Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies.

  • Austin Flint I
Date:
1875
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Licence: Public Domain Mark

Credit: Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    The age exceeded 50 years in 38 cases ; 29 of these cases being males and 7 females. The foregoing figures show that in my cases the decades from 10 to 50, enumerated in the order of the relative number of cases, are as follows: 20 to 30; 30 to 40; 40 to 50; 10 to 20. The number of cases over 50 lacks only a single case to be equal to the number between 10 and 20 years. The age of the oldest patient was 78 years. In several cases the age was above 60 years. Taking into account the fact that the number of per- sons living who are above 50 years of age is much less than the number of those between 10 and 20 years of age, the lia- bility to the disease must be considerably greater after 50 years than during the second decade of life. The striking fact in this analysis is the large proportion of cases in which the ages were between 20 and 30 years, the number exceeding one-half of all the cases. This fact, however, is by no means novel. Statistics have already established abundantly the etiological law that the liability to pulmonary tuberculosis is greater between these ages than at other periods of life. My figures are simply in accordance with this well-known law. ]STow a question which has an important pathological bearing relates to this law, namely, why is it that the disease is more likely to be developed between these ages ? Assuredly it is not because during this period of life persons are more exposed to extrinsic morbific causes acting upon the pulmonary organs; nor because other pulmonary affections, such as bronchitis, pneumonia, etc., are of more frequent occurrence. The explanation seems to involve, of necessity, an intrinsic predisposition or tendency which, in the existing state of our knowledge, we cannot explain. This con- clusion has an obvious bearing on the pathological doctrine of the existence of a diathesis, meaning to express by this term simply an intrinsic tendency or predisposition to phthisis. The marked tendency to the development of the disease during a particular decade of life, irrespective of any appreciable de- termining cause, must he considered as evidence of that inap- preciable causative condition which is understood by the term diathesis, a condition the existence of which is not rendered less certain by an acknowledgment of our inability to explain it. The number of males and females respectively is given in the 4
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