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they do not comprise, as far as respects the unprofessional reader, all the information that can be given him; and, with regard to my professional brethren, they will be ready to admit, that the lessons of experience are never more required, that their judgment is never more severely taxed, than in their treatment of the varying phases, stages, and subjects of a disease which continues nearly as intractable as ever. Even that ingenious invention, the Stethoscope, can tell us little, if anything more, than the premonitory* symptoms, on which every experienced physician previously, and, for the most part correctly, grounded his opinion and practice; and, beyond this, I am not aware that modern discovery can fairly be said to have taken a single step in advance. Numberless are, indeed, the Essays which have made their appearance since Abernethy modestly placed his views before the public; but still the same sad tale remains to be repeated—that there is no cure for pulmonary consumption. You may guard against it, you may arrest its progress, you may relieve many of its symptoms, but

there is no cure.

* The permanently quickened pulse and respiration are among the earliest premonitory symptoms. There was a third test, applicable to many diseases besides Phthisis, to which Abernethy did not fail to call the attention of his pupils; a test of more importance, perhaps, prior to the use of the Stethoscope, but still by no means to be set aside. It is this-in healthy respiration, the process is carried on by alternate expansion and compression of the chest both laterally and longitudinally. If the chest itself be the seat of disease, the lateral action will be favoured by the increased action of the diaphragm downwards; if, on the other hand, the mischief lie below the diaphragm, the lateral expansion will predominate. I do not think that this criterion, obvious and natural as it is, has been attended to sufficiently-and I can truly say that I have adopted it satisfactorily and very usefully in innumerable instances.

It is true that, among my manuscript notes taken during my attendance on Abernethy's Anatomical Lectures, in his spring course of 1803, I find the following:"There are very few subjects wholly without tubercles in the lungs, so that phthisis ought hardly to be looked upon as incurable." But the fact alluded to does no more than show, that the disease, in its early stages, may become stationary. Besides, as Abernethy further justly observes, tubercles exhibit great diversity in their structure and character, so that the term incurable may not be so applicable to some varieties as to others, nor strictly applicable, perhaps, to the disease under any modification, in its earlier stages. Abernethy has occasionally found the lungs, upon dissection, so beset with tubercles, no bigger than millet seeds, as to be rendered almost solid; and such is probably their state previously to what has been called galloping consumption; for whenever, under such circumstances, any irritation assails them, with consequent inflammation, the patient, scarcely able to breathe from the beginning, soon falls a victim to this, the last, probably, of many similar attacks, each having more or less abridged the capacity of the lungs for air, yet appearing from time to time to go off, as any ordinary cold might do; till the consolidation had become such, that at the next accession of fever, there was neither space left for admission of air enough to support life, however quick the breath, nor for the circulation of the blood, however rapid the pulse. This, as I have had occasion painfully to witness, is by far the most distressing, but happily it is by no means the

ordinary, termination of pulmonary consumption. For, not unfrequently it happens that the mind continues, to the very last, to be cheered with intervals of hope and pleasurable sensation, which still rather tend to gild the prospect altogether with a brighter and holier radiance, than to keep it too exclusively or intensely entangled with its former associations and attachments.

At the time of my revising this part of my memoir for the press, the hopes and fears of the nation have been kept in a state of painful suspense, by the severe illness of the Queen Dowager. I have anxiously watched the bulletins ; and having weighed them in the balance, in accordance with the preceding remarks, I am free to confess that, leaning at first more towards fear than hope, I have nevertheless been prepared for either alternative" to rejoice with those that do rejoice, or to weep with them that weep."

The chance of Her Majesty's recovery appears to have turned upon the precise point, whether or not the substance of the lungs themselves was so implicated in the attack, as to carry on the suppurative process after the mucous membrane of the windpipe, and its ramifications, might have regained that ordinary state of repose to which the curative means of good Queen Adelaide's physicians were, no doubt, directed.

The "Times," of the date of November 19, 1841, contained the following interesting information, purporting to come from a correspondent at Sudbury :—

"The health of the Queen Dowager has for several years been the cause of great anxiety to those immediately in the

royal circle. It is known that in this eminent lady, that change has taken place in the lungs, which is the source of decline or consumption, namely, tuberculous deposit ; and Her Majesty has several times experienced alarming hemorrhage from the same cause. But persons thus afflicted, women especially, often live many years, in delicate health indeed, with cough and occasional hemoptysis, but in tolerable physical comfort and enjoyment of life; and where there is a tranquil mind, and external circumstances are such as to provide every means conducive to the preservation of the health of the patient, a long term of existence may remain. It is needless to point out that Her Majesty's amiable and admirable character, joined with her high station, has thus secured to her a very great probability of long-continued exemption from the final decay of nature. What has been most apprehended is that which has recently occurred-a casual attack of bronchitis, or inflammation of the mucous membrane of the air tubes, from cold. In a person advanced in years, or with weak lungs, such an attack is full of immediate danger, from obstruction of the air tubes. This imminent peril in the case of Her Majesty has, however, fortunately passed by, and now nothing remains but the harassing cough and debility, which there is every reason to hope will gradually disappear; and the latent disease of the lungs, it may further be hoped, will not have had its march precipitated by the present accidental complaint."

There is so much practical good sense and internal evidence of fidelity in the above communication, that I took

full advantage of it to cheer others around me with the hope which I felt it safe myself to entertain; and the result has happily fulfilled the best promise of which the case has time admitted.

at any

The bulletin of November 29th, is the following-" The Queen Dowager has made satisfactory progress since the issuing of the last bulletin, and there is this morning a continued improvement in Her Majesty's symptoms."

The private accounts, at the same time, announced that her Majesty's cough was gradually subsiding, and her rest and strength returning; thus affording her friends (and no Queen ever had more) good grounds for believing that there was a truce, at least, gained; and as the extent of the previous structural change can be known by no one, the day may yet be distant (which God grant!) when this estimable lady shall be called to that account for which, in the opinion of every one, she is so well prepared.*

In the year 1797, Mr. Abernethy published an "Essay on Injuries of the Head," which added greatly to his reputation as a man of sense and accurate observation. It was his opinion that the trephine had been used much. too indiscriminately, whereby additional violence was unnecessarily, and often very prejudicially, offered to the powers of the system. He maintained that the generality of cases of fracture of the skull, even with depression, did

*Notwithstanding the delay which has arisen in the publication of this little volume, I have thought it right to retain the above notice of Queen Adelaide's illness, as likely to prove only the more interesting from the gratifying state of her Majesty's health since that period.

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