The Probert Encyclopaedia of Medicine

CONSUMPTION

Consumption, or Phthisis was a name formerly given for various diseases known by emaciation (serious loss of weight), debility, cough, hectic fever, and purulent expectoration, particularly tuberculosis which was unknown at the time. The predisposing causes were believed to be very variable, and around 1900 were reliably listed as: hereditary taint, scrofulous diathesis, syphilis, small-pox, etc; exposure to fumes and dusty air in certain trades; violent passions and excess of various kinds, sudden lowering of the temperature of the body, etc. The more immediate or occasional causes were thought to be pneumonic inflammation proceeding to suppuration, catarrh, asthma, and tubercles in the lungs, the last of which is was by far the most general.

The incipient symptoms usually varied with the cause of the disease; but when it arose from tubercles it was usually marked by a short dry cough that became habitual, but from which nothing was spat up for some time except a frothy mucus. The breathing was at the same time somewhat impeded, the body became gradually leaner, and great languor, with indolence, dejection, and loss of appetite prevailed. At a later stage the cough became more troublesome, particularly by night, and was attended with an expectoration, the matter of which assumed a greenish colour and purulent appearance, being on many occasions streaked with blood. In some cases a more severe degree of blood-spitting attended, and the patient spat up a considerable quantity of florid, frothy blood. At a more advanced period of the disease a pain was sometimes felt on one side in so high a degree as to prevent the person from lying easily on that side; but it more frequently happened that it was felt only on making a full inspiration, or coughing.

At the first commencement of the disease the pulse was often natural, but it afterwards became full, hard, and frequent. At the same time the face flushed, particularly after eating, the palms of the hands and soles of the feet were affected with burning heat; the respiration was difficult and laborious; evening exacerbations became obvious, and by degrees the fever assumed the hectic form with remittent exacerbations twice every day, at noon and evening. From the first appearance of the hectic symptoms the urine was high coloured, and deposited a copious branny red sediment. At this time the patient was usually costive; but in the more advanced stages a diarrhoea often came on, colliquative sweats likewise broke out, and these alternated with each other, and induced great debility.

Some days before death the extremities became cold. In some cases a delirium preceded that event. The morbid appearance most frequently to be met with on the dissection of those who had died of phthisis was the existence of tubercles in the cellular substance of the lungs, most usually at the upper and back part, or occupying the outer part, and forming adhesions to the pleura.

By about 1905 the tubercles were generally attributed to a special bacillus, and this was correctly being regarded as the originating cause of the disease, which could be conveyed from one person to another, that is, it was infectious. In fact, what had been discovered was Tuberculosis, but as it was not yet identified, various diseases were being blamed and the whole grouped under the popular term 'consumption'.

The treatment for consumption at the end of the Victorian era in Britain was based around healthy diet and fresh air, one source quoting: 'The diet should be nutritious, but not heating, or difficult of digestion. Milk, especially that of the ass; farinaceous vegetables; acescent fruits; animal soups; and, above all, cod-liver oil, etc, are usually given. It is also of the utmost importance to see that the digestive organs are in proper working order. As much open air as possible, combined with abundance of nutritious food, is at present the treatment in vogue. With regard to urgent symptoms requiring palliation, the cough may be allayed by demulcents, but especially mild opiates swallowed slowly; colliquative sweats by acids, particularly the mineral; diarrhoea by chalk and other astringents, or by small doses of opium.'
Research Consumption