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ARTIFICIAL INFLATION AS A REMEDIAL AGENT

IN DISEASES OF THE LUNGS.

By W. Y. GADBERRY, M.D.,

YAZOO CITY, MISS.

The great uncertainty attending the introduction of new discoveries in the medical profession impresses me with diffidence and distrust of my own judgment, and has delayed for a year the public announcement of a remedy which seems to possess more than ordinary merit. Even now, after assurance of confidence from a distinguished source, I am disposed to withhold much that I would like to say in its favor. I allude to artificial inflation of the lungs as a remedial agent in disease. It occurred to me after reading a history of the use of condensed and rarefied air, that it was expensive and inconvenient, and that the intervals were too long to accomplish the desired effect. I then sought for an instrument which could be used at the discretion of the patient, and one that would be in reach of the poorer classes. One was improvised by removing the spray-tubes from a Richardson hand - ball and bulb-atomizer, and inserting in place of the spray-tube a mouth-tube. After repeated trials on myself, I became satisfied that fresh air could be forced into the lungs in the following manner: insert the mouth-tube into the mouth with the left hand, take a deep inspiration, and with the fingers of same hand close the lips and nostrils, and work the hand-ball rapidly with the right hand so long as the patient can bear it. In a healthy subject the operation is painless, and may be prolonged for a minute or more; but in a subject with disease of the lungs, it is at first disagreeable, though not painful, and the patient complains that he cannot force in much air. Practice soon enables him to pump the air freely into the lungs for a longer period of time each day. After frequent use it affords great comfort to those who suffer from a feeling of suffocation, and have diminished capacity of these organs.

VOL. XXXI.-12

In the fall of 1878 I determined to try the remedy. The first case presented on the 12th of February, 1879, after having undergone a course of cod-liver oil without benefit. The following is the history recorded at the time:

William Lamb, aged 32 years, carpenter, has been losing flesh twelve months; weight in health, 147 pounds; can trace no family taint; now weighs 114 pounds; bas suffered with short breath and pain in the side for three months. Condition now: pulse 110; respiration 36; temperature 102 ; hectic flush and fever; harassing cough; muco-purulent expectoration, containing cheesy matter. Careful exploration of chest revealed tubercular deposit in both lungs, and cavities were suspected, though not positively demonstrated ; bas night-sweats, and sleeps badly. He was taught the use of the instrument, and directed to use it every two hours. February 16th, had used inflation faithfully since the 12th, but gained nothing that he could discover. Dr. J. P. Moore, of this city, now examined the patient carefully, and several times subsequently, and fully concurred with me in the diagnosis. 18th. P. 100; R. 30; T. 101; cough and expectoration increased; sleeps but little. 19th. P. 100; R. 30; T. 991; myoidemia distinct over apices of lungs on percussion. 20th. P. 106; R. 36; T. 1011; has pain in left side, and sleeps but little; ordered five grs. morphine to be divided in ten powders, one to be taken at night. 21st. P. 100; R. 32; weight 114 pounds; sleeps better; gaining strength; spends nearly all his time inflating his lungs. 24th. P. 100; R. 32; weight 118 pounds; works some every day, and feels better. March 1st. He has become quite dexterous in using the instrunient, and inflates his lungs every half hour during the day, and when he is awake at night; ordered to the country with directions to use all the milk he can take, and to work in open air constantly when not fatigued. Before leaving the city, Dr. R. L. Dum, of this place, examined him, and pronounced his case one of phthisis. 20th. Returned to the city after an absence of twenty days much improved ; P. 95; R. 27; gaining strength and appetite. April 5th. Returned after an absence of fifteen days; P. 86; R. 24; weight 123 pounds, a gain of 9 pounds since 12th of February; improving in every respect; works most of the day; carries pump in his bosom, and uses it almost unremittingly; expresses great confidence in its efficiency; has taken the ten morphine powders, but no other medicine; no cough,

pain, or fever. 17th. Absent twelve days; reports himself as feeling well and able to work all day; weight 131 pounds. 28th. Absent thirteen days; reports rapid improvement; P. 76; R. 24; weight 136 pounds; apparently well. May 22d. Reports himself well; weight 142 pounds; gets full wages at his trade; returned his inflator badly worn from use. Lamb continued well, and left the city during the following winter. This man bad youth, vigor of constitution, and good digestion, all favorable to restoration of health, but his improvement was so rapid under inflation, and his recovery so perfect from a condition usually considered hopeless, that I am induced to believe he would have died without it; and as no other agents were employed, the recovery must be attributed to inflation alone. That cavities existed in his lungs was evident from the cheesy muco-purulent expectoration, but they were not positively demonstrated by exploration.

April 12, 1879, John Moyer, aged 56 years, asked the privi. lege of using inflation. He had been sick three years; bad large cavities in his lungs; fever and night-sweats; much emaciated; normal weight 144 pounds; now 118 pounds. His case was hopeless, but he was instructed to use inflation; P. 104; R. 32; T. 102. 18th. Used inflation six days, and feels some better; less pain and more sleep than before using the instrument; P. 92; R. 26; less fever, better digestion, and more strength. He inflated often, and stated that he could not talk freely without cleansing the matter from his lungs, which sometimes had to be repeated several times before his voice could be distinctly heard. It gave him much relief from suffocation, and afforded comfort during the night. He stated that often during the night he awoke with an oppression and difficulty of breathing, which would be immediately relieved by inflating his lungs. His strength and appetite improved, and he was enabled to pass through a long, bot summer without confinement to bed, and with comparative freedom from pain and dyspnea. Some time during the winter he left here for Philadelphia (his former home), forgetting his inflator. On his arrival at his northern residence, he immediately wrote for it, saying that he would suffocate without it. IIis death was reported this spring

Charles Bracy, colored, aged 40 years, had pneumonia, and now has gangrenous abscess with extensive deposit of tubercles.

Having no hope for his recovery, I allowed inflation as an experiment. At the expiration of a week the offensive odor was nearly relieved, and his fevers had abated. No permanent improvement resulted, and he died in about two weeks.

This case is related to show that inflation will, to some extent, disinfect diseased lung tissue.

Cases having received the benefit of internal medication are excluded from this paper for obvious reasons, but the subjoined extract from a letter written by Dr. B. R. Holmes, an intelligent and experienced physician, is worthy of consideration :

Yazoo COUNTY, Miss., April 1st, 1880. Dr. W. Y. GADBERRY.

DEAR SIR: My wife, aged 49, has been suffering for many months with cough, pain in left lung, expectorating from six to ten ounces of pus every night; has evening fever, followed by profuse sweats; no appetite, but a loathing for food; constipation, loss of sleep, and chills recurring monthly. In January last she was examined by two highly cultivated physicians, who diagnosed her case one of consumption; one of whom asserted the existence of a large cavity in the left lung. She has dyspepsia, a disease hereditary in her family; has lost flesh rapidly. She has taken the usual remedies, as malt, cod-liver oil, quinine, iron, podophyllin, etc. After several weeks' use of these remedies, pain developed itself in the right lung just under third and fourth ribs. About this time I consulted you (as I had lost all hope). You kindly offered me your lung inflator, urging a persistent use of the instrument, saying that it would require some time to develop marked effect. The first effects of inflation were increased cough, followed by large expectoration. After the lungs were freed by forced expectoration, she could inflate without pain. At first inflation caused exquisite pain, but at the end of a week she complained much less; nor has she suffered with the right lung since relieved, thus confining the disease to the left lung. I find her now with marked improvement, and have abandoned all drugs. I am using at this time London porter as a tonic and appetizer. Could I prevail on my wife to make more constant use of the inflator, I honestly believe her life would be prolonged. As she is now in Yazoo City, I beg that you see her, and convince her of the necessity of constantly using inflation. I feel certain

that it has eradicated the pain in the right lung, which was constant and acute before using the pump. It forces expectoration until the cavities are cleansed, after which it dilates the torpid air-cells, and gives motion to the vessels about the cavities, which the unaided muscles could not do. She is improv ing in strength and appetite. Can sleep sweetly the better part of the night. In the day she is able to attend to her household duties and the dairy. I am not vain enough to suppose her relieved or cured of consumption by my management of her case; but, thanks to an All-wise Providence, I think she will be spared to me for yet a few years. Her fever and sweats are not prostrating, and she expectorates but little; has more appetite, and better digestion. I must again thank you for the airpump, from which I hope so much, based on the evident improvement in my wife's case, which I honestly believe has been accomplished by the—not assiduous—use of your lung inflator. Very respectfully,

B. R. HOLMES.

May 2d, 1880, Mrs. Holmes continues to improve. The history of this case corresponds with my own observations. From the relief afforded to the right lung, and the improvement of the general health, it is reasonable to infer that if inflation had been adopted in the early stage of the deposit and persistently used, the disease would have been arrested.

The result of Lamb's case, the first mentioned in this paper, was an agreeable surprise, and seemed hardly credible. I accordingly wrote to Dr. J. Solis Cohen on the 5th of May, 1879, detailing my plan of treatment by inflation, and requested him to institute experiments to determine its value. He has kindly performed that duty, and now consents to make known his views, which will settle the question of its utility and range of application.

While observing the effects of inflation, the following notes were written and are now respectfully submitted to the profession:

Inflation forces fresh air into the lungs, expanding unused capillary tubes and air-cells; displaces the residual air and noxious gases; excites cough and expectoration, which removes morbid secretions at once, thereby lessening the danger of infection from unhealthy accumulations, and obviates the necessity for

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