CHAPTER LVII.

HOT HOUSES AND CONSUMPTION.

If any individual in the wide world needs to breathe the pure atmospheric mixture of the Most High,--I mean a compound of gases, consisting, essentially, of about twenty parts of oxygen and eighty of nitrogen,--it is the consumptive person. Mr. Thackrah, a foreign writer on health, says, "That though we are eating animals, we are breathing animals much more; for we subsist more on air than we do on food and drink."

And yet I know of no class of people, who, as a class, breathe other mixtures, and all sorts of impurities, more than our consumptive people. First, their employments are very apt to be sedentary. Under the impression that their constitutions are not equal to the servitude of out-of-door work, agricultural or mechanical, they are employed, more generally, within doors. They are very often students; for they usually have active, not to say brilliant minds. And persons who stay in the house, whether for the sake of study or anything else, are exceedingly apt to breathe more or less of impure air.

Secondly, it is thought by many that since consumptive people are feeble, they ought to be kept very warm. Now I have no disposition to defend the custom of going permanently chilly, in the case of any individual, however strong and healthy he may be; for it is most certainly, in the end, greatly debilitating. It would be worse than idle--it would be wicked--for consumptive people to go about shivering, day after day, since it would most rapidly and unequivocally accelerate their destruction.

And yet, every degree of atmospheric heat, whether it is applied to the internal surface of the lungs through the medium of atmospheric air, or externally to the skin, is quite as injurious as habitual cold; and this in two ways: First, it weakens the internal power to generate heat, which, no doubt, resides very largely in the lungs. Secondly, it takes from them a part of that oxygen or vital air which they would otherwise inhale, and gives them in return a proportional quantity of carbonic acid gas, which, except in the very small proportion in which the Author of nature has commingled it with the oxygen and nitrogen of the atmosphere, is, to every individual, in effect, a rank poison.

Hence it is that those who have feeble lungs, or whose ancestors had, should pay much attention to the quality of the air they breathe, especially its temperature. And this they should do, not only for the _sake_ of its temperature, but also for the sake of its purity. Such a caution is always needful; but its necessity is increased in proportion to the feebleness of the lungs and their tendency to suppuration, bleeding, etc.

I was once called to see a young woman (in the absence of her regular physician) who was bleeding at the lungs. She had bled occasionally before, and was under the general care of two physicians; but a sudden and more severe hemorrhage than usual had alarmed her friends, and, _in the absence of better counsel_, they sought, temporarily, the advice of a stranger.

It was a cold, spring day, and in order to keep up a proper temperature in her room, I had no doubt that a little fire was needful. But instead of a heat of 65 deg. in the morning and something more in the afternoon, I found her sitting in a temperature, at ten o'clock in the forenoon, of not less than 75 deg. or 80 deg. On inquiry, I was surprised to find that the temperature of her room was seldom much lower than this, and that sometimes it was much higher. I was still more surprised when I ascertained that she slept at night in a small room adjoining her sitting-room, and that a fire was kept all night in the latter, for her special benefit.

No wonder her cough was habitually severe! No wonder she was subject to hemorrhage, from the irritated vessels of the lungs! The wonder was that she was not worse. The greatest wonder of all was, however, that two sensible physicians should, for weeks if not for months, have overlooked this circumstance. For I could not learn, on inquiry, that a single word had been said by either of them on the subject.

If you should be inclined to ask whether she had no exercise in the more open and pure air, either on horseback or in a carriage, the reply would be, none at all. Horseback exercise was even regarded as hazardous, and other forms of exertion had not been urged, or, that I could learn, so much as recommended.

I was anxious to meet her physicians, that I might communicate my views and feelings directly to them; but as this was not convenient I gave such directions as the nature of the case seemed to require, requesting them to follow my advice till the arrival of her physicians, and then to lay the whole case before them. My advice was, to reduce the temperature of the sitting-room as low as possible, and yet not produce a sensation of chilliness, and to have her sleeping-room absolutely cold, taking care to protect her body, however, by proper covering. I also recommended exercise in the open air, such as she could best endure; and withal, a plain, unstimulating diet.

What was done, I never knew for many months. At last, however, I met with a neighbor of the family, one day, who told me that the young woman's physicians entirely approved of my suggestions, and that by following them out for some time, she partially recovered her wonted measure of health.

Whether she recovered entirely, I never knew. The far greater probability is, that she remained more comfortable through the summer and autumn, but that the injudicious management of the next winter and spring reduced her to her former condition, or to a condition much worse. People are exceedingly forgetful even of their dearest rights and interests. They may, perhaps, exert themselves in the moment of great and pressing danger; but as soon as the danger appears to be somewhat over they relapse into their former stupidity.

There is, however, much reason for believing that consumptive people might often live on many years beyond their present scanty limit, could they be made to feel that their recovery depends, almost wholly, on a strict obedience to the laws of health, and not on taking medicine. If Miss H., by strict obedience, could recover from a dangerous condition, and enjoy six or eight months of tolerable health, is it not highly probable, to say the least, that a rigid pursuance of the same course would have kept her from a relapse into her former low and dangerous condition?

It is in this way, as I suppose, that consumption is to be cured, if cured at all. It is to be _postponed_. In some cases it can be postponed one year; in some, five years; in some, ten, fifteen, or twenty; in a few, forty or fifty. It is in this respect with consumption, however, as it is with other diseases. In a strictly pathological sense, no disease is ever entirely cured. In one way or another its effects are apt to be permanent. The only important difference, in this particular, between consumption and other diseases, is, that since the lungs are vital organs, more essential to life and health than some other organs or parts, the injury inflicted on them is apt to be deeper, and more likely to shorten, with certainty, the whole period of our existence.

Connected with this subject, viz., the treatment of consumption, there is probably much more of quackery than in any other department of disease which could possibly be mentioned. One individual who makes pretensions to cure, in this formidable disease, and who has written and spoken very largely on the subject, heralds his own practice with the following proclamation: "Five thousand persons cured of consumption in one year, by following the directions of this work." Another declares he has cured some sixty or seventy out of about one hundred and twenty patients of this description, for whom he has been called to prescribe.

Now, if by curing this disease is meant the production of such changes in the system, that it is no more likely to recur than to attack any other person who has not yet been afflicted with it, then such statements or insinuations as the foregoing are not merely groundless, but absolutely and unqualifiedly false, and their authors ought to know it. For I have had ample opportunity of watching their practice, and following it up to the end, and hence speak what I know, and testify what I have seen. But if they only mean by cure, the _postponement_ of disease for a period of greater or less duration, then the case is altered; though, in that case, what becomes of their skill? No book worthy of the name can be consulted by a consumptive person without his deriving from it many valuable hints, which if duly attended to may assist him in greatly prolonging his days; and the same may be said of the prescriptions of the physician. Yet, I repeat, it is a misnomer, in either case, to call the improvement a cure.

Consumptive people continue to live, whenever their lives are prolonged, as the consequence of what they do to promote their general health. One is roused to a little exercise, which somewhat improves his condition, and prolongs his days. Another is induced to pay an increased regard to temperature, and he lives on. Another abandons all medicine, and throws himself into the open arms of Nature, and thus prolongs, for a few months or a few years, his existence. If this is _cure_, then we may have all or nearly all of our consumptives cured, some of them a great many times over. Some few aged practitioners may be found to have cured, during the long years of their medical practice, more than five thousand persons of this description.

There is no higher or larger sense than this in which any individual has cured five thousand, or five hundred, or even fifty persons a year, of consumption. On this, a misguided, misinformed public may reply: Many, indeed, revive a little, as the lamp sometimes brightens up in its last moments; but this very revival or flickering only betokens a more speedy and certain dissolution.

On the other hand, predisposition to consumption no more renders it necessary that we should die of this disease in early life, at an average longevity of less than thirty years, than the loading and priming of a musket or piece of artillery renders it necessary that there should be an immediate or early explosion. Without an igniting spark there will be no discharge in a thousand years. In like manner, a person may be "loaded and primed" for consumption fifty years, if not even a hundred, without the least necessity of "going off," provided that the igniting spark can be kept away. Our power to protect life, both in the case of consumption and many more diseases, is in proportion to our power to withhold the igniting spark.

And herein it is that medical skill is needful in this dreadful disease, and ought to be frequently and largely invoked. If the estimate which has been made by Prof. Hooker, of Yale College, that one in five of the population of the northern United States die of consumption, is correct, then not less than two millions of the present inhabitants of New England, New York, Pennsylvania, and Ohio, are destined, as things now are, to die of this disease. What a thought! Can it be so?

Can it be that two millions of the ten millions now on the stage of action in the northern United States, are not only _predisposed_ to droop and die, but are laid under a constitutional necessity of so doing? Must the igniting spark be applied? Must the disease be "touched off" with hot or impure air, by hard colds, by excitements of body and mind, and in a thousand and one other ways? People are not wholly ignorant on this great subject. Would they but _do_ as well as they _know_, the fatal igniting spark would be much oftener and longer withheld; and, indeed, in many instances, would never prove the immediate cause of dissolution. The lamp of life would burn on--_sometimes, it may be, rather feebly_--till its oil was wholly exhausted, as it always ought. Man has no more occasion, as a matter of necessity, to die of consumption, than the lamp or the candle.

This, if true,--and is it not?--should be most welcome intelligence in a country where, at some seasons and in particular localities, one-fourth of all who die, perish of this disease. In March, 1856, twenty-one persons out of eighty who died in Boston in a single week, were reported as having died of consumption; and in June of the same year, the proportion was nearly as great. In Newton, a few miles from Boston, the proportion for the last ten years has been also about one in four.

But place the proportion for the whole northern United States, at one in five only, or even one in six. Yet even at this rate, the annual mortality for New York or New England, must be about twelve or fourteen thousand. Yet it seems to excite little if any surprise. But when or where has the cholera, the yellow fever, or the plague depopulated a country of three millions of people, for each succeeding year, at the rate of twelve thousand annually, or one hundred and twenty thousand every ten years?

One reason why the statements I have made, of the possible postponement of consumptive disease, should be most welcome intelligence, is found in the fact that they inspire with the hope of _living_. The ordinary expectation that those who inherit a consumptive tendency must die prematurely, has been fatal to thousands. Mankind, in more respects than one, tend to become what they are taken to be. If we take them to be early destined to the tomb, they go there almost inevitably. There is, I grant, one most fortunate drawback upon this tendency. Most people who have the truly consumptive character, are disposed to disbelieve it. They are generally "buoyant and hopeful," which, in some degree, neutralizes the effect of sombre faces, and grave and prognosticating jeremiades.

It will not be out of place to present the patient reader with an anecdote, which may or may not be true, but which I received as truth from the people of the neighborhood where the facts which it discloses are said to have occurred.

In the eastern part of Connecticut, not many years since, a young man lay on his bed, very feeble and greatly emaciated, almost gone, as everybody supposed but himself, with pulmonary consumption. And yet, up to that very hour, the thought that his disease was consumption, had never obtained a lodgment in his own mind for a moment. On the contrary, he was still fondly hoping that sooner or later he should recover.

It was fortunately about the middle of the forenoon one day,--an hour when his body and mind were in the best condition to endure it,--that his listening ear first caught from those around him the word _consumption_. Starting up, he said, "Do you think my disease is consumption?" They frankly told him their fears. "And do you think," he added, "that I must die?" They did not conceal longer their real sentiments.

He was for a few moments greatly distressed, and seemed almost overpowered. At length, however, a reaction came, when, raising his head a little, he deliberately but firmly exclaimed, "I can't die, and I won't die." After a few moments' pause and reflection, he said, "I must be got up." His attendants protested against the effort, but it was to no purpose. Nothing would satisfy him but the attempt. He was bolstered up in his bed, but the effort brought on a severe fit of coughing, and he was obliged to lie down again.

The next forenoon, at about the same hour, he renewed the request to be got up. The result was nearly as before. The process, however, was repeated from day to day, till at length, to the great joy and surprise of his friends, he could sit in his bed fifteen or twenty minutes. It is true that it always slightly increased the severity of his cough; but the paroxysm was no worse at the twentieth trial than at the first, while he evidently gained, during the effort, a little muscular strength. It was not many weeks before he could sit up in bed for an hour or more, with a good degree of comfort.

"Now," said he, "I must be taken out of bed and placed in a chair." At first his friends remonstrated, but they at length yielded and made the attempt. It was too much for him; but he persevered, and after a few repeated daily efforts, as before, at length succeeded. Continuing to do what he could, from day to day, he was, ere long, able to sit up a considerable time twice a day.

He now made a third advance. He begged to be placed in an open carriage. As I must be brief, I will only say that, after many efforts and some failures, he at length succeeded, and was able to ride abroad several miles a day, whenever the weather was at all favorable. Nor was his cough at all aggravated by it. On the contrary, as his strength increased, it became rather less harassing and exhausting.

One more advance was made. He must be helped, as he said, upon a horse. It was doubtful, even to himself, whether he had strength enough to endure exercise in this form; but he was determined to try it. The attempt was completely successful, and it was scarcely a week before he could ride a mile or two without very much fatigue.

The final result was such a degree of recovery as enabled him to ride about on horseback several miles a day for six years. He was never quite well, it is true, but he was comfortable, and, to some extent, useful. He could do errands. He could perform many little services at home and abroad. He could, at least, take care of himself. At the end of this period, however, his strength gave way, and he sank peacefully to the tomb. He was completely worn out.

Now the principal lesson to be learned from this story is obvious. _Determination_ to live is almost equivalent to _power_ to live. A strong will, in other words, is almost omnipotent. Of the good effects of this strong determination, in case of protracted and dangerous disease of this sort, I have had no small share of experience, as the reader has already seen in Chapter XXIII.

Another fact may be stated under this head. A young man in southern Massachusetts, a teacher, was bleeding at the lungs, and was yielding at length to the conviction--for he had studied the subjects of health and disease--that he must ere long perish from consumption. I told him there was no necessity of such a result, and directed him to the appropriate means of escape. He followed my directions, and after some time regained his health. Ten or twelve years have now passed away, and few young men have done more hard work during that time than he; and, indeed, few are able, at the present moment, to do more. It is to be observed, however, that he made an entire change in his dietetic habits, to which he still adheres. He avoids all stimulating food--particularly all animal food--and uses no drink but water.

I did not advise him, while bleeding, to mount a hard-trotting horse, and trot away as hard as he could, and let the blood gush forth as it pleased. It is a prescription which I have not yet hazarded. I might do so in some circumstances, when I was sure of being aided by that almost omnipotent determination of which I have elsewhere spoken. I might do it occasionally; but it would be a rare combination of circumstances that would compel me. I might do it in the case of a resolute sea captain, who insisted on it, would not take _no_ for an answer, and would assume the whole responsibility. I might and would do it for such a man as Dr. Kane.

I have, myself, bled slightly at the lungs; but while I did not, on the one hand, allow myself to be half frightened to death, I did not, on the other hand, dare to meet the hemorrhagic tendency by any violent measures; not even by the motion of a trotting horse. I preferred the alternative of moderate exercise in the open air, with a recumbent position in a cool room, having my body well protected by needful additional clothing, with deep breathing to expand gently my chest, and general cheerfulness. But I have treated on this subject--my own general experience--at sufficient length elsewhere.