has little tendency to pass into cell-forms. The original albuminous molescular matter melts into nuclei, which constitutes the tubercle corpuscles, and are developed no further.

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I am persuaded * * that tubercle is a histogenetis and not a histolytis process, and that as such it may be easily demonstrated in every organ which it attacks ;" and he regards tubercle as an exudation, that may be poured out into all vascular textures in the same manner and by the same mechanism as occurs in inflammation, and is incapable of undergoing the same transformation from defficiency of vital power.

CAUSE OF TUBERCULOSIS

Is the weakness or debility from impairment of nutrition. This may arise from any of the following causes of disease:

1st, Loss of blood; 2d, loss of food; 3d, excessive purgation; 4th, breathing impure air; 5th, loss of sleep; 6th, excessive muscular effort; 7th, extremes of temperature; 8th, mental shock; 9th, protracted anxiety of mind; 10th, hereditary diathesis; 11th, syphilis; 12th, variola; and 13th, pustulation.

One or all of these causing a change in the normal proportions of the blood, where the albumen is increased and the febrin decreased—that is, albumen 70-normal, to 100 or more, and febrin 3,5 normal to 1,5-the coloring matter and salts remaining, but little changed or altered in their proportions.

Diagnosis of phthisis pulmonalis is not difficult, even in its first stages, by the assistance of auscultation and percussion in addition to the rational signs.

The RATIONAL SIGNs are shortness of breath, contraction of chest, nervous or lymphatic temperament, general debility, frequency of pulse, heat of skin, cough, expectoration, homoptysis. The chronic character of symptoms, lasting for months and even years—scrofula or other tuberculous tumors found in any other part of the body.

PHYSICAL SIGNS.-Rude respiration, usually at apex of lungs-most frequently of left lung; dullness on percussion; mucus ral; bronchophony; amphoric respiration, and all the usual signs of lobular pneumonia, from which it is most difficult to diagnose of all the other affections of the lungs; but the chronic course of consumption will be sufficient of itself to make the distinction.

The pathological lesions of phthisic pulmonalis are indications of the pulmonary tissues with miliary or gray tubercles, or aggregate or yellow tubercle. The former, as before stated, are white, transparent hard bodies about the size of millet seed, diffused on the bronchial tubes or scattered throughout the lung tissues; the latter several cheesey, waxy, yellow corpustles aggregated together and inclosed in a cyst, filling up the air cells

and diminishing the capacity of the lungs to receive atmospheric air. They ulcerate and soften and pour out their contents into the bronchial tubes, and re expectorated or the fluid portions are absorbed and the calcarious matter remains encysted in the subtissue of the lungs. Where these tubercles suppurate they leave cavities or cloaca into which the air rushes producing the omphoric sound, and from which the air is expelled producing the blowing sound; over which spaces the chest contracts making depressions on the external surface, and a contraction of the ribs. The tumors compress the bronchial arteries and veins, hence hæmoptysis and visicular crepitation in the earlier stages. The tumors soften and lay upon the arteries, hence hæmorhages from the lungs in the last stages of the disease.

TREATMENT..

The treatment divides itself into hygienic and medicative. The hygienic is of the greatest importance and should be tantamount to everything else; for if we effect a cure by medication and pay no attention to the sources of disease, it will return. Then we should begin with avoiding all the causes of disease above mentioned, and anything that will exhaust or depress the natural amount of healthy action; should commit no excesses-live in open, pure air-feed on pure, rich and nutritious food-pay attention to any consecutive disease to remove it as soon as possible, especially diseases of the lungs, pneumonia, pleurisy, bronchitis and catarrh; should not suffer the system to be broken down by hard labor, by watching or by darrhoea; should never go from a cold atmosphere to a warm room, or from a warm room to a cold atmosphere; should avoid all drafts of cold or hot air; should take meals at regular hours of pure, rich food, and such as the stomach can digest and does digest. Nothing that produces dyspepsia should be taken; nothing that produces diarrhea; no venerial excesses should be indulged in; no impure air should be breathed; should not sleep in same bed with a consumptive or where there are supurating sores. Again we say take nothing, do nothing, eat nothing that, will debilitate.

The above may be classed as the negative hygienic rules, and we will now give the positive rules to be followed both to avoid and to assist medication in consumption; rise early, take a morning stimulant of porter, ale, wine or beer, or in tropical districts, coffee, befor leaving your room; dress to suit the season, and usually it is best to have on woolen goods, especially flannel to the skin summer and winter; bathe the whole body once a week in tepid water, washing well; take your breakfast at regular hours, never longer than 9 O. C.; if wearied remain until rested; return to some active labor, walking, riding, or ordinary labor on a farm is the best; jump the rope, exercise on the cross bar, or with dumb bells, especially if confined to room during the day; eat hearty dinners and rest until restored to ordinary strength before returning to usual labor, and work with ease and as

patient as possible; go to bed early, and if cannot sleep, should get up and walk about until a little fatigued, and then retire and the patient will sleep.

MEDICAL TREATMENT.

Nearly everything in the materia medica has been tried in consumption, and has at times and under certain circumstances done good as we readily believe, when we return to the many causes which produce the disease. Anything that will cure any of the diseases flesh is heir to, will assist the cure of cases of consumption resulting from the same; but as an impovished state of the bood or a dyscrasia is the first step in the formation of tubercle, then the first thing in importance is that food that will most enrich the blood. Hence gelatinous and aleaginous substances are of the first importance, and secondly, alteratives or eutrophics.

Then the most important of all medicines are the iodides or oleo-iodides. carbon and oleo-carbons of these we have a great variety, both as food and medicine. The most important of all these is CCD LIVER OIL and COD LIVER JELLEY. This, when it agrees with the stomach, is the most reliable of all our remedies. It should be pure, fresh, not rancid—should set well on patient's stomach. If it is vomited, it should be discontinued or lessened in dose. If it purges it should also be changed in dose or discontinted. The pure pale straw colored oil is the best. The dark is generally rancid and taken from the fish rancid or in a state of partial decomposition. It should in all cases be given in some method to suit the patient's taste. Sweetened water, brandy, vinegar, (being a solvent of tubercle). It is not well borne in the summer nor in warm climates. Hence here in the South it usually purges and depresses our patients instead of doing them good. When cod liver oil disagrees, we may resort to the iodide of potash. I give the following:

Potassæ iodidi, vi drachms.
Syrupi Stillginia, i qrt.

S-Take teaspoonful three times a day and increase dose as much as stomach will bear. Or I give the following when there is fever and hæmoptysis, and this I have found to do more good than anything I have ever used. I believe it to be especially adapted to our climate:

R Olei Terebinthnal, i drachm.
Muscilagi Arabicæ, iv oz.
Sacchari Albæ, ii drch.

S-Tablespooful three times a day. This may be taken for a long time, and I often add two grains of morphine to the above mixture if there is diarrhoea, or much cough and expectoration. I always avoid opiates or emetics in the first stages, and emetics at all times seem to do more harm than good. Morphine may be given in large doses in the last stages, when

I have found the following the most effectural of all prescription in allaying cough and producing sleep:

Syrupi Limonis, i pt.

Acidi Hydrocyani Diluti, x qrt.
Morphine, Sulphate, x grs.

For diarrhea in last stages I give

Bismuthi sub-nitrates xxx grs.
Opli. pulveris xii. grs.

Argenti nitratis vii. grs.
F. pilis, No. 12.

S-One as often as necessary.

I also use iodide of mercury over the abdomen, applied on oil silk once a week with flannel roller and oil silk all the time.

Small blisters to chest over seat of pain. but never allowed to suppurate if possible, two or three days over another surface.

Renewed as often as necessary, preferring to renew them every

I allow my patient to eat freely of honey, sausages, milk, eggs. Drinkegg-nog, regular when the cough is not tight.

Elder Berry wine is very fine, being food and medicine-an active alterative with a diffusible carbonatious stimulant. I cannot leave this subject until referring again to turpentine emulsion, for I have found in it most decidedly good effects. Being induced to give it a thorough trial from its known good effects in typhoid fever and pulmonary hæmorhag. The old tar pill was of the same effect; and, as it has the power to restore the febrin to the blood in typhoid fever, so I believe it acts in tuberculosis in restoring the blood to its normal standard; and, in this connection, I will further state I have used tincture of cantharides and gallic acid, equal parts, for the same purpose, believing the cantharides will, by its action on the tissues, produce an increase of febrin, and by it diurettic effects to remove the serum in the last stages. The gallic acid restrains the discharges from the bowels, and, to some extent, controlling the expectoration. I also have used with benefit the following:

Potassæ nitratis i. drach.
Tinc. cinchonæ

แ guiacci aa. ii. ounces.

S-Tablespoonful three times a day.

The syrup of iodide of iron I have not received any benefit from, nor, I may say, from any preparation of iron except the ferro cyanide. This given in half-grain doses in a tablespoonful of simple syrup, or lemon syrup, I think has done good. Most of the preparations of iron producing fullness of head and heaviness at the stomach.

I have not sufficienly tried the phospates of soda and potassa, according to Churchill's prescription, but so far as I have tried them, they do no good.

I have seen many cases cured by the above treatment that had had severe attacks of Homoptysis, and even with cloacca in portions of the lungs.

I have no means of ascertaining what portion of our population are sul ject to tuberculosis, but think there are less in Texas than any place I ever lived at, notwithstanding our sudden and extreme changes of temperature. Many persons coming from the interior to Galveston take hæmorrhagies of the lungs; but most are cured and look well ever afterwards. Many cases I saw while in the army at this post that I now know to be healthy, stout men. I believe many persons have tubercles in their lungs and are entirely unconscious of them until a change of climate or taking of cold produces ulceration and absorption, and with it fever, which, but for change of climate or taking of cold, would have lived and died without knowing they ever were subject to tubercles.

Since the introduction of the thermometer in the diagnosis of diseases, we have found that in all cases where there are tubercles in the lungs the thermometer will remain from three (3) to five (5) degrees above healthy temperature; that is, the thermometer placed under the the axilar or under the tongue will rise to 1030 or 1080 Far., and never fall below 1000 -990 being considered natural. In doubtful cases this is a great assistance, and during the cure it will indicate as plainly as auscultation the progress we are making.

The sprygmograph is also being used in showing not only the number of beats of the pulse, but the strength and force of the pulse-there being a difference in cases of chronic bronchitis and consumption indicated both by the thermometer and sprygmograph.