To define pulmonary consumption very briefly I would say: It is an infectious tubercular disease of the lungs. Usually appears in the chronic form from one and a half to two years' duration, the acute form lasting from about six weeks to six months. The prognosis is grave in all cases, and in advanced stages the issue is almost invariably fatal. It has been estimated that "oneseventh of deaths from all causes are due to consumption," and "one-third of all deaths of the young adult population are from phthisis pulmonalis.' This enormous high percentage of deaths at once convinces that an ounce of prevention is better than a pound of cure in this disease. As the name phthisis pulmona lis indicates, it is a wasting, a degeneration of the lung tissue from tubercles. Without tubercles there is no pulmonary consumption. Before Dr. Koch's discovery in 1884, the disease was divided into caseous, tubercular and fibroid phthisis. This division admitted of cases independent of tubercles. But since Dr. Koch's discovery, it is almost universally accepted that in all cases tubercles are the starting point. It has been also demonstrated beyond any doubt that the starting point of tubercles, the bacillus tuberculosis, requires a proper nidus in order to grow and propagate itself. Without the proper soil plants will not grow; without the germ and sperm man will not reproduce himself; and without the predisposition to consumption the bacillus

tuberculosis will not develop. Therefore it is obvious, that one way to prevent consumption is to remove the predisposition to it. If we are able to do this, then the inhalation of bacilli will be harmless.

The question, how to remove a developing predisposition, deserves careful consideration. It has been said, that the greatest boon of man is to be "born well.” Born well means to enter this life with a healthy, sound constitution. But thinking man, how thoughtlessly does he enter upon the reproduction of his species. Countless marriages are contracted where common sense tells us that the offspring will inherit a scrofulous, tuberculous, cancerous, syphilitic, or rheumatic constitution. As a general rule, very little attention is given to any advice in regard to marriages, yet it is a duty of the physician to advise the unmarried to look out for a healthy mate and never contract marriage with one of feeble, sickly constitution. And remember that a predisposition to tuberculosis may be transmitted to the offspring not only from consumptive' parents, but that children of drunkards, or of those affected by syphilis, cancer, nervous exhaustion, rheumatism, etc., may develop the tubercular diathesis.

For this reason marriages between sickly, feeble persons are to be deplored, and should be prevented by all honorable means. Next to be considered are cases where marriage exists with the predisposition to tuberculosis present in one or both parties. Some assume, that in those cases the children are doomed, and sooner or later will fall victims to the dread disease. This gloomy aspect is erroneous, and with proper attention to hygiene, sanitation and climate, many of these children will grow up healthy and the bacillus tuberculosis will be harmless to them. Proper hygiene, sanitary and climatic influences are undoubtedly efficient; however, we, as homoeopathic physicians, are able to do far more. We know that our constitutional, homoeopathic remedies attack the evil at the very root, affecting the cell life in the tissues. In young, growing children this effect produces a gradual normal development of the cellular structures, and ultimately the predisposition to any constitutional disease may be greatly, or even entirely, eliminated by this treatment. Therefore, we recommend the proper hygienic and sanitary measures

PULMONARY CONSUMPTION.

3

and besides institute a homoeopathic, constitutional treatment. Time does not permit to outline the treatment; however, I wish to mention the names of a few remedies. Sulph., calc. -carb., calc.-phosph., hep.-sulph. calc., silic., phosph., iod. -arsen., con., aur. met., baryta carb., thuja occ. mercury, the mineral acids, etc. These remedies are all old acquaintances needing no introduction. Their reliability and trustworthiness are known wherever homœopathy is practiced.

As to the question, whether a predisposition to tuberculosis may be acquired without any tubercular taint in the ancestors, the general opinion of the profession is in the affirmative. That unhealthy influences tend to develop the predisposition, no one will deny; however, it is true, as stated in Arndt's System of Medicine, that "in each case there must be added an indescribable something for them to work upon, else few persons would escape. What constitutes this indescribable something has not been discovered yet, and, until it is, all we can do is to point out the danger which may arise from unhealthy conditions like the following:

"A vitiated atmosphere, changeable, moist climate; a long residence in limestone regions, poor food (this condition exists as well in the wealthy as in the pauper classes); debilitating diseases and conditions, like miscarriages, parturition, over-lactation in feeble women, typhoid fever, la grippe, syphilis, mental depression, extreme bodily exercise, cessation of habitual discharge, as from anal fistulæ or old ulcers. Farther, as local causes may be mentioned: dusty trades and occupations, like stonemasons, needle grinders, cotton and wool carders, porcelain workers, coal miners, potters, etc. Bronchitis, pneumonia, pleurisy, hæmoptysis, chronic pharyngitis, etc." If we are able to remove these causes and to build up the general health of the child or person, we have every reason to believe that a tubercular diathesis will not develop.

Finally we come to consider those cases with a fully-developed predisposition. In these cases the bacillus tuberculosis once introduced is apt to live, and continues to live, until all life is forced out of its victim. Can there be anything done to hinder the introduction of the bacilli into the system of such a person? Yes, one preventive measure of great value is at our disposal in

such cases. It is not a medicine, but it is a suitable climate, with abundance of pure air; the purer the air the lesser the chances of infection. This opens a wide field for investigation. Where shall we find that pure, invigorating atmosphere, without any infectious, poisonous microbes? Is it in the crowded tenement houses of our large cities; or in the dusty workships of the manufacturing towns; or in the meetings of churches, schools, halls, theaters, etc.? Beware of all those places, if you know that your thoracic cavity is a savings-bank for tubercular deposits. Those deposits, although infinitesimally small, will draw a compound interest and grow enormously fast; and, in the same ratio as they grow, your stock of healthy lung tissue goes way down below par. Thanks to heaven, in this vast country are locations as salubrious and congenial for consumptives as in any part of this globe. Investigation as to the value of dif ferent localities as health resorts are pushed now vigorously by individuals and societies, and ere long we shall be able to prescribe with accuracy a suitable climate and locality for every individual case.

To those who can not change the climate, and have to expose themselves to insalubrious surroundings and morbid influences, the inhalation of compound oxygen, or artificial ozone at home, will be beneficial. In nearly all these cases a judicious homoeopathic medicinal treatment, in order to build up the general health, will be followed with happy results. The introduction of the bacilli into the system takes place mainly through the inspired air; yet many cases are on record where, it is conclusively proved, that tuberculosis was conveyed to the human species by the use of milk from cows affected by perlsucht (tuberculosis). These facts known, the following rules should be observed: 1st, As the sputa of consumptives in a dry state scatters the infectious germs `far around, great care should be taken to disinfect all expectorations, and not allow them to become dry. 2d, As to the milk from unknown sources, occasionally used for children and infants, it should always be boiled before using, or canned sterilized milk should be used. A hundred and more things can be done, and a hundred and more things can be avoided, in order to prevent tuberculosis, but time does not permit to enter into fuller details.