes the solution of the grand mystery which prevented the ancients from discovering the circulation of the blood, — that after death the whole arterial system, including the left side of the heart, is found empty. Those " vital spirits," which they of former days found playing in the arteries, and leaping along their course — the " air-bubbles" with which they found " arterial blood to be filled as it spurted out," furnish further evidence of the presence of an agent, with whose mighty moving powers they were unacquainted ; and it is one, which, as the heat that creates it fails, condenses into a few drops of water, and leaves a void ; its last efforts having carried the blood in connection with it into the capillaries of the system. 16 SECTION 11. 17. In the suggestions now to be made respecting cholera* Xve would premise, that we do not advance them as we do the theory of circulation by respiration, as proven by truth ; but merely as hypotheses, which the future will either confirm or overthrow. Nor do we pretend to be able to account for all facts relating to this dread disease ; especially those which regard its transmission. It is a dark apartment, down whose trap-doors, those who write and those who read, with millions of others, are exposed to fall ; and a taper's light should not be rejected, because it is not the sun. The practical improvement of our principles relates in the first place to prevention ; yet it differs from much of the advice given, though that is good. If a man were driving within an inch of a precipice, where to hit a cucumber would throw him off, it would be good to teach him how to shun the cucumber; but better to show him how to drive further from the 18. Cholera is a disease, whose manifestations arise from a state of' cold obstruction, whtch strikes directly at life. Let it be granted that the effects of respiration are as we have shown, then it is evident that there is in cholera, something wrong with regard to this great function. With good breathing no one can have cholera, because, as we have seen, there follows the right exercise of that function, under normal conditions of the animal system, the mind, and the air — first, sufficient animal heat ; second, free circulation ; third, healthy digestion ; and fourth, and consequent upon these, due vitality, or nervous energy — ready to manifest itself in strength of body, or of mind. Now in the season, and on the access of cholera, these are precisely the things which fail ; and the facts shown, relating to their causation, manifest that, since the cause must 17 precede the effect, these four consecutive effects of respiration go doivn in the order named ; notwithstanding, from the rapidity with which these phenomena occur, and their intimate connection, they may not be observed and noted by writers in this order. Indeed, it is a matter of common remark among the best authors on cholera, that the disease has been heretofore misunderstood ; the earlier symptoms, namely, difficult respiration, coldness, oppression at the chest, and general debility, being scarcely noticed, while those spasmodic exertions and discharges, by which nature seeks to unload the surcharged system, have been incorrectly considered the cause of the disease rather than its manifestation. 19. When healthy respiration fails, animal heat must first go down, circulation then be impeded, next digestion become imperfect, and then loss of nervous energy ensue, and the patient experience a feebleness of mind and body which indisposes, and in a greater or less degree, incapacitates for action. As heat diminishes, and the motive power fails at the lungs, the unconcocted blood will be sent feebly forward to the left side of the heart. Its impeded current will set back ; and the lungs, the pulmonary artery, (vein ?) the right side of the heart, and the great trunks of the venous system, will become engorged, as the smaller veins of the surface are being emptied into them. The blood will, by coldness, become thick,* for the newly formed and thinner portion cannot now enter the subclavian vein by the thoracic duct, but will regurgitate, and by spasmodic action be thrown back upon the bowels, from whence it will be dejected ; and secretions from the liver being withheld, it will have the whitish appearance of chyle. The liver, which is enclosed within the concavity of the thorax, and has little arterial blood, depends for heat mostly on conduction from * A reason for the thickness of the blood, found in the sanguineous system of those who die of cholera, we believe to be the want of that animal heat at the lungs necessary, as we consider, to concoct the blood and unite the serum to the fibrin. It is reasonable to suppose that heat unites these elements, since, when they lose heat, they disunite. 2 18 the lungs. It will, therefore, early become cold, torpid and congested ; and its great and important secretions will be either withheld, or thrown out in an abnormal state. Its great quantity of venous blood, tinged with the yellow of the unseparated bile, passes, with that of the system generally, into the lungs ; and finding not the heat there which is ordinarily sufficient to effect, at the same time, the change of its color to the bright and beautiful hue of health, its concoction, and the motive power, to send it vigorously on its destined course, it will be but feebly moved, but partially concocted, or changed in color ; and it will go sluggishly forward, dying the face, and the whole surface of the body, with a blue and yellow tinge. All these symptoms are but the natural consequences of deficient respiration. 20. It may create some surprise that we should account for the change of the blood from black to red in the lungs, by the simple agency of heat. That this is a sufficient cause, we quote the book of nature. We have put the black blood of slaughtered animals into phials, corked them close, and plunged them into warm water, when the dark color never failed to change to a bright red. As to the red globules, although the chemists have so long tortured them, they have neither been able as yet to make them undergo any chemical change in themselves, nor cause any to anything else ; and we predict they never will.* Their primary office seems rather beauty than utility ; for which the Almighty tinged them, as he has the flowers, the fruits, the birds — and the mists which form the morning and evening clouds. Who that looks at a beautiful face, and marks the lines of grace which every view discloses — the enchanting contrast of the colors — of the eyes, the brow, the teeth, the cheeks and lips, shaded by the dark flow of the waving hair — who can look, and not be persuaded that this combination was no chance medley ; but that the wisdom of the great sculptor and painter, quid- 19 Ed by His perfect taste, has here wrought for beauty ; and those red globules are an essential part of that beauty, and this is cause enough why they exist. But in their course through the body they become soiled and darkened ; and heat, the same agent which concocts and moves the blood in the lungs, is, we think, employed to brighten and purify them before they go to show themselves upon the face, as the mother employs her maid to wash her children, before she sends the favorites to be looked upon by admiring eyes. 21. The unknown change which the blood undergoes in the lungs, by which it becomes fit to nourish the system, we have chosen to express by the word, concocted. The term arterialized, seems connected with an idea that there is a peculiar affinity, almost amounting to mental preference, between red blood and arteries. But the phenomena of cholera already stated, and those of cyanosis* generally, show, that the arteries are quite indifferent to the color of the blood which they circulate. They are as ready to afford a passage to black blood as to red, provided it could but find a power to move it. But if, as we believe, the cause of the change in the lungs is identical with the cause of motion, then it will of necessity happen, that no healthy circulation of black blood can ever pass through the arterial system. That none ever does is the undoubted fact, and it affords evidence that heat affects, at the same time, the color, the quality, and the motion of the blood. Where there is no heat, there is no change of color, quality, or motion ; where there is but little, all are imperfect. As to the term oxygenated, to express the blood's change in the lungs, the best writers now avoid it, doubtless, because it expresses what exists not. Oxygen and carbon are both brought to the lungs. So they must both be brought and used in your kitchen. But you do not say your food is oxygenated. It is cooked, and the carbon and oxygen are indispensable, as they make the fire ; and it seems altogether probable, that in preparing, by still 20 another process, the materials from which the body is to be nourished, that the agency of heat known to be necessary in order to make vegetables, &c, a pabulum of life, is what in this last case is also needed. There is no proof that oxygen is needed, or is received ; and there are other and sufficient uses for the oxygen received at the lungs, namely, that with carbon it makes the fire by which the blood is moved, and this last concocting is performed. That the fibrin and serum are in reality concocted and kept together by heat we have this evidence — whenever the blood loses its heat they separate. Take the blood from the body, let it cool, and the fibrin collects and falls to the bottom, while the watery serum remains at the top. When, in cholera, the heat goes down, there is reason to suppose that this separation begins even during life. 22. When animal heat fails in consequence of the failure of respiration, the first marked coldness will be ajit to occur at the bottom of the lungs — from two causes : the air inspired will not so freely meet the venous blood about the diaphragm, because the portion of the lungs there, receives the first pressure of the atmosphere superincumbent on the abdominal regions ; and, second, it is in the lower portion of the lungs, where carbonic acid gas, the residuum of animal combustion, will be moot apt to settle. 23. Nature will, as we have remarked, struggle with violence against the multiform obstructions of cholera, and pains, cramps and evacuations ensue. If the system can sustain the shock of this crisis, and become so cleared that breathing becomes again free, reaction may ensue, and the patient may recover ; if not, death will soon close the scene. Since this is the condition which insufficient respiration might be expected to produce ; and since it is the one which cholera actually does produce, we, therefore, conclude, that want of good or normal breathing is the primary cause of the phenomena which cholera exhibits. 24. By good or normal breathing, is meant enough to constitute a healthy state. Breathing, it must be remembered, is combustion ; and there may be too much as well as too little. 21 A man who should have as much in proportion to his bulk, as a bird, would soon be burned to death. Hence the difference between inflammatory and sinking diseases. In the first there is too much breathing, and in the last, to which cholera belongs, there is too little. By normal or good breathing., then, we mean just enough for health. 25. Let us now enquire into the conditions of normal breathing, in order to find out which of them do not fail in cholera seasons ; so that by removing those which are innocent of the mischief, we may at length discover those upon which it is to be charged. Good breathing implies, first, a healthy conformation of the living body, with a state of the nervous system, by which its several parts perform perfectly their appropriate vital functions. Second, a proper supply of unadulterated air, duly oxygenated. Third, a due supply of properly carbonized blood, formed from suitable food, well digested ; and. fourth, there must be no obstruction to hinder the meeting in the lungs, of the oxygen of the air with the carbon of the venous blood. 26. Let this enumeration be well examined. Is there any condition of good breathing not included in these ? We can find none. We assume, appealing to all experience written and unwritten, that, where cholera prevails, there is a universal predisposition to coldness, obstructed circulation, indigestion, and lassitude. We ask, now, what is there in the process of breathing, in cholera seasons, different from what exists at other times ? Nothing respecting the confirmation of the body, for the organism is unchanged.* Not the suitable food, for that is also identical. Bread, flesh, and vegetables remain the same. 27. We have two essentials more, which are, first, the condition of the air ; and, second, we wish it noticed, its free, unobstructed access to the tissue of the living lungs, adja- * " This slowness or rapidity of the respiratory movement does not depend upon the altered condition of the lungs ; for percussion gives a perfectly normnl sound; and the vesicular murmur is heard pure, though very feeble." — Treatise on Epidemic Cholera, by Dr. Tardieu. My experiments, subsequently related, prove that the organism is uninjured.. 22 cent, to the venous blood. If your stove gets choked with ashes, and you know it not, your fire may go out, while you are wondering at the mysteriousness of the cause. If it is in danger of being thus extinguished, and you learn it in season, your sudden removal of the ashes may, by opening the way for the oxygen of the air to reach the yet unextinguishcd spark, where it lies in contiguity with combustibles, be the means of suddenly relighting it. We believe that where cholera prevails these last named conditions of good breathing, viz. : good air, and a free passage, are both at fault ; the first from a deficiency in the vital -principle, accounting for universal predisposition to the disease, (and perhaps, at the same time, from a poisonous virus ;) and the second, from the settling of carbonic acid gas, the residuum of animal combustion in the lower air-cells of the lungs : and that this may account for many of the sudden and mysterious manifestations of cholera. 28. We are aware that a universal deficiency of breathing might arise from something diffused throughout the air, which should operate like a poison to paralyze the nerves of respiration. To this opinion Dr. Kennedy, Dr. Hawthorne, Dr. Copland and others incline. But if this were so, the more air a person breathed, the more he would be poisoned ; but the reverse of this is generally true ; for the more air is breathed, the less persons are liable to be affected with the universal predisposition to the cold obstruction, indigestion and lassitude of cholera seasons. We, therefore, believe that the want of the vital principle in the air is the first difficulty, (we do not presume to say the only one.) It is confirmatory of this view, that diseases among the brute creation have been observed to prevail, simultaneously with those among men, which precede and give rise to cholera. The feathered tribe in particular are affected. Great mortality has been, at different times, prevalent among domestic fowls ; and migratory birds have been observed to flee from a cholera atmosphere.* Since all animals require 23 the due oxygen of the air, and of all animals, birds need the greatest quantity, we think the facts above stated go to prove, that in cholera seasons the vital principle of the air is not furnished in its due proportion. 29. If chemists shall say, we have analyzed the air, and find it containing its wonted quantity of oxygen, then we might reply, the oxygen itself may be at fault. Perhaps it has lost a portion of its ordinary power to support the combustion of life. Oxygen is a sublime, uncomprehended principle. It is by no means certain that it is a simple substance, though it has never been decomposed. Who can explain the mystery of its connection with magnetism and electricity ? If it should be made clear that the same quantity of oxygen supports life less efficiently now, than under the same conditions it formerly did, then it would be philosophical to conclude, that either it has some neutralizing constituent added, or some exciting one withdrawn. 30. The conditions of good breathing, as we have said, equire not only that the air should have its due quantity of oxygen, but that it should be unadulterated. Both these onditions may fail. There may be the want of oxygen ausing universal lassitude, and at the same time the air may be adulterated, to a less extent, by some specific virus. And facts concerning the transmission of the disease would eem to indicate that it is. If so, this virus is not ordiarily intense enough to prevail over the resistance of the ull tide of life. But where the nerves, in addition to the ommon debility, have been subjected to the abuses of intem)erance — the unnatural exhaustions of over excitement, — or le depressing passions of the mind, then, in cholera seasons, the disease ensues. But if a specific cholera virus constituted all the difficulty with the air, then, all persons who were not actually poisoned would be unaffected ; but since, in cholera seasons, all axe enfeebled, oxygen, whether there be a cholera virus or not, must be deficient ; and then animal heat, digestion and strength being at a low ebb, any adulteration of the air, as by undue dampness — by an unusual quantity of carbonic acid, or sulphurated hydrogen, — such cent, to the venous blood. If your stove gets choked with ashes, and you know it not-, your fire may go out, while you are wondering at the mysteriousness of the cause. If it is in danger of being thus extinguished, and you learn it in season, your sudden removal of the ashes may, by opening the way for the oxygen of the air to reach the yet unextinguished spark, where it lies in contiguity with combustibles, be the means of suddenly relighting it. We believe that where cholera prevails these last named conditions of good breathing, viz. : good air, and a free passage, are both at fault ; the first from a deficiency hi the vital principle, accounting for universal predisposition to the disease, (and perhaps, at the same time, from a poisonous virus ;) and the second, from the settling of carbonic acid gas, the residuum of animal combustion in the lower air-cells of the lungs : and that this may account for many of the sudden and mysterious manifestations of cholera. 28. We arc aware that a universal deficiency of breathing might arise from something diffused throughout the air, which should operate like a poison to paralyze the nerves of respiration. To this opinion Dr. Kennedy, Dr. Hawthorne, Dr. Copland and others incline. But if this were so, the more air a person breathed, the more he would be poisoned ; but the reverse of this is generally true ; for the more air is breathed, the less persons are liable to be affected with the universal predisposition to the cold obstruction, indigestion and lassitude of cholera seasons. We, therefore, believe that the want of the vital principle in the air is the first difficulty, (we do not presume to say the only one.) It is confirmatory of this view, that diseases among the brute creation have been observed to prevail, simultaneously with those among men, which precede and give rise to cholera. The feathered tribe in particular are affected. Great mortality has been, at different times, prevalent among domestic fowls ; and migratory birds have been observed to flee from a cholera atmosphere.* Since all animals require For the above facts see Dr. Tardieu's Treatise, pp. 86, 7, 8.. the due oxygen of the air, and of all animals, birds need the greatest quantity, we think the facts above stated go to prove, that in cholera seasons the vital principle of the air is not furnished in its due proportion. 29. If chemists shall say, we have analyzed the air, and find it containing its wonted quantity of oxygen, then we might reply, the oxygen itself may be at fault. Perhaps it has lost a portion of its ordinary power to support the combustion of life. Oxygen is a sublime, uncomprehended principle. It is by no means certain that it is a simple substance, though it has never been decomposed. Who can explain the mystery of its connection with magnetism and electricity ? If it should be made clear that the same quantity of oxygen supports life less efficiently now, than under the same conditions it formerly did, then il would be philosophical to conclude, that either it has some neutralizing constituent added, or some exciting one withdrawn. 30. The conditions of good breathing, as we have said, require not only that the air should have its due quantity of oxygen, but that it should be unadulterated. Both these conditions may fail. There may be the waul of oxygen causing universal lassitude, and at the same time the air may be adulterated, to a less extent, by some specific virus. And facts concerning the transmission of the disease would seem to indicate that it is. If so, this virus is not ordinarily intense enough to prevail over the resistance of the full tide of life. But where the nerves, in addition to the common debility, have been subjected to the abuses of intemperance — the unnatural exhaustions of over excitement, — or the depressing passions of the mind, then, in cholera seasons, the disease ensues. But if a specific cholera virus constituted all the difficulty with the air, then, all persons who were not actually poisoned would be unaffected ; but since, in cholera, seasons, all are enfeebled, oxygen, whether there be a cholera virus or not, must be deficient; and then animal heat, digestion and strength being at a. low ebb, any adulteration of the air, as by undue dampness — by an unusual quantity of carbonic acid, or sulphurated hydrogen, — such 24 as in ordinary seasons nature would successfully resist, might overset the constitution ; as a slight breeze prostrates the tree, whose roots have been already loosened. 31. On every supposition, then, we are specially called on, when cholera is prevalent, to do what is ever our wisdom and our duty — to endeavor by all proper means to keep our health up to the highest standard possible. All, as we have seen, are more or less languid, even though not diseased. Among us animal combustion seems good as far as it goes ;* and we believe there is such a thing as learning, like persons in low latitudes, to conform to this state of the atmosphere ; so that healthy persons may continue to have good, though not high health. To this end we must be careful to breathe the purest air fossible, with the chest free, and with the excitement of ealthful exercise, both of mind and body. We must by no means continue long in positions where we cannot get our natural breathing ; and we must beware how we breathe an air exhausted, or of a cellar-like dampness, or foul with fetid substances. We must have our sleeping apartments filled with fresh air, and not allow the oxygen in them to be consumed by lamps and candles. When the fire at the lungs is not burning so brightly as usual, we must not expect it to consume the usual quantity of carbon. We must, therefore, diminish the amount of food consumed, and take care that it be of a digestible kind. We must keep our minds calm, and avoid, if possible, depressing excitements of a painful kind. Moderate attention to our daily business is good, as it affords the accustomed stimulant to the mind and body. Joy and hope are healthful ; and a little of that anger which is moved only by wrong, and is without malice, will rather invigorate the nervous energy, than destroy it. But the depressing passions, such as anxiety for sick friends, fear of death, and especially the fear of death by cholera, often in such times produces fatal effects ; paralyzing, it is probable, the enfeebled nerves of respiration. High health can go through conflicts, that lower health, which is yet health, can- Cholera was at this time prevailing. 25 not sustain. Keep, then, your health up to the highest point possible, by a constant attention to all the conditions of good breathing, especially that of suitable exercise. 32. To give an example, if you who inhabit cities, or live in dignified indolence in the country, take to your carriage for a drive, go to the heights, rather than to keep along low grounds ; and when you come to a hill, alight and walk up. But remember that full, free breathing, rather than the mere moving of your limbs, is what you want. Exercise increases your natural breathing, without which it would only exhaust you. Therefore, as soon as the strain upon the muscles of your limbs has, by throwing blood upon your lungs, given them the natural stimulus, and when you feel its excitement prompting you to breathe faster and deeper, then, instead of forcing yourself forward with your mouth closed, and making a point of suppressing this wholesome dictate of nature — turn full to the breeze ; stop and breathe in your fill. Open your mouth, if you feel disposed, as well as your nostrils,* and be careful to bring up the return breath from the very profoundest depths of your chest. When } r ou have inhaled enough of the refreshing breeze, walk on, until you again feel the excitement at the lungs, and then stop and breathe, as before. Then, when you ascend your carriage, while you rest from your fatigue, and freely inhale the delicious current of pure air which your vehicle sets in motion, you will have taken, I venture to assert, the best possible specific against cholera. This, and other healthy exercises, should be begun and continued while you are yet well. Persons who sit down and give way to languor, invite the approach of cholera. A man might as well give himself up to drowsy inactivity, when he is lost in the snows, and the wintry * This reminds us nf the wide mouths and broad nostrils of the colored race, who, it is well-known, are lively and vigorous, in climates where there is too little oxygen in the air to sustain the same state of health in the whites. They being made for colder regions, have a conformation of mouth and nostril to take in a less bulk of air — more oxygen existing in a smaller bulk in proportion as the air is . colder. This is "an adaptation," as Dr. Paley calls it, worthy of notice, as one among the myriads which are proofs of the divine wisdom. 26 cold is benumbing his vitals. Rouse, then, to the performance of duty, and while your physical and mental powers are actively engaged to do good, and to get good, let your spirit rejoice in God our Saviour, — by whom, having a better building than this, " a house not made with hands, eternal in the heavens, "it ill-becomes us to torment ourselves with overanxiety concerning this tabernacle of clay. 33. The theory of circulation by respiration affords a Etionale to the effects of bathing, and other applications to c skin, by which it may be decided when and how far ese are advisable. Hydropathy must seek its principles in aeripathy. Nature has established a standard of mean temperature for man, which is stated at about 98°. This is the medium between, internal heat and external coldness. Let the pendulum swing each way as far as it will, this is the middle point. When its motion is brisk, it rises high on each side ; when feeble, but a little way ; but in a normal state this is the point at which nature is constantly watching to keep it. Throw cold water upon a man in high health, and nature instantly dictates deep, successive, and rapid inhalations of air, by which inward combustion is greatly increased. This is naure's expedient for producing inward heat, to counterbalance sudden outward coldness. The blood is soon moved into greater velocity, and the increased heat is [uickly carried to every part of the body. Perspiration ensues, obstructions are cleared away, and good is done. 3ut beware how you try this experiment when the combusion at the lungs is low, and the nerves of respiration parially paralyzed. It might cost 3^oll your life, if the inward combustion should fail to increase. 34. The theory assumed, again shows that the motive power by animal heat, naturally mounts upward.* We can bear to bathe the neck, shoulders, and arms, and especially the face and hands, and shall find ourselves refreshed by this process, when cold water about the lower region of the * Sr>p Trpatisfi nn thp Mntivp Piwprs 27 lungs, and that of the liver, and the bowels, would be dangerous. 35. Again, our theory shows that, if the ivhole exterior should be so heated as to have the same temperature as the interior, the motive power would fail ; and death must be the ultimate consequence. Perspiration, in which caloric is taken from the surface of the body to form water into vapor, is nature's agent employed against this dangerous equalization of heat. If there is intense coldness at the extremities, it may endanger the stoppage of the circulation, and external stimulants should on this account be applied. But while the feet are heated, the face and hands should be kept cool. When mean temperature is failing, or in danger of failing, heat should not be allowed to escape from those parts of the body contiguous to the lower part of the lungs, but rather increased by external aids. We find in the sanitary advice upon the cholera, published by the general board of health in England, the excellent recommendation to wear, in cholera seasons, a flannel band around the body next the skin ; which, say the board, " has been found very useful on the continent." That single national recommendation goes far towards establishing the correctness of many of our preceding and following views. 36. The entire phenomena of the cold and collapsed state in cholera, go to confirm the supposition of the influence of the caloric of respiration in the formation of steam in the lungs. Why is the nose colder in cholera than any other part ? and why does such remarkable coldness come over the parts of the mouth ? Because the mouth and nose being made (and constantly lubricated) to receive the heat of the returning breath, the Creator leaves them without the means of being otherwise warmed ; else in the normal state they would be overheated ; and so, when heat fails at the lungs, their coldness becomes, of course, peculiar and remarkable. Then the general collapse of the body ;—; — what can make it fall and shrink suddenly in its dimensions, but the cause already assigned for collapse of the lungs ? Neither bone, nor muscle, nor blood would perceptibly change 28 their volume by a change of a few degrees of temperature. And if air or gas of any kind was in the body, would that suddenly diminish in volume so as to make the parts of the body, the face particularly, grow less ? On the contrary, if, as is often the case, the surrounding air was warmer than the face, any air contained in it would expand, and the face be swollen instead of shrunk. But if a portion of the water of the blood does spring into vapor in the lungs, and £ asses through the arteries in that state, it is probable that lany minute divisions of this vapor enter into the capillaries, and from them into the veins. True, these would instantly condense, as the atmospheric pressure met them at le surface of the body ; but they would as constantly be enewed by fresh bubbles sent forward by the arteries, most of the veins of the head being in vacuo, they may, n ordinary cases, retain considerable vapor uncondensed. 'he normal circulation of the head is so extremely rapid lat the venous blood cools but little, and does not much differ in colour from the arterial, as it goes to the face. It is probable, therefore, that it holds much vapor in combination, and in the algide state of cholera, this vapor condenses in life, as in other cases it does at death. This would affect the appearance of the face as death affects it — more than any other part of the body ; and hence the pinched features and cadaverous face, which the choleric, in the full algide stage, invariably and peculiarly presents. 29 SECTION 111, 37. It may be asked, why should any one be so desirous to prove a theory, even if true. If mankind, the medical faculty inclusive, choose to believe that the heart's action circulates the blood, when in reality it does not ; and furthermore, to believe that respiration is not the cause of circulation, when in reality it is — what of it ? Is it any great matter? It is a great matter : For, if the heart's action is the moving power, we cannot control the circulation by any voluntary act. (We cannot, by our will, make the heart strike one beat quicker or slower.) But if respiration furnishes the moving power, we can. For though our ordinary breathing is involuntary, yet we are provided, for extraordinary occasions, with voluntary nerves of respiration, by which we may breathe, for a time, with unwonted force and rapidity ; and thus, when a disease, like cholera, threatens to stop the circulation, we may set the checked current in motion and save life. Again: if it be a truth that respiration is the cause of circulation, then all deranged circulation must proceed from deranged respiration ; and no correct views of the cause of a disease, affecting the circulation, can be taken, except this truth be first acknowledged and made fundamental. In cholera and all sinking diseases, death is caused by deranged circulation. If the cause of any disease is not rightly apprehended, neither can the means to effect a cure be understood. 38. Of our enumeration of the essentials of normal breathing, there yet remains one unexamined. It is, that no obstruction must exist in the lungs to the meeting of the air of the atmosphere, with the venous blood of the circulation. For, if there is, they cannot come together in the manner designed by nature, and no combustion will ensue. Such an obstruction, we believe, there does exist in cholera ; and in other sinking diseases 30 nlso. Carbonic acid gas, heavier than atmospheric air, is, we know, a product of animal combustion, being ordinarily thrown out from the lungs in respiration. Authors state, that it is sometimes found in small quantities in the air-cells of the lungs. When the breathing is good, and the habits are those of bodily activity, this gas would not be likely to settle and stagnate in the lungs, in a sufficient degree to give uneasiness, or cause disease. But let vitality go down by deficient breathing, and we can well conceive, that this heavy gas might settle in the lower bronchial cells, instead of being thrown out at the trachea ; and if a sufficient quantity should be collected there, to keep the atmospheric air from coming in contact with that living permeable tissue of the lungs, against which lies the venous blood, it might stop the breathing, as effectually, as if it were so much water. A candle put into carbonic acid gas goes out as entirely, and as instantaneously, as if immersed in water ; and men die when they descend into subterraneous pits, where carbonic acid gas is inhaled, or when they receive it b} r breathing the fumes of charcoal, as certainly, as if they were immersed in all the waters of the ocean. 39. Before introducing some experiments which; we consider, prove that carbonic acid, or some heavy gas, becomes the cause of disease and distress, by settling in the lower air* cells of the lungs, instead of being given off in respiration, we bring forward facts to prove, that in cholera this residuum of animal combustion is not thrown out of the system in the usual and natural manner. In the work of Dr. Tardieu, of Paris, (see p. IS, Dr. Bigelow's Translation,) he says, "J. Davy made analyses of the air expired by individuals attacked by epidemic cholera, and found that it contains not more than a third part of the carbonic acid ordinarily existing in the air expired by a healthy person." Dr. Clauney proved, that there is not the least trace of carbonic acid to be found in the air expired by choleric patients. 40. Again : if carbonic acid has settled in the air-cells, then, after this, the lungs remaining in a quiescent state, the oxygen inhaled into the trachea not reaching, and not, therefore, 31 combining with the carbon of the venous blood, that oxygen would be thrown back as received. That this, in fact, occurs, we find evidence in the work of Dr. Tardieu, before quoted. (See p. 18.) " Finally, M. Rayer has satisfactorily established, in a series of very important experiments, that the air expired by those laboring under an attack of cholera, who do not present the external character of asphyxia,* contains nearly the same proportion of oxygen as the air expired by healthy individuals ; and that the air exegin to be engorged, as the impeded current would set )ack. This blood might accumulate in the head, and agoizing pains ensue. I had once seen a person apparently ying from the fumes of charcoal, and it seemed to me that my struggles and distress were similar. 42. Reflecting and reasoning after this manner, I arose from my bed, opened my window, and standing, (for position is important,) in a full current of air from an open window, I commenced a species of violent artificial breathing, for the purpose of ejecting this supposed heavy gas, and rilling my lungs with pure air. This was done by contracting the chest on every side to its smallest possible dimensions, and at the same time throwing out the air violently, and from the bottom of the thorax, as if under the operation of an emetic ; then alternating, by opening the chest to its greatest extent, and drawing in, by successive inhalations, all the fresh air possible, and pressing it down to the lowest depths of the lungs. This process at first gave such intensity and sharpness to the pain in the head, that it required much resolution to continue it. Nevertheless it was persevered in. After a few minutes, the pain diminished ; and, soon after, entirely ceased. This was followed by free perspiration, and equalized warmth and circulation. Perfect repose and quiet sleep ensued. Friends, who a short 33 person, were astonished to behold, an hour or two afterwards, on my awaking, the full glow of restored health, with the happiness of relieved distress. One of them, at my request, immediately wrote an account of the experiment, which is now in my possession. 43. Subsequently, on similar attacks of the same complaint, the same process was resorted to with similar success ; until, at length, the habit of sick-headache was broken up. This was, however, to be attributed in part to the discontinuance of coffee and green tea. Perhaps these nervous stimulants affect the functional power of the lungs, so that their weakened forces do not, in a natural manner, expel the hidden, invisible, and impalpable enemy. Perhaps alcoholic drinks do the same. Observations on the good effects of riding, and such exercises as agitate the lungs, helped to satisfy me, that my conjectures were sound. In short, I became fully convinced that such a cause of insufficient breathing, and of consequent disease, was no imagination ; but a reality, which might prove of great importance, as respects the cause and cure of sinking diseases. 44. On the reappearance of cholera, during the past summer, (1849,) my mind was peculiarly affected, from the belief, that a false theory of the circulation prevailed ; and that while it did, lives must be lost, which might otherwise be saved. Bat what could Ido ? On the sth of August, I began a letter to the President of the New- York State Medical Society, which I did not finish, but from which I quote the following :—: — "If the phenomena exhibited by Asiatic Cholera, including the effects of various dissimilar modes of cure, are such as might be expected from the principles above stated, then, these principles are true ; and if they are true, then, perhaps, new and more efficient modes of cure may be deduced from them. The possibility that this may occur, appeals to my conscientiousness, while thousands are dying around, the victims of this terrible scourge. And if these fundamental doctrines in physiology can be once established 3 34 as true, so that scientific men embrace them, the improvements to which they may lead, are beyond present thought. The physiological heavens are full of new truths in that direction. Sometimes, when I think of this, it seems to me that I stand in the way, and I could wish myself dead ; for rated as I am, not as a discoverer, but as one " going out of her sphere" — a pretended Harvey in female garb, lam not assisted ; but my mind, in its sensitiveness, is here chilled by a cold silence, — and there irritated by a contemptuous sneer — and I gloom in secret." When I had written this desponding strain, perhaps, the first which ever escaped my pen, I was ashamed of it, and determined that I would trust the Lord, and do, for that truth, of which he had, as I believed, made me the honored recipient, whatever should seem expedient ; and whenever, in his Providence, the way was opened. 45. I kept the subject before me, and studied it anew, while I read the most approved works on cholera, and reasoned, as explained in the foregoing pages ; — coming to the belief, that imperfect respiration was the cause of the disease, and that one cause of this was carbonic acid gas in the lungs. Thus was I occupied, although the debilitating air of the cholera weighed upon my health and spirits. I had been affected for about three days with what I regarded as the ordinary complaints of the season, when one night, after my family had retired, I found myself suddenly very ill ; my symptoms being coldness, debility, and spasmodic pains. I believed myself to be attacked with cholera,* and my first thought was to arouse my family, go to bed, and send for a physician; but, taking a second thought, I determined first to try an experiment. I opened wide my windows, turned my face to the breeze, and commenced, as efficiently as I might, the artificial respiration, as before described. Gaining strength as I proceeded, I was able to increase the • Perhaps this attack did not proceed far enough before it wae checked, to be absolute cholera ; but it was of the same type, and, perhaps, was what some writers would call cholerine. 35 Vigor of my efforts ; and I soon found a death-like coldness was giving place to genial warmth. The excitement of scientific discovery connected with religious feeling,- — as well as the happiness of relief from this mysterious pestilence which was to my imagination like a veritable death with his scythe, — raised my spirits and gave me fresh energy. I soon felt strength enough to make violent breathing natural, by rapid exercise of the whole person, in moving backwards and forwards ; keeping my face towards the open window, and at the same time rapidly moving my arms, as in spinning on what our mothers used to call the great wheel. This exercise was kept up, with such rests, and full, free breathings as nature required, for perhaps a quarter of an hour ; after which I went to bed, — fatigued, yet happy and thankful ; — perspired profusely, soon fell asleep, and was well in the morning. 46. This was an occurrence which sunk deep into my mind ; and the more so, as I could not speak much of it, for the truth was too improbable to be believed. It happened without witnesses ; and had I gone immediately forth and told the fact, that I had thus parried an attack of cholera, I might have received only a laugh of incredulity for my pains. Not that my veracity would have been questioned, but my judgment concerning what constitutes cholera, would have been. And besides, of what use would it be to relate the fact, without the reasons of it ; and these could not be intelligibly explained, in an ordinary conversation. But the successful issue of this, my first experiment upon the disease, prepared me to act with boldness and efficiency, in a case which occurred about a week after, concerning the circumstances of which, there is full and direct evidence ; and which having been laid before physicians of the highest eminence, they pronounced the case one of cholera ; — and that of the most alarming and fatal of its different types. That, fully believing it was so, I dared to take upon myself the responsibility which I did, would have been incredible, but for the previous fact, that I had, as I believed, met the dis- . 36 come it, — by means which I now was called upon to try with another.* 47. On the 14th of August J. F., a young woman in my service, of about twenty-five years of age, having been ill for four days with diarrhea, was suddenly struck with cholera from fright. Alarmed by unwonted sounds near her window, in a basement room, she mounted the window-seat to look out at the top sash, and found herself close to a man ha,ving cholera, who, in his death-cramps, was brought from a steam-boat, on a litter, and rested upon the pavement. She asked what was the matter, and was told, here is a man dying with cholera ; and the cover was lifted from his face. At once she was taken with faintness and trembling ; and struck with cramps in the back, which soon spread throughtut her bowels, I was called to her room by E., an intelligent oung woman, who happened to go to J. F.s room soon after he took to her bed. She asked me to come quick, for J. F. vas very bad. Afterwards, this witness, in speaking of her appearance at the time, used the words, " she had a claycold death look." This witness also testifies that there was a frightful looking blackness around and beneath her eyes. Just such a living face I had never before seen ; so livid and so pinched in features, especially about the nose and lips. So corpse-like, indeed, was her appearance, that I said to myself, at my first view of her, now shall I have a death in my house by cholera. She seemed only to breathe from he top of the lungs, and her speech was husky and inarticulate. E. and myself could understand but a part of what she attempted to say. She has since told me that she said, " I am dying." There was a clammy coldness about her, while she felt a burning just above the stomach. Her pulse had not a regular beat, but merely a feeble flutter. 48. Directing the whole window near her to be taken out, I raised her up gradually, and directed her to breathe, as * That the cases to be described were cholera, and that the reaction was produced in the manner related, the evidence is sufficient were it a case of taking away life, to convict and execute. These cases regard the saving of life, not the taking it away ; and if any physician wishes to examine the witnesses for him. self, he cau do so. 37 hard as possible. I then told her she must get up and be helped out of doors. She was accustomed to obey me, and I spoke with the unwonted energy of intense excitement. She made efforts, that of herself she could not have made ; for she now testifies, that so nearly had she lost her sight at this time, that when she tried to see where the window was, she could not ; and so benumbed was she, that, as she moved, or rather was moved along, she did not feel her feet touch the floor, or the stairs. She was, when in the open air, placed in an upright position, with her back resting against a board-wall, a fresh breeze blowing full in her face. I then told her to breathe violently ; for she must get the bad air out of her lungs, and the good air in. At first, she said, " I can't, something rises up in the inside." I told her that her life depended on it, and she must. She then made violent efforts. Being accustomed to teach, I succeeded, after earnest endeavors, in showing her what I would have her do. My directions* were, that she should draw her arms down to aid the motion of the ribs in compressing the chest ; and for the same object to bend forward, curving the spine between and just below the shoulders ; and then throw out the air from the bottom of the lungs with violence and with successive ejections, as if under the operation of an emetic. Having done this, to stand upright, raise the arms from the shoulders, resting the hands upon the hips, so as to give the chest its utmost capacity ; and then to catch in the breath, several times, successively, with violence, as if cold water ware thrown in the face ; and to continue inhaling, until she had filled her lungs to their utmost distension; then, as before, to throw out the air from their lower parts, with # These I describe with particularity, because others may hereafter wish to follow them. But I warn any one against it, unless confident that his disease is one in which coldness and obstructed circulation prevail. If lie should do the same thing in an inflammatory disease it would injure him. But if any one feels himself sinking with coldness and debility — if he has breathed the fumes of charcoal, or is freezing with a chill which is creeping on his vitals air! inducing him to drowse ; or, if the coldness of cholera comes over him, let him arouse; he has not a moment to lose ; and if he has, beforehand, learned what was done at this time, let him go and do likewise. 38 force. She said, "It makes my head feel dreadfully." "No matter," said I, "itis a good sign, I expected it." In a few minutes after the deep breathing was fairly established ; perhaps, I might say as soon — and while I was watching with intense anxiety the patient's face, the color changed from the " clay-cold death-look," to the full flush of the warm hue of life. Never did I witness any sight with emotions so intense. A sign in the heavens, portending good, could not have affected me more. 49. With returning warmth, the pulse, while yet under my finger, changed from a feeble and fluttering, to a steady and natural beat. " O." she said, "It was the scare ! the scare!" This phrase she had, when I first saw her, uttered again and again ; but in such a whistling, inarticulate manner, that I could not, though I tried, make out the words. Now, her voice had so far returned, that when she said, " O, it was the scare," I knew what the words were, and that they were the same which she had before indistinctly uttered. The first moment of relief, as she has since told me, was when I raised her arms and placed her hands upon her hips, and she " breathed in." I asked her, as soon as her countenance changed, " are your pains relieved ?" She said, " they are not so catchy." She could now support herself, and walk a little, with assistance. At first she could move but a few steps without stopping, putting her hands to her chest, and struggling for breath; when she would, for a moment, grow black in the face. The deep breathing, being several times resumed after the struggles, soon confirmed a free circulation, and she could walk unsupported. She joyfully exclaimed, "O, I feel well!" And she added, "I should soon have died if you had not come to me ; everything was all dark to me. [ thank you." " Thank God," said I. "It is his air which has cured you." In about an hour after, I sent her to walk to the next street, to see Dr. Robbins, to tell her own story, and get some medicine, of which her previous complaints indicated the necessity. 50. This was, it is true, a sudden restoration. So was the attack : and if death from cholera had been sudden 39 who would have wondered ? Had she been struggling with the pangs of drowning, she might have been as suddenly relieved. If carbonic acid was in her lungs, and restoration occurred by throwing it out, the relief would, of course, be immediate. If you have an inflammation in your finger, and poultice it, restoration will be slow ; but, if you find, and pull out a sliver, the finger will be fit for use at once. What occurred in her case was but the speedy accession of a state recognized in all treatises on cholera, and named the reaction. Persons seized as she was, most frequently, according to authors, die without experiencing this last stage of cholera ; but if, after they have lain some time, they do experience a return of warmth and circulation, still they often die, from the lesions of those parts of the sanguineous system, pressed by congested blood. The suddenness with which my patient was relieved, saved her from any such consequence. When the removal of carbonic acid had made way for oxygen to be brought to the yet uninjured lungs, the carbon of the venous blood ignited, the motive power was furnishe — the blood was again moved forward into the arterial system, and the dammed-up venous current pushed on — so violently as at times nearly to produce suffocation ; but the struggle was soon over; and the lungs, free, both from carbonic acid gas and an unnatural quantity of venous blood, once more received pure air ; and to the relieved sufferer, respiration became easy ; the circulation passed freely through unbroken veins ;; — and the cholera was cured. 51. Again, another case occurred. It was at one o'clock on the night of the 23d of August, when a young woman, then in my service, stood with a lamp in her hand at my bedside ; and awakened me, to say that she had been attacked at nine in the evening, with symptoms which had obliged her to rise from her bed once in fifteen minutes. Her case was clearly that of cholera. Not only the symptoms, but the great quantity, and the quality of the whitish dejections, proved this to be a case of cholera. Contrary to orders, given to all my family, she had put off coming to disturb me, till, as she said, she was losing strength so fast, that she was 40 afraid, if she waited longer, she should not be able to walk. She complained of " a dreadful coldness all over," especially below the chest, about the abdomen, and at the extremities. Her lips and face were of a deadly bluish paleness. That the fire of life had already gone down at the lungs, was apparent; and whether or not carbonic acid was there, an extra portion of oxygen would do good. Having given her a little brandy and camphor, I took her to a room where the air was fresh, and having opened wide the windows, I placed her in the full current, and gave directions as before ; except that in this case I made more account of the inhalations, and said less of the manner of exhaling. She practised the artificial breathing well, — not having the same oppression at the chest as J. F., — for, perhaps, eight or ten minutes ; when again, as I looked upon the death-like face of a choleric, I had the awestricken satisfaction of beholding, as it were, a standing corpse change to a living worn an. Again Isawthe colorchange, and I felt the pulse alter. The crisis of the disease was past. The patient was soon in her bed, warmly covered, and perspiring freely. Equal warmth and free circulation were established, and she fell into a quiet sleep. She was not, however, fully well the next day ; the great quantities of ricewater dejections having weakened her. The alteration in her appearance, in consequence of one night's sickness, was matter of surprise to those who saw her. 52. This young woman is a perfectly competent and reliable witness. She asked me sometime after, if I wished her to keep, as a secret, the manner of her cure ; or whether I was willing she should instruct other people, where she could do good. I told her that there was no secret about it ; but she must be careful how she entertained the supposition, that because in her case the violent breathing taught her, cured cholera, that it would cure every other disease. In some diseases, people already had too much breathing ; when, to do what she did, might seriously injure them. 53. Another case is within my knowledge, where a person who had exhausted her nervous energy by mental excitebathed 41 in cold water on retiring, was awakened in the night, being alone, with symptoms of cholera, decided and alarming. While she gathered the bed-clothes around her, she practised, to her ultimate relief, violent artificial breathing, in a sitting posture, and with the brisk use of a fan during inspirations. She also practised friction with her hands, and spared not scratching with the nails, and even severe pinching, where rubbing failed to produce warmth. We struggle hard for life.* * This person was myself. When I first wrote these cases for publication I had wholly omitted the mention of the first case, in which, as I believe, I struggled with cholera in my own person. This second case was merely alluded to in the manner above, to show a different position of body, and a different manner of applying the same principle. The first perspiration which my violent exertions and breathing at this time produced, was icy cold, even at my breast — a proof that the temperature had gone down, and that the serum of the chilled blood was separating from the fibrine. But this was wiped off, and exertions not one instant remitted, until a warm perspiration was produced. This serious attack I had feared, on account of the excitement of my mind in reference to the situation in which I was placed regarding those cases of cholera related ; in which I had tested my theory of the circulation, and hypothesis of carbonic acid, and, as I believed, both were confirmed. Cases of cholera were occurring all around me, some of which I believed might certainly have been cured by a knowledge of the truths in my possession ; these circumstances made me feel that I must come before the public • but who would believe my report ? Yet come what would, my duty must be done ; I must write and tell the truth, or I was guilty of what the truth might prevent. What I had first and last suffered, for the maintenance of the great truths which I have endeavored to explain, and which led me to these successful experiments, it may be, important ones to the human race, is known only to my Maker. Galileo never suffered more for science than I have done. Spurned with contemptuous coldness by ditors, when I wished to lay before the public, (at first anonymously,) what had ost me years of study besides money: — paid to professors to aid me in experiments and investigations, — then applying to learned physicians and naturalists n Europe, I was re-buffed by them. A New-York physician, of elegant nd seemingly simple manners, known to me only as a popular writer on cholera n 1832, engaged to espouse my theory, and teach it by lectures in Boston; and )eiug previously deceived by facts and by false testimony from unsuspected ources, concerning his moral and religious character, I engaged to espouse him ; nd I fulfilled, conscientiously, that engagement, though it was to my hurt. But le Lord delivered me from " the unrighteous and cruel man," and I remain, to this day, a spared monument, to show the world, that a woman is, in and of herself, a unit in creation ; — that, with two friends, her God and herself, she need never despair. — But this theory, which had thus been my bane, proved for a time my antidote ; for, when keen recollections might have made me mad, this 42 54. Since occupied in writing this essay, I have heard of a gentleman who was seized with cholera, being at the extremity of a forest, a mile and a half in length ; and who fearing to die alone, mounted his horse, and rode rapidly through the wood to the house of a friend. His ride cured him. It was an excellent method of effecting the object proposed to my first patient —to get the bad air out of the lungs, and the good air in. 55. Within a few days past, I have known the case of a lady who was taken with faintness and cholera symptoms, merely by sitting in a current of fetid air. Is it not clear, that if getting bad air into the lungs gives sudden disease, )reathing it out, like pulling the sliver from the finger, may give instant relief? These remarks are introduced to meet an objection which may be made, and, perhaps, by those vho believe in infinitesimal charcoal, that the means used were not, in the cases related, adequate to the result hown. 56. But let it not be supposed that, because the persons mentioned were suddenly restored, that any one being careless of the air habitually breathed, the confined posture kept, the pressure on the lungs by dress, the quantity and quality of the food eaten, — can always, if cholera ensues, be restored by a few extra breaths. Violent artificial breathing, with its essential requisites, is not so very easy to be rightly performed, by persons who do not understand the animal structure, nor the objects intended to be produced. Nor is the violent use of the voluntary muscles of breathing an exercise with which it is safe to tamper ; for, if the dis- Case were of an inflammatory character, great injury, might, ,s before stated, be done. In the cases mentioned, there was not, it is true, a person to direct the operation, who had received a medical degree ; but one, be it understood, who, witnessed dissections of the hearts and lungs of animals, and post-mortem examinations of the same organs in human subjects. In 1846, 1 published, at my own expense, my theory of, the Motive Powers ; and now, again, I publish in the same manner. And if the world, for whom I thus spend myself and my means, is yet too busy to trouble itself about so small matters as breath, circulation, death and life, — and my work receives little notice, — while every pitiful novel is mentally devoured, — I shall not be disappointed, though I shall be grieved. 43 since Miss Blackwell's admission, is a candidate ; having studied the organs of respiration and circulation in nature's own complete living laboratory, for nearly thirty years ; one who, while other medical learners were cutting up dead hearts and lungs, was watching, by night and by day, the play of the living ones ; — noting every change produced on them, by whatever agent, and every change which they produced. On these subjects, then, she regards herself as prepared for examination ; though making small pretensions to the hundred other things connected with medical science. But, jesting apart, we hope the learned and respected faculty will themselves consider the hypotheses here stated, and the facts by which they are sustained. They will, probably, find better means to apply the principles to curative purposes, than those herein described. 57. We have seen no well-attested phenomena of cholera which are inconsistent with the views we have here advocated. It is no small confirmation of their truth, that in the universal disorder of the system, produced by the disease, and necessarily attendant on deranged respiration, many curative agents we know are, as they might well be, usefully employed ; and, furthermore, that when nature can sustain a crisis, which by unloading the system, makes room for the lungs to play and the blood to move, health we know often returns, as well it might. In cholera, the congested lungs are pressed from beneath by the disordered bowels, stomach, and liver. When discharges from these take place, room is made for the lungs to expand downwards. The operation of emetics, and such other strains as would oblige the patient to throw off the heavy gas from the lungs, may save from death.* Bleeding makes room in the veins, •* In the French work on cholera, by Dr. Tardien, p. 124, it is asserted, that the disease has been, in some mysterious manner, cured by parturition. I have lately known a case, where a lady was seized with cholera symptoms, accompanied by violent sneezing and vomiting. She recovered. Gaping is, doubtless, an expedient of nature to relieve the lungs of stagnant, heavy air. Gaping and sighing, are often named by writers as diagnostics of cholera. Dr. Copland says, that "Hiccough, coming in the intermediate moments between the threatening of death and the beginning of reaction, is a favorable sign, and generally announces the return of circulation." We believe it produces the return of circulation. 44 and thus tends to take the congestion from the lungs. Some medicines have an effect to "keep up internal heat, by warming the stomach and bowels. Calomel, the great agent to produce activity in the liver, and thus to disgorge it, has, doubtless, often given relief. Medicines to excite the nerves may quicken those of respiration, and thus increase animal combustion and circulation ; and if enough internal heat can be raised to produce a warm natural perspiration, the immediate danger is regarded as over. — But when the tree is being blighted by a worm at the root, whose influence is quickly fatal, it were a pity to attack the destroyer indirectly, and to waste time by endeavoring to operate on him through the branches, — if we can at once go and battle with him there. For if the root is restored, all the branches will, of course, become sound. 58. If deficient respiration is the proximate cause of cholera, and carbonic acid gas in the lungs the immediate, then I see not, but that any one may expect, what, believing this, I did expect, and on trial found, that violent ejections from the lungs, forcing out the carbonic acid, — and violent injections of atmospheric air into them, by the return breath, and this long action enough continued, will prove not an indirect, slow, and partial cure, — but a cure radical, rapid, and entire. To effect this cure, no extra apparatus is asked — no medicine required ; but some knowledge of the human frame is needed, and enough acquaintance with pathology not o mistake an inflammatory for a sinking disease. Let all acquire this, and whoever is seized with cholera, whether >y day or by night, (when it is most likely to come) — whether n his home, or abroad and alone, — let him not wait till he is >ast cure, but the moment he perceives that the cold debiliating enemy has attacked him, let him rush for the breeze ; and contend — struggle — agonize — for what none but himself, (under God,) can obtain for him — breath and life ; — remembering the watch word — breathe the had air out, and the good 45 that the lungs are not poisoned, — is shown by the foregoing cases of sudden restoration. It is also proved by frequent cases of resuscitation ; some occurring, as melancholy evidence exists, even after burial. Where the disease has already far advanced, and death is threatened from coldness ; and where, from the patient's consequent weakness, artificial treathing cannot be practised, the case would seem to indiate administering air to the lungs, with an added portion of oxygen; or even in extreme cases, that gas in a pure state. This, Dr. Richardson, of Baltimore, as we learn from his late Essay on Cholera, has practised — sometimes with success and sometimes without. Carbonic acid interposing might prevent the access of oxygen to the carbonized blood ; and in such cases no combustion would occur. If this be so, t is worth while to inquire, if it be not possible to find some mechanical process of clearing the lungs of carbonic acid ; o that their natural aliment might again reach their tissues ; md if the spark of life is there, produce its proper effect on he carbonized blood ; restoring animal combustion, and renewing life. If nothing could be done in this way until as)hyxia, or apparent death, had put an end to the irritability of the trachea, — even then, where the crisis had been sudden, it would, if nothing more, be a satisfaction to friends to know that a faithful trial had been made, to admit freely to the lungs, that only stimulant, which would certainly rekindle the spark of life, if the slightest portion remained; so that the utmost assurance might be felt, that vitality would not return, to give its possessor the horrid consciousness of being enclosed in a coffin, in the dark and airless grave. 60. We find ourselves strengthened in the positions we have taken, by the ablest treatises which we have met on the subject of cholera ; and also more and more impressed with the fundamental importance of the theory of circulation by respiration, as regards the pathological character of cholera, and also that of other diseases. Once let the theory of respiration be settled, and the medical telescope, in a thousand able hands, will be turned to a part of the physiological heavens, where new truths lie thickly studded. But while the 46 effects of that primary function are held in doubt, there can only be, respecting cholera, a mist of wide-spread and discouraging uncertainty. Dr. Kennedy, in his treatise on the disease, thus expresses it : "My idea may be introduced in the language of the Bombay Medical Board, that in cholera there is a somewhat pressing on the vital functions, and what that somewhat is, I leave for others to speculate," &c. "Of the two suggestions offered by the Board, I consider that the oppression is on the nervous, not on the circulating system. I consider purging and vomiting to be no part of the disease, but the struggle and effort of nature to relieve the constitu(DO tion ; the indication is to relieve the brain, (we think the lungs,) by bleeding, and to induce the sanitary process of vomiting and purging, when they do not exist, or to moderate them when violent. Into these brief injunctions may be resolved all that has been written on respectable authority." Dr. Dickson, in his elegant article on the progress of cholera, thus remarks : " We must admit that our practice is still unsettled, and that it is our imperative duty to examine, on all sides, and inquire with the utmost assiduity after better measures, and remedies more effectual, than any which have yet been devised for its subjugation." 61. The support of animal life more resembles the continuing of a flame than anything else. In fact, it is in some respects identical. The place to make and keep up the fire being provided, there is necessary to the process, the mysterious spark, the carbon or fuel, the oxygen, and its unobstructed passage to the fuel, just where the fire exists. In animal combustion the place provided is the lungs. The trachea is the only aperture by which oxygen can enter, and the bronchial tubes and vessels present the only surface where it can meet the combustible carbon of the venous blood. Breathing is a constant bellows, which, though we cannot by volition stop, yet for a time we may blow faster and harder, whenever we find that the precious spark is in danger of extinction. The fire of life burns low in seasons of cholera. Heap on too much fuel, or use that which is poor, and you put it out. 47 Gather around it delicate portions of that which easily ignites, supply oxygen, and it will burn with a flame as pure, if not as great as in any other season. If you find at any time that you have put on too much, you must find means to take it off; and when nature would of herself give you this relief, you must not counteract her designs. Guard against adulterations of the air, or obstruction to its free admission, and if your fire-place becomes clogged by the residuum of combustion, hasten, without a moment's, delay, to clear out this animal ashes ; and the fire of life will again give you the comfort of a ruddy and cheerful light. Note. — It may be asked why the cures related were not given to the public at the time the cholera was raging. This I wished to do; and three times, — twice for the newspaper press, and once for v pamphlet — this section to have been the close — I was prepared on my part to publish. It was the fault of others, not my own that I did not. But Providence overrules. Let these principles be studied and understood, as they must be before the directions can be observed ; and then E entry hope, that if another season of cholera should occur, that irould, with the blessing of that God, in whom I humbly trusted, c same success in overcoming this long dreaded disease. 48 SECTION IV. 62. Last spring I applied to the Smithsonian Institute, through Professor Henry, its learned and accomplished Secretary, to be aided by its funds in producing an apparatus, which would illustrate and confirm the principles of circulation by respiration. This I proposed to do by experiments on an artificial human figure. But the Almighty has, it seems, to me, himself graciously given the opportunity of bringing this portion of his physical truth to the test of experiment on his own handy-work. But, if the facts already stated are appealed to in proof, it may be said, these all occurred within your own house ; and, perhaps, those of your houseiold share your own enthusiasm, and color their statements. Such an assertion would not be true, nor would it )e a fair inference. If I were on trial for my life, no judge would object to my introducing witnesses, because they were nmy employ.* But another case has occurred, which did not happen in my own house, and where the weight of evidence is such, that were it an absolute miracle, it could carcely be discredited ; much less where it is but the natural consequence of principles already proved by arguments a priori ; and which being again reduced to practice, the )roof a posteriori, has again followed. 63. The event alluded to, occurred after the preceding >ages of this essay were completed. The subject, Mrs. G., )f R., is a Christian lady, extensively known, respected, and >cloved. Her character, as shown by her course in life, is eminently hopeful, and courageous. She was formerly my >upil. She went forth to teach, and herself became the ? Neither J. F., who now lives with her husband, to whom it will be recollected she had been, at the time of her attack, a few days married ; nor the other young woman bunder of a Female Seminary, which has given rise to others. Now she is the affectionate and happy wife of one f the most eminent citizens of our state. The confidence which she first gave to me as her teacher, remains to the >resent time. And I would not have attempted, nor would now attempt, to advise, much less direct such operations, xcept where there was faith and confidence. The languid movements of any one destitute of belief, that his efforts would do him good, — what would they effect ? Nothing, mt to give a caviller an opportunity to say, I tried this jreathing, and it did me no good. How different are the ases already related, where the excited energ3 r of my own will was communicated to my believing and obedient jatients ; and they hasted — hurried — breathed for life ; no nstant lost — no weakness — no agony regarded. »64. Mrs. G. was visiting in Troy, about two hundred liles from her home ; and was staying, at the time, with er respectable and worthy friend and relative, Mrs. G — r > who, with three of her daughters, are witnesses of the circumstances which lam about to relate. The account of the occurrence, which follows, was made out by myself, soon after it happened, and was examined and approved by Mrs. G., and Mrs. G — r. 165. " On the evening of the 23d of September, my friend, rs. G., sent me word that she was taken ill, at her lodges, and wished to see my son and myself. It was at half- LSt eight, p. m , when I was introduced to her chamber, y son remaining in the parlor below. I found her in a ite of extreme lassitude, approaching to syncope. She sired that my son would telegraph her husband, that he ght take the cars and come to her immediately. She d, for twenty-four hours, been weakened by diarrhea; d she was so entirely without appetite, that she had, during it time, taken no food. She complained of oppression d distress at the chest ; her countenance was unnatural, r usually clear complexion being merged into a kind of rplish suffusion, as if of venous blood, which covered the tole face and neck. Her features appeared pinched, and her 4 ' % ? m SECTION IV. 62. Last spring I applied to the Smithsonian Institute, through Professor Henry, its learned and accomplished Secretary, to be aided by its funds in producing an apparatus, which would illustrate and confirm the principles of circulation by respiration. This I proposed to do by experiments on an artificial human figure. But the Almighty has, it seems, to me, himself graciously given the opportunity of bringing this portion of his physical truth to the test of experiment on his own handy-work. But, if the facts already stated are appealed to in proof, it may be said, these all occurred within your own house ; and, perhaps, those of your household share your own enthusiasm, and color their statements. Such an assertion would not be true, nor would it be a fair inference. If I were on trial for my life, no judge would object to my introducing witnesses, because they Avere in my employ.* But another ense has occurred, which did not happen in my own house, and where the weight of evidence is such, that were it an absolute miracle, it could scarcely be discredited ; much less where it is but the natural consequence of principles already proved by arguments a priori ; and which being again reduced to practice, the proof a posteriori, has again followed. 63. The event alluded to, occurred after the preceding pages of this essay were completed. The subject, Mrs. G., of It., is a Christian lady, extensively known, respected, and beloved. Her character, as shown by her course in life, is eminently hopeful, and courageous. She was formerly my pupil. She went forth to teach, and herself became the * Neither J. F., who now lives with her husband, to whom it will be recollected she had been, at the time of her attack, a Jew days married ; nor the other young woman restored, are now in my employ, or any ways dependant on me. '* |)under of a Female Seminary, which has given rise to thers. Now she is the affectionate and happy wife of one f the most eminent citizens of our state. The confidence /hich she first gave to me as her teacher, remains to the present time. And I would not have attempted, nor would I now attempt, to advise, much less direct such operations, except where there was faith and confidence. The languid movements of any one destitute of belief, that his efforts would do him good, — what would they effect ? Nothing, >ut to give a caviller an opportunity to say, I tried this >reathing, and it did me no good. How different are the ases already related, where the excited energy of my own vill was communicated to my believing and obedient >atients ; and they hasted — hurried — breathed for life ; na istant lost — no weakness — no agony regarded. 164. Mrs. G. was visiting in Troy, about two hundred iles from her home ; and was staying, at the time, with ;r respectable and worthy friend and relative, Mrs. GG — r> ho, with three of her daughters, are witnesses of the cirimstances which lam about to relate. The account of the currence, which follows, was made out by myself, soon ter it happened, and was examined and approved by Mrs. ? and Mrs. G — r. 165. " On the evening of the 23d of September, my friend, rs. G., sent me word that she was taken ill, at her lodges, and wished to see my son and myself. It was at half- LSt eight, p. m , when I was introduced to her chamber, y son remaining in the parlor below. I found her in a ite of extreme lassitude, approaching to syncope. She sired that my son would telegraph her husband, that he ght take the cars and come to her immediately. She d, for twenty-four hours, been weakened by diarrhea ; d she was so entirely without appetite, that she had, during it time, taken no food. She complained of oppression d distress at the chest ; her countenance was unnatural, her usually clear complexion being merged into a kind of purplish suffusion, as if of venous blood, which covered the whole face and neck. Her features appeared pinched, and her 4 50 eyes sunken. Her voice was weak ; her arms and hands were numb ; her pulse fluttering, and almost gone ; and her skin without perspiration. She had been breathing a close furnace-warmed air, with the windows closed. Her imperfect breathing; her weakness and faintness — her purple hue — the oppression at her chest, and loss of pulse, indicated that the motive power of the circulation was nearly gone ; and that probably there was carbonic acid in the lungs. Being a former pupil, and a confiding friend, she was willing to do what I recommended. I thought the stimulant she needed was oxygen, with a clear passage to the bronchial cells ; or, in other words, to get the had air out of her lungs, and the good air in. Opening a window which threw a current of fresh air into her face, and raising her head a little, I requested her to breathe from the bottom of her lungs, and inhale, as deeply as possible, the fresh air. At first, she succeeded better in throwing out her breath as I directed, than in taking it in. It seemed, she said, that she could not draw in a full breath, there was not room. She had not breathed more than four long breaths, before her color changed to a brighter red, and she began to feel more strength. We then raised her quite up,* into a sitting posture ; when, with her back supported, she used, with energy, (in the manner heretofore described,) the voluntary muscles of respiration. In about a quarter of an hour from the time I entered her room,t she was perfectly relieved of oppression at the chest ; the numbness of her hands and arms had passed off; her pulse was restored, and beat steady and full ; and her whole person, which we kept carefully covered, was drenched with perspiration ; her eyes were bright, and her complexion clear, and ruddy. * I know not the exact time, for none thought of looking at watches ; but at the full completion of this change, I called on Mrs. G — r, and her daughters, to remember the circumstances of the case, and to make up the best judgment possible concerning the time. It was then suited to have been about fi.tcen minutes. t The rapid change depended, in degree, on the change of position. The important and intricate subject of position, I have not been able to treat in this work, but have fully explained, in my " Treatise on the Motive Powers," that the force by respiration works most efficiently, when the posiiion of the body is such, that the aorta ritex from the heart, and the carotids from it. 51 She was full of animation, talked and laughed, and wondered at the change ; exclaiming, " how refreshing is this air !" which she now deeply inhaled for the gratification it afforded her. During all this time she had taken nothing into her stomach, not even a drop of water. A homeopathic physician who had attended her, and who was now specially sent for, came in. " Well, Doctor," said I, " I have been interfering with your practice. Your method is homeopathy, and mine is aeripathy ; but you see how much better the patient appears. I now leave you to take care of the bowels. I only attend to the lungs." This physician had not seen Mrs. G., in her sinking state. My friend mostly kept her bed for two days after this, but had no return of alarming faintness, She said that she was two or three times threatened with it ; but she immediately raised herself in the bed, and breathed three or four long breaths, and her feeling of weakness passed away." Here ends the account approved by Mrs. G. and Mrs. G — r. 66. To review the case, there were three different states from the beginning to the close of the eventful fifteen minutes. The first was, at the time of my coining into the room. In addition to the appearances already mentioned, she had then an anxious, solemn countenance, from which the accustomed smile of greeting had wholly departed ; and a sunken melancholy eye, which seemed to ask me, " am I not about to die, and to die before I can see my husband ?" When I asked her how she felt, she said, with a feeble voice, " I am sinking ! sinking ! and I have been for the last hour." It was a time of sudden deaths, and so far had she already sunken, that her pulse was scarcely perceptible, her breathing short and difficult. My feelings were strongly moved ; not, however, to make sad faces, and frighten my friend, but to encourage her, and rouse up my own energies for her restoration. The second and intermediate state came on as she was raised up into a sitting posture, and when, after hard struggling, she had succeeded in getting fresh air fully into her lungs. The livid violet tinge of her skin now gave sudden 52 place to a dark crimson hue, which came all over her, not excepting her forehead. Her pinched features seemed to swell out to their natural dimensions, and the expression of her countenance changed from axiety to hope. She now practiced the artificial breathing with' vigor. Her pulse changed, and was full, but unequal. Soon, she began to perspire. She had on when she lay down, a wrapper of chintz, lined with buff-colored silk ; and so drenching was the perspiration, that the white bed-gown, worn under it, was, as Mrs. G. afterwards told me, dyed yellow from the wrapper's lining. In the third state, the unconcocted venous blood had all passed from her face, and her complexion was perfectly clear. Water, like dew-drops on roses and lilies, was standing on her cheeks and forehead, and a more beaming, animated and happy countenance I never saw, as she exclaimed, in a full, ringing voice : " How well I feel ! Why ! what docs this mean? Was ever anything so good as this air? Water to the traveller fainting with thirst, was never so refreshing." Not only did she now smile, but her laugh rang through the apartment, while her eyes seemed expanded, and radiant with gladness. Could I give a true picture of Mrs. G. as she was at this moment, and another as she had been a quarter of an hour before, I should want nothing more to gain full attention, to the simple, yet philosophic means, by which, with God's blessing, this great change was effected. And why should there not be rejoicing, when the hope of sudden restoration from mysterious disease, succeeds that fear of sudden death, which has, during these last fatal months, cast an universal gloom ? My own feelings would be altogether different from what they were at the beginning of this season, should the cholera, as is most likely, visit us again. 67. Yet, circumstances attending this case, show, that if artificial breathing'shall hereafter be found a curative agent, it should, in its first introduction, as much as possible, become so by being adopted as such by the medical faculty except in cases of sudden coldness and debility, where, if 53 life is precious, time must not be lost, but each one must breathe, as best he may, by his own skill. Before the entrance of Dr. Bloss, Mrs. G.s physician, but after her restoration, I had said that if the case were my own, I would put on dry clothes after the perspiration had subsided; rise from the bed and walk about the room, for the purpose of establishing, by gentle exercise, the natural circulation, which had now returned ; have the bed aired, and then lie very quietly down, avoiding any excitement, with the expectation of sleeping well and feeling refreshed in the morning. Having left her soon after the doctor came in, and that without knowing what medicine he would give, or what course would be pursued, I felt extreme anxiety lest the two modes of practice might interfere ; or lest the windows should remain unclosed, striking her with a chill as she should rise ; and I hastened the next morning, and was with her at an early hour. I found her not so well as I had left her. She was too much heated, and the circulation too rapid; yet she was sitting up in her bed, with the window open, and making very full, though not forcible inhalations. This, she said, she had done a number of times in the night, for the gratification the fresh air afforded her. I told her she had now overdone the matter, and must stop. She must have the window shut, and lie quietly down, with her head as low as was comfortable, and try to sleep ; and at any rate, she must not leave her bed that day. She and her friends had not considered it prudent to follow my advice, respecting her getting up to exercise and have her bed made. She had remained in bed, and the heat of the exterior had been kept up by plenty of bed-clothes, while she had breathed very freely afresh air ; and thus she had raised the tempeture too much. Under such circumstances, it was well, matters were no worse. With keeping quiet that day, she was able to sit up the next, and to leave her room the clay after. 68. Should I be inquired of, whether or not, this was to be regarded as a case of cholera, I should say, I know not whether the medical faculty, to whom it belongs to pronounce, would or would not, call it cholera ; but of this 1 54 am persuaded, — that medicine taken at the stomach, could not have set in motion the checked and fast ebbing tide of the circulation ; but that this lady was about to die, from the same cause which produces death in cholera, — namely, a loss of motive -power, to move the blood from the lungs ; that violent respiration cured her, and that respiration was the only human means, it being the only motive power; and as the case was urgent, it must be violent respiration : especially, since there, doubtless, was a cause of death lurking within, which nothing else could remove. And I further believe, that the same means, and no other, would he attended with the same result, in the same checked and ebbing slate of the circulation, in cholera. Under this impression, I incline to the belief that this was cholera. Diarrhea had preceded, and there was a cholera atmosphere around. 69. This case I regard as fully confirming the supposition of the existence of a heavy gas in the lungs.* Though artificial breathing, by bringing in addit ; onal oxygen, may, at any time, increase animal combustion, and should sometimes be practised merely for that object ; yet such sudden and remarkable effects upon the respiration, circulation, countenance, and whole system, — with such profu.se sweating, would not, it appears to me, be produced, except where serious obstructions should be removed, as well as vital air introduced. So few breathings would not have accomplished so much, unless the respiration-stroke had done an important work, both in ascending and descending. The case of Mrs. G. I regard as one which exemplifies the principle, that where no coldness comes to the exterior, little heat will be within. The subject, in such a case, has always a short sweep of the pendulum of circulation. (See 33.) He is disinclined to exercise, debilitated, and his blood creeps lazily through his veins. His complexion is not clear, but shows unconcocted blood ; his health is feeble, and * Probably carbonic acid ; but it is of no significancy whether it be that or some other, not now known. Such may yet be discovered, as peculiar to a cholera atmosphere. It is related, among- experiments on air, in Dr. Tardieu's work, that atmoapheric air had been found heavier in cholera seasons than at other times. 55 » a little prostrates him. Now, if you who are parents, do not wish this state of health to be that of your families, keep them not shut up in unventilaled stove or furnace-heated rooms ; but let them keep warm by exercise and clothing. If you undertake to supply the comfortable temperature which they should thus acquire, by keeping them in warm air, while their heat is going down internally, this theory teaches you, that you may even cause their death ; as that will occur, when the external equals the internal heat. 70. All the experiments related, go to prove, that there is no original difficulty in cholera seasons, either with the nerves, or animal organism. Should you see a water-mill, which had been suddenly stopped, as suddenly resume its perfect motion by the letting on of the stream, you would conclude that the want of motive power was the whole cause of the stoppage ; since, if the machinery had been broken, the letting on of the water would have produced, not a perfect, but a disordered movement. Suppose that the stopping of the mill had occurred in a mysterious manner. The miller opines, that the head raceway is clogged in a certain place, out of sight ; and he institutes, in the dark, a process to clear it out. As soon as this process is accomplished, the mill instantly goes on, every wheel playing, as before. In this case would any one doubt that the miller rightly conjectured, both where the motive power existed, and what was the difficulty, which had produced the suspension of its movement? 71. Every new-born child is entitled to such a name as its parent chooses to give it. The use of air by voluntary respiration, for the purpose of operating on animal heat and circulation, I have called aeripatiiy.* This is no pat hy which was bought, or is sold. It originated in a desire to do good • and is, to all mankind, as free as the air from which it is named ; — that air in which their Creator formed them to be and to exercise various callings ; from which lo turn aside and, for a time, to live the lives of fishes, although it maybe healthy, is certainly inconvenient. It deals in no medicine, •* Voluntary inhalations have been directed by Dr. Ramage and others, but differing in manner and object. 56 and therefore, may not, like pills and pillules, cure various diseases of the digestion, &c; but if its rules are observed, it may do much toward preventing them. In short, we believe that aeripathy, will, when, as a science, it is brought to its perfection, teach the art of maintaining or acquiring health, beauty, and vigor. SECTION V. 72. The sudden cures herein related were no mere lucky chances ; but they proceeded on principles, followed out into action ; and if the principles arc correct, then the same results may be expected to occur always, under the same circumstances. For example, if J. F. was thus cured of that worst type of the cholera, called by the French, cholera foudroyant, then, may any other person, seized in the same way, expect the same result, if treated on the same principle. Note. — Concerning this description of cholera, we quote the following from the great Medical Dictionary of Dr. Copland : " The rapid transmissibility and maturity of the disease in persons to whom it is. communicated, is another peculiar feature in its contagious character. This extreme rapidity of development is in perfect keeping, also, with the often astonishingly rapid termination of the disease, in death." This case of J. F. being so important, I here insert her own account of her attack, in the words in which she described her sensations to me, when, some little time after, I interrogated her. I copy from the original paper upon which I wrote, sentence by sentence, her expressions as she uttered them to me. They describe the case, and are testimony. " How long," 1 asked her, " had you a diarrhea, before your attack ? " About four days." v How were you taken ?" "I heard a noise, and went and got up on the window bench, so that my face was just about on a level with the man's face; they set down the bench they were carrying him on. Eight or nine men were carrying him. I asked, what was the matter. They told me they were bringing the man from the steam-boat — he was dying with the cholera; then they took the rag off his face, and I saw it. It struck me all — and made me tremble all over." ** Did you smell anything?" 57 "O, yes ma'am ! I drew my breath to me, and it was all as if it was knocking me down." o 11 Was it a stench ?" 11 No It was something — that I was all overcome with weakness. " Was it the sight or the smell that affected you ?" 11 Well, I guess it was both. I was taken a trembling. My breath was a cutting me ; the pain struck me. It struck me right on my back» and spread all over my sides, and, (moving her hands over the abdomen) — and all over. When I tried to breathe then it would catch me." "What kind of a feeling had you here?" (putting my hand on the epigastric region, or what is commonly called the pit of the stomach.) " Oh ! a burning — a burning — just like I would, if I put my fingers in that fire." (E. says she complained of this burning when she first went to " Had you coldness about you ?" "I was as cold as cold could be. When you put my hands on my hips, and I breathed in, it was the first time I felt to have any feeling of myself. When I came up stairs I had no feeling of my feet, when I put them down." " How was it about your speech ? "When I first lay down on my bed I could not speak.' I could not catch my breath. I wanted to call E. ; she happened to come into the next room. The door was half open, and I could not make her hear, till she happened to come in my room. 1 told her I was a dying. I tried to tell her how it happened, but I could not. I could not get it all told to her. She went to call you." "Why couldn't you speak?" " Why, I was a choking — kind of choking like — it was all in my throat. When I wanted to call E., I could not speak the words. I was choking to catch my breath. I could not breathe. The first relief I had was when you made me raise up my arms, and you put my hands on my hips, and I drew in. When 1 was going up stairs I guess you had mostly to carry me — I had no feeling. I did not feel my feet touch. I could not 6ee. I tried to see the window in my room, and could not. 11 1 told John — (her husband — she had been married four days) — when he came in the evening, that 1 was a dying, and would have been dead, if you had not come to me." [Now, was there in the whole wide world another person beside myself, who would have taken such a living corpse, dragged it out of doors, and set it upright, on feet which could not feel, with the expectation that it might breathe out death — bre athe in life — and be restored ? 1 alone had that faith. Faith in truth leads to wisdom in conduct; whereas, faith in falsehood leads to folly. The result of my conduct showed, that my faith was a faith in truth.] 58 73. But it may be said that others before me have taught thatdeficientrespirationis the cause of cholera. Dr. Copland, Dr. Kennedy and others, suppose that the nerves of respiration are disordered ; and that breathing being deficient, animal heat and due arterialization of the blood, must fail. Dr. Charles A. Lee, and others, maintain that atmospheric influences disorder the respiration, and produce these results.* But as they do not believe that the power which moves the blood from the lungs is furnished by respiration, their doctrine is, therefore, essentially different from mine, especially as regards the influence of respiration in cholera and similar diseases. They know that in cholera the circulating current is checked at the capillaries of the lungs. The question, on which hangs life or death, is, what can set this stagnating mass in motion again ? They have looked for power to the action of the heart, that curious double organ, which is but the lapping together of the opposite sides of the continuous channel of circulation. If the heart's action had truly furnished that power, then, that action must now have ceased; and the last particles of blood which had received momentum, must have gone on, leaving on each side of the heart, in the containing system, a void in advance, and causing a congestion in the rear. But in the rear of the current on the left side of the heart is a void, and in the advance on the right side, is a congestion ; nor has the heart ceased its action. On the contrary, it has beat faster, and struggled harder and harder, as the blood has moved slower and slower ; and it was the right heart which beat the hardest, and struggled the longest ; but all its efforts could not avail to throw off its own load, much less tQ move the blood through the lungs. No : the heart, that paddle-wheel of life, cannot of itself set in motion the steam-boat of man's animal existence ; and he who should deem it but the whim of an ignorant * Dr. Dickson, in his e'xcllent treatise on Malaria, mentions, that Dr. Leavcnworth believes that carbonic acid has deleterious effects on the lungs; but since he does not believe, that clearing it away and bringing in fresh air would save life by furnishing motive power, his views and miuc cannot be identical. 59 woman, that the making of a fire under the boiler would do it, — would never effect the object, — no matter how many steam-boats he had dissected, — and no matter how numerous or how sagacious his other expedients : while that ignorant woman, having learned by observation, that as the fire was, so was the boat's motion ; or, having been taught by the Maker of the vessel, — she might, by the simple expedient of causing a fire to be put in the right place, do, what they could not with all their learning — set the gallant boat under head-way, full upon her course. 74. Although respiration, operating by heat, causes circulation, yet circulation becoming disordered, may re-act, and become the cause of the stopping of respiration — the moment of which, is reckoned the moment of death. Thus it is in the closing scene of cholera. Respiration failing in the first instance to produce the ordinary quantity of heat at the lungs, the motive power is phecked, and the wonted momentum is not communicated to the blood as it comes on ; then the checked current stopping, the posterior portion of the lungs becomes so much engorged with venous blood, that the bronchial cells are compressed ; and thus this plethora of blood in the lungs, originally caused by a want of due respiration, now acts to compress and finally to close the air passages ; and so, disordered circulation, in its turn, tends to abolish respiration and cause death. But this pressure on the bronchials and diminution of their capacity, may cause sudden death. If but a little carbonic acid gas shall be in the bronchial system, that diminished system will now have room for nothing else, so that no oxygen can come to the venous blood. When breathing is thus about to stop, and death is at hand, medicine cannot arrest it ; for this lack of breathing does its work so quickly, that nothing taken by the stomach can be rapid or powerful enough to meet the emergency. Hence it is, that the ablest physicians, not yet believing the theory of circulation by respiration, have stood by with folded hands, and looked on in utter despair. For nothing, except what can go to the lungs and move off the' clogged current there, can meet the case. And what can 60 do that but animal combustion ? and what can get air to the fire-place of life but breathing ? and who can inhale that air but the patient ? not even his very mother. And if a heavy gas, the ashes of animal combustion, clogs the fireplace and bars the entrance of the air, who can get that heavy gas out of the air-cells of the lungs ? Not all the physicians on earth. But the patient may, however violent his attack. But he must move, or be moved, quickly ; and without a moment's delay, breathe out the death that is within, and breathe in the life that is without. If he delays, the fatal coldness will increase, and soon overpower his lungs — the last citadel of vital warmth, — and they will fall collapsed. What persons attacked with cholera, and knowing that artificial breathing could keep them from such a fearful state, would be so stupid as to delay a moment? But if they had become thus torpid, friends, seeing it, should rather, like the Canadian gentleman whose travelling companion was freezing to death, take rods, and scourge them to life. Anger them, if nothing else will do, and make them breathe, in struggling to defend themselves from disgraceful blows. They will, as did the saved Canadian, thank you afterwards for their preservation.* 75. In this cure of cholera no apparatus is required. And nothing can be a cure for a pestilence which is most apt to attack in the night, — often suddenly and without the least warning of the danger, — but something which can be used without delay, and without assistance from others. How many have been found dead, who lay down and breathed their last alone ! If even a tube for this aeripathy were required, the patient might lose his life in waiting for it. But nature's own tube, the trachea, with fresh air, is always at hand. 76. If the principles concerning the cure of cholera herein mentioned are true, how is future experience to be made their test, since each patient may practice them in private * If a little child were seized with this cholera coldness. I would hold it by the feet with the head downwards, for one moment ; and strike the back, to start the carbonic 61 for himself? The ten lepers who were cleansed, all but one, went on their way, and said nothing about their cure. And those cured suddenly, would perhaps, themselves, think that, after all, they had not had the veritable disease. But should we again experience the depression and danger of the cholera atmosphere, there is to me a satisfaction in believing that many precious lives may be saved. These views, to my own mind, and I hope they will to other minds, dispel mystery, and allay fear. Physicians, having a full understanding of the conformation of the body, will know how to perfectly use this agency. 77. The fact of the extreme suddenness of death, and also, that, after death, the bodies of persons dying with cholera grow sometimes warmer rather than colder, for several hours, may, we think, be satis factorily accounted for. When, by a condensing degree of coldness, the vapor in the lungs is suddenly changed into water, the solids and liquids of the lungs fall upon the air-cells and compress them. If, at this time, those cells shall each contain, at the posterior portion, carbonic acid gas, and at the anterior, atmospheric air, — as the cells are compressed into a smaller and smaller compass, the atmospheric air will first escape from the trachea ; after which, the whole diminished bronchial system will be filled with the carbonic acid. These considerations of the action of the accumulating blood upon the bronchial system, when partially filled with carbonic acid, may help to account for sudden seizures of cholera, like that of J. F. She was feeble, and had, we suppose, not only an over quantity of venous blood, but also heavy gas in her lungs, which was not yet sufficient to fill the bronchials and prevent her having such a partial combustion at the lungs, but that she had the strength to keep up. She becomes frightened, and her emotion sends an added rush of blood to her lungs. This blood presses still more upon the bronchials; and first, as their capacity diminishes, the uppermost gas will be forced out at the trachea, and the undermost, which will be the heavy carbonic, will then fill nearly the whole bronchial system. And if a few breaths of sulphuretted hydrogen, or 62 any other irrespirable gas, at the same time is inspired, these two causes are sufficient to abolish respiration to such a degree that circulation must stop ; and if the patient cannot immediately be roused to clear the bronchials and bring in good air by breathing, coldness will soon collapse the lungs, and death ensue. Death in such cases occurs with the maximum coldness ; but as the pressure on the bronchial system still continues, the carbonic acid next escapes from the bronchials through the trachea, and leaves room for atmospheric air to press into them through the nares, and meet the venous blood. Vitality, so sudden was death, exists in the tissues of the lungs ; and a little combustion is rekindled. [hould this combustion be sufficient by its expansive power » heave the chest — the apparently dead, even if in his coffin, : his grave, would breathe again. But generally, in these ises, so it is to be hoped, such lesions have occurred in the slicate parts of the brain, that sensibility does not return. And now, having to the best of my ability, discharged my duty, I commit my cause to God, and my work to the world. 63 NOTE. Containing an extract of a letter from Mrs. G., in which that Lady describes her sudden and remarkable change. — Related in Section IV. While engaged in composing the fourth section of the preceding work the case of Mrs. G.) it occurred to me to write and ask her to give me >y letter a particular account of her symptoms, and her own impressions of her situation before my seeing her. Her answer did not arrive is seaon to aid me in the article ; nor can I now stop the press to get her permission to publish her account, as contained in her letter. But trusting to ler goodness to excuse me, and feeling the whole importance of sustainng such remarkable facts, as I have now related, by explicit testimony, I end her original letter to the printers marking on it the following passages as extracts : After saying that the scene " is as vivid to my mind to-day, (Nov. 1,) as it was that night," (Sept, 14,) she speaks of having been out of her bed at 6 o'clock, p. m., and thus continues: " when I lay down again I felt very much fatigued and faint, but thought it would soon pass off, (as when 1 was ill at home, much in the same way, some weeks previous. I had a number of sinking turns that would last five or ten minutes, and I would evive again,) but I soon found this fainting and sinking to be unlike those. had no pain, but my hands and feet were numb, and I had a dreadful )eating of the heart, that resembled pumping from a cistern with a per-* )endicular pump-handle. I said to cousin Sarah, who was sitting by me, that I did not feel as well, and wished her to call her mother. She did, and they sent for the doctor. I then requested Sarah to go for yourself and Mr. Willard. I wished you to stay with me, and him to telegraph my husband ; I felt conscious I was sinking very rapidly, and could not ast long at that rate. My mind was perfectly r.alm and resigned ; it had >een a day of much prayer with me,* and although it seemed hard to be ick and die from home, I could say cheerfully the will of the Lord be lone. 1 had given up myself to die, and my husband and children into he hands of a wise God. I had arranged all my last words for them, to ay to you. I felt that a few hours would close my earthly history, and what I had to do must be done quickly, or my strength would entirely ail. I never was more composed than when you came in, and my first equest was that Mr. Willard would telegraph my husband ; and I was sadly disappointed when you told me it would not be best to do it that night. I thought you were not aware how much 1 had changed in an hour, and were unwilling to have me think 1 was dying — -but you began so resoutely that I felt encouraged. * It was the Sabbath. 64 •• After you opened the window and raised me up, I commenced breathing the long breaths, (which were pretty short at first,) it seemed perfectly delightful. I could think of nothing but taking fresh draughts of exhilarating gas, it. was so delicious. I don't think it was more than five or ten minutes before my hands and feet began to prickle, my pulse returned, and that dreadful beating of the heart subsided, and I was in a most drenching perspiration. Just then the doctor came in, and you had many witnesses to the change. It was so great to me, that I felt almost like coming back to life, after I was dead — and exclaiming, give God all the glory, — the simplicity of the means seemed so like Him. " You are at liberty to make use of my case as may be a benefit to others. This letter, of course, is not designed for the public." The above is copied verbatim from an original letter of Mrs. G., to Mrs. Emma Willard, dated and post-marked Nov. Ist, received at Troy, and remailed to Mrs. W., at New- York. Attest, Pudney & Russell, Printers. 64 " Aficr you opened tlir window and raised mo up, I commenced breathing the long breaths, (which were pretty short at first.) it seemed perfectly delightful. I could think of nothing but taking fresh draughts of exhilarating gas, it was so delicious. 1 don't think it was more than five or ten minutes lied ire my hands and feet began to prickle, my pulse returned, and that dreadful beating of the heart subsided, and I was in a most drenching perspiration. Just then the doctor came in. and you had many witnesses to tin 1 change. It was so to me, that I felt almost like coming back to life, after I was dead — and exclaiming, give God all the glory, — the simplicity of the means seemed so like Him. " You arc at liberty to make use of my case as may be a benefit to others. This letter, of course, is not designed for the public." The above is copied verbatim from an original letter of Mrs. f!.. to Mrs. Emma Willard, dated and post-marked Nov. Ist, received at Troy, and remailed to Mrs. W., at New- York. Attest, Pudket fo Russell, Printers. RESPIRATION, AND ITS EFFECTS; MORE ESPECIALLY IN RELATION TO ASIATIC CHOLERA, AND OTHER SINKING DISEASES. J valuable volume. The name of its author will recommend it more lJ framed a true theory of the circulation of the blood." — Cincinnati Weekly Cc 3 r*di § j~t PVtli (l » V '•} Ijjg^ " The theory advanced, possesses the extraordinary merit of combining ;n>'] originalities with common sense. It is the result of some fourteen years' Viet Mf» investigation." — Northern Budget. #>ji The London Critic, a journal of great ability and force, reviewed this jW Work in the most decided and favourable terms, giving her arguments the Wa pi'aise of being " complete and cogent," and placing her on a level in re- t§h •n> ¦) spect to these researches in physiological truth, with Mrs. Somerville in rj*^ physical science. $2| Dr. R. J. Breckinridge, whose learning and weight of character make ~.z§ 5W his sanction of much value, says in a note to the author, that after read- )^jj ;£A ing her work on the Circulation of the Blood with great attention, he Mj; ;n>g must say, "that the theory of Mrs. Willard seems to him eminently in- rf|j IjiM genious, and, to say the least, full of probability ; and, that it is exhibited )M jg^ in her little work with great clearness and ability." |W K3F* Mrs. Willard's Treatise, on Respiration as a Cure in Asiatic W| jg^ Cholera, and other Sinking Diseases, which is the object of this pam- £gji gn phlet, will be much more clearly understood, by first perusing this f'Cf •&& on the Motive Powers, &c. ;«^