These directions will suffice for the treatment of hemorrhagic. in general. Upon menorrhagia we shall enter more fully in the article Miele:nom, and shall only in the present place offer a few words on phthisis.
Phthisis ; or Pulmonary Consumption : upon the Cullenian system is made a spe cies of hemoptysis. The impropriety of thus naming a disease from a single, and that only an occasional symptom, must be obvious to every one. But our only duty at present is to describe the disease. This then is generally preceded by more or less of the following symptoms : a slight degree of fever, increased by the least exercise ; a dry burning heat of the palms of the hands, particularly towards evening, and of the soles of the feet towards morning ; moisture of the eyes after sleep ; irregular flushing.; hoarse ness; a dry, troublesome, and sonorous cough, occasioning slight pain or stiches, most commonly in the ides some degree of hardness of the pulse ; lancinating or fixed pains in the thorax ; head-ach ; frequent fainting fits ; some degree of dyspnces, increased on using exercise ; an expectoration of a small quantity of thin, frothy matter ; impaired appetite ; restless nights, and universal dianclination to motion or exercise ; this may be termed the inflammatory or first period. In a short time the fever becomes more severe, with accessions in the after noon or evening, and some remission in the morning ; the pulse, however, is even then quicker than natural : the cough is increased by a recumbent posture, and prevents sleep till towards morning, when a slight moisture appears upon the breast and upper parts of the body; the expec toration increases in quantity, is frothy, and sometimes streaked with blood ; the face is commonly pale, but during the fever the cheeks appear as if painted with an almost circumscribed spot of pure florid red; the feverish heat is augment ed after eating, particularly solids, and on taking exercise ; the burning heat in the palms of the hands and soles of the feet becomes more perceptible ; there is diffi culty of lying on one more than the other side, wandering or fixed pains are felt in some part of the thorax, and the disease is accompanied with lassitude andasperi ty of the temper : the appetite becomes somewhat impaired,and there is frequent. ly vomiting after eating. As the disease ad vances, the hectic fever is established, and the remissions become more distinct, at tended with colliquative morning sweats; an exacerbation occurs about noon, ands slight remission happens about five in the afternoon : this is soon succeeded by ano ther exacerbation, which gradually in creases until after midnight, but after two o'clock in the morning, a second remis sion takes place, and is attended with more or less, sometimes profuse, sweat ing, which greatly debilitates the sometimes, however, the second exacer• bation in the evening is not observed, but the exacerbation which took place about the middle of the day increases till even ing, continues violent until the morning sweat breaks out, when the patient gets some unrefreshing deep; the exacerba tions are frequently attended with some degree of cold shivering, or more fre quently only a sense of chilliness, or in creased sensibility to cold, is perceived, when to the thermometer the skin is pre. ternaturally warm : the expectoration now becomes more viscid, copious, yellow, greenish, streaked with blood, disagrees. ble to the taste, and is discharged in small spherical masses, resembling pus, and is frequently also of an ash-colour ; the cough abates in violence, but not in fre. quency, and is more distressing in the first part of the night, the breathing is abort and quick, and the breath has an offensive smell; the pulse is frequent, full, and tense, or small and quick; the countenance now gives evident signs of wasting, the eyes lose their lustre and brilliancy, sink, grow dull and languid, the cheeks appear prominent, the nose sharp, the temples depressed, and the strength rapidly declines; this may be esteemed the second period : from the beginning the appetite is less affected than could be expected, the body is for the most part costive, particularly after the morning sweats have begun to take place : the urine is generally lugh-coloured, and deposits a curdly pink sediment ; about this period, in females, sometimes sooner, the menstrual discharge ceases, in conse quence of the increasing debility. The
third stage commences with a slight purg ing, which soon becomes a colliquative diarrhea; when this takes place the fe ver, heat, and morning sweats abate; but the cough continues distressing through the night ; the tunics adnata becomes of a pearly white, the tongue appears clean, and with the fences is of a bright red co lour, sometimes covered with aphthz, and generally sore and tender ; the voice grows hoarse, and there is shortness of breath and hiccup, both of which dis tress the patient greatly; the lower ex tremities swell, and retain the impression of the finger. At this stage of the disease, sometimes sooner, the appetite is observ ed to become unnaturally keen, which de ludes the unhappy sufferer and friends : as the disease advances, the diarrhe a. be comes more violent, and sometimes alter nates with the sweats, the strength rapid ly decays, and memory and their• affec tions forsake them ; as the fatal period approaches, they have frequent and long faintings, the hairs fall off, the nails are incurvated; sometimes there are slight convulsions, and a few days before death delirium comes on, and continues till that event takes place, or the senses remain entire, and the mind remains still confi dent and full of hope, till death steps in, and gently puts an end to their hopes and sufferings. As it is a matter of conse quence to distinguish pus from mucus, we shall subjoin the following ingenious experiments of the late Mr. Charles Dar win : 1. Pus and mucus are both soluble in the sulphuric acid, though in very differ ent proportions, pus being much the less soluble. 2. The addition of water to either of these compounds decomposesit ; the mucus, thus separated, either swims on the mixture, or forms large fiocci in it ; whereas the pus falls to the bottom, and forms, on agitation, an uniform tur bid mixture. 3. Pus is diffusible through a diluted sulphuric acid, though mucus is not ; the same occurs with water, or a solution of the muriate of soda. 4. Ni. trous acid dissolves both pus and mucus; water, added to the solution of pus, pro. duces a precipitate, and the fluid above becomes clear and green, while water and the solution of mucus form a dirty-colour ed fluid. 5. Alkaline lixivium dissolves (though sometimes with mu. cue, and generally pus. & Water pre cipitates pus from such a solution, but does not mums. 7. Where **Aims lizi vium does not dissolve pus, it still distin guishes it from mucus, ask then prevents its diffusion through water. 8. Coagula ble lymph is neither soluble in diluted nor concentrated sulphuric acid. 9. Wa ter produces no change on a solution of serum in alkaline lixivium, until after long standing, and then only a very slight sedi ment appears. 10. The muriate of mer cury coagulates mucus, but does not pus. From the above experiments, it appears that strong sulphuric acid and water, di luted sulphuric acid, and caustic alkaline lixivium and water, will serve to distin guish pus from mucus ; that the sulphuric acid can separate it from coagulable lymph, and alkaline lixivium from serum; and hence, when a person has any ex pectorated material, the composition of which he wishes to ascertain, let him dis solve it in sulphuric acid, and in caustic alkaline lixivium, and then add pure wa ter to both solutions ; and if there be a fair precipitation in each, he may be as sured that some pus is present: if in neither a precipitation occur, it is certain that the material is entirely mucus : if the material cannot be made to dissolve in alkaline lixivium, by time and tritura tion, we have also reason to believe that it is pus. To the above ingenious expe riments may be further added, the coagu lation of pus by the muriate of ammonia, as observed by Mr. Hothe, and its globu lar appearance through the microscope ; pus is also of the consistence of cream, of a whitish colour, and has a mawkish taste ; it is inodorous when cold, and when warm it has a peculiar smell.