Respiratory and Cardio-vascular disease
(by Gillian Sheehan)
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Tonsillitis | Influenza | Asthma
Croup (Acute Laryngo-tracheo-bronchitis) | Pleurisy | Pneumonia
Rheumatic Fever | The Common Cold
Now there is nothing wrong with meBefore the advent of suitable antibiotics, after the Second World War, the treatment of consumption consisted of physical and mental rest, fresh air, good food, and freedom from worry. [Boyd, William, An Introduction to Medical Science, p. 93.] Those who could afford to went abroad to warmer, drier climes hoping to halt the progression of the disease.
Except - I think its called T.B.
And that is why I have to lay
Out in the garden all the day.
‘I drive on the breakers. But before I strike, I shall save hundreds, thousands, millions, perhaps by my little trumpets.’Laennec’s invention of the stethoscope was certainly a colossal advancement in physical examination, and hence in diagnosis, but actually did nothing to treat the patient. In real life Laennec suffered from a chest complaint, probably consumption, from which he died in 1826.
‘And lucent syrups tinct with cinnamon’it is obvious to Shaynor that Keats had been a ‘druggist’. And he is correct. When Keats was orphaned at the age of 15, he was apprenticed to a surgeon in Edmonton. In 1816 he became a dresser at Guy’s Hospital and later qualified as a surgeon. It is likely that he had contracted consumption from his mother, who died in 1810. The disease remained relatively quiescent for several years until he went on an extensive walking holiday taking in the English Lake District, the Western Highlands of Scotland and ascending Ben Nevis. On doctor’s orders he cut short this holiday and went home only to find his brother, Tom, extremely ill. After Tom’s death he moved into the house of his friend Charles Armitage Brown. While staying there he fell in love with Fanny Brawne the daughter of a neighbour, and wrote ‘The Eve of St. Agnes’. (When Shaynor goes out for a walk with his girlfriend, Fanny Brand, they go by St Agnes’s Church.) By 1820 Keats knew he was dying. In a final attempt to improve his health he sailed for Naples. He died in 1823 at the age of 25 and was buried in the Protestant cemetery in Rome.
‘The whole trachea quite down to its division in the lungs, was lined with an inspissated mucous, in the form of a membrane, remarkably tough and firm; which, when it came into the lungs, seemed to grow thin and disappear; It was so tough as to require no considerable force to tear it, and came out whole from the trachea which it left with much ease; and resembled more than any thing, both in thickness and appearance, a sheath of thin shammoy leather.’In 1826 Pierre-Fidele Bretonneau described the illness and coined the word diphtherie from the Greek for leather. In 1883, Theodor Albrecht Klebs isolated and described the diphtheria bacillus, Corynebacterium diphtheriae. [Porter, Roy, The Greatest Benefit to Mankind, Fontana, 1999, p.438.]
[Major, Ralph H, (editor), Classic Descriptions of Disease, Charles C Thomas, 2nd edition, 1939,p. 168.]
‘The poison itself (diphtheria) is believed to be intimately connected with, if not to arise in, stagnant pools, foul drains, sewage or privies.’In "A Second-Rate Woman", Under the Deodars, Wee Willie Winkie, (1888), Dora Bent contracts diphtheria. Kipling says she is a baby. But 85 per cent of nursing babies have natural immunity which lasts eight months, so she is probably older than this. [Moore, William, A Manual of Family Medicine and Hygiene for India, Sri Satguru Publications, reprint 1989, p.153.]
[Moore, William, A Manual of Family Medicine and Hygiene for India, Sri Satguru Publications, reprint 1989, p.153.]
‘….the Bent baby has got it (diphtheria), and the whole hotel is upside down in consequence. The Waddy has “set her five young on the rail” and fled. The Dancing Master fears for his precious throat, and that miserable little woman, his wife, has no notion of what ought to be done. She wanted to put it into a mustard bath - for croup! ... The manager of the hotel is abusing the Bents, and the Bents are abusing the manager.’Mrs Waddy has taken her five children away by train. Dora is removed from the hotel . But we are not told whether this is at the request of the hotel manager or on the advice of the doctor. Mrs Hauksbee, very kindly takes her in. She doesn’t think Dora’s parents capable of looking after her during the illness. She calls them ‘a feckless couple’. Part of her treatment would have been to have her in a well-ventilated room, isolated from the rest of the family, where she could have complete quiet and rest to help conserve her strength.
‘there was no sign of the membrane getting to the air passages’.At the dance the doctor meets Mrs Delville and tells her of his concern for the child. It must be the general weakness, (may have been due to heart failure caused by the exotoxin), that he most fears at this time. Mrs Delville leaves the dance and goes directly to Mrs Hauksbee’s house. She finds Dora about to suffocate. The child’s mother and Mrs Hauksbee are too panic-stricken to do anything. She immediately demands a bottle of caustic, and with this she burns the membrane blocking the child’s trachea. If she had dropped the caustic anywhere but on the membrane the result could have been fatal. She is courageous to attempt it, but also extremely lucky. The Doctor is obviously very shaken firstly by the rapid deterioration in Dora’s condition and, secondly, in Mrs Delville’s action:
‘It was the general weakness I feared,’ said the Doctor half to himself, and he whispered as he looked, ‘You’ve done what I should have been afraid to do without consultation.’After six weeks at Mrs Hauksbee’s house Dora has not developed any complications and is able to return to the hotel with her mother. At the end of the story we are told that Mrs Delville’s son had died of diphtheria.
I have Ruddy laid up since Friday last. He has been very ill with Quinsy - but the fever has gone down at length and I hope to have him down stairs tomorrow. He has been patient and cheerful - even amusing, and on Saturday after reading Swinburne, wrote the following verses descriptive of his condition….Are they not comic?:In this condition the tonsils are enlarged and inflamed and covered in spots of pus. Quinsy, is a diffuse inflammation of the whole tonsil that extends into the surrounding tissues. The uvula may be deviated away from the affected side. The cervical lymph nodes, are enlarged and tender. The patient may have throbbing pain in the throat, earache, headache, a constant desire to swallow, but may be unable to do so. With a quinsy, when the abscess bursts or is lanced, there is immediate relief.The Song of The Sufferer[Rutherford, Andrew, Early Verse by Rudyard Kipling, 1879-1889, Clarendon Press, Oxford, 1986, p.53.]
His drink it is Saline Pyretic
He longs, but he shall not eat,
His soul is convulsed with emetic,
His stomach is empty of meat.
His bowels are stirred by blind motions,
His form in the flannel is bound,
He has gargles, and powders, and potions,
And walks as not feeling the ground.
For the doctor has harrowed his being,
And of medicine wondrous the might is;
He suffers in agony, seeing
He is prey to acute tonsillitis.
The treatment in the first stage of the disease must be of the antiphlogistic character, acting on the bowels by means of aperient medicine, such as one or two antibilious pills and a dose of Epsom salts, the warm bath, and, if necessary, an emetic; abstaining from all stimulating drinks or animal foods, applying harts-horn and oil to the throat on a piece of flannel, and covering the whole with a hot bran poultice, so as to encircle the throat, and by inhaling the steam of warm water, or sage tea. Sometimes leeches and blisters are required….This is a disease very liable to return….In such cases blisters are often necessary, or the application of iodine or camphor, and mercurial ointment, to induce absorption….In Kipling’s case, the ‘disease’ appears to have ‘returned’ for in January 1881, while at Westward Ho! he wrote:
I have got something swollen in my neck, they say it’s a gland and I’m regularly blistered with iodine in consequence. It makes your neck look like crocodile-skin and utterly ruins your temper.A few years later when working in Lahore he had a sore throat and in a letter to his cousin, Margaret Burne Jones, 28 November 1885 - 11 January 1886, wrote: :
[Letters, Vol.1, p.8-9.]
Cold fever, Cataplasm. ‘Sister sitting on bed, slapping hot plaster on throat askin’ if it stung. Throat like superannuated organ pipe - Jus’ so. Camphor, Rubinis and balsam of quinine - no balsam of aniseed and Rubinis quinine - no Coleman’s pectoral quinine and Rubini’s plaster of aniseed…This appears to be a deliberate confusion of terms. Rubini’s Camphor Essence or Solution was used for diarrhoea! The dose was 2 to 5 drops on sugar every 5, 10, or 15 minutes according to the severity of the symptoms. Martindale p.275. ‘Pectoral’ means that the substance was used to relieve respiratory problems. Quinine was used, but was not as effective as the salicylates, for bringing down the temperature and relieving pain. Aniseed oil was used as an expectorant and was a common ingredient of cough mixtures and lozenges.
... and then to London to be married in January ’92 in the thick of an influenza epidemic, when the undertakers had run out of black horses and the dead had to be content with brown ones. The living were mostly abed. (We did not know then that this epidemic was the first warning that the plague - forgotten for generations - was on the move out of Manchuria.)I do not know why Kipling associated the influenza epidemic in London with plague in Manchuria. It must have been a strange wedding. Kipling’s only relative present was his cousin, Ambrose Poynter. His future mother-in-law, and sister-in-law, (later Josephine Dunham) were both ill with ’flu and unable to attend the wedding on 18 January 1892. On his side, his aunt Georgiana Burne-Jones and her son, Philip, were ill as was his aunt Agnes. After the church ceremony, Carrie, his wife, left him at the church door as she had to rush off to give her mother medicine and did not attend the wedding breakfast at Brown’s Hotel.
Meantime, every bone in her body ached; her head throbbed; her hot dry hands would not stay the same size for a minute together; and her body, tucked into the smallest possible compass, shrank from the chill of the well-warmed sheets.The sensation that her hands were changing size is not a common symptom of influenza. But it is a sensation that Kipling would have experienced from taking too much quinine when suffering from malaria.
... from some obscure form of chronic bronchitis, complicated with spasm of the glottis.This makes her have very severe attacks of breathlessness when she is unable to speak and feels she is ‘nearly choking to death’. She treats herself with ‘washes, gargles, pastilles and inhalations’. Her younger sister, Miss Elizabeth, is:
... victim to very much the same sort of throat but secretly devoted to another set of medicines...A third sister, Agnes, has also had the condition, and has accidentally fallen out a window and been killed when trying to get more air during an attack. This has been mistaken for suicide. Mr Baxter, a cousin, also has the same affliction which makes him cough and clear his throat frequently. The Narrator, mistaken for a doctor, (as in "An Error in the Fourth Dimension") sees Miss Mary when she has ‘some sort of seizure’ which comes on while she is asleep at night. He says ‘she crowed and whistled as she struggled towards the window’. Also ‘she writhed and fought for breath’
... was knocked down by rheumatic fever and for six weeks disorganised Polder’s establishment, stopped Polder’s work, and nearly died in Polder’s bedroom.Agnes Laiter’s husband in "Yoked With An Unbeliever"in Plain Tales From The Hills (1886), had rheumatism of the heart. (We are not told when he had had rheumatic fever.)
Three years after he was married, - and had tried Nice and Algeria for his complaint, - he went to Bombay, where he died and set Agnes free ...A combination of intermittent fever and a diseased heart valve caused problems in "The Other Man" in Plain Tales From The Hills (1886).
That cursed left-hand cylinder the doctors call my heart‘Pinking past redemption’ refers to an irregular beating of the heart such as occurs with atrial fibrillation. This could be due to coronary artery disease. It could also refer to ventricular fibrillation which frequently precedes death, but in that case the chauffeur would be unconscious and unable to complain about it.
Is pinking past redemption - I am done.
‘Now I will steep myself in camphors and benzoins and the abominable drugs of the merchants.’In 1906, while in South Africa, Carrie had a bad cold which she treated with a vibrator. Apparently Kipling had found it while staying with his parents the previous year. He called it ‘an American notion’. When applied to the side of the nose it was supposed to cure colds. It seems very unlikely that it ever actually worked efficiently. Possibly it could have loosened mucous secretions in the nasal passages and partially relieved the symptom of ‘blocked nose’ that is commonly associated with the common cold.
[Letters, Vol.3, p.79.]
Tonsillitis | Influenza | Asthma
Croup (Acute Laryngo-tracheo-bronchitis) | Pleurisy | Pneumonia
Rheumatic Fever | The Common Cold