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^   INFORMATION  RESPECTING

|)           THE   PRACTICE
    F.  H.  RAMADGE,  M.D.,

miOW OF THE ROYAL COLLEGE OF PHYSICIANS, SENIOR PHYSICIAN TO THE IN-
      FIRMARY FOR ASTHMA, CONSUMPTION, AND OTHER DISEASES OF
                THE CHEST, ETC.,  LONDON.
CONTAINING
An Account of several Cases in relation to this Practice,
         in which it has been beneficial in
                 this  Country,

        WITH  OTHER CORROBORATIVE TESTIMONY.
BY J. M. HOWE,  Ml
S
>$&GE0V
             NEW  YORK:          ^'"
      PUBLISHED BY THE AUTHOR,
GRAND STREET, FOUR DOORS WEST OF BOWERY.
■v"-" •• v
 
sr<g>itf&(9iB a
  The attention of Professors of learning, Clergymen, Invalids,
and all persons especially interested in the education and training
of Youth, are respectfully solicited to peruse the contents of this
pamphlet, and then to  circulate it, that the information may be-
come general.
                     CONTENTS.
           Introduction.              ;
           Letters from and cases of individuals benefited.
           The author's decline and recovery.
Chap.  I.—Observations on Consumption.  Dr. Ramadge's views,
             published about thirty  years ago.
Chap. II.—Causes of Consumption.  Depression  of mind caus<
             of Dyspepsia, and leading to Consumption. Throa^
             Diseases.
Chap. III.—Symptoms of Consumption.
Chap. IV.—Means by which Tubercle" in the  Lungs may be pre-
             vented.
Chap. V.—The Treatment pf Consumption, of Bronchitis, Asthma,
             &c.   ry
Chap. VI.—Cure of Consumption.
  Persons who wish to avail themselves  of this remedy will do
well to make themselves acquainted with the subject;  or, if conve-
nient, to consult the author.  Without this necessary information,
the patient may find himself in difficulty, from which a little in-
struction might have saved him.   In some instances persons have
returned, after two or three  months, stating  that they had used
the tube, but were not benefited;  and upon inquiry it was as-
certained that they had not used it once as it should have been
used.
  The author has  had more  than fifteen  years' experience in re-
lation to this method of treating Consumption, and also the treat-
ment of Dyspepsia, during which  he has seen  many persons
whose lives might have  been preserved if  the tube had been
early  employed.   He has  also known some instances in which it
has been resorted to  in so advanced a stage  of the  disease as to
prove rather an injury than a benefit. .Persons who may wish to
use (his instrument would do well to have Dr. H.'s opinion ;  and
in no case will he recommend it unless  he sincerely believes its
use will be beneficial.
   P. S.—All letters must be post-paid.  (See 3d page of Cover.) 
CONSUMPTION  CURABLE.
INFORMATION  RESPECTING

        THE   PRACTICE
                   OF
 F.   H.   RAMADGE,   M.D.,
FELLOW OF THE ROYAL COLLEGE OF PHYSICIANS, SENIOR PHYSICIAN TO THE INFIRMARY
         FOR ASTHMA, CONSUMPTION, AND OTHER DISEASES OF
                 THE CHEST, ETC., LONDON.
                     CONTAINING

An Account  of  several Cases in  relation to • this Practice,
         in which it has been beneficial in
                  this  Country,
WITH  OTHER CORROBORATIVE TESTIMONY
*^Jtfcf
            BY J.  M. HOWE, M.  D
              ______________________________________________________________________   ■  \
                                    V      ^

                 NEW YORK:
          PUBLISHED BY  THE AUTHOR,
227 GRAND STREET, FOUR DOORS WEST OF D..(V4RY.
                      1856. 
C«1
        Entered according to the Act of Congress, in the year 1853, by
                          J. M.  HOWE,
in the Clerk's Office of the District Court of the Southern District of New York. 
ilntrnintttan.
   If an apology be necessary for this  publication, it may be
found in the fact, that the remedy recommended will arrest
the progress  of pulmonary consumption,  bronchitis, asthma,
and other diseases of the throat and chest.  It will certainly
save life, if judiciously and timely employed.  The author
owes the continuance of his earthly existence to this means,
and he has seen its beneficial effects demonstrated hundreds
of times in the cases of others for  a period of fifteen years
past.  Prior to the  year 1838, this remedy was unknown in
the United States, and was introduced by the author  in that
year.  Since  which, the knowledge of it has been extending
throughout our country, to a limited  extent, and it  affords
him pleasure to know that  some  liberal-minded  physicians
are employing it successfully in their practice; but it is  not
known as it ought to be.   It should be wide-spread over the
land wherever the name of consumption is known,—there it
should be  published that there is a  remedy adequate to arrest
the destroyer: not a combination  of drugs and medecines,
known only to its compounder, but a simple mechanical pro-
cess, available to all.   This valuable discovery, like  all the
great discoveries connected with civilization  and the natural
world, has  been  arrived at by a  slow process—the work of
centuries.   How slowly has man (and not yet), as an entire
family, arisen from a state of barbarism to a state of civiliza-
tion—and how slowly has he arrived at a correct knowledge
of the laws which govern the heavenly bodies—and by what
a long process has he arrived at the knowledge of the power
of electricity and of steam: these elements ever existed, but
through lack  of knowledge their  power was not known, and
especially as adapted to modify the condition  of the  world; 
4
INTRODUCTION.
so, in the medical profession, how slowly have men arrived
at the knowledge of any great truths.  How long did they
plod before they arrived at a correct knowledge of the circu-
latory system in man, and especially that of the blood ?—and,
when Harvey dared to present this great truth to the world,
he did it at the expense of reputation and practice.  So with
pulmonary  consumption, from the days  of Hippocrates  to
the present, the faculty have been relying for  the  most part
upon drugs and medicines to arrest this disease,—proving, a
thousand times, or more, every year, the inefficacy of all such
means, and yet how tenaciously do they adhere to their course,
and when a man of genius dares to depart  from the old track,
and  to  proclaim to the world that exercise and  air is  the
true remedy, how severely is he anathematized.  Professional
men say of him as they said of Columbus, when he  advocated
his belief in the existence of another hemisphere—or of Co-
pernicus, the great astronomer, when he presented the true
laws which govern the heavenly bodies—or of Harvey, when
he discovered and proclaimed the circulation of the blood in
the human  system—" He is mad ! "  "He is a fool! "  Hap-
pily  for  the world, the discoverer of the great benefit  of in-
haling the  common air through a tube for the cure of lung
and  throat  diseases is  no novice, a man of no mean standing,
but one of the most distinguished  physicians of Europe.
  Dr. Ramadge is the senior  physician to the London Lung
Infirmary, an office which he  has held for nearly forty years.
This is a public institution,  and under the patronage of  the
nobility and  gentry of England.    Its  president, for  many
years past, was the venerable Duke of Sussex, uncle  to her
Majesty, the Queen;  and  in  this  institution Dr. R. has  had
greater  opportunity to  make  observations on consumption,
and to  try the various experiments in such diseases, than
perhaps any man living.  From the numerous  consumptive
patients that I saw while there, both at his private dwelling
and at the infirmary, who applied  to him  for advice, I should
think he has more consumptive cases in one month than any
physician in  the United States in one year.—See the Royal
Calendar, and Court  and  City Register  for  England, Scot-
land, Ireland, and the Colonies, published annually.
   Dr. Ramadge's practice  would  doubtless have  been more
extended, but for  a most  unfair review of  his work, " Con-
 sumption Curable," which appeared in the July  number of 
INTRODUCTION.
5
the Medico-Chirurgical Review,  in  1834, edited  by James
Johnson, M.D., London.  This publication has ever been re-
garded as the leading periodical among the profession, and in
consequence of this article, Ramadge's work has been thought
of little or no account.  The innovation in practice—exercise
and air instead of drugs and medicines—was too unprofes-
sional  to be considered  orthodox; but, just as  sure  as  that
truth must prevail over error, just so surely will the  time
come (slowly it may be) when it will  be made apparent to all
enlightened minds that Dr. Ramadge's  system of treating
pulmonary consumption is  the remedy of nature, and the
only one in  our artificial manner of  life which  will success-
fully arrest this dreadful disease.
   The inefficacy  of  medicinal  treatment  in  consumption is
well known.   The venerable Noah Wetmore, Esq., for forty
years the superintendent of the New York City Hospital, re-
marked to the author,  " They never  ought  to  allow a  con-
sumptive to come within  these walls, they invariably die."
This subject is worthy the  attention of the most intelligent
and scientific minds; the  profession will  do themselves no
indignity so to lay aside their prejudices  as to learn what
Dr. R.'s practice  is,  and to observe the effects of a systema-
tic course of inhalation in incipient consumption.  The reader
will not allow himself  to be prevented from examining this
subject by the remarks of  illiberal  physicians, who practi-
cally  know  nothing of the merits  of this subject.   Such
men answer  all  questions  of their patients upon  this  sub-
ject by the exclamation, " Humbug ;"  " The system is based
upon  a false  pathology;"  " It is r r no value, especially in
your case ;"  " Breathe deeply wiluout the  tube."   Thus,
many  who might live, had they this  means, are prevented
from  making  further  investigation,  and  die.  While  some
physicians oppose this  method, it is  not  a little mortifying
and amusing  to  see some  men  in  the medical profession,
who,  finding that the tube is really valuable, have  con-
nected with it, for money-making  purposes, a great deal of
quackery, selling  with  the tube large quantities  of medicine ;
and not  only  so,  but some  have had the  effrontery to pub-
lish themselves as  the  author of all  Ramadge's particular
views  on lung and throat  diseases.   Such men may make
money, but they are to be pitied.   I trust that the  time  is
at hand when honorable and high-minded men will take this 
6
INTRODUCTION.
subject in hand, and place it in the position before the public
that it ought to occupy.
  The author feels his inability to do justice to this impor-
tant subject, and would have been glad  had this duty de-
volved upon one of  the ablest men in the  country;  but as
Providence  has placed him in this  position, he dares not
shrink from putting forth his efforts, feeble  though they be,
to relieve suffering humanity.
  New  York, January 23J, 1853. 
                       ttittti


 FROM GENTLEMEN WELL KNOWN IN THE CITY OF NEW YORK AND
                        OTHER PARTS.


  Throat Diseases—as Bronchitis, Enlargement  of the Tonsils,
&c.—indicate a scrofulous tendency in the lungs; these appear-
ances give reasonable ground to suspect tubercular deposits in the
lungs.  If the disease in the throat continues, it will prevent the
progress  of disease in  the  lungs; but a persevering use of the
tube will recover the throat and the lungs to good health.  It is
certainly as valuable in Bronchitis as in consumption.  The fol-
lowing letters will convince every  unprejudiced mind of this
fact.

The following  Recommendation  is from M. L. North, M.D., of
  Saratoga, Author of " The Invalid at Saratoga," a Physi-
  cian OF MUCH CELEBRITY AND REPUTATION :--

  A Card.—The  subscriber having somewhat  cursorily perused
the work of Dr. Ramadge, and  received  particular  statements
from Dr.  Howe, begs leave  to  recommend to his medical breth-
ren a careful perusal and thorough examination of the doctrines
contained in the work.  He beheves Dr. Ramadge's  sentiments
respecting the effect of warm and cold climates are correct, and
can easily be substantiated by many cases in our country of rad-
ical benefit received by patients bursting away from all the assi-
duities of nursing, hot rooms, and other  enervating  treatment,
and exposing themselves to the air and storms, which, to the
common  observer, would promise anything but recovery.   There
seems something very desirable, too, in accustoming the  lungs to
deep inspirations, while  the  process is cautiously guarded by
Dr. Ramadge's judicious directions to avoid any inflammation that
may occur.
  Is it not wise for the fraternity to search everywhere for truth, 
8
LETTERS.
 and fbr  remedies against this destroyer of the  human family ?
 And from Dr. Ramadge's respectable talents, and his peculiarly
 favorable position  for observation,  may we  not hope that his
 treatment, faithfully applied, may be instrumental in rescuing
 consumptives from the hands of death ?
                                      M. L. NORTH, M.D.
   Saratoga Springs, Oct. 26, 1839.


 Interesting  Account of Fjstep. Hoffman, Esq., Merchant, late
   of the firm of Hoffman, Vreeland, and Co., of Pearl street.

 x __ _     , _                Claverack, Nov. 26th, 1852.
 J. M. Howe, M.D.,  277 Grand street.
   Dear Sir,—I am informed you are about to publish a work on
 the  Causes,  Symptoms, and  Care of Pulmonary  Consumption.
 The  subject  is one  of great importance  to the afflicted and the
 public.   The great  experience you have had for the last twelve
 or fifteen years in the many cases of consumption you have ex-
 amined, and  the  many  cures you have already  made (through
 the use of the Inhaler,) are sufficient  evidence of the importance
 of giving it publicity.  From  the experience  I have had in my
 own  case (having  been  entirely  cured,) I consider  the subject
 well worthy the attention of medical men and the community
 and remain, very respectfully, yours,
                                     PETER HOFFMAN.

  The following  remarks will  furnish a brief account of the case
 of Mr. Hoffman.

  In  the fall  of 1842, Mr. Hoffman called on Dr.  Howe to con-
 sult him in relation to his health.   He had been laboring under
 pulmonary symptoms for  some time,  and had  had the  advice of
 able physicians, who, after they had exhausted their medical skill
 without affording him any benefit, informed him that the only
 hope of recovery left him was to remove to a warm climate and
 as the winter was approaching, he must soon get away  For this
 purpose he had purchased for  himself a horse and carriage and
 was on the eve of setting out, when some of his friends suggested
 to him the propriety of obtaining  the opinion of Dr. Howe and
 being governed by  it.  Mr. Hoffman said  to Dr. H., "I have
 made  all  my arrangements to leave,  but I now come to obtain
 your advice, and I will be governed by it.  If you say go I qo •
  stay, 1.stay."  With my knowledge of climate, its advantages
 and disadvantages, and the great value of the tube, I could not
 do otherwise  than to advise him to  abandon the idea of going
abroad, and to stay at home;  to reside in his own dwelling  on
 Brooklyn Heights, to attend to his business,  and to use the tube 
LETTERS.
9
faithfully and perseveringly, promising him entire recovery.  Mr.
Hoffman abandoned his journey, and recovered his health, and is
now in  the enjoyment of excellent health, and every few weeks
recommends some consumptive friend to call on Dr. H. and pro-
cure a tube and his directions.

From W. E. Baldwin, Esq., Store corner Broadway and Court-
                        land street.

                                  Newark,  30th Nov., 1852.
  Dr. J. M. Howe,—Dear Sir,—It is with much pleasure I learn
you are preparing  a new  publication on Consumption and its
cure.  Having for three years past thoroughly tested the efficacy
of your " Inhaling Tube," in my own case,  and  having seen its
beneficial effects on several friends who have used it, I feel quite
confident in recommending it, and am warranted in assuring you
that I believe its judicious use to be invaluable to every person
in any way predisposed to that most insidious of all diseases—
consumption.
  May you have that richest of all rewards for your philanthropic
efforts,  the knowledge that many who through your efforts have
been rescued from disease, now live, and in comfortable, health,
bear witness to the  success oT your efforts in their behalf.  With
great regard for you personally, I am happy  in testifying to  your
Christian courtesy and urbanity.
           I am, my dear Sir,  very truly your friend,
               '  J                    W. E. BALDWIN.

                From the Rev. C. P. Bragdon.
                                    Avburn, Jan. 1st, 1853.
  John M. Howe, M.D.—Dear Sir,—I rejoice that you are about
 to issue a new Pamphlet of Facts for Consumptives.   I am the
 last man to flatter any one;  but truth and  justice compel me to
 testify that I believe you are  one of the greatest benefactors of
 this remarkable age.  You first introduced  to the afflicted of this
 nation  inhalation for the cure of Consumption.    That to you I
 am  more indebted  for  the  continuance of  my life than to any
 other man on earth, I cannot doubt, and to my certain knowledge,
 hundreds more can and would, were they called upon, witness to
 the same thing.
   Many of our most useful ministers have been, and  are  being
 saved from premature death by the use of the Inhaling Tube, first
 introduced in the United States by you, in 1838.   Let the people
 have the facts, dear sir, and hundreds and thousands by this sim-
 ple  philosophical instrumentality will yet  be rescued from the
 grasp of the fell destroyer, Consumption.
 &                             Very truly yours,
                                         C. P. BRAGDON.
1* 
10
LETTERS.
    Some years since Rev. Mr. Bragdon wrote as follows:—

                                   Auburn, March 20, 1846.
    John M.  Howe,  M.D.—My very dear Brother,—Please ac-
  cept these few facts in relation to the use of your Inhaling Tube.
  In the month of June, 1843, I had an alarming hemorrhage from
  my lungs, which prostrated me for months.   Late  in the fall of
  that year, as I was going South, (where none ought to go from
  the North, except for asthmatic lung affections,) I called on you,
  and obtained a tube.  I used it during the winter, and was so far
  restored as to preach thirteen times before March.  I have con-
  tinued to use it much of the time to this day—have had two very
  slight hemorrhages since.   One in April 1844, and  the other in
  August 1845.  Have preached occasionally up  to this last winter.
  My chest is enlarged, and I now breathe more  fully, and as freely
  as I ever did.   Such, however, is the complication of diseases
  upon me, that I am not, and never shall be, a well man.
   But were my lurgs alone affected, with my tube in my mouth,
 I would bid defiance to pulmonary consumption, such is my per-
 fect confidence in its powerful instrumentality.
   I can most heartily recommend its use to  all in any degree
 inclined to, or at all afflicted with,, lung affections, as either a
 preventive or cure the most certain and safe of any one  thing
 ever yet known.  A friend writing to  me from the South says,
  How have you kept out of the grave so long?"  It is mostly,
 with the blessing of God, by the use of my tube.
           Yours affectionately,           C. P. BRAGDON.


 From the Rev. D. P. Kidder, D.D., Editor of the Sunday School
               Advocate,  of the M. E. Church.

 sa^ vou^rr^06^ SirrI  am ha?pyt0  W occasion to
 say to you that I have the  strongest reasons for believin°-  that

 Z^TZ^ ^^ Tube' *° be of ^eat, if not°of in!
 dispensable, importance to persons subject to pulmonary affections.

   at    v 7  *r   ,     D- P- KIDDER> 200 Mulberry street
  New  York, March 20, 1846.


           From the Rev. Bishop Janes, D.D.,  M.D.


m From  a  limited acquaintance wth  £"*Lfo?^'^
Tube, I am persuaded  that a iudic™ and ^1 ^  InhaJmg
ment of it is a healthful exercise fopersons afflS wT^
chest, or the dyspepsia, or for persons o7?J^lZ^L    ^

                                   EDMUND S. JANES. 
LETTERS.
11
From the Rev. John Dempster, President of the Theological
                Institute at Concord, N. H.
  Dr. Howe—Dear Sir,—Constrained by a sense of duty, I can-
not longer refrain from acknowledging to you the special benefit
I have  realized from your  breathing  tube.  Under  the  divine
blessing, it relieved my shortness of breath, increased the volume
of my voice, and much aided my digestive organs.  My convic-
tion that this improvement is the result of that agency is strength-
ened by several instances similar to my own that have  fallen
under my notice.             Yours as ever,
                                     JOHN DEMPSTER.
  Nov. 25, 1845.

From the Rev. B.  F. Tefft, D.D., late Editor of the Ladies'
  Repository, Cincinnati, Ohio, addressed to his friend, the
  Rev. C. P. Bragdon.

                                      Lima, July 25, 1852.
  Rev. C. P. Bragdon,—In reply to your request, I  am free  to
say, after the hemorrhage I suffered last summer, I began imme-
diately to use the tube you handed me; and I have used it every
day, more or less, ever since.  Then I was very thin in  flesh, be-
sides being dangerously ill, as you remember.  How much bene-
fit I have received from  the  tube, I cannot say;  but  you are  at
liberty to do what  you please with the following/acfe.   1. I now
weigh twenty-five pounds more than I did a year ago.   2.  I have
a better appetite than I ever had in my life.  3. My throat, which
has been sore for ten years, is better than it has been at  any time
during that time, though I do not  consider it prudent to use my
voice much in public speaking.   Having overworked myself so
long, my only cure now is rest, so as to give my whole system
time to recover. 4. Whenever I  get very tired, or a  little un-
well, or in need of  exercise for my chest, I use  the tube freely,
and thus always  obtain relief.   5. I may add, that under  the
arms, I now measure two inches more than I did a year ago.
                                            B. F. TEFFT.

From Jacob Campbell, Jr., Cashier of the Pacific Bank, New
                           York.
                                 New York, January, 1853.
  J. M. Howe,  M.D.,—Dear  Sir,—I am glad to learn that you are
about to furnish a more full  account of your  long  experience in
inhalation of the air for  pulmonary affections.  Your efforts  are
worthy of all praise.  In my own person I have received  the
greatest possible benefit.  You may recollect that my friend, Mr. 
12
LETTERS.
  Buck, now first teller  in our bank, introduced me to you about
  seven years ago, at which period I was having hemorrhage from
  the lungs daily, and also was raising dark purulent matter.  My
  symptoms began to excite the deepest anxiety of my friends, but
  as soon as I received your advice and commenced using the tube,
  I began to improve, and soon lost all my consumptive symptoms.
  My chest enlarged some two or  three  inches, and  I increased
  several pounds in flesh. I am now in most excellent health,  and
  take pleasure in calling attention of the public  to your laudable
  efforts to make known so valuable a remedy.
       Very respectfully,          JACOB CAMPBELL, Jr.


  From Rev. Wm. Roberts, now Superintendent  of  Methodist
            Episcopal Church  Missions in Oregon.

   To John M. Howe, M.D.,—Dear Sir,—After  having used  the
 tube occasionally for nearly seven years, and witnessed its bene-
 ficial effects on many others during that  time, my confidence in
 its excellence  remains  unchanged.  I  think it  a most valuable
 remedy for persons suffering with pulmonary affections.
           Yours respectfully,      WILLIAM ROBERTS.
   Jersey City,  March 26, 1846.


 From D. G. Johnson,  Engraver.—Copious Hemorrhages.—In-
   efficacy  of  spending six Winters successively in a Warm
   Climate.—Benefit of persevering in the Use of  the Tube.


   When I first heard of the tube I J^"^^
 about six years with my chest  and lungs.  I had not known what
  was to have  a comfortable night during the whole of tthTpe-
 wJL   i7 ^J?110.6,1  Place(Wself in 1 horizontal  positron I






flesh, sprits, Ld enemas ZtacC  tffeVKt 3 !fli*


«ion, but ^ITnfXln^ eTef0l3PttSof0lt,repUt'-
approached, succeeding  mv first  attS T ,1.■ ?  ' ?" J™
would be death for me to Slav in  rtSf?   T"S '?formed that it
that  I should go to Cuba  fnd  o^Tf' ^ l WM *"*<*
Mend on earAehind, ^C^S^ilZTi^{Zl 
LETTERS.
13
since been South six successive winters, but  each time returned
with little or no permanent benefit.   In the meantime  I have
taken, to please my friends, all kinds of syrups, balsams, teas, &c,
which I now consider useless, in fact, worse than nothing.  While
in New Orleans, in the year 1840, I had six hemorrhages in two
days, amounting in all, to  perhaps over a quart of clear blood,
which reduced me  to the very lowest extreme, from which I only
recovered by the most judicious management, and the being kept
sitting erect in  bed for  three successive nights and days.  This
was the last winter I spent at the South.   I  recovered more in
six months, by using  the tube, than in the whole previous six
years.   In fact, it is the only thing from which I have derived the
least permanent benefit.
  The expectoration of  bloody and purulent  matter  and mucus
entirely subsided within the first six  months' use of the tube.
My improvement was gradual up till  within  a year  past,  since
which my cough and all my pulmonary symptoms have  entirely
left me ; and I  consider  my lungs perfectly sound, and my gene-
ral health recovered.  For nearly five years I have exposed my-
self to all kinds of weather, and been enabled to  attend to my
business.  Had I been directed to Dr. Howe and the tube, I doubt
not that a few months' use of it at an early period would have
restored me to  perfect health, and saved me the six years of con-
stant suffering day and  night, with the  anxiety, vexation, &c,
attend/mt on this vagabond life, of going away from all friends,
and  nearly all  one's comforts, in this useless  business of going
South  every winter, to  say nothing of the  breaking up of my
business, and the expense of some thousands of dollars, which I
could badly spare.  The  improvements in my health I know have
been produced solely from the use of the tube.  I have encour-
aged many consumptives to use the tube, but the great difficulty
in the way of receiving  permanent benefit, is the lack  of con-
tinued perseverance in inhaling until all the difficulties arising are
fully overcome  ; this I have done, although I have toiled during
day after day, amid discouragements, for  several years;  but the
result is, I now have a healthy and an  expanded chest.
  But perhaps  some will say that my lungs could not have been
diseased, or they would have been incurable, as it has always
been supposed  that diseased lungs could not  be healed.   I en-
deavored to doubt that  my lungs were diseased as long as pos-
sible, but it  was  useless; it was too true and apparent  to be
resisted, and I gave up all hopes of recovery, until I saw Dr. Howe,
who convinced me that  I might yet recover.   I am, in fact, ano-
ther  man in spirits, energies, health, comfort, and of course hap-
piness.
  I  am sure that Dr.  H. should be highly esteemed  by our
fellow-citizens  for  his  efforts  in  introducing  Dr.  Ramadge's
practice in  this country,  and for the republication of the doctor's 
14
LETTERS.
 work on consumption.  Had I not been providentially directed to
 this means, I must in all probability have been a wanderer from
 my family every winter, if I had not ere this been in my grave.
   With the sincere desire that it  may be useful  to many. I  re-
 main, dear Sir, with gratitude, truly your friend,
             D. G. JOHNSON, Engraver, 61 East Broadway.
                                 New York, January, 1853.
  I hereby endorse all that I wrote in 1846: my health is most
excellent, and my views of the use  of the  tube  unchanged.  I
wish it was more extensively known.
                                        D. G. JOHNSON.

      From Rev. N. N. Beers.—Remarkable Recovery.
             Mecklenburg, Tompkins Co., N. Y., Dec. 9, 1852.
  Dr. J. M. Howe,—Dear Sir—It  is now nearly five years since
I first wrote to you for advice in relation to the use of the  Inhal-^
ing Tube.  At that time I was thought  to be near my end with
consumption.   With my right  lung badly ulcerated, my  whole
system very much emaciated, and all the other prominent  symp-
toms of that dreaded disease, such as a bad cough, profuse  ex-
pectoration, drenching night sweats, occasional bleeding  at the
lungs, and daily hectic fever, there was apparently no reasonable
hope of my living but a few months.   This was  the opinion of
my most intimate acquaintances, including  several physicians.
But by the blessing of God upon the use of the Tube, the disease
was arrested, my lungs healed, and my general health restored.
The disease, however, had made such an inroad on my constitu-
tion, and wasted so much of my right  lung, that I am  not as
rugged as I once was, though I am sufficiently so to be able to
attend to any ordinary business, and feel that my constitution
every year is becoming more and more firm.   I  commenced
preaching again after being laid aside for a year and a half, and
have been constantly employed  in  the work of the  ministry  for
the past three years.  At the present time I  have  a large charge
where I have  to preach twice every Sabbath, besides riding  ten
or twelve miles, winter and summer.  I do not know how to  be
sufficiently thankful to my Heavenly Father for his good  provi-
dence in directing me to the use of the Inhaling Tube.  I have
taken considerable pains to  recommend it  to others.  I have
procured tubes probably for nearly or quite  a hundred different
individuals.   To give as full a statement as I would like to, of my
experience and observation in relation  to its use, would make
this communication quite too lengthy
thl'T tiT'Tu1 knowledSe of ^s use in my own case, and in
that of others, I have reason  to believe                '

earHe'fstag^. *  ^ absolutely cure seated consumption  in  its 
LETTERS.
15
   Secondly, That it will prolong life  for years, in certain  cases
 where perfect recovery to sound health is impossible;  and
   Thirdly, That it is  a perfect warrant against consumption in
 those who are inclined to it from hereditary taint, or from a weak
 and deranged state of  the system.
   If this latter class would universally adopt its  use, I can but
 think  that  the  dreadful ravages  of consumption  would  soon
 be stayed.   I have known  persons commence its use too late to
 save life :  but scores, by taking it in time, have been restored to
 sound health. Jeremiah Johnson, of Ovid,  Seneca county, N. Y,
 after using the Tube nearly a year, said to  me, " Why, if I could
 not get  another, I would not take fifty dollars for it."   Similar ex-
 pressions have been made  to me  by many others.   I have had
 the pleasure of directing the attention  of  several physicians to
 this subject, who have  afterwards introduced it into their practice
 with great success.
   And  now, while facts abundantly prove that the use of the
 Tube will cure cases of genuine tubercular consumption, if taken
 in its earlier  stages, it would be vastly better for individuals to
 resort to its use while laboring under the premonitory symptoms,
 before consumption is fully developed.  A perfect cure could then
 be very easily and readily effected.
   All catarrhal or  bronchial  affections  of the throat  and lungs
 are  regarded by  Dr. Ramadge as  evidence of latent consump-
 tion. Persons so  affected  should resort to the use of the  Tube
 without delay.
   Weakness  of the  chest and lungs should always be regarded as
 a precursor of that dreadful disease; but the use of the Tube will,
 in every case,  absolutely strengthen the lungs, and make the
 voice strong, deep, and musical.  The effect on the voice alone is
 worth a great many times  the  cost of the instrument, especially
 to public speakers and to singers.
   I most sincerely desire that the real merits of inhalation of the
 common air  through a tube properly constructed, for all throat
 and  lung  difficulties, may  become generally known  and prac-
 tised.
   I remain, dear sir, sincerely your friend and brother in Christ,
                                            N. N. BEERS.

 Interesting Case  of the  recovery  of a Young Lady intro-
   duced to Dr. Howe by Ashel  Jones, Esq., of the Firm of
   Jones & White, No. 263  Broadway.
   The attention of  Dr.  Howe,  about ten years ago, was called
 to Miss  M'W., a young lady of  about  twenty-two years of age,
and of  delicate constitution, with a narrow and contracted chest,
by Mr. Ashel Jones, of 233 Broadway.  At the time when Dr. 
16
LETTERS.
 H. first visited Miss M'W., he  found  her cheeks highly tinged
 with the hectic flush,  and her  pulse very rapid: she was  also
 laboring under a  severe  cough,  with night sweats  and  her
 strength was greatly prostrated.   She  had within a few week*
 buried a sister, who had died of consumption ; and her symptoms
 wen s-ioh that her physician  had informed the family that she
 wouid inevitably fall a victim  too.  Her mind was about made
 up that no earthly means could reach her case.  As her expecto-
 ration had not  been copious, Dr. H. gave  her much encourage-
 ment that she  would entirely recover if she would follow hia
 directions.  He directed a more free  ventilation of her apart-
 ments, and a wood instead of  an anthracite coal fire.  He then,
 by medicinal treatment, reduced  the action about the chest,  and
 directed a steady and persevering use of the tube, by which means
 she soon began to improve in health, and to venture to walk out.
 Occasionally her symptoms returned, and her fears were excited as
 to the result; but she persevered  in inhaling, and kept on steadily
 improving, and although more  than ten years have elapsed, con-
 tinues in good health.
  New York, January, 1853.


 From Mr. P. S. Carpenter, late of No. 29 Wall  street.—In-
  crease in the Size of the Chest of Four Inches, and a Gain
  of Twenty Pounds of Flesh in Three Months.

  My attention was called to Dr. Howe  and the use of the tube
 by  Mr. T. D. Camp,  now  engaged  in  the  Blind Asylum, New
 York, in the month of May, 1845, who  had known of beneficial
 results from  the use of the tube, and to whom I shall continue
 ever to feel grateful.  At the time Mr. Camp called my attention
 to this remedy, I was much reduced in strength, and confined to
 my room.  I had had hemorrhage of the lungs, and was laboring
 under lever, the pulse being on an average one hundred per min-
 ute.   I was-induced to discharge my former  physician, and  by
 the advice of my friends to trust my life upon the tube/and the
 treatment of Dr. Howe, they fearing that if I did not I  mi°ht

 nrl^inT; ul "T^ t0 d° S°' &Qd beSan ^mediately to Im-
 prove in health.  I was soon  enabled  to walk out   Mv chest
 expanded, or enlarged, within three months, about four indfes and
  gained about twenty pounds  of flesh in  the same  period 0f
 time.  It is now nearly a year  since I obtained the  tube  and
 during the past winter I have  encountered all kin^ of weWhe,
 without experiencing any inconvenience.  My apnetite il TnZ  '
 and my system regular                    y dPPeute 1S  good,


invaluable r^7Jmnded J ^f^^^ 
LETTERS.
17
 stages of diseased lungs.  Greatly desiring that the salutary effects
 of this remedy may be more generally known
         I am yours truly,           P. g. CARPENTER,
              Late of 29 Wall street, and 134 Christopher street.


      From Professor Vail, of Concord, New Hampshire.

                              Concord, N. K, Jan. 10, 1853.
   To Dr. J. M. Howe,—Dear Sir—It  affords  me great pleasure
 to say that the " Tube" which you sent to my mother  last win-
 ter, who, as I told  you, seemed to  be near  the borders of the
 grave from lung affections, has entirely recovered, and  seems to
 be about as well now in this respect as  at any former  period of
 her life.  She considers that the Tube, under the blessing of Pro-
 vidence, has been of the greatest benefit.
                 Yours truly,       STEPHEN M. VAIL.


 Facts stated by Mr. John Gore, Machinist, of Brattleborough,
   Vermont.—Beneficial Effects  of the Use of the  Tube  in
   Asthma.
   He informed me that he had been afflicted for a long time with an
 asthmatic affection of the chest, and that he had tried the various
 remedies prescribed by the regular practitioners, without benefit.
 He then applied to the Thomsonian  doctors, but still his disease
 was not mitigated.  His affliction was  so great, that after obtain-
 ing advice of three physicians in the place of his residence, neither
 of whom gave him any hope of recovery, he relinquished his busi-
 ness and  went abroad, hoping that change of climate would ben-
 efit him; but in this he was disappointed.  He then heard of the
 inhaling tube, and obtained it; and by a few months'  use of it
 has recovered his health, and  has  resumed his former  business.
 He also obtained a tube last summer for a young woman about
 eighteen years of age.  Her physicians considered her a decided
 case  of consumption.  She had  been restored  to  health, and
 attributed her restoration to the use of  the tube.  He  likewise
 gave.me an account of another woman, also a  consumptive, who
 was perfectly restored to health by it.  In reference to one of
the above cases, he stated that in  his opinion  the woman could
not have lived three  months longer had she not obtained the
tube.  On the 20th of July, 1843, he called on  me, and purchased
three tubes and six books to take home with him.


                 Letter from J. M. Titus.
                              New-York, October  29, 1841.
  Dear Sir,—I have just arrived in this city from the island of 
18
LETTERS.
  Jamaica, W. I.  Having in that island met with facts strikingly
  illustrative of the benefits'which may be confidently expected  in
  the early stages of tuberculous  diseases  from  pursuing the
  practice  of F. H.  Ramadge,  M. D.,  I  hasten   to  lay  them
  before you.
    Allow me to place two cases of different result side by side, by
  which I hope the truth will be  more clearly seen.
    In the fall of 1840 an elder brother became ill, and in a  short
  time afforded conclusive evidence of a diseased state of his lungs.
  He was prevailed upon to commence a  course of inhalation, but
  not until his strength was so far wasted  as scarcely to permit him
  to leave the house.   He then commenced, but with no hope, fre-
  quently saying it could  do him no good.
   From the lateness of the period when  he commenced inhaling,
 and the despondency with which he pursued it, the result was as
 We anticipated—he died in May last.
   Almost immediately  after  the death  of this brother, another
 brother was attacked with the same disease.   His physician, Dr.
 M'Fayden, of  Ejngston, examined  his lungs repeatedly, and did
 not conceal from him his belief that they were ulcerated.  My
 own physician, Geo.  P. M. Downer, M. D., who often  made my
 brother a friendly call,  repeatedly said most  decidedly, "He is
Jar gone with consumption."   The usual symptoms  were attend-
 ant: soreness of his lungs, and frequently much pain in his side-
 exhausting mght sweats, hectic fever,  a severe cough, and expec-
 toration of colored mucus, or pus, so  dense as  to sink instantly
 S^tiT11 mt°^auer' r*e amon£ the alarming evidences of
 ulcerated lungs.  My brother had thoroughly read Dr. Ramadge's
 work, and being convinced by his  reasoning and exp^mente-
 notwithstanding the ill success in our  dear bf oSertcasThe£*■
 SthereCbrSA0nf inhalf0D^  believing he should be ben"
 « l  I ♦ i7'  An?10us fnends had already mourned  over  him
 as lost to them, and no physician whom he consulted beheved he
could recover.   He had not, however, used the tube six weeK
IITt h«r«-were evidences of improvement  On the 29th of
to?t*Jnf^hKm mthe e.Wment of such  health as permitted  him
^T^^Tt^t^^l^ aff°rding almostfnduS

oweshiBli^^p^i1™^  wper«  ulce^ted,  and that hi
of the practice of Dr  RaSgi     G°d) S°My t0 an observance

Dr^madgTs wor/said ^7". T^T*' after «"»***
from *n „♦£* \Z— '  Said he had n°t derived so much infm-™^*
as confident that its use would 
LETTERS.
19
result in the more healthy development of the lungs, as well as
be of incalculable benefit to those afflicted with tubercular con-
sumption.  With  much esteem,  I remain,  very  dear  sir, very
truly yours,                                 J. M. TITUS.


\ Case illustrating the Use of the Tube in a Throat and
               Lung Affection, from a Lady.
  Dear Sir,—I have been using your tube for the last  seven or
eight weeks, and  am happy to say, with the blessing  of a kind
Providence, the means has been blessed  thus far.  The  ulcers in
my throat,  which discharged  considerable blood and very offen-
sive matter, have ceased to discharge, and there are no  ulcers to
be seen in the top of my throat; but the lower part at times feels
quite sore,  and at other times feels as though my palate was down.
Before I used the tube,  at time3 I could not  speak a loud word,
tnd it  was very difficult for me to breathe  ; but after using it
about three weeks I was not again attacked with such extreme
weakness of voice and  difficulty of breathing.  I am  acquainted
with two ladies who are using your tubes, who  have received
great benefit from them:  one resides at Newburg, the other in
this place.   Yours respectfully,
                                 CAROLINE GREGORY.
  Shawangunk, August 23.


From A. D. Matthews, Merchant, 93 Main-Street, Brooklyn,
         L. I.—Recovery from Bronchial Affection.
                                   Brooklyn, June 18, 1841.
  Dear Sir,—A sense  of duty induces  me to acquaint you that
the tube, which I purchased of you about a year ago, has had the
desired effect to cure my wife of the Bronchitis.
  For  four years previous to the  use  of the tube she had been
much of the time under the care  of our family physician; during
the winter seasons especially her  sufferings have been  severe in
the  extreme;  confining her  almost  entirely  to the house, and
much of her time  to her room. The disease  had become so severe
at the  time when she began to use the  tube that we had much
cause for alarm; assured, as we were, that the disease was a very
near approach to consumption, if it had not become so already.
  From the day that she began to use the tube no other remedies
have been  tried;  and for months past she has considered herself
cured.   During the  past winter she has been able to go out in all
kinds of weather, and her health has been uniformly good;  and
as all other treatment of the  complaint,  such as blistering, leech-
ing, &c, only gave  temporary relief, we are forced to conclude
that the use of the  tube alone has produced this result.   I take 
20                      LETTERS.
the greatest pleasure in being able  to  make public the above
statement, (though unsolicited by you,) knowing that many min-
isters of the Gospel and others are afflicted with this distressing
disease.           Yours, &c,
                         A. D. MATTHEWS,
                              93  Main-street, Brooklyn, L. I


     Additional  Statement from Mr. A. D. Matthews.

                                Brooklyn, April 10th, 1846.
  Dr. J. M. Howe :—Sir,—I most cheerfully state that in the case
of my wife, although her health is not generally good, she has not
since the first six months of the use of the tube had  a  return of
that complaint.  I desire also to add that I have recommended
the use of your tube in many cases, and  have never known one
of what was supposed to be incipient consumption that was not
benefited by its use;  while two  or three cases which I and oth-
ers supposed were confirmed consumption, and apparently in the
last stages, have  been cured, or very much  relieved, by it.   A
case of the latter kind I will  mention.   The wife of Mr. Elijah
Wentworth, of Hinsdale, Mass.,  had  been long afflicted with a
very severe cough, and she, with two of her sisters, living in dif-
ferent places, appeared to be rapidly sinking  with  consumption.
It was at times thought Mrs. W. would be the first victim.  She
being a relative of mine, I was there  some three years since on a
visit, and spent a day, and proposed on my return to send her a
tube as a last resort.  I accordingly did  so.  I visited her last
summer, and found her enjoying (with naturally a very slender
constitution) comfortable health; her cough had nearly subsided
her countenance was bright, and she was able to  do the domes-
tic work of her  family.   She attributed  her recovery to the use
of the tube.  Her  sisters died not far  from the time when she
commenced using it.
  I also would mention  the case  of Mrs.  Throckmorton  formerly
of this city, to whom I recommended the use  of the tube about
five years  ago   For many years  she had been a great sufferer
with lung complaints but after using the tube a few months, she
told me that the benefit she had  derived  from  it was truly aston
ishing; and her husband speaking to me of her case, more than
a year after this, said that it seemed to him more like a miracle

X$££^^?*~*  * recent*heard ^ *•
  I could mention several other cases similar to the above, all  of
which have confirmed me in the belief that by the timelv use  of
the tube consumption is curable.   I am, dear sir, your obhW and
6incere friend,                                       &cu ttUU

                       A. D.MATTHEWS, 93 Main-street 
LETTERS.
21
           From Orrin  Swltt, Esq., Brooklyn, L I.

  Dr. J. M. Howe:—Dear Sir,—After much persuasion, I was in-
duced to make a trial of your breathing  tube for exercising the
lungs; and after using it about six months, I became fully con-
vinced that all you had said to me in favor of it was true.  I had
been troubled with a cough, which had been of some years' stand-
ing, and which had become quite  alarming, being attended with
considerable expectoration.  I also suffered much  from  great
weakness, soreness, and pain  in the chest,  attended frequently
with tightness across the upper part of the chest, causing at times,
particularly nights, a difficulty in breathing, sometimes amounting
almost to suffocation.  After continuing the use of the tube for a
few weeks, I began to experience  relief;  and before  the expira-
tion  of the year, all  the above  complaints had  nearly disap-
peared,  nor have any of them seriously troubled me since, though
nearly five years have elapsed.
  I still continue to use  the tube  occasionally, and find  it quite
useful.  As a preventive to taking cold it is invaluable;  and did
it effect no other good, this of itself would be enough to recom-
mend it.  Very respectfully yours,                        %
                                         ORRIN SWIFT.
  Brooklyn, July 28,1845.
  From Mr. Reuben  C. Barnes, No. 255  Bleecker-Street.

  In July and August last I was in a miserable state of health.
I had a cough that distressed me much if I went out in the damp
air.  I sometimes coughed so violently as  to have to stop and
hold on to a post to keep me from falling. I  had hectic fever
every afternoon, and sweat a great deal at nights.  I commenced
raising in April, and  from  that  time my expectoration became
very copious. I lost flesh; and my whole appearance indicated that,
unless relieved, I would soon be beyond the reach of all means. Mr.
Tate, of No. 134 Eighth Avenue, who had known of the tube ben-
efiting two or three persons, called my attention to its use, and
went with me to see Dr. Howe,  who did not give me much en-
couragement, but ventured finally to recommend the tube to me;
and by its use I have so recovered as to astonish my friends.   I
have increased in  flesh, and  my appearance has altogether im-
proved.  The tube I believe has saved my life; and I cheerfully
recommend it to others in  a like condition, believing it worth
more than all the balsams and blisters in the land.
                                  REUBEN C. BARNES.
  New York, March 17th, 1846. 
22
LETTERS.
 Extract of a Letter from Rev. Robert M'Nutt, a  Member
   of  the Kentucky Annual Conference  of the Methodist
   Episcopal Church.

   To  Dr. J. M. Howe :—Dear Sir,—-In the year 1841 I obtained
 an inhaling tube from you; and I take pleasure in informing you,
 that,  by the divine blessing on its use, it had the desired effect.
 I have more than  realized my anticipations before using it.  In
 September, 1844,.I was licensed to preach, and in the same month
 joined the Kentucky Annual Conference, in which I still remain,
 and am endeavoring to do something in my Master's vineyard.
 Last year, through my feeble efforts, I was instrumental in adding
 fifty-three souls to the church, and this year my prospects thus
 far are flattering.   And  but  for the use of the tube, with the
 divine blessing, my career of usefulness (small as it has been, or
 may be,) I verily believe would long since have closed.   The object
 of writing to you is to obtain a tube for a gentleman here.  Please
 accept my respects, and  the  gratitude of my heart.   Inclosed I
 send-you five dollars for the tube, which you will please forward
 by mail.  Yours respectfully,
                                             R. M'NUTT.
   Smithland, Kentucky, Nov. 5, 1845.

      From Gilbert T.  Sewell, Esq., New York City.

                              New  York, August 10, 1841.
  Dear Sir :—I write this to add my testimony to the great ben-
 efit derived from the use of the breathing tube.  In the summer
of 1839 I was attacked with the usual symptoms of consumption
—spitting of blood, accompanied with general debility.
  I heard of the method of curing  consumption invented by Dr
Ramadge of London,  and practised by yourself—applied to you,
and purchased a tube.  Without using any other remedy I found
immediate relief, and now enjoy as good health as any one could
wish.   With pleasure I remain yours, &c.

To Da. 4o„k K How™BET T' HEwkl* 58 »—«**


   From Mr. James Davis, Merchant, 37 Liberty Street
                       New York.

  rio  j^*v, un      t-v    n.New Torh January 20th, 1843.
  Dr. J©«sn M. Howe: Dear Sir__I fp^l it +n u„   a I  I
priee you of the benefit I have receivedI fromt^     ?£ *? K
ing tube I obtained from you S 18^1  T^Ia*?^
doing  ,o until now from a Lire to be^eutLred'thTt thetn- 
LETTERS.
23
 efit is permanent; and being well satisfied on that point, I feel
 great pleasure in certifying that  I have  derived great advantage
 trom its use.                                               B
   In the latter part of the previous winter I contracted a severe
 cold, which in the month of March  settled on my lungs  with
 strong indications that they were  permanently affected   The
 symptoms, as well as I can recollect, were a  violent pain in the
 chest, a quick palpitation  of the  heart, greatly accelerated by the
 least  exercise,  or even by walking up  stairs,  a prostration of
 strength, and other symptoms, which were evidently premonitory
 of consumption.  My pulse generally ranged from ninety to one
 hundred and twenty.  The usual remedies were resorted to, but
 my health continued to fail.   In  June I procured the tube; and
 commenced using it three  times a day.  I soon  felt  better.   My
 breathing, which before appeared to come from the upper part of
 the chest, is  now corrected.   I  was  able to take long breaths
 with  ease,  which before was difficult;  and  my  respiration was
 much more free.  In the course of a few weeks my chest had ex-
 panded about two inches.   The  pain in  my lungs, however, con-
 tinued ; and  notwithstanding that  I gained strength, the other
 symptoms  would occasionally discourage me, and  make me at
 times disposed to relinquish the use  of the tube.   I however con-
 tinued to use it regularly, being well satisfied that unless it could
 effect a cure no earthly means could;  and I have now reason to
 thank God that through his blessing I have been so far restored to
 health that I  am as able to attend to business as I ever was.   In-
 deed, I think I can safely  say that I am well; but  as I do not
 wish to speak too positively, I will only say that notwithstanding
 my exposure to all kinds of weather, my health has not been af-
 fected, either by colds or otherwise,  more than before the attack
 which brought on the disease.   I, however, continue the use of the
 tube occasionally, as  I find the exercise beneficial, especially when
 I feel a tightness in the chest.
  In conclusion I would say  that I attribute my recovery from
 the premonitory symptoms of consumption to the use of your
tube', and desire  to  return my thanks  to God  for directing my
attention to the remedy, and to  you  for your  kindness in  the
encouragement and advice received from you.
    Very respectfully yours,                JAMES DAVIS. 
%  gritf  3'ntn  at  *&*  &»*!(**'*  *****
  My attention was first directed to the subject of consump-
tion by my own declining health in 1837.   A  slight  cough
at first, then fever and chills daily, accompanied with  night-
sweats, and great  prostration of strength, and loss of voice,
and wasting of flesh,  with cadaverousness of countenance, all
bespoke that I was seriously ill.  At this period, being con-
nected with the New York City  Hospital  as  the  chaplain
of the house, my daily walks led me to make observations on
patients somewhat similarly afflicted, over whose beds were
written  Phthisis  Pulmonalis,  or  pulmonary  consumption.
Consumption was a horrible name to me ;  and now that I
began to fear that it was grasping  me, no language can des-
cribe the acuteness and agony of  my mind.  I strove to be
cheerful, and to throw off  these  feelings.   I  rose early, I
walked, I  rode;  I washed and rubbed, and took the best
medical advice the city could afford, then went  the rounds of
all  the  popular  medicines;  but still  I  was declining.   As
months  rolled on I  began to  expectorate, and  my  chest,
which had formerly measured 33 inches in circumference, had
contracted to  30 inches, and how to  account  for it I knew
not.  Stripping myself, and observing  my figure in the glass,
I was horrified by my appearance. My chest was so  drawn
together, the clavicles or collar bones were so prominent, with
a deep sinking beneath them, and the whole system  so dis-
torted, as  made me fearful for  my own  eyes to behold.  I
took the  counsel of many physicians, but  without  relief.
"Surely," said I, " I am in a bad way; there is no use in
resisting the conviction longer;  I am in consumption."  My
feelings at this period  none may  know  but those similarly
afflicted.   My physicians, although   they  encouraged  me, 
THE AUTHOR'S CASE.
25
assured my friends that I must decline.  The tubercular de-
posits, however, they stated were confined to the upper lobes
of the lungs.   As I became sensible of my condition, and
knowing full well the  inefficiency of  all medicinal remedies
in use among physicians in consumption, my only hope was
in looking to God for help, and my prayer  went' up contin-
ually that  He  would interpose his strong arm and save me
from dying of  this disease.  I felt that the simplest means
with His blessing would avail.   My medical friends having
exhausted all their skill, as a last resort recommended a sea-
voyage to Europe, and  travel.   Accordingly, on  the  1th of
June,  1838, having previously adjusted all my affairs, I sailed
for Liverpool, in such a state of health as  I would not wish
a friend of mine to embark in, and arrived there greatly pros-
trated from sea-sickness.   After resting a few days, I jour-
neyed to the Noitb, directing my course towards Edinburgh
in Scotland, consulting the most prominent physicians in
many places.   A guinea paid—a box of pills and a blister, or
a  box of  ointment, received—was the  usual prescription.
Gaining  no relief,  I directed my course to  the South.   In
London I was very unwell; but my hopes were  buoyant as
it  regards  the  climate  of  France, could I  get  there ;   but
these hopes, like others, were not to be realized.  I arrived
in Paris in the  month of August, but found the winds  cold
and  piercing, and the weather so  variable for some days that
I  rather grew  worse, and as the fall of the year was  ap-
proaching I came to the conclusion, after tarrying a while,
that I had better return home while I had strength to do so.
In Paris I would have called in medical counsel, but felt that
by so doing I might be  prostrated by medical treatment, and
thus be prevented from ever reaching my native land  again.
When I arrived in London, on  my  return, necessity again
compelled me to send  for  a doctor.  A blister and leeches
were again applied to  my chest.  While  in this dilemma,
lying in a bed in a dark chamber in a large hotel pleading the
promises of God, a gentleman entered my room and remarked,
" I knew a clergyman in Manchester, who  was in consump-
tion, who obtained a book  the title of which is  ' Consumption
Curable,'* and,  by following  the directions, he soon  got
well, and is now preaching."   His words were  like electric
sparks; hope, which had almost deserted me, as to human
                * Dr. Howe has this work for sale.
            2 
26
BRIEF HISTORY OF
 instrumentalities, s^ain revived.   By this circumstance I was
 led to obtain the book, " Consumption Curable," and by it,
 and the advice of a lady, was induced to consult F. H. Ram-
 adge, M. D., the author, who at his first interview, said to the
 lady,  " He is very ill, but he has come just in time to save
 his life."  Upon  examination  of  my chest,  he  remarked,
 " You have tubercles in both lungs."  I then, in a whisper,
 (for I could not speak above a whisper), put the following
 interrogatories :—" Doctor,  can  I live, or  must  I die 1
 Be honest with  me."   He replied,  " You  will  perfectly
 recover."  "Shall  I ever  be  able to  speak loud?"  " 0
 yes."   "Shall  I ever be able to sing?"   "Yes."  "Shall
 I,  sir, ever be  able  to preach again ?"  " Yes, I see noth-
 ing to  hinder."   " How long,  sir, will  it  be before all
 this takes place ?"   " In about four or six months you will
 be  quite  well, but  you  will attain  a strength about  the
 chest  that you have not  had for years."   " Ah!  doctor,'
 said I, " I  am  afraid  to  believe you."    He answered
 warmly, " I  would  insure  it by  my  right  arm,  were it
 possible."  To  this  man, under  God, I owe my life.  He
 gave  me  instructions  concerning  what I  should  do and
 what  I should avoid, by the observance of  which I have
 been restored to good health as far as the chest is concerned,
 although I am occasionally dyspeptic.
  The principal means he  directed me to use  was a tube,
 through which  I was to breathe,  for the purpose of expand-
ing, airing, and exercising  the lungs, by which exercise they
 would become enlarged, the sores be absorbed, and the sur-
faces brougt in apposition, and healed.  This tube, with his
instructions, gave me relief at once ; and from the day I got
it I began gradually to improve in  health, and now consider
my chest quite  well.  After having tarried with Dr. R. as
long as he wished, and it being the time that I purposed to
return home, I was led to  ask Dr. R. for advice as to climate,
supposing,  that as I would arrive in New  York (my native
city) in the month of October, it  would be  death for me to
think  of passing the winter at home, and that  I should have
to  go  to  the South.  " But," said  Dr. R., " go  home, and
stay at home."  " Then," replied I, " I shall  have to shut
myself in the house all winter."   " By no means," he replied,
"go out every day."  " But," said I, " ours  is  a  dreadful
climate ;  it snows, and hails, and  blows."  " Well," said he 
THE AUTHOR'S CASE.
27
" choose the  best  time  in the day, and go out every day."
Thought I,  it is  death to follow the old beaten path, and it
can be but to die if I do as  directed ; and, considering the
high character of Dr. Ramadge, I resolved implicitly to fol-
low  his directions.  The returning  sea-voyage  reduced me
much, but I  reached home  in better health than one could
have expected.  Upon my arrival I began to  speak of the
remedy I had found; and feeling desirous  to benefit  others,
I published a few letters in  the New-York Observer, Chris-
tian  Intelligencer,  and  Christian   Advocate,  which  were
extensively copied into other papers.  These letters brought
many to see me, among whom were some  of the most res-
pectable physicians, who requested  the privilege of seeing
the tube, and examining my chest:  " For," said they, "there
is much that passes for consumption that is  not."  I acqui-
esced ; and the result of such examination was, in the lan-
guage of Dr. Washington, " I have  no more doubt  of the
tuberculated state of your lungs than if I  could see  them ;"
and  Dr. Cox said,  " The right lung is hepatized;"  that is,
changed by disease, resembling liver in appearance ;  and said
another, " Half of the right lung is gone."   I received many
letters from  various parts of the United States, to  answer
which consumed much of my time, and subjected me to some
expense ;  but, being desirous to spread the information, I
abridged Dr. Ramadge's  work on consumption, and published
one thousand copies, which I principally distributed gratui-
tously, and nine months  after put his large work to press.
Of this I have sold a number of copies.  I have also kept the
tubes on hand  for  sale, and instructed  persons in the use of
them ; and  am now happy  to state that  many have been
greatly benefited, and others restored to health.
  It has, however, been objected by some physicians,  who
have  no .personal knowledge  of me, that I could not have
been fairly in consumption, or I could not possibly, by any
means, have recovered.   To this objection I will only reply,
that  distinguished  physicians  pronounced  my case  to be
tubercular phthisis, and further stated that  it was impossible
that  I could live;  that no means  could save  me; and the
symptoms were such as fully to corroborate  their testimony.
These were—slight soreness in  the chest, which was increased,
particularly  by  the sea-sickness, and  which spread  itself
throughout the  lungs ; a hacking cough at times;  loss of 
28
BRIEF HISTORY OF
voice, so as to be unable to converse much above a whisper,
and then with the greatest exertion, accompanied  by much
hoarseness ; night sweats,  followed by great chilliness along
the spine in the morning, hectic fever  in the  afternoon, and
with  wasting of flesh and sallowness of complexion ; and,
upon some occasions, the expectoration of mucus, and some
purulent matter, with a growing contraction of the chest for
several years.   The fact was, I had long been declining ; but
for years the consumption of  the lungs had been checked by
chronic catarrh, and subsequently by bronchitis.  By following
Dr. Ramadge's directions all these symptoms have left me:
my chest  is astonishingly  altered  in shape and  enlarged in
size; the sinking under the clavicles, or collar  bones, which
was full an inch in depth, is  now  so  filled  up as  to leave
no  indentation  at  all; and my  strength  of  lungs has
returned to me to such a degree (though I  am, and always
will be, a slender man) that  I have been  able to perform,
since my recovery, one year's service as chaplain in the New
York  Hospital, in visiting  the sick, and  preaching on the
Sabbath ;* and for several years past I have usually, Sabbath
after  Sabbath, preached once,  and  sometimes  twice,  in
different  churches.   I consider my recovery as one  among
thousands, and attribute it entirely to my being providentially
directed to Dr.  Ramadge.
  It is now nearly fifteen years since I  was first  made ac-
quainted with this method of treating consumption, during
which time I have had ample opportunity to test its efficacy
in my own case, and  in the case of a great number of per-
sons ;  and, as the result of  this experience,  I do not hesitate
to say that  I as much believe  the  practice  herein rec-
ommended to be a remedy for pulmonary consumption, if it
be employed when any human means  can reach the case,  as
I believe the Gospel  to be  a remedy for  sin and its conse-
quences.   So convinced was I of its utility, from the first of
my becoming acquainted with it, that  one  of the  principal
desires which led me to hope  that my life  might be prolonged
was, to see it introduced  extensively;  and one of the chief
sources of my pleasure now growing out of past reminiscen-
ces is, that I have  been the honored instrument  in  intro-
ducing this remedy  into my own  country, and  of seeing it
adopted  successfully by many reputable  physicians in  differ-
  * I resigned my office id the NewYork City Hospital 1st of March, 1840. 
THE AUIHOR'S CASE.
29
ent parts of the United States.   Many persons, too, through
my instrumentality, have been recovered to good health, who
now cherish towards me similar feelings of gratitude to those
I entertain for Dr. Ramadge, several of whom, had they not
followed my advice, would  long since, in all probability, have
been numbered with the dead.  Intelligent gentlemen through-
out the United  States are giving attention to this practice,
among whom  are  several members of Congress, to whom I
have forwarded  the tube and the doctor's work on consump-
tion ; and  I live in hopes that  the  time is not far distant,
when the prejudices of those who are opposed to giving this
practice a fair and candid investigation may be removed, and
that facts may be permitted to speak for themselves.   But in
this practice,  as in other innovations, the community must
lead the van;  and  as facts multiply,  and persons are raised
up to  speak in  such terms of commendation as this subject
demands,  (and it  is of no small importance,) inhalation for
pulmonary consumption will  be  generally introduced.  Who
that reflects upon the great number of persons that are daily
falling victims to this dire disease throughout our country,
and among these some of the brightest ornaments of society,
but must Teel interested to learn some  particulars about a
remedy that is comparatively little known, which has been the
means of  rescuing many persons from death ?  By a parity
of  reasoning,  if it  be beneficial in  some cases, why not  in
others ?   But great regard should be had to its applicability
to proper  cases.   I  have seen many persons who, I felt per-
fectly confident,  might be saved by this means, but who were
unwilling  to try it,  because some of their friends  could not
understand how the lungs could  be  benefited by breathing
throuo-h a  tube.  I  have seen others also who have been
recommended to use it, when  their general  symptoms were
such  as to render it impossible for  them to recover—the
lungs having been previously wasted away—yet, as they had
known  a  case in which it had been beneficial, they were not
willing to  be advised not to use it, not considering that they
were more  diseased.  Some,  too,  are ready to conclude,
because they have  seen the tube used, and the patient has
died, that therefore it is useless, and consequently exert then-
influence against this practice, not considering that the patient
was one of those in whose case the tube should not have been
employed  at  all,  and that  he was so diseased previously to 
30
BRIEF HISTORY OF
using it  as  to render his case not only doubtful as to recov-
ery,  but certain that it would terminate  fatally whether  the
tube were used or not.   A case occurred some time since:—
A gentleman, who had been sick for some length of time with
consumption,  and had been treated by several eminent phy-
sicians without relief being afforded  him, was desirous to
have my opinion ; but his wife feared to invite me to see him,
lest  I should predict his death.   A lady, however, called on
me,  and stated  his case.  I  at once informed her that  the
tube would  not  be proper in his case, and that  in all proba
bility he would not live, feeling assured at the same time
that he would certainly die. Subsequently a physician advised
the  use of the tube, and promised him that it would  restore
his  health.   It was procured; I insisting at  the time that
it was  improper.   He  used it, and for  a  few weeks grew
better.   He was encouraged,  and the family were gratified ;
but  I  knew full well that their hopes were elated but to be
disappointed—a change followed,  and  he died.  Now  this
was  a case in which the use of the tube was highly improper.
   It must not, however,  be supposed, that when  inhalation
is employed in pulmonary affections, medical  treatment is to
be  rejected.  It is to be  used  to reduce the inflammatory
symptoms, as an auxiliary, while the tube is mainly relied
upon to effect a permanent enlargement of  the pulmonary
muscles, and to perform the cure.
   In asthma, the use of the tube will be found invaluable;
but  it should only be used when the patient is free from  any
paroxysm or difficulty of breathing, to exercise and  air  the
lungs  for  the purpose  of  contracting  their looseness  and
flabbiness, to  prevent the recurrence  of  the paroxysms.   If
its use be steadily persevered in for a long  period, when  the
patient is free and  unoppressed for breath, the return of  the
difficulty of breathing  will not only be less frequent, but in
many instances the  patient will  be entirely relieved.
   The consumptive must not suppose that he  is to commence
and  pursue  a course of inhalation without experiencing a va-
riety of difficulties.   He will meet with opposition from some
persons,  who will  laugh at his  credulity, and  from others
who would reason him out of it;  and also from  some physi-
cians, who are unwilling to countenance an innovation of which
they themselves are not the author, and which  disperses all
the  fog in which  the treatment of consumption has so long 
THE AUTHOR'S CASE.
31
been enveloped.   For want of information, some, through
discouragement, have laid the tube aside;  others, who have
partially examined the subject, or pretended to have examin-
ed the utility of the use of  the  tube, have concluded that if
heavy  breathing, or exercise and air, be  all  the benefits  de-
rivable from its use, these  can be had  as  well without the
tube as with it.  This is not true. The tube is so constructed
that the air is admitted into the lungs  gradually, and they
are slowly expanded and  aired,  while it is  not permitted to
rush out at once, but  is retained, and slowly emitted again,
by which process the lungs and blood are fully aired.
   Since I commenced inhaling, I have  been  assailed with
various arguments to prove its fallacy ;  but being fully con-
vinced, from personal  experience, and from  years of observa-
tion, that to follow the usual course prescribed for consump-
tion, was but to hasten one's dissolution, when Dr. Ramadge's
work on consumption came to my hands,  upon an examination
of its  theory and practice, I was prepared to embrace them;
and so rational  did they appear to  me, that I at once con-
cluded to give them a fair  trial.   This  resolution was based
upon the consideration that my death was  inevitable if  this
means failed me.
   But there are other difficulties more  formidable than the
aforementioned:  these are the bad feelings in the  chest and
lungs.   Where the lungs are diseased,  the exercise, expan-
sion, and  the action  of  the air may cause them to be sorer
for a time than they have been before; and there may be a
great  deal of local irritation for some  months, which may
excite alarm; and also, upon the softening  down of the tu-
berculous deposits, a larger and more free  expectoration ;
this will arise from the liquefying of the old  tubercles, and
not from an actual increase of the  disease.  After a person
has inhaled for  full three months steadily, as directed, all
tendency to the formation of any fresh  tuberculous deposits
will be removed, and  whatever irritation or uneasiness of any
kind may exist—and  it may be  considerable—will be in  the
old  diseased part.  A leech or two  under  each clavicle, or
collar bone, or the use of homoeopathic remedies, will greatly
assist  to relieve it;  and  by steadily pursuing the inhalation,
time and the powers of absorption will remove the difficulty.
The patient must also expect the return of the consumptive
symptoms  for  months, at intervals.  At these he must  not 
32
BRIEF HISTORY  OF
be discouraged ; they must be met as directed, and he  must
steadily pursue the inhalation.
  To those who are not prepared to encounter these difficulties,
I would remark, they are too faint-hearted to get the better
of  consumption.   If one would  live, he must resolutely
move  on, bad feelings  notwithstanding,  for month  after
month, with untiling perseverance.  If one were to ask, For
what particular length of time ?  I would answer, Until all
soreness  is removed.  So long as any uneasiness exists, so
long the tube should be used:  when the lungs  are healed
up,  the soreness will gradually be diminished, until  perfect
soundness be restored; and time and  the powers of absorp-
tion will do it.  Notwithstanding these difficulties, the  patient
will be growing stronger and  stronger in the chest,  save
temporary relapses, and the changes of the weather will have
but  little effect.  The voice will  be improving, the lungs will
grow stronger,  the  chest will be materially altered in shape,
and  permanently enlarged in size, while the appetite  will be
increased.  It will gradually effect a happy change. Let the
courageous try  it, and they shall prove to their great  benefit
that these remarks are true.
  In a letter to Dr.  Ramadge, in answer to certain inquiries
relative to my own case, he wrote:—
  " After using the tube for  two  months, you lost all ten-
dency to have fresh tubercles.    Whatever changes you have
had  under seeming attacks of  cold, arose,  I am satisfied,
from a change in some previously formed tuberculous matter.
Sometimes, where  the summits  are the seats of  several tu-
berculous nodules,  they occasionally,  from some cause or
other, perhaps  by cold, soften in succession, and  create for
no  inconsiderable  period a good deal of alarm, a good  deal
of local as well as general irritation.  The steady  proeess of
expanding the  lungs, by inhalation, speedily obliterates the
cysts thus produced; and every time you have a change for
the worse, and  think some old  tubercle  has liquefied, you
ought soon afterwards to be doubly attentive in pursuing the
inhaling system.  The observance of this, with the other di-
rections, cannot fail to  make you a sound man."  But for
these directions and encouragements I should have despaired.
  In conclusion, I  would  add, that persons in every situa-
tion  who lead a sedentary life—merchants, clerks, mechanics,
&c, and particularly public speakers, lawyers, and ministers 
                  THE AUTHOR'S CASE.               33

of the Gospel; those who have weak voices, or who arc
afflicted with  bronchitis, or inflammation of the throat, ac-
companied  with hoarseness and loss  of voice at times, or
those who are liable to take cold in the throat or upper part
of the chest upon  every change  in the weather, &c—will
find the tube  a sure remedy, if they will persevere in its use.
   The exercise produced by it, and the  action of the air upon
the throat, will so toughen the parts, that the changes  of the
weather, and  exposure to  the  air, under any circumstances,
will not affect the throat or the bronchial tubes in the least.
Delicate females, who  do  not get the necessary exercise in
the  chest for health, will  find it very pleasant and healthful
to use it, on the same principle that they would calisthenics,
or any muscular exercise.   Those whose chests or lungs are
at all weak, or contracted,  will find that the tube will accom-
plish great  things for them ; it will improve the voice, and
increase its powers and compass.  To all who  are in danger
of becoming  consumptive  from  any cause, a few months of
its use will entirely check  the  predisposition; and consump-
tives will be  restored  to  health by it, if any human means
can effect a cure.  It will do more than a sea-voyage, travel-
ling,  and  change  of climate; and that,  too,  without  the
necessity of leaving home, or  neglecting one's  regular busi-
ness.  The benefit derived from this  means is not a tempo-
rary one, but  of permanent duration; but with many it is so
novel, and so  unlike the  old  remedies, and it is so  much
easier to swallow medicines than to take exercise and air, that
they prefer the drugs.  Consumptives, who use  the  tube,
however, risk  nothing.  In my case, I felt assured that  death
was inevitable without it, and more than death  could not re-
sult from  its  use.   To be benefited by inhalation, persons
should not wait until they  are  actually in sonsumption; but
so soon as they are convinced there is any liability to it they
should begin at once, and  cheerfully pursue it.   Some, who
have commenced the use of the tube, and been  benefited by
it, but who have felt  considerable irritation in the chest, for
want of proper instruction  concerning its use, have been in-
duced to discontinue it.  Many such persons have been per-
manently  benefited;  their disease has been brought to a
stand,  and its progress arrested, and  had  they persevered
they would have been perfectly restored to health.
  A time will come, however, when this practice will be under-
               2* 
34                BRIEF HI3T0RY, &C.

stood, and when the intelligent physician will cheerfully direct
the attention of his consumptive patient to the tube, keeping
him at the same time  under  his own care, and  follow-
ing out  the directions  laid down by Dr. Ramadge,  not to
inhale vapors,  &c,  but  the  common  air;  to  exercise,
strengthen, and enlarge  the  lungs.   One of the oldest and
most respectable physicians of  this city, who called on me to
obtain a tube for one of his patients, (he had had two pre-
viously for other patients,) remarked, " I am not particular by
what means my patients are benefited, if   I can  only cure
them.  I have  lived  long  enough to know that it  is  best
to  ascertian the real merits of a case before  I pass judgment
upon it."
   I trust the time is not  far distant when this practice will
be  understood, and then it will certainly be appreciated.  When
that day does come,  be it sooner or later, it will be a happy
season to multitudes—for then  the ravages  of consumption
will be arrested, and not till then. 
Cpgttr Jfirst.
        OBSERVATIONS ON CONSUMPTION AND THROAT DISEASES.

  Is there a remedy for Pulmonary Consumption, Bronchitis,
Asthma, and other chest diseases?  is a question of vital im-
portance to the whole community.   The young, the interest-
ing, the talented, the eloquent, the beloved ones of our land
are falling by this ruthless and fell destroyer on every hand.
Consumption is confined to no class of persons : it enters every
circle, cutting down  the Statesman,  the Clergyman, the Law-
yer, and even the Physician,  and their families.   The writer
has in his mind the family of one of our most distinguished
physicians, whose sons and daughters have died notwithstand-
ing all the aid that regular medical skill  and the usual tra-
vel  abroad  in foreign countries  could afford.  The bills of
mortality, too, show that these diseases are alarmingly on the
increase ;  that  about one in  every six who die are its victims ;
Dr. Ramadge supposes one in every four in England.  Reader,
you are  interested in this subject; for  if you have not the
disease already, for lack of information, you may contract it;
and if you escape yourself,  perhaps  your children or your
dearest relatives may fall by it.  Are there not in the circle of
your friends and acquaintances numbers whose whole appear-
ance warrant you  to  believe that, unless they find a remedy
quickly, they will speedily decline ?  While in numerous instan-
ces the hearts of many are sorrowful by the sad havoc already
made in the  family circle.   Nor is there exemption from con-
sumption in our Southern States : as is generally supposed, all
through Maryland, Virginia, North and South Carolina, Geor-
gia, Alabama, Mississippi, and our Western States, they are
scourged with this fell  destroyer.   In  England,  Scotland,
Ireland and  France,  the  inhabitants die in full as large pro-
portions with consumption as in our own country ;  nor is the 
36
CHAPTER FIRST.
south of France  or  the  sunny  shores of Italy free from this
scourge, whole families baing swept away by it.
  "It is found  that phthisis, as in the middle regions of the
United States, is much more frequent in the temperate regions
of Europe,  comprised between the fifty-fifth and forty-fifth
degree of latitude,  than it is further to the north.  While in
London it is  calculated  that two hundred and thirty-six of
every thousand deaths are  caused by pulmonary phthisis, in
Sweden the ratio is only sixty-three.   At St. Petersburgh and
Stockholm  it  is much less destructive than throughout Ger-
many, and  more especially at  Berlin, Munich, Vienna,  and
Paris; and, by Sir William Crichton, it is stated, that con-
sumption  is infinitely more frequent in Great  Britain  and
Ireland,  in  comparison with their  population,  than in the
northern parts of Russia.   In the southern parts of  Europe,
from the forty-fifth to the  thirty-fifth parallel,  it  is still  found
to be a very common disease."
  " It is altogether  a mistake," says a correspondent of mine,
residing in Sumpter Co., Alabama, " to suppose that a south-
ern climate  is good for a  consumptive.  I do not believe it;
but,  on the contrary, think a cold climate preferable.  In my
opinion, the  reason why some are benefited by coming south,
is on account of the change, and the exercise of travelling:
a change to a cold climate  would have the same effect."
  The  number  of deaths  in the city of New York during
the year 1845 was  10,983; of which 1659 died of pulmo-
nary consumption, and  about 642  of inflammation of  the
lungs,  amounting to 2301 deaths by diseased lungs in  the
city, being nearly one-fifth  of the whole number.   In the city
of Boston, the  number of deaths  in 1844 was 2241 ; of
which  number 305  died of consumption and inflammation of
the lungs :—from Jan. 1st, 1845, (to Jan. lst,1846, the whole
number of deaths was 2585 ; of which  number 426 died of
consumption.  In the city  of Baltimore, in 1844, 2879  died;
of which 510 died of consumption, and 21 of inflammation of
the lungs:—in 1845, whole number 3107, 523 of consump-
tion and of inflammation of the lungs.
  Consumption  throughout what may be termed the middle
latitudes is  committing its ravages: nor are the extreme
north and south exempt; and I doubt not that if  the fact
could be  ascertained, the  disease would be found greatly on
the increase.  The  growing effeminacy of the habits of mul- 
CONSUMPTION, ETC.
37
titudes of our  population may be a sufficient reason why it
is so.
  The truth  is,  consumption is not confined  to  locality—
although a damp, wet climate is more deleterious than a dry,
cold atmosphere  ; but  there  are general causes which sap
the vitality of human life, and are destructive to the functions,
and especially to the throat and respiratory organs.   What
these causes are  must first be ascertained, and then counter-
acted or avoided ; and this being done, the means of prevention
and the remedy will be made  apparent.
  The following remarks set forth the views of Dr.  Ramadge,
as published by him in London, about thirty years ago :
  1.  That consumption is  scarcely known at all among wild
men,(except the licentious and the intemperate,) or men who
are actively employed and much exposed in the open air. The
race-horse and the  hunter, as  long as they are kept em-
ployed, never  have tubercles in the lungs.   The exercise of
running  tends to give that deep and full inspiration which is
so necessary to expand the volume of the lungs, and give full
scope to the pulmonary muscles.
  2.  That there  are  a  number of diseases which counteract
pulmonary consumption.
  3.  That however unsuccessful medical treatment is of itself
in this disease, it is a powerful auxiliary as a palliative, or in
reducing the inflammation which at times exists.
  When we consider the peculiarly delicate  conformation of
the lungs, and their immediate susceptibility of every altera-
tion in  the  atmosphere, we at once see how essential it is, in
order to maintain a  healthy action and proper configuration
of the chest,  that  our  inspiration should be uniformly deep
and full;  but  from the great inequality of atmospheric pres-
sure, resulting from the constant fluctuations of the weather,
as well  as from  the dress and postures of the body, the
depth and fulness of the inspiration are exposed to frequent
diminution,  and that play of the chest which is as requisite
to a healthy state of the lungs, as exercise is to muscular de-
velopment, is consequently subject to repeated checks.
  4. Hence,  it is almost an invariable law, that pulmonary
consumption commences in the superior lobes of the lungs-
owing, doubtless,  to the small extension of the upper ribs, as
compared with the more complete movements of the lower ones.
  5. From what  is stated above, will be seen the pernicious 
38
CHAPTER  FIRST.
 effects of tight lacing, and the danger to which those expose
 themselves who compress the chest  in any way, either by
 their dress, posture of sitting, working, &c.
    That the free use of balsams and blisters frequently tends
 to weaken the patient.
    6. That inhalation of  air (not fumes of  iodine, turpentine,
 &c.) through  a tube, properly constructed, for the purpose
 of airing the lungs, and exercising  and permanently enlarg-
 ing the pulmonary muscles, is the main thing to be depended
 on to effect a cure in cases of tubercular phthisis, or  pulmo-
 nary consumption.
    The  benefit usually derived from a sea voyage, or change
 of  air, is not so much due to the removal from an impure to
 a"purer atmosphere, per se, as to the stimulating effects pro-
 duced  on the  breathing organs, and the increased muscular
 powers of the  chest, on which  pulmonary dilatation is, of
 course, dependent.
   Compare the expanded chest and muscular frame of  the
 mariner, with the emaciated figure, contracted chest, and ge-
 neral want of vigor observable in the artisan of manufacturing
 cities for proof on this subject.
   7.  That a warm climate is more injurious to the consumptive
 than  a cold one, and that heated or warm rooms should be
 avoided, and that  the  patient should daily exercise in the
 open air.
   8.  That  a more generous  diet than has formerly been
 allowed  tends greatly to keep up the strength of  the patient,
 regard being had of course to febrile  symptoms.
   9.  Tubercles are less frequently met with in the muscles of
 voluntary motion than  elsewhere; from  this  fact we  infer
 the necessity of artificial means to increase the  action of  the
 lungs, and thus arrest any new development of tubercular
 eruptions.
   10. Tubercular  disposition is a specific vitiated secretion,
 arising  from  an aberration of nutrition.  And the author
 gives a clear and full view of  the manner in which tubercles
 undergo absorption in their early state, and their insulation,
 even in a state of  crudity, as also the mode of union and cic-
 atrization of ulcerous  excavations in the lungs.
   11. The  mere expansion of the lungs tends indirectly to
remove  congestion of the  liver,  and also of the stomach,
spleen,  pancreas, and  intestinal canal, all dependent on the 
CONSUMPTION, ETC.
39
more free circulation of the blood in the former.  The biliary,
as well as the great salivary secretion, is hereby promoted to
a healthy activity.
   12.  Grief, as well as protracted indisposition, is productive
of diminution of  the chest;  the general debility causing local
muscular weakness, more particularly in  the  muscles  of
inspiration.
   There is  no possible method for healing phthisis, than by
bringing their surfaces in opposition, since, unlike other  ul-
cers, they never granulate.
   13.  Restoration by means of inhaling  through  the tube
is not  to be expected, only when the cavities  are confined
to the summit of one  or both lungs.   When they extend into
the  lower lobes, relief may, indeed, be given,  but it would
be unreasonable  to expect a perfect cure 
                   CAUSES of consumption.

  In laying down the  causes of consumption, it becomes
requisite to distinguish  betwixt those which are direct, and
the far greater class  commonly confounded  with them, but
which,  in  point  of fact, are indirect.  Among the first we
notice the  transmission of this disease from  parent to child,
as a melancholy fact.  The marks of this sad  inheritance may
be  traced  in the  sanguine,  yet  delicate hue of the  coun-
tenance, the unusual brightness of the eyes, the confined and
narrowed  waist,  the  sharp projection of  the  scapulae or
shoulder blades, and  the fragility of the bony structure of
the  body,  not unfrequently  united  with a disposition  to an
unhealthy  stoutness.   Amongst  the latter,  may be enume-
rated inflammation of the lungs, pleurisy, contagious eruptive
fever,  repelled eruptions,  badness  and deficiency  of food,
amenorrhcea, unhealthy localities, affections of the abdominal
viscera (sometimes caused by excessive drinking,) spitting of
blood,  constitutional syphilis,  and  a long list of  disorders,
 whose  sole influence  in producing consumption consists in the
 debilitated state  of the body  they  induce.   I have said that
 it is requisite to distinguish  betwixt the direct  and indirect
 causes of  consumption, not  that there are any that can with
propriety  be termed direct, but in order to impress thoroughly
upon the mind the grand truth,  that phthisis is for the most
part the sequence of debilitated bodily health alone.   When
the general health becomes impaired, a total change takes
place in the fluids and  secretions of the body, and there  is
consequently an aberration of  nutriment: on this, the forma-
tion of  tubercles soon follows.
   " The frequency of this disease  has long been attributed
to the variableness of our climate, but the mode by  which this
           40 
CAUSES OF  CONSUMPTION.
41
operates has not been clearly explained.  It seems to me, how-
ever, -that the action of the climate on the system may be re-
duced to three distinct heads,  each equally  common, and
equally fatal:  checked perspiration, retaining the superfluous
humors, and  thus vitiating  the fluids of the body; constant
fluctuations of health, resulting from constant atmospheric
changes ; and dejection of spirits, caused by mental troubles."
It is essential, in order to enjoy a healthy action, and a proper
configuration of the chest, that our inspirations should be uni-
formly deep and full; but from the great inequality  of atmos-
pheric pressure, resulting from the constant fluctuations of the
weather, the depth and fulness of the inspirations are greatly
diminished, and for want of proper exercise, the healthy func-
tions  of the chest become deranged, its expansion restricted, its
action languid, and by degrees its shape alters. A cold, result-
ing either from imprudent exposure to the air when the body
has become heated, or from the wearing  of  too light and in-
sufficient clothing, is  deemed one of the most general and
powerful causes of consumption.  Yet, in many instances, I am
persuaded that the real and efficient cause is to be found in the
pre-existence of  latent  tubercles  in the  lungs;  and when
 these become softened by general indisposition, produced by
 the action of the  cold, phthisis ensues.  Frequently, indeed,
 the  irritation occasioned by latent tuberculous disease, will
 determine a catarrh, and the patient will be treated for this
 complaint without any suspicion on  the part of the medical
 attendant of  the  real state of the case.   Should the catarrh
 continue,  the consumptive  disease  masked by  it  will be
 effectually cured; and if a cavity has been formed, this will
 be obliterated by the increase that takes  place in the volume
 of the lungs.  At other times, tuberculous deposits  will be
 found insulated, and rendered innoxious, as I shall hereafter
 explain, by the secretion of black pulmonary matter.  I have
 verified these facts by numerous autopsies, and it is very re-
 cently, that,  opening the  body  of an asthmatic  individual,
 who died  at the advanced age  of seventy, I found distinct
 traces  of  a   former  consumptive state, which, having  been
 arrested  by  the  supervention  of asthma,  had existed un-
 known to himself, his family, or his  physician.  Still, where
 an hereditary tendency to consumption exists, or the consti-
 tution  has been  previously  debilitated, taking cold is  most
 certainly a frequent exciting  cause of pulmonary phthisis. 
42
CHAPTER  SECOND.
  Intimately connected  with  the  contraction  of  the chest
among females, is the style of their  dress, rendering a full
and  free dilatation of the chest almost impossible.  Taking
into  consideration the more  delicate structure of the female
frame, and her retired and domestic habits, with the sensitive-
ness  of her mind, as compared with  that of the male, and
her  adherence to this baneful  part of her costume, she de-
prives herself of  almost the sole chance  of recovery,  a due
expansion  of  the chest.   " At the Hotel Dieu,  the  great
hospital at Paris, a young  girl of eighteen lately presented
herself to Breschet for his advice.   On the right side of her
throat she had a tumor of variable size, but never larger than
one's fist.  It reached  from the  collar bone as high as the
thyroid  cartilage,  (called  in   common  language,  Adam's
apple :) when pressed downward, it wholly disappeared ; but
returned as soon as the  pressure was removed:  it was indo-
lent,  soft,  and elastic.   It was observed to be largest  when
the chest was tightly laced in  corsets.   In short, by placing
the ear on  it, the murmur of respiration  could be heard in
the tumor, which proves that a protrusion of the lungs had
taken place, or, in other  words, that the poor girl had been
laced so tightly that her lungs, having no longer sufficient
space in their natural position,  were  squeezed out of it, and
were forcing their way up along the  neck."  This is by no
means an isolated case.
   The following  remarks, copied from a foreign paper, will
present the subject forcibly :—" When we breathe, we take
into  the  chest, or inhale, and  give out a certain quantity of
air,  which can  be measured by breathing through a curved
tube into a bell  glass of  water, inverted over a pneumatic
tub.   Dr. Herbst, of Gottengen, has lately been performing
some curious experiments  in  relation to the quantity  of air
that  is breathed.   Now, a person of any  understanding will
appreciate  from them  the  comfort of  full and  unrestrained
breathing.   Dr.  Herbst says, that  a middle-sized  man,
twenty years old, after a natural expiration or  emission of
air, inspired or took in eighty cubic inches  when dressed, and
one  hundred and sixty when  his tight dress was loosened.
After a full dilatation of the chest, he inhaled one hundred
and twenty-six  cubic inches when dressed, and one hundred
and eighty-six when undressed.  Another young  man, aged
twenty-one, after a natural expiration, took  in fifty while 
CAUSES  OF CONSUMPTION.
43
dressed, and ninety-six when undressed.  Had Dr. Herbst
made his observations on some of the ladies  who carry the
use  of  corsets to extremes, we  apprehend he would  have
obtained  results of a nature  really alarming.  Particular
employments, in which  dusty particles and  noxious fumes
are inhaled, have long been  regarded as producing this dis-
ease ;  but experience has  taught me that some catarrhal
affection, and  not  consumption, is  what  most frequently
supervenes, and  that the former complaint is a preservative
against, the latter."
   Our habits  of  life have much to do with debilitating our
physical constitution : in addition to individuals being con-
fined within doors, and preventing the  exercising and airing
of the pulmonary muscles, and  expansion  of the chest, by
improper dress and imperfect  breathing,—unhealthy apart-
ments,  especially in the  inclement  season  of the year, are
most promotive  of  consumption.   Throughout our  widely-
extended land, how few  sleeping apartments are anything
more than boxes into  which persons shut themselves, there
to remain from  seven to ten hours, breathing almost the
same air over and over again ; to  awake in the morning with
the tongue coated, and the  whole system  feverish  and ex-
hausted.  When we reflect, that with most persons one third
of their  whole life is spent in a bed encased in feathers, it is
a matter of no little importance that the room in which  they
lie should have ventilation.   Rooms, where anthracite coal is
burned, are unfit for sleeping apartments—and lying in the
beds on the floor is most injurious, as all the bad air  sinks to
the floor.  And during the inclement season, among the more
wealthy class  of our citizens,  (to say nothing of  the badly
ventilated apartments of the poor,) many of the  dwellings
are kept so intolerably heated  by furnaces, or stoves in the
hall, and a large  fire in the  grate, of anthracite coal, in the
same room in  which several of the family sleep, as to con-
sume a  large portion of the vitality of the air: while all the
physical exercise  taken by the  ladies is that of a fashionable
walk of a few blocks, at a snail's  pace, with ribs compressed
by fashionable attire ; and the gentlemen ride or walk  to their
places of business, there to remain, frequently  in over-heated
offices, to spend the  day in  mental pursuits, with occasional
sudden  exposures.  Excesses  in eating and  drinking, and
rapid swallowing, without taking time to chew the food, and 
44                CHAPTER SECOND.

thus  preparing it  for the stomach,  lays  the  foundation of
much functional derangement.  Take  time to  eat, to chew,
to grind the food well; to use the teeth is the best method
to  preserve them.   The  common class of  Europeans, who
eat hard bread, have a clean mouth, good teeth, and a strong
digestion.   A cheerful mind has  much to do in  preserving
health; depression of spirits disturbs digestion.   Cultivate
 cheerfulness,  which is an " implied praise and thanksgiving
 to Providence for all His despensations; it is a kind of acqui-
 escence in the state wherein  we are  placed, and a secret ap-
 probation of the  divine will in His conduct towards men."
 Our errors, for the most  part, as it  regards both body and
 mind, are so many, that were it not for the great tenacity of
 life, within the human constitution, life would be even shorter
and more burdensome by diseases than it is.  There is much
to learn  of the  physiological lawrs  of  life, and until these
laws are studied, and  better  understood, the loss  of  health
and life must  be the  consequence.  Intense application  of
mind to studies,  to the neglect  of physical exercises, often
prepares the  way to an  early grave.   The ambitious youth
are in such haste to accomplish so much in a given time, that
they push on  with all their energy, until, just as they are
coming  to maturity, their physical constitution is broken, and
they are ruined for life.   How much  better would it be to
keep up the general  health, and do no more than could be
done without destroying the whole structure; for if the body
be  ruined, of  what avail is the education ?   The more deli-
cate and slender the body is,  the greater the caution  requi-
site to counteract the continual  draughts  made upon it  by
mental application; and, let not the strong and the healthy
suppose that they can  violate the laws of life with impunity.
Numerous  are the examples which  might be given of the
most promising, who, just as  they were about to enter upon
the great theatre  of life, have  fallen  by consumption ; and
that, too, the result  of  a course of habits, which might at an
early period have been prevented.

               THE CAUSE  OF DYSPEPSIA.

  Depression of mind has much to do with  the destruction
of health and  life.   As the author has never seen the modus
operandi of the effects of depression of mind upon the  bodily 
              THE CAUSES OF DYSPEPSIA.           45

health explained by any writer, and as  multitudes  of lives
are destroyed  daily and annually through this medium, the
mind being the incipient cause of disease,  he will avail him-
self of this opportunity to remark, that the first effect of
mental depression is to produce imperfect breathing, which
is one of the most direct, if not the direct cause of dys-
pepsia, AND ALL THE DERANGEMENTS OF THE VARIOUS ORGANS
INCIDENT  UPON INDIGESTION,  HEADACHE, ETC.    Instead  of
taking into the lungs a full  quantity of air, unconsciously
sighing is indulged in, and as this seems to give some  relief,
it becomes frequently repeated,  until the habit becomes con-
firmed, and a numerous train of evils follow : the  diaphragm,
which in a state of health moves upwards and downwards—
a kind of churning  motion, and acts upon the  stomach, the
bowels, and,  indeed,  upon the  whole  abdominal  viscera,
causing the whole abdomen to swell out when a full inspira-
tion is taken—now lies dormant—the diaphragm is drawn up,
and has by imperfect breathing lost its downward motion ; the
whole abdominal viscera lies quiescent, scarce any action at
all is had below the pit of the stomach,  and for lack of tak-
ing in a full quantity of air in the lungs, the muscles of the
whole body become  tightened and flattened.  Nor is  this
strange, if  we consider that " every square inch of the surface
of  the globe is pressed by a column of air of fifteen pounds
weight; every square foot by one  of  two thousand  one
hundred and sixty pounds; and a middle-sized  man, whose
surface is about fourteen square feet,  carries a load of atmos-
pheric air equal to  thirty thousand  two hundred and forty
pounds weight.  This may appear incredible ; but the resist-
ance  of the  air that is within our  bodies prevents  us from
feeling the pressure  of the external  air; for  the air which is
pent  up in our bodies maintains an equilibrium with that
which acts upon us in  all directions."
   The circulation of the blood being imperfect, the  feet and
hands become cold, the position of the body bent, and inclin-
ing forward ;  the  bowels for a long period, for months, or
even  years, are constipated, and then alternately are  affected
by diarrhoea. The whole physical frame suffers ;  the  nervous
system becomes exceedingly  sensitive, and  the brain very
active,  while   the  mind   at  timss  is  greatly  depressed;
and what characterizes this long i'ain of evils is frequently
an  entire  prostration  of  strength   fainting  turns,  or con- 
46
CHAPTER SECOND.
vulsions; all  produced  by upward  breathing, or exhausting
the atmosphere from the" lungs ; by a habit of what may be
termed  continuous  sighing, which acts upon the lungs much
as the air-pump would; exhausting the air from the lungs,
and causing the  system  measurably to collapse;  and what
adds  seriously to this derangement is, that the patient (and
the physician frequently, too) is insensible; but  that he is
breathing just as he was made to breathe.   From this cause
commences the history of decline,  In the case of thousands.
The young,  the beautiful  and the gay, through disappoint-
ment, hope deferred, yield themselves unconsciously to this
pernicious  habit.  The  ambitious,  the jealous, the envious,
the sorrowful, indeed, persons in all the departments of life,
though  once strong and full of vigor, fall alike into this vor-
tex ; and when  once this habit of  breathing is formed, the
foundation  for  permanent  ill  health is laid ; and the  proba-
bility  is,  that  the habit will become confirmed.   The  physi-
cian's skill is sought; physics, blisters, tonics, bleeding, sali-
vation are all successively employed ; but every dose only
increases the weakness of the organs,  and renders recovery
more  improbable ;  and  then comes the recommendation of
sea-voyage and  travel.   The  only  remedy,  however, that
will bring back health, if it be commenced before it is too late,
is a restoration to correct habits, full inspiration, the resuming
a  healthy  posture in standing, sitting, walking or reclining.
Let nature work, give the organs room to act; and here, I am
sure,  that intelligent physicians would serve the cause  of hu-
manity a thousand-fold  more, were they to direct their atten-
tion to  imparting instructions in this department, in number-
less instances, than  in  relying upon any system of  medicinal
treatment whatever.  As the effects of upward or incorrect
breathing seem to  have  been entirely overlooked by the
profession in practice,  although fully  and fairly expatiated
upon  in theory, I  subjoin  a  few facts, which I might swell
indefinitely.
   The first,  that of a  young man of  about twenty years of
age, of  nervous  temperament  and  melancholy cast  of
mind, but ambitious and  determined character, being left to
his own resources, and  having to commence life under many
disadvantages, his pathway was strewn with numerous diffi-
culties.   In the pursuit  of business the physiological laws of
his constitution were often violated, irregular meals,  food hur- 
THE CAUSES OF DYSPEPSIA.            47
riedly eaten, and not well chewed, up late at night, and confin-
ed within  doors with the smell of cloths ; and breathing an
atmosphere exhausted and heated by gas-lights, <fec, without
vigorous manly exercise in the open air and cheerful society,
then  unconsciously came the habit of sighing or exhausting
the  air  from the lungs, which at times would entirely pros^
trate him ; there were seasons when he would become almost
lifeless ;  they were called  fainting turns;  but there was no
lack of consciousness, the mind was  as acute and vigorous
as ever, and nothing transpired around him without his know-
ledge ; but he  was without power to move a muscle, even
to raise  a  finger; the  countenance would become livid, the
feet  and hands cold ; and in this condition  he would lie for
half an hour, then revive and then relapse again; these turns
would last at  times several hours ; while every exertion was
made by friends to keep him  alive.  After a few months his
strength permanently forsook him; and he was obliged  to
retire from the pursuit of business, the most  eminent physi-
cians  of the  old  school were employed, physic and tonics
were  alternately  employed,  then cold and warm  bathing ;
then local and general bleeding ; twice he was salivated with
mercury, which all tended to reduce his general strength ; then
country  residence was tried;  then  sea voyage  and travel,
and  the consultation  of  eminent  physicians  abroad.  The
result  of  one consultation of  distinguished  physicians  at
home, was the advising a course of   dissipation.   He was
thought  to be  in  a deep decline; but when all hope seemed
to be  expiring, he providentially was directed to a physician
who understood  the  philosophy of correct breathing; a few
lessons upon the use of the lungs  and the effects of full inspi-
ration  upon  the  diaphragm;  and some artificial motions ap-
plied to the abdomen, put him all right; but the organs being
greatly debilitated for lack of  use,  months  transpired before
he  regained  his strength.  More than twenty years have now
elapsed during which he has been freed from those distressing
turns of weakness, and  has been actively employed  in busi-
ness ; but  the  lessons of experience were bought at a great
price—the loss of five  years of the  best of his  life, and
sacrifice of a most flattering business.
  Another case—a  young lady in  the  vicinity  of New
York, once a beautiful rosy-cheeked girl, full of vivacity and
good  nature ; but just as she was verging  into womanhood, 
43
CHAPTER SECOND.
  circumstances  occurred which greatly depressed  her mind;
  and she  beo-an  gradually to decline; her   countenance be-
  came so  altered  as  to be scarcely recognized by those with
  whom she had formerly been intimate ; the once sparkling eye
  had lost its fire ; the body became emaciated ; spirits dejected,
  her form bent forward ; and  being  long confined to the
  house,  the impression became  general, that she must die.
  The physicians had exhausted all their skill, and her recovery
  had been given up as hopeless ; but a few lessons upon correct
  breathing, and a restoration to the observance of the physi-
  ological laws of her constitution,  and she recovered.  She
  subsequently married, and became  the  mother  of several
  children,  and for many years has enjoyed excellent health.
    The case of  Samuel P----1.   He was the only child of a
  widowed  mother, and her  dependence ;  a  promising, active
  young  man, of correct habits ;  he was greatly beloved ; but
  his health failed him ; strength and spirits were gone ; bowels
  disarranged; breathing bad;  and  finally he had  to  take to
  his room.  The best physicians were employed, but without
  help ;   he was  finally pronounced incurable.   For  two years
  he had been confined to the house, when the author saw him ;
  he sat  bolstered up in his chair, spitting more than a pint of
  frothy  mucus  daily;  upon  intimating  to  him and  to the
'  family  that  he would recover,  the  family would  give no
  credence   to the  thought,  so long  had they regarded his
  case  as   hopeless.   A  few  simple instructions  on  correct
  breathing, and artificial exercise to aid the action of the dia-
  phragm and the abdominal viscera, and he began immediately
  to improve ; and in less than three months, he was in excel-
  lent  health, and had gained  many pounds of  flesh.  He
  subsequently married,  and for many years has been a success-
  ful  merchant  in  Green County, New York.   The  following
  remarks,   showing the effect of  depression of mind  as pre-
  paring  the way for consumption, will be found interesting.
    " Mental anxiety, or any depressing passion long continued,
  as well as chronic diseases of various kinds, engender a con-
  sumptive predisposition."
    Laennec, the French author,  gives an interesting  account
  of the  effect of depressing passions in producing phthisis, in
  the case  of a  religious association  of females, all of whom
  became consumptive from the ascetic spirit  which regulated
  their minds,  rather than the austerity of their diet.  Confine- 
THE CAUSES OF DYSPEPSIA.          49
ment, most  likely, contributed to this result.  Since this so-
ciety was bound by no vow, Laennec persuaded the members,
as soon as  consumption  was clearly  indicated in each, to
change to another place of  abode, and he expressly declares
that nearly all who took his  advice recovered.  Dr. Ramadge
remarks:  The possibility of consumption being cured is even
yet denied by many practitioners, although the light of truth
is beginning to dawn upon them ; and yet the above relation is
a proof, that, some years previously to the appearance of his
work, " Consumption Curable," the greatest medical authority
on the disease had stated opinions similar to his.  A parallel cir-
cumstance has occurred, in the course of my practice, within
the last two years.   Two young ladies were removed from a
school in the  neighborhood of London, in order to be put
under my care  for consumption.  I ascertained  that ten or
twelve of their school-fellows had sunk under decline, within
the preceding twelve-month: and, on inquiry, I found  that
the only exercise they were allowed, and  this but seldom,
was the prim, formal walk, two by two; which pernicious
and false decorum,  it is to  be hoped, will soon be banished
from  these establishments.
   To such an excess were the fantastical  restrictions of the
school carried, that the poor girls were  not allowed to hold
their  heads erect, or maintain a proper  carriage, being told
that so to do was a sign of  pride.  By this enforced humility,
conjoined with the radical error—want of exercise—both my
young patients not only stooped,  but, I am sorry to add, had
contracted chests, and lateral curvature  of the spine.
   I should  mention the sequel of Laennec's account, in order
to establish more fully the  coincidence between the circum-
stances,  and to direct attention to the ill effects of such ab-
surd  confinement. He proceeds to narrate, that he witnessed,
in the course of ten years,  two or three renewals of the re-
ligious society, by the admission  of new members to replace
the loss  of the old ones ; and that the  only individuals at-
tached to  it,  who  withstood its depressing influence, were
the superior,  the grate-keeper, and the  sisters  who had
charge of the kitchen, the garden, and the infirmary.  In
addition to  the exercise given by these  offices, the same in-
dividuals were  called upon, occasionally, to visit the city on
the concerns  of the establishment.   This narrative requires
no comment.
                2 
50
CHAPTER SECOND.
  Many writers are of opinion, that various thoracic diseases
are fruitful  causes  of consumption;  but I am satisfied that
this supposition is groundless.   It is merely owing to the loss
of health  entailed by them, that the development of  those
accidental productions, called tubercles,  takes  place.   To
enumerate the indirect causes of consumption, would be end-
less ; for, in  fact, whatever is capable of impairing the consti-
tution, is liable to produce a phthisical state.
THROAT DISEASES.
   As inconvenient and distressing at times as is the enlarge-
ment of the  tonsils—bronchitis and inflammation  of  the
throat—yet these diseases, like catarrh, instead of leading to
consumption, are nature's remedies to arrest the disease, and,
but for  them, the  ravages of consumption would be  more
general than they  are.   See this subject explained in  the
chapter on "The Cure of Consumption."
   The  causes  of  bronchitis are the same  as those  which
lead to consumption ; whatever  tends to debilitate the gene-
ral health,  may result  in  bronchitis or  throat diseases.
Persons who go about the street crying out the articles they
wish to sell, are seldom the subjects of throat diseases, their
general  health being kept vigorous by their exposure to  the
air, and exercise; but  school teachers and clergymen allow
their general health to decline, while their voice is in constant
use in a most pernicious atmosphere.
   But what tends  more  directly to produce bronchial  and
lung affections among clergymen, is a bad style of  delivery •
speaking is frequently too rapid, time is not taken to breathe'
or to take in a proper inspiration ; the lungs  are  exhausted,'
the throat is strained to  perform what could  easily be  ac-
complished, if moderation were  used in  delivery  and care
taken to breathe well, and the intonations and modulation  of
IVn^T11 Cultlvated'  Br fleeting to observe a proper
style of delivery, many a  valuable minister is laid aside • and
by due  regard to it  many a slender, delicate  man,  has  been
enabled to wear well, and to  perform  effective  service in the
church  or many years and  to improve his voice and  fuZ
.n preaching.   "It's all  preach  with you,"  said a learnfd
professor  one  day to a  young  poacher,   '^f you Tote
Scripture, or fliustrate it,  or relate an incident,  you preach ft 
THROAT DISEASES.
51
all.  Now, would you not do better to talk more, and preach
less ?"                                            r
   Let clergymen then take  care of their general health, and
let them cultivate a proper style of preaching, and throat and
lung  affections will become less  prevalent.  But to  those
who are thus affected, I unhesitatingly state, that  the use of
the tube is the best remedy that can be employed. 
          SYMPTOMS OF CONSUMPTION.

      LOCAL AND SYMPATHETIC--PHYSICAL SIGNS OF THE DISEASE.

  It has long  been acknowledged, that the symptoms on
which practitioners  generally rely in the  incipient stage, as
indicative of  consumption,  are  extremely variable  and un-
certain.  Its attack, indeed, is, in many instances, so deceitful,
that before the  patient is in the least aware of his danger, the
case has become desperate.  Again, it seldom happens that
pain, or any other uneasy sensation, is felt in the part which
is well known to be the primary seat of the disorder, although
it results from tubercles disseminated at first in the substance
of the upper part  of one or both lungs.  At  other times,
we  sec cases in which its progress is latent and altogether un-
heeded ; still, a slight cough  is generally the first symptom,
and this is attributed to some uneasiness in the  throat, pro-
duced  by a common cold.   After a time the cough increases,
and from being either hard or dry, is followed by the expec-
toration of a little mucus often devoid of color, as in common
catarrh.  This  is succeeded by some degree of weight and
slight pain felt in the  chest, along with difficulty of breath-
ing, general weakness, and an  accelerated pulse, which sel-
dom ranges below 90;  during  the hot state of the hectic
fever, it is generally 120.   A  sense of chilliness along the
course of the spine, commonly experienced towards noon, is
the next symptom ;  this is followed by an augmented tempera-
ture of the body  on the approach of evening, and finally by
perspirations, which usually come on profusely after  mid-
night,  and  greatly attenuate  the body; and sometimes  spit-
ting of blood occurs, and the expectoration begins to assume
               (52) 
SYMPTOMS  OF CONSUMPTION.          53
the appearance of  pus.   With these symptoms, and, indeed,
without all of them, we have strong grounds to suspect the
presence of  pulmonary consumption.  The occurrence  of
cough in any case, in which the general health has been im-
paired, ought to be regarded with no small suspicion.   Cases
are not wanting in which the disease manifests itself most ir-
regularly.  For instance, the usual characteristic symptoms
are not uncommonly preceded, for a short time, either by mes-
enteric enlargement, aphthae, (sore tongue, &c.,) severe diar-
rhoea, amenorrhcea, (suppression of the menses in woman,) or
by an affection of the larynx, attended  with a slight alteration
of the voice.   Though in the early stages there may be some
doubt as to the existence of phthisis, without the aid of phys-
ical  signs, there  can  be, however,  little chance of mistake
in the advanced stages.  As soon as hectic fever is fully es-
tablished, the wasting of the flesh becomes  remarkable, and
rapidly increases, if perspiration, diarrhoea, and expectoration
have  been abundant.    To me, who have been for so many
years accustomed to see this disease  daily,  the very look of
the patient is in most  instances sufficient.
   The nose and cheeks assume a  striking  prominency, and
the bluish paleness and emaciated appearance of the face are
remarkable, when  contrasted with the suffused, and at other
times,  circumscribed  flush, which  quickly goes and  comes,
together with the shining white or  pearl-blue appearance of
the conjunctiva of the eyes; the shoulder-blades project, so
as to be likened to  wings, while at  the  same time, the chest
is narrowed in its lateral as well as transverse diameter, in
consequence  of the increased convexity of the ribs, which has
a greater inclination  downwards, and which thus likewise
admits of the  nearer approach  of  the  sternum towards the
back.   On the upper  and anterior part  cf the  chest,  the in-
tercostal spaces appear widened and depressed, and the belly
is at the same  time flat  and  retracted;—the  fingers seem
lengthened, and the joints of these,  as of other parts, are ap-
parently enlarged; incurvation of the nails  takes place,  and
where large tuberculous  excavations have  long existed, an
actual enlargement of the ends of the fingers  is observable ;
the neck seems elongated and impeded in its movements, and
the angles of the  lips  are drawn back, and produce a bitter

 ^Phthisis is not difficult to be recognized in that stage in 
54
CHAPTER THIRD.
 which  the tuberculous mass, becoming softened,  finds an
 opening into  some of the neighboring bronchia, and  finally
 leaves  a  cavity, whose existence is  clearly indicated by its
 characteristic symptom—pectoriloquy.  This peculiar phe-
 nomenon is generally first heard in the upper portion  of the
 right lung, when the tubercles which first appear there are
 softened down;  and  it may be detected  by applying the ear
 over the uppermost ribs, or over the  infra-spinal fossa of the
 shoulder-blade.   When the voice of the patient, on applying
 the ear either alone, or armed with the stethoscope, to that
 part of the chest corresponding with  the supposed seat of an
 excavation, is heard much louder than natural, and seems to
 issue uninterruptedly from  within  with a  thrilling sound, it
 constitutes what is termed a  satisfactory  pectoriloquy, and
 is an indubitable sign of a tuberculous cavity; the contents
 of which we even hear not unfrequently by the same method
 of diagnosis, agitated by the action of coughing.  Whenever
 the walls  of an old, and nearly emptied excavation, are dense
 and firm, a severe fit of coughing gives to the ear a  metallic
 resonance, or a  sound as of some empty glasses  slightly
 shaken  against each other.   If the excavations are numerous,
 and communicate one with another, the liquid matter within
 is heard changing its situation every time the patient breathes.
  The plan I always  pursue, and indeed a most ready one,
 to distinguish consumption from  pulmonary catarrh, with
 which it is liable to be confounded, is  to apply the ear to the
 posterior part of the chest,  about two  or  three inches below
 the inferior angle of the scapula.  Should the respiration be
 almost  natural, or slightly puerile here, we may at once and
 early, proclaim the case to  be phthisical, if  the patient have
 a troublesome cough,  though he may present few of the other
 common symptoms belonging to  a  consumption.   Except
 near the fatal  termination of the  disease, when the  ereat
 emaciation, confirmed hectic fever, diarrhoea, and other bad
 symptoms manifest themselves, we have no physical  sign of
 any bronchial inflammation ; save  in  cases  m  which  some
 progress towards recovery has taken place.   When the sonor
 ous rattle  occurs before  the lower lobes of the  Ws are
affected with turbercles, it is to be considered as a S y fa
vorable symptom.   In other cases, however violent and lone
the  cough may  be, auscultation mves m  n?!      r !fg
catarrhaf state which precedes  andSwTcompELte^ 
SYMPTOMS OF  CONSUMPTION.           55
Having daily opportunities of seeing new consumptive cases,
I readily come to a  conclusion, by the  absence of catarrh,
that they are undoubtedly consumptive, without taking the
trouble to ascertain the state of the upper part of the chest;
for if an individual coughs up  blood, or  muco-purulent mat-
ter, is subject to chills,  accessions of fever, and night sweats,
wastes  away and complains of  debility, and  no  catarrh  is
heard in the inspirations, we may be  perfectly satisfied that
tuberculous cavities exist.  When there  is a cough which  is
not influenced by remedies, and the sympathetic signs of con-
sumption and the auscultatic results beneath  the clavicles are
somewhat unsatisfactory, while the  lower part of the  chest
has the murmur of respiration  almost natural, I should then,
satisfied with the experience derived from exploring the chests
of several thousand consumptive patients, unhesitatingly pro-
nounce the case to be  genuine consumption.  In numerous
instances I have pronounced a patient to have tuberculous
disease in the superior lobes, while he exhibited no look indi-
cative  of such serious illness,  but  had  merely an  annoying
cough.  This prompt decision, after  I  have ascertained  by
the ear the sanity of the respiratory murmur, and absence of
bronchial irritation in the inferior part of the chest, has gen-
erally  proved correct.   In  some  instances, obscure respira-
tion in the upper part of  the chest, arising from tubercles and
pulmonary induration ;  in others, a tuberculous cavity, afford-
ing the most perfect pectoriloquism,  has  been ascertained ;
and, on closely questioning the patient, the symptoms he has
detailed have usually been corroborative of  what might be
termed, if we  were  guided by  the  apparently unimpaired
state of health, latent phthisis. 
€]mttx  ftfttrtjr.
     MEANS BY WHICH TUBERCLES IN THE LONGS MAY BE PREVENTED.

   The remedies which will  be found most advantageous in
 preventing consumption from becoming confirmed, are those
 which will tend to  keep  the  body in the greatest degree of
 health and  strength.  Wherever there is a tendency  to  a
 scrofulous habit, either in the genera] systern, or in the luno-s,
 —and consumption is but scrofula of  the  lungs—the diet
 should be generous, and of a  nutritious character; as, for in-
 stance  roast  beef, or mutton, or something equivalent  to
 them should be eaten  at least once a day.   Time to eat should
 be taken, and  the food well masticated to prepare it for the
 stomach.  A  cheerful mind  should  be cultivated, that the
 process of digestion may not be impeded, while daily exer-
 cise in the open air, sufficient to call into action the whole sys-
 tem, should  answer all the purposes  of keeping the bowels
 m a  healthy  condition  without  any  medicines  whatever.
 The inspirations  should be uniformly full  and  deep, causing
 the diaphragm to  have its full action upon the abdominal
 viscera   The  employment should be a healthy one, and  in a
 good atmosphere, while crowded evening meetings and niaht
 a.r should be avoided   Moderation should be used in menta
 pursuits which should be carefully counteracted by pE<n
 exercise daily  Standing, sitting, or walking, if performed*wen
 will contribute to the  general improvement of  heaTth   but
 they may all be performed so badlv as to W m„ I  Au
 benefit.   An air/bed-room shoul/not be oveiCkeV' whue'
 rooms heated,  and  especially  bv antl,™,;^    i  ,  '  ,, le
avoided.  Bathing, if it be pronerlv W.   Th Ih°Uld be
by friction, will at be mosf Si?'Tslt if ?0W?
ance on medicinal treatment in preventing *h*   UP"** rdl"
sumption, when the habits are CrectTnd e^     J « ^
is taken daily  in the  open  airTcaniZ   ?'T^^
              5fi            '     n  be ™t>rely dispensed 
PREVENTION OF TUBERCLES.           57
with.  It should be kept in mind that whenever a person is
tending to consumption, there is a growing contraction of the
chest, and that the lungs, for the most part, being  but par-
tially inflated by the small quantity of  air inspired, and the
throat being somewhat altered by disease, that the air passes
so freely from them that the lungs and the blood lose a great
portion of the benefit which nature intended should be derived
from full and  perfect inspiration.   Now to counteract the
growing  contraction  of the chest, and the consequent  com-
pression  of the lungs, and to bring the lungs into full and per-
fect use,  nothing can effect what a daily systematic use of the
inhaling tube will.  The construction of the tube is admira-
bly adapted for this purpose.  The air is  drawn in gradually
through  a larger aperture, and then when in the lungs a
small valve closes, and  leaves  a smaller- opening  through
which the air passes out; thus leaving  the  air in  the lungs
for a longer period of time than it would  remain without the
tube, causing  ultimately  a permanent enlargement of the
lungs and the chest,  while the system in general is by this
means greatly invigorated.  The  use of  the tube  will  more
effectually exercise the lungs than all other gymnastic  exer-
cises, especially when persons are debilitated from any cause.
An individual  may  stand, or sit, or  even lie down, and  by
drawing  in the air through  the tube, have all  the  benefit of
full inspiration  to  the lungs.   It  is  on this principle that sea-
voyages and  short excursions are recommended.  The  exer-
cise and  the exposure to  the  air increasing the depth of  in-
spiration, and stimulating the system in  general,  while the
tonic power  and bracing atmosphere from the sea-breezes,
which are impregnated with saline particles, act as stimulants
to the  lungs, and cause deeper  and more  frequent inspira-
tions, and thus forward the enlargement of the chest—a  point
of the greatest importance to the invalid.  Another advan-
tage sometimes resulting from  taking  a sea-voyage is, that
not unfrequently one contracts  a severe cold, which termi-
nates in some variety of catarrh, which  catarrh will entirely
arrest the progress of consumption.  It is on  this  principle
that sea-voyages are found beneficial, but in numerous instan-
ces they result most disastrously.
   Of the different kinds of exercise I  would particularize
running and riding, as the most calculated  to forward the
purposes of prevention ; indeed, as the best general prophy-
                3* 
58
CHAPTER FOURTH.
 lactics.   After a quick and brisk run, the respiration becomes
 frequent and deep, and the panting that ensues by exercising
 the muscles  of the chest, favors a healthy development of
 that part, and enlarges the volume of the lungs.  It has been
 my universal practice to recommend a constant attention to
 this healthy exercise, in those schools I have been  in  the
 habit of attending, and to advise  the preceptors to  promote it
 by every inducement within their power; and  I have never
 been disappointed in  the  results  experienced.  Nor are its
 happy effects confined to the mere expansion  of the  chest;
 by the greater portion of air thus brought into contact  with
 the venous system, the blood becomes  more effectually decar-
 bonized, the animal heat  increased, the  action  of  the  heart
 more vigorous, and the multifarious secretions  are carried on
 with greater energy.
   Riding is an exercise of no  mean value, for  the  self-same
 reasons,  with this advantage,  that it  yields  all the  good
 effects of the former, unattended with its fatigue.   To those,
 however, in whom consumption has decidedly  appeared,  the
 benefit derivable from this mode of exercise may, perhaps, be
 enhanced by the tendency to an upward motion imparted to
 the lungs, thus disposing to apposition  the diseased surfaces
 in the upper region of the chest.
   A strong proof of the advantages  of exercise may not un-
 warrantably be sought for in the probable exemption of man,
 in a savage state, from the ravages of this disease.  Although
 various disorders are mentioned by travellers as havino- fallen
 under their observation, I do not remember, in  the  c °urse of
 my reading, to have met with any notice of consumption  re-
 corded by those who have mingled with the savage tribes of
 either the old  or the new world ; at least,  amongst  the more
 active races of uncivilized man.  Indeed, it would  be won-
 derful were the case otherwise.  Dependent for their subsist-
 ence on incessant v.gilance and vigorous exertion ; constantly
 engaged in the toils of the chase,  or animated to activity  by
 he animosities ever subsisting between neighboringbribes
however they  may lapse occasionally into habitsof K Wl
indolence, their life from the cradle to  t\TvZ L
erally speaking, be calculated to call forth  afdZTf ^
bodily energy.  Free from  the re.^^^^
voidable consequence of  a  state of superior  ,Wm
neither confined to the ™*^,^^tS?£to 
              PREVENTION OF TUBERCLES.           59

desk of the counting-house, untrammelled by dress, and un-
cramped by the various devices to  which either fashion, or
the force of habit^renders us subservient despite the dictates
of reason,—the savage possesses, at least, the uncontrolled use
of his limbs; and the symmetry, usually observed in him, is
perhaps the best index  of  the health he enjoys.  If, too, we
extend our course of reasoning to the inferior race of animals,
and observe the differences existing between them  and their
wild and domestic condition, we shall find a singular analogy
betwixt them and man.   To go no further than the harmless
creature, the  rabbit,  I  have found, in the course of my re-
searches in comparative anatomy, that this animal frequently
dies of consumption in its tame state ;  but I  never  met with
an instance of the kind in the wild rabbit.   Perhaps the ben-
efit of exercise cannot be better exemplified than by way of
contrast.  Swine, proverbially the most indolent of animals,
are also the most subject to tuberculous disease ; hence  the
derivation of the word scrofula from the Latin scrofa, a swine ;
and consumption and scrofula  are identically the same, both
resulting from the presence  of tubercles.   To  pursue  the
analogy, another strong instance of the force and good effects
of exercise  is observable  in the race-horse, the hunter, and
indeed in all this class that are subject to frequent and active
exertion.   These seldom or ever, I believe, are found to have
tubercles in  the  lungs, so long as they are kept constantly
emploved.   Many illustrations of this  nature might be  ad-
duced^ but sufficient  has been said  to enable the  reader to
extend this  comparative inquiry, and to confirm  the  high
value  which I set on the effects of  judicious and well-regu-
lated exercise,
                2* 
€\mttt  ixn\.
                 TREATMENT OF CONSUMPTION.

  There are but two modes by which we can hope to cure
this disease : the one is by rendering it chronic, and the other
by artificially enlarging those portions of the lungs which are
pervious to air.  In the first, we endeavor to effect an ab-
sence of constitutional disorder; but,  after this  change is
effected, there may still remain for an indefinite period one or
more  cavities uncicatrized,  with lining  membrane,  partly
semi-cartilaginous, or of such condensed and insensible struc-
ture as to be productive of little  inconvenience, if we  except
occasional cough and some haemorrhage, which last  occurs
at long  intervals, and rarely to a great extent.  In the sec-
ond, there is produced  what is invariably seen when  nature
or art has effected a cure—an  enlargement of the vesicular
structure of  the lungs, and subsequently a gradual  healing
of the tuberculous excavations.  It has always been my great
aim to put  an end, as early as possible, to the symptoms of
hetic  fever, and this  is  to  be accomplished  by  medicinal
treatment, in allopathic practice, by moderate  antiphlogistic
means, among which I may mention general and local blood-
letting.   But a better treatment,  in the opinion of Dr.  Howe,
is that of Homoeopathy, and to some extent Hydropathy may
be employed most successfully.   In the hot stage of hectic
fever, relief  may be had from having the hands and  upper
part of the  body sponged with tepid water and vinegar.  In
the cold stage the patient should  be  wrapped up  warm, the
feet placed  to the fire or immersed in warm  water, and some
warm beverage taken.   When  the perspiration is profuse an
infusion of columba, chamomile, or other treatment will lessen
it.  As  it regards blood-letting,  it  must be  premised  that
any active treatment of this kind  employed  without discrim-
ination,  particularly when much  tuberculous disease  is dis- 
TREATMENT OF CONSUMPTION.          61
numerous cav-
SITi? 1  lirough the lunes' and has formed "
 !inWfc™  i fVG Ser,ously and manifestly impaired the general
health, would m most cases be productive of the greatest evil,
and possibly  soon give rise to oedema of the lungs, or some
other watery effusion elsewhere.   Few consumptive cases ter-
minate  fatally,  without  being preceded by some dropsical
state  of  the lungs.   'J his generally occurs when the feet and
legs begin to swell, and is  a period  too when leeches even
are rarely admissible.
   The object of medicinal treatment is " to effect  an absence
of constitutional disorder "—or to reduce the fever or sweats,
or cough, or  oppression which may exist upon the chest; but
medicinal treatment alone is  proved daily  inefficacious in
healing a cavity in the lungs.   Dr. Young, of St. George's
Hospital, London, writes thus:  " It is probable that without
assistance not one case in  a thousand of the  disease would
recover ; and with the utmost  power  of  art, perhaps not
more  than one in a hundred will be found curable."
   "As well might the mason attempt to repair a stone wall
without  mortar  or stone, as to cure consumption  by putting
medicince into the stomach.  Mortar, stone, and  labor—air,
food,  and exercise."—Ed. Scalpel.
   Few men have had so extensive an opportunity to test all
the systems of  medical treatment in consumption  as has Dr.
Ramadge—and it was  with deep  mortification that he saw,
notwithstanding all his efforts while he relied upon medicines
alone, that his patients invariably declined.  Dr. R. remarks :
"I felt mortified  and  degraded at  the utter inefficacy of
medicine; and I was soon convinced,  that the  only means of
rescuing  my  profession  from this ' darkness  visible,' was to
make  the physician subordinate to the anatomist.  From the
post mortem examination of more than three thousand bodies,
he discovered, that  by some means nature frequently inter-
posed to arrest the progress of,  and  cure consumption.   In
numberless instances he discovered cavities which formerly
had existed in  the lungs,  which had subsequently  healed,
and the patients had ultimateiy died  of other diseases.   In
tracing back the history of such individuals, when informa-
tion could be had, Dr. R. ascertained that there was  a period
when  they had  had all the symptoms of consumption, and
were rapidly  declining, but for  some  reason unknown to the
patients or their friends, their diseases took  a turn, and they 
62
CHAPTER FIFTH.
 gradually began to recover, and soon lost all their consump-
 tive symptoms, and subsequently enjoyed excellent health.
 It was a matter of the highest importance to ascertain what
 those means were which caused their recovery; and by long
 and patient investigation, he arrived at the knowledge of this
 fact, that from some  cause or other the lungs had become
 enlarged, and the disease had assumed an asthmatic form, in
 other instances that catarrh had intervened and arrested the
 disease, and  health had returned.
   Further investigation assured him that bronchitis, (instead
 of being a cause  of consumption, as is generally supposed)
 the enlargement of the tonsils, and any chronic inflammation
 of the larynx, all  operated to prevent  the  progress of  con-
 sumption, and to  recover the  lungs.   A  violent  racking
 cough, which to a common observer was indicative of decline,
 has not unfrequently been the means of curing consumption,
 the cough being of a convulsive character like that of whoop-
 ing cough, producing a rupture of the air-cells, and causing
 infiltration  of air within their partitions, thus renderino-.the
 lungs voluminous, and  producing a species of asthma, which
 naturally  would  bring the surfaces of any excavation  into
 contact, and heal them.  In view of the inefficacy of medi-
 cines, and  having already  satisfied himself of  the folly  of
 consumptives going to a warm  climate, it very naturally oc-
 curred to him that  if  persons in consumption could become
 asthmatic, or contract some disease of  the throat to counter-
 act the disease of the  lungs, that they would recover.
  In his efforts after nature's remedy—nature seemed to lead
 himr°,n~one wmter booming  discouraged with his unsuc-
 cessful efforts in  treating his patients—he advised them to
 leave the warm apartments in  which  they were during the
 inclement months of  the  year,  being  assured that if they
 continued with  him  they would  sink on  his hands ;  and
 they went their ways,  some of  them to poor, and  often ex-
 posed habitations.  Subsequently,  he  found  some  of those
 persons, much  to  his  surprise,  in the enjoyment  of good
 health; and by careful investigation he ascertained that their
exposure had been the means of their restoration, they having
 £ken a severe cold, which had  resulted in  chronic catJri?
 He  records an account of one person, who becoming impa
tient of the  confinement of the house, and of medical treat-
ment, broke away from  the sick room, and went iftfc^ month 
TREATMENT OF CONSUMPTION.          63
of March and  seated himself on  the  banks of  the river
names to fash, and in  so doing contracted a  severe cold,
which  resulted m catarrh, and he recovered "
  Before 1 was aware, the Doctor remarks, how materially the
lungs can be enlarged by simply inspiring through a tube of
proper diameter, 1 was induced some years ago to try various
means  for producing pulmonary catarrh, or some correspond-
ing affection, in the great air-passage vulgarly called the wind-
pipe ; knowing well what an excellent agent such an affection
is for  expanding the  chest, removing  speedily  well-marked
symptoms of consumption, and, in a word,  destroying  altoge-
ther the tuberculous tendency. For this  purpose, as in the heat
of summer and the early part of autumn,  we rarely meet
with cases attended with a catarrhal  complaint, one of my
expedients was to  oblige  the patient to breathe twice or
thrice a day atmospheric air, made cold by artificial  means.
In more  than one  case I succeeded in producing a catarrh,
which  led to  the  recovery  of .the  consumptive patient.  I
have, on several occasions, dismissed those in-patients of the
Infirmary for  Diseases  of the Chest—the wards of which
are  heated in  winter  so as  to imitate a  moderate summer
temperature—whose consumptive state  seemed to be but little
relieved;  but, owing to their going at once from the warm
atmosphere to their own abodes, where  perhaps some of them
were badly secured against cold, or indeed owing  perhaps to
their imprudent and  thoughtless  exposure to the open air,
they have  caught a severe  cold of a catarrhal  nature;  and
this, I can assure the reader, has alone  effected a cure in
some who have had tuberculous excavations of  ancient, as
well as recent date.  I  subjoin a case,  in which will be seen
the  value of a catarrhal affection  in removing, or affording
perfect security against  cousumption.
   Before Dr. R. had  arrived at the knowledge  of the bene-
fits to be derived from inhalation—knowing the value of some
obstruction or inflammation in the throat to arrest  consump-
tion, he made  an experiment, which resulted most favorably,
upon a young man (a cutler  by trade) who had lost three
brothers by consumption, who came to Dr. R., seeking to be
relieved from  symptoms similar to those  which he had[ob-
served in the deceased brother's during their illness   >\ itu-
out detailing  the case, I will remark,  that in order to wrest
the consumption, he advised a steel spring to be worn on the 
 64                 CHAPTER  FIFTH.

 neck, so constructed as to make pressure upon  the  trachea,
 immediately above the sternum, and between the  sterno-
 cleido mastoid muscles.
   This instrument was worn at intervals for the space of two
 months.   In front, a small piece of  dry sponge was placed
 between the converging points  of this imperfect collar and
 the wind-pipe; most happily for the patient, the pressure on
 the wind-pipe caused a slight mucous  inflammation within it,
 and this was  succeeded throughout the lungs by bronchial
 irritation, with a slight wheezing denoting an enlargement of
 the air-vesicles.  None of these symptoms were interfered
 with ; and they continued for some months, after every ap-
 prehension of consumption was removed.  It was really
 wonderful how much he increased in flesh, and to what bodily
 vigor he arrived, especially when the catarrhal complaint had
 established itself in the neighborhood of the tuberculous dis-
 ease in the superior lobes.  At the expiration  of a fortnight
 from  this time, a.loud mucous rattle began to appear near to
 the seat  of the pectoriloquy in the top of the right lung ; all
 trace  of a cavity was nearly lost, and  the respiration there
 daily  became  more audible.   The same improvement  took
 place in the respiration of the upper portion of  the  other
 lung,  which, I have  already mentioned, seemed  to  be  dis-
 eased.  "With  the exception of periodic shortness of breath-
 ing, sometimes preceding and at other times following fits of
 coughing, the patient might be said, were he judged only  from
 his looks and  his  feelings, to  be perfectly  well.   After tra-
 cheal rattle had  been distinctly heard in the  larnyx  for a
 month, and appeared to be extending itself along the trachea
 to the larger bronchial  tubes, he was directed  to discontinue
 altogether the  further use  of that simple apparatus, the  steel
 collar.  On one occasion only was it necessary to  moderate
 by the application of leeches, the mucous excitement of the
lungs, when it ran  so high as to cause suffocative breathino-
incessant cough, superabundant expectoration, and  general
febrile disorder.  With the exception  of five  grains of com-
pound ipecacuanha powder, and double that quantity of ex-
tract  of  hops, made  into  pills to be taken at bed-time, and
the occasional  use of a mild  aperient, there  was  little else
done for the supervening  catarrh ; for I felt exceedingly re-
luctant to interfere much,  well knowing the value of the new
disorder, and that it would long prove  a successful antagonist 
TREATMENT OF CONSUMPTION.         65
to any future, as  well  as  present, liability of sinking under
consumption.  In the  month of August, three  years from
the time he  became  my patient, I had an opportunity of
seeing him in the enjoyment of excellent health; if I except
a little asthmatic respiration, which I detected by the naked
ear, whenever he  made a forcible expiration.   The  expira-
tions were of an emphysematous character, in the upper part
of the chest, both before and behind: the air, in fact, was
heard escaping from the enlarged air-cells with  a prolonged
murmur, in  which dry cracklings  were  audible, perhaps
arising from some air-cells being united into one.   Having
ascertained what I have  just  described, and how  much the
shape of the chest had been  altered, which, from being nar-
row  in its antero-posterior  diameter and flat,  was  become
cylindrical and enlarged, I assured him that he  never would
relapse into  his former  consumptive state; and that with
some care, on his part, in attending to the  directions which
I gave him, his present asthmatic symptoms would have little
effect in abbreviating the duration of his life.
  This case is highly instructive.  It  is one by which me-
chanical aid produced, in the midst of summer, such a degree
of general  catarrhal affection of the air  passages of the
lungs, that complete recovery took place.   Nor was this all;
for, through the emphysematous  state of the lungs, perfect
security existed against any liability hereafter to tuberculous
productions.   In a word, he escaped all danger of pulmonary
consumption.
   It may not be uninteresting to mention the particular cir-
cumstance which led  me to  imagine  and  adopt the above
invention.   A gentleman of the name of Willis, who a few
years ago resided in the neigborhood of Kennington, and was
under my care, happened to have a small  oblong tumor in
front of the  neck, with its inferior portion lying between the
sternum and the trachea, from which resulted a slight ob-
struction to his  respiration.    This tumor, which had existed
for some years, had induced a perfectly asthmatic state.  By
preventing free expiration, and likewise by exciting a slight
continuous inflammation  of  the mucous membrane from the
point of pressure into the numerous ramifications of the bron-
chi, the air had become imprisoned within the an-celis, and
in this manner was produced a general emphysematous state
of theTungs   Besides  the difficulty of breathing, usually 
66
CHAPTER FIFTH.
 attendant on this  condition of the  pulmonary organs, the
 obstruction from the tumor naturally caused him to breathe
 with a loud, wheezing, and somewhat croupy sound.  Ob-
 serving this, I concluded that if a slight mechanical resist-
 ance to the free egress of air from  the lungs could be pro-
 duced, so as  to  impart  the  prophylactic benefits  of the
 asthmatic state,  without  the  distressing and  aggravated
 accompaniments noticed in the case just described, it would
 be a remedial  agent of no small efficacy.  " On this hint I
 spake ;"  and seconded by  the ingenious contrivance  of the
 artisan, whose  case I  have particularized, I  was fortunate
 enough to bring the contrivance to bear, and  to find that I
 had not miscalculated its advantages.  I  have entered into
 this detail as it serves, by analogy, to  throw additional light
 on the position I have advanced  respecting the non-liability
 of  the asthmatic, or catarrhal, patient to phthisis; although,
 from the superior benefits to be obtained by a duly extended
 course of inhalation, and having satisfied my curiosity  by the
 experiment, I have never since employed the preceding me-
 chanical contrivance.
   Dr.  Ramadge's  experiments  ultimately resulted  in his
 adopting  the inhalation of the air through a tube,  as his
 great reliance to enlarge the luuo-s.
   Inhalation.—I am well  aware that many objections may
 be  started to this practice from prejudice, or inefficient  obser-
 vation.  Strange to say, the principle on which this mode of
 treatment operates beneficially, appears to me quite unknown
 to medical men. It is supposed, that the inspiration of medi-
 cated vapors has m many instances proved  useful by  allavino-
 cough,  and  by producing  some healthy  and  unexplained
 change m diseased parts of the lungs, as well as on such ad-
 ventitious surfaces  as are formed  after the softening, or  dis-
 charge of tuberculous matter: but the permanent advantages
 which mbalmg is capable of affording, are  for several reasons
 unsuspected  by the generality of practitioners  Frst  be-
 cause the  period during which persons are directed to inhale
 is generally too short to produce either a catarrhal or Ten-
 arged state of the lungs, one  of which  conditions  is abso-
 lutely necessary in order to suspend,  or cure  consumption-
and, secondly, the apparatuses employed for thisZ   are'
not constructed scientifically, so as to facilitate tho^physical
 change, which it  * desirable  the  chest   should  undergo 
TREATMENT OF CONSUMPTION.          67
Proper  inhalers ought to be so  arranged, as  to offer  some
slight impediment to free expiration.
  An extraordinary, but most  undeserved reputation is be-
stowed on various substances, mechanically received into the
lungs in a state of vapor.   Among these I may mention tar,
iodine, chlorine, hemlock, turpentine, and many other articles
of a stimulating, or  sedative nature.   I attach little or no
importance  to  any of them.  If benefit is derived,  it  is,  in
almost every instance, in consequence of some such effects  as
the following:—Pulmonary expansion, to  a degree sufficient
to exert an influence in bringing into contact the surfaces of
those early cavities which  are almost invariably formed in the
summit of the lungs;—pulmonary  catarrh,  or  its common
consequence, a vesicular emphysema, in both of which the
lungs acquire an unusual  magnitude; in the latter  more
especially.
   Neither perfect recovery, nor indeed exemption from the
danger of relapse into a consumptive state, is found to occur,
except in very  rare  instances, unless the  pulmonary organs
become naturally, or artificially, voluminous; which  not un-
frequently happens  by  the  supervention of some catarrhal
state of  the  larynx, trachea, or bronchial tubes.  It is a
most fortunate circumstance for some affection of this kind to
occur early, as it never  fails permanently to arrest this most
fatal disorder.  When the lower lobes of the lungs are en-
tirely free from tuberculous matter, (which is  often  indis-
putably the case for a  considerable period, unless there  be
strong hereditary predisposition) and though there  exist, at
the same time, cavities  in the  superior part of one or both
lungs, clearly indicated  by perfect  pectoriloquism,  there is
almost a never-failing hope of recovery  to  be  entertained,
provided an emphysematous sound can be heard.   In fact,
I never  knew a consumptive person who did  not lose all his
formidable symptoms and regain health, when an emphyse-
matous or a semi-asthmatic change had early taken place ;
and, likewise, I never knew  an individual to become consump-
tive who was subject to chronic catarrh, or to any species of
asthma.   It is from long consideration  of these facts, that I
interfere  but  little with  any catarrhal inflammation which
  iy show itself in the midst  of consumptive symptoms, for
I well know that  it will gradually supersede allI these.
  I may here remark, that  cavities m the upper part ot tne 
68
CHAPTER FIFTH.
 chest are  never healed, unless the pulmonary tissue be ex-
 panded in their neighborhood, or in the other lobes of the
 lungs.   In such  case, I have repeatedly listened to some
 bronchial  inflammation  which  has  fortunately taken  place
 near to those cysts, which are left when  tuberculous  matter
 has been removed by absorption or expectoration.   I have
 been truly gratified  to  hear the well-marked pectoriloquy
 gradually become  less distinct, till, together with the con-
 stitutional symptoms  of phthisis, it has been at last entirely
 lost, and nothing has remained but the dry rale of enlarged
 air  cells, slight catarrh, and a little  absence of respiratory
 murmur in the place before occupied by tubercles.
   Should there be catarrh in the superior bronchial tubes, of
 a duration sufficiently long only to heal ulcerations and cure
 the  patient,  he may  be again  attacked by  consumption,
 months or years afterwards, if there  be  any cause assisting
 to impair the general health;  but never can this relapse hap-
 pen, if the bronchial  tubes  be  subacutely inflamed  for a
 period  sufficient to produce  habitual asthma,  more or less
 severe.   Half of  those  which  are commonly  regarded as
 cases of catarrhl  asthma, originate in consumptive disease
 whose progress has been arrested by the supervention of that
 affection ; but in which neither fresh  crops of tubercles nor
 hectic fever, are to be apprehended.   Any individual indeed
 having asthma,  from  whatever cause, is as perfectly exempt
 from consumption as he who had been consumptive, but has
 afterwards  had his disease merged into asthmaf In a word
 it may be confidently affirmed, that no asthmatic person need
 ever fear becoming consumptive.
  In order to promote expansion of the aerial tissue of the
 lungs, it is  my usual practice, m the absence of  catarrh, and
 when congestion in the chest and  the symptoms  of hectic
 fever have  been diminished  by small  general bleeding Ve
 peated at proper intervals, or by the  application of leeches
 over the second and third ribs anteriorly, to advise ^nhaTation
 as soon  as possible.*  There are few cases of 7n •  •  *
 sumption but  will  be  rapidly  impTovedbv thST? 'T
steadily pursued.  The disease bdng thus  check d'tT'6'
changes  will follow which are rttKt^9"™
nodules of unnpe  tubercles will become innoxLt in conse-

G^tt^l^ew'Yor^ PUrP°SG' ™* ** ** of Dr. J. M. Howe, 227 
TREATMENT OF CONSUMPTION.          69
quenae of being surrounded by black secretion, or what has
been called  black pulmonary matter; and small  cavities, al-
ready formed, will have their surfaces soon brought in con-
tact, so as to heal by what surgeons term the first intention.
It is, we must own, preferable to effect pulmonary expansion
by ^ure artificial means, rather than to depend upon the un-
certain  production of catarrh.  And there is another point
gained, inasmuch as recovery takes place unaccompanied by
the cough, or difficulty  of breathing, generally attendant on
those cures which Nature herself now and then accomplishes,
by introducing this less fatal, yet distressing complaint.   In-
haling, performed two or three times daily, for half-an-hour
each  time, will in the space of a few weeks or months work
a  wonderful change  on the  chest; externally the  muscles
concerned in respiration will  be manifestly enlarged,  and the
bony compages  of  the  chest,  both  before and laterally,
visibly increased ; whilst, at the  same time, the natural respi-
ratory murmur will  be heard  internally, far more distinct
than ever.  Such has been  the  increase  of size  which the
chest, in  young persons especially, has undergone  through
the  exercise  of inhalation,  that I have known  individuals,
after inhaling  two or three times little  more than a month,
require their waistcoats to be let out.  It is in fact incredible
to one who has never been at the pains to measure the chest,
or examine its shape, what an enlargement it acquires by the
simple action of breathing for the time above stated, back-
wards and  forwards, through a narrow  tube properly con-
structed.  I have several times  found, on measurement of
the  chest, that its circumference has  increased, within the
first month after  inhaling, to the extent of an inch.  Every
impediment to the free action of the ribs is to  be  guarded
against by loosening  whatever,  in the way of dress, is at all
likely to confine them ; and it would be advisable too for the
patient, if strength allows, to inhale at times in a  standing
position, as the diaphragm will then descend more easily and
deeply, and of  course allow the  lungs more room to expand.
   There  are  cases in which inhalation is contra-indicated;
for  instance, in  dilatation,  or  hypertrophy of  the  heart,
severe mucous catarrh, general emphysema of the lungs,
pleuritic or pneumonic inflammation,  haemoptysis, or jatem,
consumption of long standing.                          .
   It is to be  discontinued a day or two, should tneie arise 
70
CHAPTER  FIFTH.
distressing head-ache, or much  internal  thoracic  soreness.
When it agrees well, it can be safely and most beneficially
used for six months, or even  longer.*   By this time, besides
a removal of every consumptive  symptom, a permanent en-
largement of the chest will have  taken place, proving a per-
fect safeguard against the recurrence of any future attacjt.
  No permanent benefit is to be expected from this remedy,
when  the  inferior lobes of the lungs contain cavities, or are
studded with tubercles: yet, even in this unfavorable state, I
have known relief arise, and surprising prolongation of life
ensue, from its employment.   I have  individuals  under my
care, at this  moment, in whom one lung is almost useless
from extensive tuberculous disease, and with  even well-mark-
ed pectoriloquy on the top  of the opposite lung; still, from
having the rest of the lung on this side in a satisfactory state,
and thus being partially susceptible of the influence of inhala-
tion, the progress of consumption has been arrested ; and, in
more  than one instance, the relief afforded  by inhaling has
enabled the individual to attend to the duties of his calling—
of course, no very onerous ones.   Indeed, I  shall feel happy
to introduce  any of my readers, who  may entertain a desire
to see such remarkable instances of the virtues of  inhalation,
to these patients of mine.
  How  long will it be before this truth will lead  the scien-
tific to  adopt its fellow truth—that, so surely as medicine
alone will ever fail, the mechanidal means I have pointed out
will succeed ?  However interested motives  may bias some,
there is an active and honorable spirit abroad in the profession
at large, which induces a frank and manly openness to con-
viction.   The owls, who shut their eyes to the light of truth,
because it would bear others through the " palpable obscure,"
are likely  soon to  be  left alone  in  their  blindness.   An
amended medical education will rectify all these.
  "The effects of prolonged expiration are the same,  whether
produced  by natural or mechanical impediments.   I shall
briefly recapitulate them, viz., imprisonment of the air in the
lungs ; distension of all the permeable air-cells ; increase of
the pulmonary volume ; enlargement of the  cavity  of the
thorax,  from the  pushing out of  its walls in every direction

  * Inhalation may be continued in some  caipa <iaUw r™ ™~ - i.
or even longer ; and should be resumeT should I natfentZZ ^° ^
be threatened again with consumption.          P ient once rec°vered, 
TREATMENT OF CONSUMPTION.         71
by the expanded  lungs ;  approximation of the surfaces  of
cavities, from  pressure on all sides by the pulmonary tissue
externa, to them ;  union of  these surfaces, if early, by a soft
membrane, if  late, by a semi-cartilaginous intervention, &c.;
arrest  of  the tendency to fresh  tuberculous deposition from
exercise and full  expansion of  the  pulmonary tissue, and a
state of dormancy or quiescence more or less complete of the
tubercles  already  formed  and  uneliminated, they being sur-
rounded by  black secretion, isolating  and often rendering
them innocuous.   Such are the  effects  of prolonged expira-
tion in favorable cases.  The great comparative advantage of
the tube over nature lies  in the following circumstances:—
It is capable of being so made that we have neither more nor
less prolongation  of expiration  than is  exactly necessary; it
can be taken up and laid aside at pleasure, so that the lungs
when fatigued with this anormal exercise may have repose;
it can  be persevered in for any desired length of time, and
abandoned when no longer necessary, or  when contra-indicated
by the supervention of some accidental malady or symptoms ;
and finally, from its proper use no evil consequences  will be
found to result.   It is, in short, an instrument completely at
our command, simple in its mode of operation, certain and
safe in its effects.   It may be  properly called a surgical or
mechanical means of treating phthisis.  No medicated vapors
are required.  The simple atmospheric air is the great  me-
dicinal agency, and  elasticity its  essential ingredient.   We
have no occasion  for the  fumes of  tar  or iodine, of chlorine,
hemlock,  or turpentine.   With  the value of these medicated
vapors I have nothing to  do.  The principle of the treat-
ment I advocate is essentially different, as has already been
seen.
    Simple  as this instrument is, its power is greater than
can be appreciated  by those who have not used it.  Let it
not be despised  on account of its apparent simplicity being
so incommensurate with its pretensions.
   " When Naaman, the favorite minister of the Syrian mon-
arch,  applied  to the wonder-working prophet of  Israel  for
the cure of his leprosy, he was ordered to bathe in the waters
of Jordan, but he  indignantly exclaimed,  < Are not Arbana
and Pharpar, rivers of Damascus, better than all the wateis
of Israel? may I not wash  in  them and  be clean   bo ne
turned and went away in a rage.'  His servants judtciouly 
72
CHAPTER FIFTH.
 reminded him that it was but a little thing the prophet com-
 manded.  He bathed in the prescribed waters, and his lep-
 rosy was removed.
    " Thus v/ould I counsel those  who at first may treat this
 simple instrumentality with the haughty disdain that sits so
 lordly on the brow of more complicated science, and imposing
 agencies.  Is it not a little thing ?   The difficulty in making
 the experiment is little ; try it;  and though I have no pre-
 tensions to the gift of prophecy, or the working of miracles,
 I promise you success, exceeding, if such may be, the san-
 guine expectations I have endeavored to create.
   " There are, however, certain rules which should regulate
 its use and stages, symptoms and  complications of consump-
 tion in which it is either inefficient, inadmissible, or for inter-
 vals longer or shorter to be suspended."—{London) Medical
 Times, Feb.  4, 1843.
   The beneficial effects of this regulated respiration are not
 confined to the pulmonary organs.   I cannot point out the
 collateral advantages better than by quoting Dr. Ramadge's
 own  remarks on the  subject.   He says, in  the  chapter on
 treatment :—
   " It may be advisable to explain in what manner the simple
 process of inhalation, while it expands the pulmonary appa-
 ratus, at the same time regulates the most important of the
 visceral functions.   The mere  expansion of the lungs, in the
 first instance, tends  indirectly to  remove congestion of the
 liver, and also of the stomach, spleen, pancreas, and  intesti-
 nal canal, all depending on the more free circulation of the
 blood in  the  former.  The biliary, as well as the great sali-
 vary secretion is hereby promoted to a healthy activity, such
 morbid irritability of the mucous  membrane of the stomach
 as may be present, productive of indigestion, is removed; the
 chyhferous absorption belonging to the small intestines,  so
 indispensable to life, is actively carried on, and the injurious
 £!? °l excrementitl0us ^tter in the larger intestines is
 obviated   by  increased  mucous  moisture  and  accelerated
peristaltic motion.   It  were easy,  did I deem it es  2  !
point out at  length the beneficial' efec^^^iS

 "Thrkidnevs  T amm 6 T^ b? Whlch -Elation ac
£.   a   i   J  \  ?*  su.fficient  has been stated to  enable
ularsm"     ^         hlS °Wn deducti0ns  in the*e P^
« 
            TREATMENT  OF  CONSUMPTION.          73

  In  asthma,  the use  of the tube will be found invaluable ;
but it should only be used when the patient is free from any
paroxysm or  difficulty of  breathing, to exercise and air the
lungs for the  purpose of contracting their  looseness and
flabbiness, to  prevent the recurrence  of the  paroxysms.  If
its use  be  steadily persevered  in for a long  period, when
the patient is  free and unoppressed for breath, the return of
the difficulty of breathing  will not only be less frequent, but
in many instances the patient will be entirely relieved.
  " The subject,"  says an  English practitioner, who had
adopted Dr.  Ramadge's  practice for consumption, " is not
only  inexhaustible, but so important, and of such magni-
tude, that it requires to be examined in  all its bearings, for
only by the test of  scrutiny  can  it become established as
it deserves.    The  finger of  nature has  been pointing to it
for ages,  yet  no eye  has followed the sign.  In vain had
science asserted that there is  no bane without an antidote:
the fact, as it  regarded consumption, was denied ; and, until
Dr.  Ramadge made  the  discovery, the hearts  of all who
were afflicted  with that terrible disease  were left  to  sink
in despair.
   " In all cases of consumption, the grand law which effects
its cure is the  prevention  of contraction of the chest.  The
localities in which this prevention appears are, as I shall
have occasion to point  out, various.  Yet, in every variation,
the antagonism to  consumption is  established by one ruling
principle, viz., the re-adjustment of the deranged  relation or
balance between the  organs of inspiration  and  expiration,
throucrh the  agency of something obstructing more or less
the  exit of the air in the act of expiration.  Here let it be
observed, by  the way, that  nature, in her operations under
this law, rarely does  her  work perfectly  ; and,  in  many in-
stances, runs  from one  extreme  to  another.    The  forces
which represent the powers of inspiration are stronger than
those forces which represent the powers of expiration; con-
sequently, when the impediment mentioned  exists, owing to
the weaker expiration, and the imprisonment of air, in some
degree, an enlargement of the lungs takes place, and the cure
 of the  disease is brought about.
   " No sooner does consumption occur, than i-is carh*  or
 later marked by contraction of the  cbest   Ihe -md pipe
 by retaining its original size, becomes compaiat.vely too large 
74
CHAPTER FIFTH.
 for this reduced compass;  the exit of the air is too free to
 offer antagonism to the advance of the disease, which would
 be attended by the occurrence of new crops of tubercles, and
 their presence and subsequent liquefaction in the lower lobes
 of the lungs.  It is pleasing to observe  that when nature  or
 art interrupts the daily contraction of  the lungs, before the
 invasion of the tubercles in  the lower lobes, we find little  or
 no disposition in the larynx or intestines to fall into diseased
 action.   The following exhibits  a hasty and imperfect cata-
 logue of the admirable, yet  simple and accidental processes
 by which the beneficial interruptions  alluded to are brought
 about, and which I shall comprise under the head of
   "Different means by which consumption  is  arrested  by
 nature.—Enlargement of the tonsils.   Diseases of the heart.
 Tumors of any sort on the  windpipe, or its  division.  Hys-
 teria.  Asthma.  Catarrh, symptomatic, or idiopathic.  Pol-
 ypus in the nose, or, indeed, any mucous intumescence in the
 same part, or nasal  fossce.   Disease in the  vertebra of the
 neck has, in more than one instance, been noticed by my pre-
 ceptor to point beneath the  pharynx, and constitute a tumor
 standing m the way of the expired air.
   " I now proceed  to recapitulate the  modus operandi of
 these agents.
   « Enlargement of the tonsils.—The great  rarity of manifest
 consumption in children is owing to the enlargement  of the
 tonsils  so  commonly observable in them.   The  same stru-
 mous habit that give rise to the foregoing state, an e^edentiv




 but we not unfrequent  v witness th* w„ 1   / •  dDS0.rP,tlon >
 tions in the summik «f ti,          , black  stams  or  ndura-
 wuus> m me summits 01 the 'uno-s wher* tV,Q„ i,„    i_      Ti
 maybe  here mentioned  that ^en the trL      ^T'  *
 adults who are seen with any degree of en^   J f™^ °f
 recollect, when only superficial?? if, '■    Ft tonsiIs' can
 suffered under some^nTcedSnt^Son^'  i^ they had
 constitutional symptoms tft^^' d»PkW a11 the

ev^tder^Se S^^j^ »-* ^
more freedom than it can escape th;Z,,   ^e airW'tb
will, of course, expand  the lung ^HS^ffi %£ 
            TREATMENT  OF  CONSUMPTION.          76

ness of  the expiratory powers, imprison  air sufficient to in-
crease that  expansion, and thus enlarge the thorax;  and,
what is  remarkable, by making the patient short-breathed or
asthmatic, so completely alter the scrofulous habit as to re-
move the very impediment (i. e., the enlarged tonsils) which
has the  capability of  defeating any contraction of the lungs
that  would  lead  to  unmasked tuberculous  phthisis.  Still
more extraordinary, the enlargement  of  the  tonsils  alone is
sufficient to render the lungs voluminous, and  to close up a
cavity resulting from  liquefied tubercles.   Dr. Ramadge con-
siders enlarged tonsils as indications  of  a scrofulous" habit,
and that the lungs are, or have been, tuberculated ;  but this
enlargement is, at the same time, a sign of the non-liability
of the patient to sink  under phthisical disease, of which it is
an indication."
   The following cases, proving  the power which pulmonary
expansion exercises over consumption, are taken  from  The
Medical Times, London, Feb. 25,  1843 :—
   " M.  Lebeau, physician to the  king of  the  Belgians, and
principal physician to the military hospital at Brussels, in the
preface to his translation of Dr. Ramadge's work  on con-
sumption, mentions, that having long devoted his attention to
this disease, he has been himself struck  with the conviction
that asthma has the power of arresting, as well as preventing
it, and that he could  cite a  considerable  number of facts to
illustrate this statement, but confines himself to one of recent
date, and complete in  its  details.  M.  ------, aged forty-
eight, a  captain of an infantry regiment, presented himself,
April 26, 183G, at the  military hospital at  Brussels, with a
view to obtain a certificate to exempt him from active  ser-
vice, in consequence  of habitual dyspnoea.  He complained
of no other ailment, and was of full habit; his chest of  re-
markable amplitude,  respiration  wheezing, the sibilant  rale
was heard throughout, the heart's action regular and moder-
ate, the pulse calm and natural, and  the face  exhibiting no
signs of venous congestion.   He gave the following account
of  his case,  in the presence of Dr. Coombe, of Edinburgh,
who happened to  be  there at the time, Drs. Liraaugue and
Biefve,  of Brussels,  and several  pupils:—'In 1816,  after
severe fatigue, I was  attacked with  cough and copious ex-
pectoration, wasted away rapidly, and was ^J^* to 8™J"-
logs in the daytime, and perspirations  at night, with wanaei- 
76
CHAPTER FIFTH.
  ing pains below  the  collar bones.   My medical attendants
  repeatedly assured  me  I was  consumptive,  and could  not
  long survive.  While matters were in this state,  I was seized
  with a difficulty of  breathing, to such a  degree  that I was
  obliged to get out of bed at night, and repair  to  the  window
  to breathe fresh air.   From this period my strength began to
  return, the perspirations ceased,  and I  soon became of  as
 full habit as you now see me.   My chest, which  was  flat and
 contracted, enlarged in an extraordinary  manner, and I  was
 completely cured, save the difficulty of breathing, for which I
 could obtain no remedy.'
   " M. Lebeau adds,  that Dr. Canstatt, a young physician
 of great merit, had related to him  a similar  and strikingly
 illustrative  case  which  had  occurred  in his own  family.
 Among other remarks worthy of attention in  his preface, he
 makes the following very interesting and curious one :—' Tak-
 ing into  consideration  all the circumstances  preceding and
 accompanying this disease, and the appearances after  death,
 I have had the most satisfactory evidence  that the compres-
 sion on the upper part of the chest of young soldiers,  caused
 by the weight of the arms and accoutrements, has  contributed
 very much to the occurrence of phthisis.'
   " The subjoined cases are submitted as  examples  of the
 benefits derivable  from pulmonary expansion by measured
 mechanical respiration:
   " Miss-------, aged twenty-three, the daughter of a mem-
 ber of parliament, was attacked  by consumption, displaying
 itself in  the usual  manner  by cough, expectoration,  night-
 sweats, and  gradual emaciation.  A  few months after  its
 commencement, one of her tonsils acquired considerable size
 and coincidently her symptoms showed signs of amendment!
 I his tonsil, after a  short interval, suppurated, and the signs
 of amendment disappeared.  Her relatives now be^an  to en-
 tertain serious apprehensions, more especially as she had lost
 a brother and two sisters by consumption within  a few months
 Dr. Ramadge was called in, and felt satisfied, upon examina-
 tion and inquiry that disease had commenced in the  rio-ht
hang and  been interrupted by the enlargement of  the tonsU
 He also ascertained that it now existed in the summit of  the

btiTery^
the left sid7remarkable.  The J^^^SSS^ 
TREATMENT OF CONSUMPTION.         77
  ?7f    fat °f the chest were educed  by the applica-
thLrZ IfTi    }GS occasionaHy between the  second and
third nbs of the affected side,  and the administration of nitre
and tertarized antimony, &c.  Tonics and sedatives were also
prescribed, to support the system and allay irritation.  The
patien   however, was taught to  place her chief reliance on
the artificial respiration, and not expect results sooner than  a
month, that is, in a very sensible degree.   By perseverance in
the use  of the inhaling apparatus, her strength gradually re-
turned,  the  appetite improved,  the  nocturnal perspirations
ceased,  the quality of the matter expectorated was amended,
a satisfactory respiratory  murmur became audible, the fre-
quency  of the pulse abated, the countenance resumed its for-
mer animation, the  chest expanded, and she increased in flesh,
and  the entire  constitution  was  renovated.  Before  these
desirable results were gained, she had twice or thrice, within
six  months,  fresh liquefactions  of  pre-existing  tubercles,
attended, of course, with more or less renewal of the consti-
tutional symptoms, during which the expectoration  showed
the softened opaque tuberculous matter minutely subdivided
and suspended in the muco-purulent sputa.  With the excep-
tion of these changes, the cure went steadily on, till recovery
took place.   The great  augmentation of flesh, and enlarge-
ment  of the chest that followed, were  particularly noticed
by the respectable circles in which she moved, to whom she
is in the habit of explaining  the  improvement that has taken
place, by throwing her shoulders upward and forward, thus
bringing the clavicles greatly in advance of the upper ribs, in
imitation of the appearance of the chest  in its previous state,
that they may judge by contrast.  This patient had used the
tube for the space of about twelve months, three times a day,
as directed, and her symptoms had disappeared some months
before she left it  off.
  " Hohnbaum, the distinguished German pathologist, who
has translated Dr. Ramadge's work into his native language,
strongly recommends this extension of the term of its use for
the sake of security.  About two years afterward, at the
close of the gay season  in London, Dr. Ramadge was  again
called in to see her.  She complained of cough  and pain in
the lower scapular region, which he  attributed to fresh soft-
enings   of old  tuberculous  nodules.   Appropriate  medic-
inal "treatment, with the use of  the  tube,  soon removed 
73
CHAPTER FIFTH.
  these symptoms of relapse, and  she has not since required
  any medical advice.  The mechanical  respiration in this case
  has prevented the deposit of fresh tubercles, and altered that
  peculiar habit which  generates it.
    " Her eldest sister, with whom she had been  in  the  habit
  of sleeping, a few months previous  to her  attack, exhibited
  unequivocal signs of  consumption;  and, though having the
  advantage of  the most  distinguished advice, experienced no
  relief till she removed to Hastings.   The bracing sea-air, and
  horse-exercise, which she here   enjoyed, brought about an
  amelioration, so far as to  check  the most distressing symp-
  toms, and do away with the cough,  but still she remained in
  a very delicate state.   The satisfactory result of her sister's
  treatment induced her mother to  draw Dr. Ramadge's atten-
  tion to her case also. •  He found  her chest  very much  con-
 tracted, the middle of the collar  bones  standing out nearly
 three-fourths of an inch  in advance of  the upper ribs, which
 were, of course, greatly depressed, particularly those  on the
 right side.  Auscultation  discovered  in  the  summit of  the
 right  lung  clear indications that consumption existed  in a
 latent form, attended with an  insensible excavation.   For the
 improvement  of her general  health, tonics, chiefly quinine
 with  preparations of iron, were occasionally prescribed, and
 for the local  affection  the  artificial respiration was steadily
 employed.  The result  was, that under this treatment, she
 rapidly improved, the  chest expanded, her complexion, from
 very pale became somewhat florid, and the functions of the
 system, which had been  deranged by the constitutional debil-
 ity, were restored to their  normal action.  She  was subse-
 quently married to an  individual of noble rank, by whom she
 had two children, and  her general health has  not since been
 interrupted by any phthisical manifestations
   "In examining the chests of the remaining members of the
 family,  Dr.   Ramadge's  attention was  directed  to  that of
 a younger sister, which  was preternaturally full  and  ale
 forming a remarkable contrast  to   the two precede   3S
 general appearance was that of robust health r compS
 ion florid, and her size and growth  beyond her years  T0m
 the conformation  of the chest, he at once susnJ*a k . *i
 was some physical impediment to  the S    t]jat there
inspecting the throat, proved to be the caTe the t'on"  Z^' -^
so large as almost to rn^et.   This enla^n^^ ^ 
TREATMENT OF CONSUMPTION.         79
fered with the voice.   There was nothing remarkable in the
respiration, except that it was puerile.  He explained to her
family and her father, who was present, the connection be-
tween the tonsils and the highly developed chest;  and added,
that although he could not  by the ear detect the si^ns  of
tuberculous disease, yet he had no doubt  the  peculiar habit
which had given rise to this  unusual  tonsillarv enlargement,
had also led to the deposition of tubercles, and that they ex-
isted in a scattered form in the lungs.   With a view to lessen
the susceptibility of  mucous irritation in the throat, he sug-
gested  the  propriety of diminishing  the  tonsils, by a leech
applied occasionally below each ear, to be  succeeded  at times
by  movable  blisters.   Sarsaparilla  to improve the  general
habit, and iodide of  potassium to promote absorption, were
also recommended.   This  treatment  was adopted,  and  the
tonsils were reduced in size.  .The young  lady was sent to a
school at Brighton, where the tonsils became still more dimin-
ished, from the sea air;  and her  chest, after some time, be-
gan to flatten, and other signs of phthisical disease betrayed
themselves.  She had been  forewarned to use the  tube, to
make up by art the loss of protection derived  from the less-
ening  of the  tonsils, but neglected it.   She returned to
London for advice.  Dr. Ramadge, who was called in, pointed
out that the reduction of the tonsils, coupled with the opera-
tion of  some exciting cause, had  brought  on the  softening of
the tubercles previously  suspected, and that the flattening of
the chest, with the other symptoms,  would have been pre-
vented, had his directions relative to the tube been observed.
Finding her constitutional  symptoms  urgent,  he  advised the
abstraction of blood  from the  upper part of  the chest  by
leeches, attention to  medicinal  remedies, alleviating and pre-
paratory, and the regular employment of  the artificial respi-
ration.   These were followed up some months at Brighton,
to which place she after a  short time returned, and finally
got quite well, in the identical locality where the  disease  had
first declared itself in a manifest form.
   " The eldest son of this family had recently returned from
a continental tour, undertaken to improve  his  general health,
which was delicate.   On examination, no  evidence of disease
was detected by the ear, but his chest was very much con-
tracted, and his general appearance  by no means  healthy.
He had spent some  time among the  mountains  of  Sw.tzer- 
80
CHAPTER FIFTH.
land, where the climbing of ascents was well calculated to
excite his lungs to deep inspirations.  But the flatness of the
thorax, the tuberculous diathesis prevalent in the family, the
absence of tonsillary enlargement, disease of the heart, or any
other protective, led to the conclusion  that  his lungs  were
extremely  liable to  tuberculous  invasion,  if not   already
tuberculated.  He had just obtained a commission in  a light
regiment, and  was about  to join  it, a course which could
not fail to  be approved of,  as  the  exercise,  which in-
cludes a great deal of running, would prove highly favorable
to the proper expansion of his lungs.  The  service  agreed
with him remarkably well, he liked it much, and was  exceed-
ingly active ; his chest expanded, and his  general health  con-
siderably improved.    After  some  months  he married,  and
about a year subsequently, the regiment to which he belonged
was ordered to hold itself in readiness for foreign  service, on
the breaking out of the war  in Syria.   Being the presump-
tive heir to  a  peerage, and  by the particular desire of the
nobleman whose daughter he had  married, he retired from
the army, very much  against his  own wish.  This  change
from an active to a comparatively inactive life was followed
by an  impaired state of  his general health, and  a  cough.
Four months from its commencement, he came up  to town
and had the advice of one of her Majesty's physicians in or-
dinary,  who considered  his  case  decidedly phthisical, and
exceedingly serious, and directed  him to proceed immediately
to Tunbridge, giving him the name of a medical man under
whom he was to place himself.   This was in the  middle  of
summer, and in the early part of autumn he was to leave for
Nice.   He had applied to this physician for advice  in the
first instance, by the particular request of two noble relatives •
but before acting on it, consulted Dr. Ramadge, whose treat-
ment of the other members of  the  family had proved so suc-
cessful, and who found, on examination, that the  rio-ht  lung
was diseased, and that the difference between the  semi-diam-
eter of this side of  the  chest and the  other amounted  to
nearly an inch and a half.  The  usual symptoms, cough,
nocturnal perspirations, &c, were present.   Considering that
it would be highly improper to send him away in such criti-
cal circumstances, from the very  place where it mio-ht be ex-
pected he could procure  the best attention, that it'would be
in fact, a virtual abandonment of the case, he dissuaded him 
TREATMENT OF CONSUMPTION.          81
in conse-
from his proposed journey, and apartments were ..
quence: taken  for him near the residence of  his  parents, a
short distance from Hyde Park.   Due attention having been
now premised for the relief of the  constitutional  symptoms,
he was placed under a course  of mechanical respiration, and
shortly began  to  show  evident signs of  amendment, which
ended in recovery, and thus superseded all necessity for leav-
ing town, or going abroad.  Two winters  have elapsed, and
he still enjoys immunity from  any return of the symptoms.
  " The  above cases are not the less interesting from the cir-
cumstance  of having occurred in  one family, shortly after
three of  its members had been cut  off by consumption; and
it is not going beyond my own conviction to say, that but for
the use of the mechanical respiration, these in all probability
would have shared the same fate.   In none of  the cases did
the mechanical treatment operate injuriously; and the cures
have so  far proved themselves permanent, that after a lapse
of a considerable time they all  enjoy excellent ordinary health.
As  a proof of the satisfaction  this highly respectable family
derived from the success of the treatment, Dr.  Ramadge has
been indebted to their expressions of approval for the confi-
dence reposed in him  by some  of  their  friends, who have
since applied to him for advice under similar affections.  It is
not a little  remarkable  that all  its  members  attacked with
consumption who had not adopted this  peculiar treatment
died; and  the remainder  (seven in number)  who availed
themselves of it,  are  now living,  and in excellent health.
The conjoint features in their  history afford at  once negative
and positive  evidence  of  the soundness   of  the principles
assumed in the preceding arguments.  Some of these details
are worthy of remark.   In the first case,  the  pulmonary af-
fection showed itself originally in the right lung; and here
we see it retarded, and driven back as it  were, by the acci-
dental enlargement of the left tonsil: on  the  return of this
gland to its former size, we find the consumptive indications
reappearing, the site of the disease having changed from the
right to  the left lung.
   " I may here incidentally remark, that the greatest amount
of dUea=e is almost invariably  recognizable before  and after
death in the left lung.   I have heard this accounted for  by
Dr  Ramadge, as well  as I can  recollect, in  the following
     er   When tuberculous deposition first commences, it is
               4* 
82                  CHAPTER FIFTH.
 generally in the  summit  of  both lungs, but  greater  in  the
 right than the left, and therefore solution is first discovered
 in the former.  After this, it will often happen that some ac-
 cidental circumstance interrupts its progress by expanding
 the pulmonary tissue in the neighborhood of the disease, and
 this expansion will be greater where the tuberculous deposit
 is more extensive, i.  e., on the  right side.   The more this
 tissue is expanded, the less susceptibility does it retain of new
 tubercularization, and hence the disease, if not subdued, as it
 advances, spreads more on the left side,—makes its first  re-
 appearance there, and  its most  extensive ravages in that
 lung.
   " The effect of tonsillary enlargement is also seen in  a very
 marked and unequivocal manner in the third case, where the
 chest was prematurely full,  and  well-developed  during its
 presence, but sunk into an opposite state of contraction upon
 its removal.  The whole family, indeed, evinced a predisposi-
 tion to the  malady.   Tubercles had formed in all their  lungs,
 but in the  cases  adduced, their liquefaction  had  been kept
 back, and controlled partially and temporarily by natural an-
 tagonistic causes, and ultimately in a permanent way by art,
 which stepped in with aid more  certain  and decisive than
 nature.   Some credit was, no doubt, due  to  the medicinal
 treatment,  both  preparatory and accompanying; but the
 complete failure of mere medicinal treatment in similar  cases,
 or its very modified  and unsatisfactory results, argue strongly
 that the mechanical respirator had to bear the brunt  of the
 action, and may with justice lay  claim to  the credit  of
 success.
  " The fourth case exemplifies the absence of the necessity
 for removal from town, either  to the country or abroad,  under
 manifest phthisis.  The practice  of sending  patients  away
 from their friends and their country in this disease, appears
 to me incapable of being defended.   The chief argument in
its favor would seem to  be precedent.   The fashion has  so
long prevailed, that the propriety of it has ceased to be ques-
 tioned._  No good could have  resulted from  the patient's re-
moval in this case.  He would have been separated from his
friends and relatives at a time, and under circumstances, that
most call for their  attention  and sympathy, also from the
opportunities of procuring the best  medical advice, which it
may be presumed are  much more  numerous in this'metropo- 
TREATMENT OF CONSUMPTION.          83
lis than abroad.  He recovered without removal, and was thus
spared the inconvenience and peril to which a long journey
would have  exposed  him.  Liquefactions  are  of constant
occurrence.   While they are going forward, patients require
all the medical  skill and care  they can have, to watch and
control the symptoms  as they arise.  Travelling, by  land or
sea, places these, in most instances, beyond their reach ; and
when located in the  place of their destination, they  run the
serious risk of falling  into the hands of unskillful practition-
ers, who too frequently by the administration of improper
medicines—as, for instance, mercury—cut short the  work of
decay.  These  considerations are serious drawbacks to the
hypothetical  benefits of warm climates.  Some of our high
medical  authorities, however, still sanction this practice, by
recommending  migration to many of their patients.  When
benefit appears to be derived,  and the patient has returned
alive, I have always  been able to  trace the cause to some
natural protection, such as a contraction of the trachea,  dis-
ease of the heart, <fec, existing before he  left home, or to
pulmonary expansion, brought  about by accidental  catarrh
caught in the prosecution  of his journey, or, when  the  dis-
ease has been incipient, to  the deeper and more energetic in-
spirations  which  change  of   air and   increased  exercise
occasion."
   Did the limits of this  pamphlet admit, it would afford me
pleasure to extend remarks upon  each opposing influence to
the progress of the  disease, and  particularly in relation to
any  medicinal  treatment  which may be employed;  but  I
must forbear—and will conclude with a few remarks on diet
and  climate.  When there is febrile action, the diet should
be  light—but  not a milk  diet.  On the abatement of  the
hectic fever,  the food  may be of a nutritive and invigorating
description ;  in the absence of inflammation, and  of haemop-
tysis, a moderate  use of  meat once a day, with  an egg at
breakfast; or, by way of a lunch,  nutritive  broths may be
taken lukewarm.
   Climate.—It has been seen from the preceding pages, how
much I am at variance with the common opinions entertained
of nhthisis, and  to  none  am I more diametrically opposed
 Lfto those which respect climate.  So  far from  send.ng
a  consumptive patient to the south  of France  or  Italy  ■
should, if change be  requisite, deem the climate ot  bt. 
84
CHAPTER FIFTH.
 Petersburgh a thousand times more beneficial.   In the latter
 case  the patient  has a chance of contracting catarrh, and of
 thus staying consumption :  in the former, any catarrhal state
 which might exist  would  assuredly be fatally  removed.
 When I hear of consumptive individuals being recommended
 to try the genial climes, as they are absurdly termed in these
 instances, of Lisbon, Madeira, or other  sunny  lands—and
 when I reflect on the evidence given  by medical statistics of
 their deadly influence on phthisis, I long to suggest the fitting
 answer to such advisers : " Me vestigia terrent omnia adversum
 spectantia, nulla retrorsum."  My experience on this point
 is  full and explicit; and I could substantiate it, were it requi-
 site at the close of a  treatise  the scope of which has been to
 prove the true nature of this little  understood  malady, by
 numerous cases.
   So decided am I on this head, that I never admit into the
 infirmary a phthisical patient with recent catarrh, because its
 wards are heated in winter-time so as to resemble a moderate
 summer temperature.  The cases of consumption, that come
 under my notice in suntmer, are nearly double the number of
 those I see in winter.  The reason  is evident;—the aug-
mented temperature  of the weather increases the intensity of
 two of the most important stages of the hectic paroxysm—
 the hot, and the sweating.   To subdue these, then, becomes
peculiarly difficult: how likely they are to be aggravated by
going abroad,  any  well-constructed thermometrical  table
will tell.   Again, if the disease be latent, removal to a warm
climate is  the most probable  means of making the case one
of manifest  phthisis.   In uniformity with these  opinions, I
feel no anxiety respecting consumptive  patients being kept
scrupulously within doors.  Whenever the weather permits,
they should be allowed to take an airing daily; but be by no
means suffered to remain so long as to be sensible  of chilliness
or cold.
   From every inquiry I have made with respect to the influ-
ence of climate, I conceive that, all things duly considered,
 the patient cannot  have a more suitable residence in winter,
than in some of  the  spacious, well-ventilated streets of our
own metropolis.   Another consideration—a great one to the
invalid—is that  of comfort, a word indigenous among our-
selves.  Many of those who had been led by blind guides to
roam abroad in a vain search after that health which, under 
TREATMENT OF CONSUMPTION.          85
judicious treatment, they might have preserved here have
assured me, to use the language  of Sterne, that  they had
done  better to "have  remained dry shod at home ;" and I
am convinced that the greater number thus sent on a useless
errand  make—when hundreds of miles  from their own com-
fortable  fireside—the  reflection that  occurred to  honest
Touchstone, " Ay, now am I in Arden—the  more fool  I;
when I was at home I was in a better place." 
               CONSUMPTION CURED BY NEGLECT.

  A silversmith, when in good health and circumstances, and
nearly fifty years of age, was exposed  to one  of  the  most
terrible of ail paternal inflictions—the misconduct and subse-
quent legal punishment of his son.   The young man, having
formed  dissolute connection, had been persuaded to pass a
forged note; and, on the fact being proved against him, was
sentenced to transportation.   The disgrace,  thus brought on
their hitherto unimpeachable family, operated so powerfully
on the feelings  both of the  father, and  of  a daughter  just
entering  into life, that their  distress and agony of mind at
last entirely undermined  their  health.   The debility, thus
induced,  terminated in each of them in consumption.   After
a few months'  illness, the  daughter died;  and  the  father,
after extreme suffering both  of body and mind, having ap-
parently  reached the  verge  of the grave, and being indeed
so utterly reckless of life,  which he  regarded only  as a bur-
den, as to neglect not only recourse  to  medical advice, but
even common care of himself, yet  recovered,  and survived for
many years.  It was fully seventeen years subsequent to this
seemingly miraculous recovery, that I attended  him on the
occasion  of his being seized with  an apoplectic fit, resulting,
as I afterwards had reason to believe, from valvular disease
of the heart.   During his  convalescence from this attack, he
was unfeelingly taunted by some  brute in human shape with
his  son's  disgrace;  and so  wounded and humiliated did he
feel by this unworthy allusion, and so deeply did it sink into
his mind, that I entertain  no  doubt it accelerated his death.
It was during my attendance on  him, that learning from his
wife his previous consumptive state and recovery, and per-
ceiving that he  labored under a bronchial affection, of long
          86                                             8 
           CASES  OF CURED CONSUMPTION.        87

standing I at once attributed the return to health, which she
regarded as so strange, to the ingression of catarrh on phthi-
sis,  ihe post-mortem examination verified my conclusions ;
it presented well-defined cicatrizations, especially on the sum-
mit  of  the right  lung;  nodules  of tubercles^ yellow and
opaque in  the centre, and rendered inert by the secretion of
black pulmonary matter in  the surrounding tissue,  and the
lungs were exceedingly voluminous.   I will venture one ob-
servation  on the  case, and  although  it may appear harsh,
regard  for truth and the advancement of medical science
compel me to make it, namely, that had this  person, when
reduced to a phthisical state, recurred to medical advice, the
probability is,  that the bronchial affection, which  was  his
safeguard, would  have  been interfered with, its value being
unknown to the profession, and his  life, consequently, short-
ened for years.

            CONSUMPTION SPONTANEOUSLY CURED.

   Miss M----, about  twenty-three years of  age,- a lady of
great personal attractions, and highly cultivated mind, con-
sulted me in the summer of  1826, for symptoms of confirmed
consumption;  for which she had already enjoyed the benefit
of Mr. Howship's  advice.  It was arranged that I should
visit her  in conjunction with this talented surgeon; and we
continued to attend her for several weeks.  In all  the cases
I have witnessed, I never met with  such distressing, racking,
and perpetual cough.   We  tried every method  of  relief we
 could possibly  devise,  and  administered  sedatives  of every
 description, but without effect.  Her disorder, instead of re-
 ceiving  mitigation,  evidently increased; and  not only were
 the fears of her friends awakened, but we ourselves  began to
 despond.   At this crisis, through  the ™F«™*?™"
 near connections, her mother was persuaded to trjthe advice
 of an individual, who, although I am not aware that he had
 received a regular medical education, enjoyed some notoiiety
 On eceivin/a delicate intimation  to  this  effect and  being
 of coursTbclined to humor the natural anxiety  of  a parent,
 ;?a°greSeedThat it mightnot  be totally^ g-^^t
 the more  legalized authorises, to hearwhat tb» per      g^
 suggest, although a formal  consultaUon wa  o«       4^
 tion   To do him justice, we found  his opmi 
88
CHAPTER SIXTH.
  much to the purpose; but he considered the condition of the
  patient as so hopeless,  that he  declined interfering with the
  case.   Yet, notwithstanding these  grave prognostics,  the
  young lady, to our great satisfaction, soon after this began to
  exhibit signs  of amendment.  Her health was gradually re-
  stored, and continues, I believe, unimpaired up to the present
  time.   From  my further experience, and from  cases which
  have  subsequently  come under my notice,  I entertain no
  doubt that the  cough I have already alluded  to, and which
 was  of a convulsive character  like  that of  the  whooping-
 cough, must have produced a rupture of the air-cells, which
 caused infiltration of air within their partitions.  This variety
 of emphysema, similarly to the vesicular, renders, while it
 lasts,  the lungs  voluminous; and when happening in the
 neighborhood  of  the  diseased  summit of  the lung, would
 naturally bring the surfaces  of any excavation into contact.
 Indeed, although  from my reluctance to put the  patient to
 inconvenience by examining the chest  in the  latter  part of
 her illness, I could not possibly affirm the existence of emphy-
 sema, still all my reflections on the case lead  me to the belief,
 that she  is in no  small  degree  indebted for  her  cure to a
 cough, which in general would be considered highly injurious,
 and in fact appeared so to me at the time.

 REMARKABLE INFLUENCE  OF  THE  PROTECTIVE  POWER OF  A
                  BRONCHIAL  AFFECTION.
   I offer  this  case as one instance out  of many, equally as
 decisive,  which I could  adduce, of the value  of catarrh in
 preventing  pulmonary consumption.  An eminent publisher
 of Paternoster Row, all  of whose brothers and sisters have
 been the prey of  consumption, is himself subject to asthma,
 induced by a catarrhal  affection of the chest  contracted in
 childhood.  The gentleman  to  whom I allude, is at present
 about fifty years of age, of a ruddy, healthy complexion, ex-
 panded chest, and excepting occasional inconvenience experi-
 enced from  the above constitutional complaint, he enjoys life
 in every respect.   It is but fair then to infer that since, out
 ot a numerous family, he is the sole member who has escaped
phthisis,  this singular  exemption  has been owing  to what
might to a superficial observer appear an infliction, but which
is really m this instance a providential  dispensation ; namely
catarrhal asthma.                                       y' 
CASES OF CURED  CONSUMPTION.         89
  Being thus naturally led to the subject, I take the oppor-
tunity of explaining a very remarkable phenomenon, exhibited
m the offspring of consumptive and asthmatic individuals.
lhat consumption is hereditary, I have already noticed;  but
an additional confirmation not only of this  fact,  but of the
truth of the opinions I have given on  the preventive nature
of catarrh, may be found in a circumstance  often noted  by
me—that when a consumptive individual becomes asthmatic,
the children  born prior  to the supervention of asthma, ex-
hibit a phthisical diathesis, whilst those who tire born subse-
quently are  entirely  free  from any consumptive tendency.
Exceptions may undoubtedly be  met with, the result of some
strong exciting  cause; but, generally speaking, the rule will
be found to hold good : the exception, indeed, will substanti-
ate the rule  from the  resistance, in such  cases, offered by
nature to  the inroads of  consumption.

CONSUMPTION  CURED, NOTWITHSTANDING EXPOSURE TO COLD
                AND  NEGLECT OF MEDICINE.

   Mr. D----, aged 24, had so materially impaired his con-
stitution  through  irregular habits, as  to fall in consequence
into a decline.   He of course availed  himself of the benefit
of medical advice,  which produced no very visible  ameliora-
tion of his state of  health.  Being naturally of active habits,
he grew  impatient of the confinement to which  he was sub-
jected, and, tempted by the return of spring, he  suddenly
deserted his heated apartment, and determined, since he con-
cluded he must die, to die in the manner most agreeable to.
himself.   Accordingly he betook himself to his favorite sport
of fishing  This  was in the month  of  March, a period at
which easterly winds are most prevalent.   The worst conse-
quence of this apparently rash  exposure was,  that after a
time he caught a cold, which, as it would  appear, was con-
fined to the trachea.   His respiration was  sensibly affected,
and he labored under a  distressing fulness of the chest.  He
continued subject to this affection, with an apparent increase
of the violence of  his disorder; but he still rejected all cate
and medicine,  and  persevered in going out.   After  some
period, he began to exhibit signs of amendment  he gradu
ally lost  his  emaciated  appearance  and acquiredflesh and
bodily vigor;  but was  much annoyed by wneezing 
90                 CHAPTER SIXTH.
chest, and  loud rattle in the  throat.  He had remained in
this state for some months, when he applied to me.  On ex-
amination of  the  chest, and hearing  a detail of his com-
plaints, not only from himself, but from the gentleman under
whose care he had previously been, I  at once  perceived that
he was indebted for his recovery from consumption to this
catarrhal state of the trachea.  I may here observe,  that re-
coveries of this kind are more frequent among the lower, than
the other  classes of community ;  owing, doubtless,  to what
may at  first  appear a  misfortune, but is to the consumptive
patient, in numerous instances, a blessing—exposure to cold !

CASE OF CONSUMPTION EXEMPLIFYING THE  GREAT  VALUE OF
                       INHALATION.

  A gentleman, aged  50, whose house  of business is  in
Hatton Garden, began to exhibit decided symptoms  of con-
sumption about three years ago.  Originally of delicate con-
stitution, and inclined by his make to phthisical disorder, his
health was undermined by family afflictions.   Within a very
brief space, he lost his wife and two grown-up daughters;
the two latter through the same destructive complaint, which,
supervening on the  decay of health  occasioned by grief  for
their loss, has since endangered his own life.   At the time I
was called in, he exhibited the physical signs, as well as the
constitutional symptoms of the disease.  He had inflamma-
tion of the inferior and middle  lobe of the right  lung, and
expectorated no inconsiderable quantity of blood.  This cir-
cumstance,  indeed, is no unfrequent concomitant of the above
inflammatory state, when it co-exists  with  tuberculous exca-
vations of the lungs.  He had  been  under the care  of  two
able practitioners, his brother-in-law,  Mr. Wallace, and  Mr.
Christie, a surgeon in the  neighborhood of his country resi-
dence.   Both  these  gentlemen considered their patient in a
most alarming state; and on seeing him, I fully shared their
apprehension.  The  first consideration  was to subdue  the
inflammatory state; and  for this purpose blood was taken
from the  arm, and  medicines  were  likewise exhibited  to
further the end proposed.  The pneumonia continuing, it be-
came necessary to repeat  the general  abstraction  of blood,
and to follow this up by the application of leeches near the
Beat of the  inflammatory action.  By  these depletory mea- 
CASES OF CURED CONSUMPTION.         91
sures, the pneumonic disease lost its more violent symptoms;
out, after displaying a temporary amendment, the active de-
termination of blood to the  chest recurred with its former
severity.   At this juncture, his brother-in-law, Mr. Wallace,
who watched the case with great anxiety, considered himself
fully justified in bleeding him in  my absence, and that to
some extent.   Leeches  were  also repeated, and medicines
given,  whose chief action was determined  to the  kidneys.
Under this plan of treatment, he  gradually got  rid of the
formidable pneumonic complication, anu it remained to coun-
teract the phthisical disease alone ; which, after a time, began
to exhibit graver and more pressing symptoms.   In  fact, the
patient was at this period  in  so lamentable a condition, and
so utterly hopeless of recovery—being rendered additionally
uneasy by the discharges of  blood again appearing—that he
arranged his affairs, and made every preparation which  a con-
scientious man  deems it imperative to do, when looking for-
ward to the awful summons.   Having first  reduced  the spit-
ting of blood, and removed  some  of  the  more  formidable
external  symptoms connected with phthisis, I  pressed the
necessity of recurring to inhalation.  The practice was novel
to the other medical  gentlemen, but I pointed out its ration-
ale,  and  illustrated my opinions by the convincing support
of cases.  They yielded to my arguments, inasmuch as their
reason was convinced; yet so unwillingly, that  they could
not enlist their  hopes on my  side.   The utmost they at first
expected was palliation ; but they could not bring themselves,
as they have since owned  to me, to  believe  that inhalation
could effect the healing of internal ulcers, and  prevent the
fresh formation of tubercles.    The trial was, however,  made;
and its result up to the present date, has been attended with
marked success.  In less than two months from the period of
the patient's commencing to inhale, his chest was so much
enlarged as to render it necessary  for him to have his waist-
coats let out;  and his general health was proportionably
amended.  It is now two years and a half since he  began
this process, and for the  last  two, he  has  been enabled to
attend constantly to his business  in  town.  He inhaled for
many months twice a day,  except at such  times as slight
spitting of blood, arising from the cavities  not being yet en-
tirely closed, has called for an interruption.   This is a circum-
stance, which,  although it is apt to  occasion alarm  in the 
92
CHAPTER SIXTH.
patient, is to be expected in many instances, so long as, the
excavation remains.  I have already adverted in Case XI.  to
a similar instance of sanguineous expectoration, which like-
wise proved  perfectly innocuous.  The  cure was in the case
of this lady complete; and in that now under consideration,
I am happy to be able to say "finis coronat opus."

CASE OF A MEDICAL GENTLEMAN WHO  HAS RECOVERED BY
                      INHALATION.

  Mr. Clements, aged 25, member of the Royal College  of
Surgeons, did me the honor to solicit  my advice more than
two years ago.   I found that he labored under well-marked
symptoms of consumption.  Since, however, they presented
no peculiar features, it is unnecessary to recapitulate  the long
list of  constitutional and  physical phenomena, which have
been so often described in the preceding pages as concomi-
tants of the disease ; suffice  it is to say, that I have enjoyed
the satisfaction of seeing  him recover; and that he chiefly
owes his restored health to inhalation.

PROTECTING INFLUENCE  OF PARTIAL EMPHYSEMA,  EXEMPLI-
   FIED IN THE LONG LIFE OF A CONSUMPTIVE PATIENT.

  Martha Henderson, of Cherry Garden-street, Bermondsey,
first came under my care about thirteen years ago.   She was
at that time fifteen years of age.  It appeared that phthisical
symptoms first supervened after  an attack of the small pox,
which had seized her naturally the year preceding.   The  ill
health  engendered  by this, it is probable, gave  rise to the
formation of tubercles in the lungs.  She  exhibited  no signs
of consumption in her person.  Her countenance was florid,
not flushed ;  and the emaciation usually witnessed  in con-
sumptive patients, was not observable.  The hectic symptoms
were very irregular and undefined, recurring at uncertain in-
tervals, and those far distant.   She was subject to cough,
and shortness of breath, influenced by changes of weather;
but the most remarkable  symptom was the quantity and the
fetor of  her  expectoration.   It  resembled the  matter dis-
charged by a phlegmonous abscess, and  she could  bring  it
up at will.   She imagined, from the peculiar  sensation she
felt there, that it proceeded from the right side of the chest;
and,  in poinf  of fact, a great sympathy was discernible be- 
CASES OF CURED CONSUMPTION.         93
\na    a ?xternal and internal parts on this side.   A swell-
  g»  and induration of the  mamma, invariably took  place
w lenever the matter  collected to any great extent within.
l nave alluded to the fetid odor of  the expectorated matter;
it was  of so rank and sickening a nature, that her  parents,
although she was their favorite  child, needed  every excite-
ment that  a  sense  of parental  duty could  give, to enable
them to live with her.   It is no  exaggeration to say that it
contaminated  the whole house, and  was perceptible as soon
as the  street door was opened.   I have seen my own  pupils
ready to vomit at the disgust it occasioned, and have, used as
I am to such  scenes, been affected by it myself.   When I
first  examined her, she exhibited the following symptoms :—
The  sound of respiration  was barely audible over the right
side  of the chest, with the  exception of  a space, about two
inches square, between the clavicle and the third rib, where
a loud gurgling rattling was heard, caused by the intromission
of air  into a  cavity containing a quantity  of puriform sputa.
A mucous, and  sometimes sibilous sound was occasionally
heard  in some of the bronchial tubes, in the inferior  region
of the same lung.   The opposite side of  the chest gave out
an asthmatic  wheezing, from the clavicle downwards, as far
as the fourth  rib.  The inferior  part of  the same side, both
before and behind, yielded a dull sound on percussion : and the
respiration was nearly inaudible over the same region.   When
she spoke, I could discover on; the same  side distinct pecto-
riloquism in the midst of  this imperfect  respiration.  After
examination,  I   recorded  the following   diagnosis:—Large
excavation in  the superior lobe of the right lung, containing a
quantity of liquid  matter ;  the rest of the lung, on the same
side, tuberculated ; cavity in the middle of the inferior lobe of
the left lung, the remainder of the lobe in a state similar to
the opposite ;  the upper lobe of the  same lung emphysematous

1 Tluo°ured  no long period after this, that she was likely to
live  imany years; feeling assured that the asthmatic condition
of the one lobe  of  the lung would  counterbalance the de-
fects alarming as they were, of  the rest  of the pulmonary
onni'ratus    f caused her to attend on  several occasions,
w*hen  lecturing  on diseases of  the chest, to point out the
phenomenon  of a person existing so long under such ravages
From consumptive  disease.  She was seen several  times at 
94
CHAPTER SIXTH.
the Central Infirmary, as well  as the Infirmary for Diseases
of the" Chest;  was well known to the  two apothecaries of
those establishments ;  and must have come under the notice
of above one  hundred  professional individuals.   I was  not
aware, for some time after her  first attendance on me, of  the
value of that  emphysematous state, which I now  recognize
as the preserver of her  life for so long a period.  Hers was
at first considered by me as a remarkable case, from  the cir-
cumstance of her  displaying most of  the  external signs  of
health in spite of  her really distressing  condition.   Of late
years, however, I have learnt to estimate properly this strong
corroboration of the  truth of  those  views, which  I  have at
last systematized, and reduced  to proof.
   A singular peculiarity, connected  with the history of  the
patient, is, that from  the  age  of  fifteen to twenty-two,  her
personal appearance  exhibited no change.   She  displayed
the same  girlish look throughout these years; and it was
not,  indeed, until  she  had turned her  twenty-second year,
that she underwent the  catamenial crisis.  After this, it was
astonishing how quickly she acquired the aspect and  propor-
tions  of  womanhood.   She was  an  occasional patient  of
mine, as I have  already stated, for the space of ten years ;
applying to me from time to time, whenever she was in Lon-
don.  In the course of these  years she experienced  several
severe inflammatory  attacks.  The immediate cause of  her
death was, in fact,  a violent pleurisy, which seized  her when
on a visit to some friends about forty miles from town.  She
endured this as long as she could hold up, without taking any
medical advice; and  at last hastened home, and sent for me.
But she had delayed till too late.  Her tongue was thickly
covered with aphthae, her lips livid, her respiration so impeded
as to prevent  her  from lying  down, and accompanied with
extreme pain in the side:  her extremities were cold,  and  she
had occasional hiccough.  I saw that  she was  beyond  the
reach of medical aid; and the  pool girl expired within thirty
hours after reaching home.
   Dissection, thirty-six hours after death.—The right lung
was adherent throughout, by  ancient  attachments,  to those
parts with which  (though without adhesion) it is naturally
in  contact.   The summit was  indented,  indurated,  and
covered, or capped as it were, by a fibro-cartilaginous  mass.
Highly condensed  cellular substance, of irregular thickness, 
CASES OF CURED CONSUMPTION.         95
the 1      aU i,lch and a half in length, extended  .tself into
whi h"^' and ^ave  °^ severa^ bands, of the same structure,
thp    ian m nearly a horizontal direction, and gradually lost
tuemselves in  the cellular membrane of the  viscus.   The
structure  just  described, was  probably  formed  from the
    nzation of  anc>ent vomicae.   In the same summit there
were  a number of tubercles, in different stages, several  of
mem surrounded by black pulmonary matter.  There was a
laige cavity, nearly opposite the third and fourth intercostal
spaces, containing a calcareous secretion of the size of a peach
stone; and instead of being lined by semi-cartilaginous mem-
brane, its lining was composed  of lamina?,  of the color and
consistence  of old yellow wax.  The rest of the lung con-
tained  a  multitude  of grayish tubercles, of unusually firm
consistence, and of various sizes;  on cutting it, a quantity of
frothy serum flowed out.   The upper lobe  of  the left lung
completely filled the cavity of the chest, on that side;  and,
when handled, imparted  a sensation different from the natu-
ral crepitation, and somewhat similar to that caused  by the
displacement  of some elastic fluid.  Its surface exhibited
several transparent vesicles, some  of  the size  of an almond,
evidently  dilated air-cells.  The  dilatation of the cells over
the rest of this lung, was likewise remarkable.   On making
a longitudinal section of this lobe, a slight  trace of cellular
cicatrix was  perceptible; and  two  of  the bronchial tubes
were considerably dilated from their cartilaginous termination.
The mucous  membrane  of all the tubes, without  appearing
highly vascular, was considerably thickened,  and contained
much yellow opaque matter.   The inferior lobe, on the same
side, on its anterior and lateral surface, was adherent through
the medium  of a false  membrane a quarter  of an inch in
thickness, containing beneath it a gelatinous  substance, trans-
parent, and  almost colorless.   There  was a large  cavity,
with tubercles, similar to those presented in  the superior lobe
of the  opposite  lung, but not so numerous; and marks of
inflammation were exhibited  in various places.  The  above
cavity, which  occupied the centre of the lobe, and communi-
cated by  a large  opening with  another of less  size, had a
membranous  lining  exactly resembling  in structure  that
which I have described as appearing  in the  excavation of the
right  side.                                . .
   I entertain no doubt that there  existed originally a cavity 
96                  CHAPTER SIXTH.
 in the summit of the left lung, along with tubercles in a state
 »f semi-transparency ; the latter of which had been absorbed,
 and the former healed by the first intention.

 CONSUMPTION WARDED  OFF BY THE PRE-EXISTENCE OF ASTHMA.

   Mr.  Morgan,  a general practitioner of  Great Newport
 Street, has, on various occasions, invited me to accompany
 him to post mortem examinations.  I have had the  pleasure
 of pointing out to him, in some of these associated labors,
 the cicatrices of cured consumption arising from enlargement
 of the volume of the  lungs.   In  the case  now under con-
 sideration, extensive cancerous disease had destroyed a great
 portion of the uterus  and the bladder; had produced con-
 siderable induration of the rectum, as  well  as obturation of
 the external iliac, with a portion of the  adjoining hypogastric
 vein on the right  side; and  had affected the  whole of the
 right leg and thigh in  a manner similar to what is witnessed
 in phlegmasia dolens.  Notwithstanding the ill health induced
 by the continuance of cancer of the womb, with the deplor-
 able accompaniments just detailed, as well as exhausting dis-
 charges for upwards of two years, no symptom of consump-
 tion  appeared; but the  patient,  at last,  succumbed under
 general effusion, the result of protracted debility.  On open-
 ing the body, I  pointed  out to Mr. Morgan the asthmatic
 state of the lungs, (with cicatrices on their summits), which
 had  acted as a  preservative  against  the ingress  of  that
 phthisical condition which, without this state, would in such
 a, case have indisputably supervened.  I have had opportuni-
 ties of showing similar cases to several respectable practition-
ers, and, amongst others, to my worthy friend, Dr. Helsham.
My chief inducement for mentioning this  case, is to impress
upon the medical  world the high advantage  of recurring, in
all instances of debility occasioned by long-continued chronic
ailment, to mechanical means for preventing the sure inroads
of consumption, the consequence of such state.   Mr.  Car-
 michael, of Dublin, has indeed affirmed, in  the second edition
of his excellent work on cancer, that he never examined the
body of a patient who  died with any variety of that disease,
without finding the lungs tuberculated.
  The author would have gladly extended his remarks, but
the limits ot this work forbid. 
   J-he following letters will be  read with interest.   Special
attention is called to one from a  Physician, exhibiting the
value of the Tube in asthma.

                            Charlottesville,  Va., Sept. 5th, 1853.
 , Dr. Howe—Dear  Sir,—You probably recollect my applying to
you about six years ago for your Inhaling Tube.  You will also
recollect that, on examination, you found my lungs so much dis-
eased, that you considered my recovery very doubtful, recommend-
ing, however, the trial of the tube.   I began immediately to ex-
perience some relief, and subsequently my health has been entirely
restored, and my lungs pronounced by several physicians who have
examined them perfectly sound.
  Having experienced this personal relief from one of the most de-
structive diseases incident to our climate, I have felt it incumbent
on me, in gratitude to God, to endeavor to promote the use  of this
great and only remedy among my fellow-sufferers.  Several  of my
acquaintances have, by my advice, applied for the tube, and have
been relieved by it.   The  object of my present communication is
to obtain two tubes for the use  of two afflicted friends.   In the
families of both consumption is hereditary, but not personally fully
developed in either.   One is  the case of a  married lady of about
forty, who is just beginning  to  feel occasional uneasiness  in the
region of the  lungs, with slight hacking cough and general debil-
ity.  The other is a young unmarried lady of  about eighteen, of
slender  make,  fair  complexion, and  blue  eyes.    Her  maternal
grand-parents  both died of  consumption ;  her mother  and  only
brother fell  victims to  the  same disease about two  years  ago.
She is beginning  to show the same symptoms,  but seems wholly
unaware of  her danger.  She has considerable cough, profuse night
sweats, and  general debility, loss of appetite, &c.
  Will you  please send me by mail  two of the short tubes!   My
address is as follows:
                     ANN FANNIE E. R. DAVENPORT,
                              Charlottesville, Albemarle Co., Va.


                    CASE OF  CURE  OP  ASTHMA.
                     Speedwell Post-office, June Uth, 1853, Barnwell
                             District, South Carolina.
  Sra —In the  year 1846 youVnt me a tube.  I treated with it a
confirmed case of Asthma of eighteen years' standing- in  a  young
lady; so severe was her attacks at times that life became a bur-
then.  She  or  her  father applied to me for medical treatment. I,
immediately after examining her case, sent  on  to you for a tube.
After using it three months, her chest had increased  one  and
fnuarter ilches   In eighteen  months it  had  expanded  three
"nches    S^e hatnever hod an attack since 1847, and is now  in the. 
enjoyment of excellent health.  I have now a  case of the same
kind, and wish you to send me on the price of your last improve-
ment on the tube, so that I can remit  the  money to you and get
the tube.  An early compliance to this will oblige
                          Yours, most respectfully,
                                   WILLIAM FURZE, M. D.
    CASE OF RECOVERY AFTER THE LUNGS  WKRE  GREATLY DISEASED.

                                   New York, Sept 28th, 1853.
   Sir,—During last winter I was laboring  under a severe cough,
 confined breathing,  pain in my lungs, and spitting  of blood.   I
 consulted two  physicians, who agreed that I was in consumption,
 leaving little hope of my recovery;  and one of them assured me,
 the only chance I had was to return  to  my native  country. Just
 at that time I was advised by Mrs. M'Clean of No. 44 Morton street,
 to call upon you, which I did, and got  one  of your tubes.   I then
 quit all medicines, and used it  according to directions, and, thank
 God, in less than a month,  the  cough and pain in my lungs was
 removed, the spitting of blood  stopped, and my breathing became
 almost  as free as usual.  I record this as another proof of the  as-
 tonishing effects of your tube.

                         I am, sir, yours, sincerely,

                                         P. DOHERTY,
                                    No. 149 Hammond street.

   P.S.—I would add, the day I first visited  you I was so much ex-
 hausted and my breathing so bad from  walking up stairs, that I
 nad to drop down on a chair, not being able to stand.—P. Doherty.

   Was the  benefit of correct breathing alone known and practised
 with  proper habits  of mind and body, it would save multitudes
 Irom  Dyspepsia and  Consumption.  For Consumption and Bron-
 chitis and  Asthma the Tube will do more to effect a cure than
 all other means  put  together, medical treatment in  some instances
 being neceesary as an auxiliary.   If  there was  a necessity to  do
 without the Tube, or  to dispense  with a  physician,  I  would
 sooner give up the latter.   My  conviction is, that  the tube is of
 more  value  than all  medicinal  treatment;  but medicinal treat-
 TlS  V°*•    ^ rejected.  If  medical men knew the value
 n J  T,trJnes "Seated  in this little work, they would thank
 SS„?t« I  Z cour"Sc..fcoung  confident that they had a remedy
 ienttto Tthf pensive ravages of Consumption, if seasonably
 employed.   I  trust the time is not far distant when prejudices,
superciliousness  and, ignorance  may  be succeeded  by a desire to
«w! p   "1  '  Gt. Xt C°T. throuSh  whatever channel  it may
please Providence to send it.                                J 
 
NLM032772138