Answer to a review of M'Dowell's treatise on consumption.

  • M'Dowell, William A. (William Adair), 1795-1853.
Date:
[1844?]
Catalogue details

Licence: Public Domain Mark

Credit: Answer to a review of M'Dowell's treatise on consumption. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    .^ *v The fact that the general impression of the pro- fession, as well as of the community, is adverse to curability, I believe is unquestionable. In alluding to this general scepticism, I may not, in every instance, have adverted to the exceptions; but the quotations throughout the work, and other manifestations of anxiety to sustain myself by authority against the general scepticism, it seems to me, should exonerate me from charges of inordinate desire to seem original, indepen- dently of my positive disclaimer of such preten- sions in my introduction, with the single excep- tion of the above peculiarity. The general impression that consumption is in- curable, is even at the present day, sustained by the highest medical authority in our country; and also the opinion that no improvement has been made in its treatment. Known from the ear- liest times, says Professor Chapman, and stu- died, especially of late, with unexampled dili- gence, and under every advantage, it still proves as intractable in the management as at the dawn of medical science. Being fully established, I doubt whether a cure was ever effected of it. I Not an instance, at least have I seen, and I be- lieve that those who report to the contrary de- | ceive themselves, or the truth is not in tbtm. Efforts directed by talent, and learning, and pa- tient industry, have been rewarded by little suc- cess of any value. They have revealed its mor- bid anatomy, without advancing in any degree our control over it.t The above quotation, I have reason to believe, exhibits a fair exposition of the impression of a vast majority of the medical profession. Aware of this deep-rooted scepticism, in the face of all the light that had been thrown upon the subject, up to the time of writing my treatise; and not on- ly of the incredulity, but of the odium which had got to be attached to pretensions to cure; I thought it best to rest my evidences of curabil- ity of consumption chiefly on the exhibition of the nature of the disease, and of the modus operandi of the remedies used in its cure, rather than on the detail of cases cured. Because in the latter, doubts might arise as to accuracy in di- agnosis. And I confidently believe that the chemical and physiological evidences there ad- duced, will alone suffice to satisfy any intelligent wnprejudiced physician. 1st. That the disease, from its very nature, is necessarily curable. 2d. That the modus operandi of the treatment recom- mended, is precisely adapted to accomplish what the nature of the disease developes to be essential to the cure. 3d. That we have many and conclu- sive evidences of spontaneous cures. The best of all evidences of curability, and conclusive, I think, that if nature's efforts were rationally and appropriately aided, that cures might generally be expected to result. But in our prafession no evi dences, however clear, have heretofore proved sufficient readily to induce general acquiescence in any radical change, however advantageous. A large class, especially comprehending the indo- lent and Ihe conceited—not only in our profession but I believe I may say of every calling!—are commonly found arrayed in opposition to any ex- tension of the limits of the science which is con- tChapman on Thoracic and Abdominal Diseases, 1814. t Even changes in government, from a despotism to a republic, w e generally see violently resis<ed,not only by those interested in the stability, but also amongst the mass who can but be benefitted by the revolution! nected with their pursuits. Looking upon all in- novations, not originating with themselves, wheth- er improvements or not, only as the imposition of additional labors. These violently arrayed them- selves against Jenner for introducing vacination. By these the immortal Harvey was persecuted into penury and misanthropy, in requital for the greatest advance ever achieved in physiology. It then would be folly in me to expect a more mode- rate outpouring of such tender mercies. My ad- vance is neither less revolutionary nor less im- portant to mankind than theirs, and founded in unalterable physiological truths, its ultimate pre- valence is equally inevitable. The revolutionary tendency of my treatment, is not the only revolution which the philosophical labors of the age have achieved, with regard to this much misunderstood and badly managed dis- order. 1st. Until recently the causes of consumption have been so badly understood that temperate climates were esteemed chiefly incident to the disease, and physicians were in the habit of ad- vising a tropical or Southern residence as a chief means of prevention and cure. We now have sta- tistical, matter of fact evidence, that inhabitants of tropical climates are much more consumptive than any others of the world. Those of the tem- perate the least so. 2d. Until recently hereditary predisposition was considered a predominant cause of consumption; by many reckoned a prerequisite, and almost unanimously admitted to be sufficient of itself. This is now by the best evidences attainable on the subject,§ found to be wholly unsupported by facts, a mere delusion of the fancy. 3d. Until recently the tuberculous deposits in the lungs were looked upon with horror, as unnat- ural, malignant, immovable matter. With a great number of physicians such is still the impression. We now have analyses of tubercle by several of the ablest chemists of the world, who are concur- rent in representing it to be composed exclusively of principles that are found as healthy constitu- ents in the body. Being constituted in the propor- tion of not less than 80 per cent, of albumen: identical with the albumen of the blood, and with about one half of the natural solids of the body. The most bland and unirritating and easiest absorbed of any of its solid constituents. 4th. Until recently consumption was considered and treated as a local disease of the lungs. It is now known to be a general disorder of the system. A constitutional disease. 5th. It was until recently considered, essential- ly an inflammatory disease. It is now known, from actual observation, to be wholly independent of inflammatory action, most to pertain indeed to the least inflammatory constitution. With all these radical errors as to the causes and nature of consumption, what reason exists for wonder, that our predecessors should have been radically wrong in their treatment of it? And what better grounds of objection exists against revolu- tionizing their treatment, than of their theories of the nature and causes of the disease. Errors in the treatment of our predecessors mav readily be traced to their erroneous conception of the nature of the disorder. Considering it a local disease, they endeavored to eject the tubercles from the lungs by expectoration. With this view the exhausted and ulcerated organs were irritated' § Louis on Phthisis, 2d edition.