ART. I.-Remarks on Negro Consumption. By A. H. BuCHANAN, M. D., of Columbia, Tennessee.

THERE prevails a disease in Tennessee known as Negro Consumption, which annually proves destructive to many of our black population. The character of this disease is by no means generally understood, and we are frequently asked, what is the nature of this malady? Is it peculiar to the negro? Why is it called " Negro Consumption," &c.? Not long since in consequence of this name, "negro consumption," not being known in the books as designating any known

affection, we were called on for our deposition in a medicolegal point of view, touching the nature of this disease, in a case involving property to some amount. The following are some of the questions put by the attorney: What is negro consumption? What are the symptoms by which you judge of the existence of this disease? Is it peculiar to the negro? Is it the same kind of disease known by the name of phthisis pulmonalis, or consumption among the whites? What causes produce the disease? Is it a curable affection? &c. &c. Now all of these questions, according to the answers given, it can readily be seen, an ingenious lawyer might wield with great effect in his pleadings. But it so happened in the above case that the parties came to a compromise, and we were spared from any further questioning. I shall endeavor however to answer some of these questions, with a view of defining our meaning of the term "negro consumption;" and to describe its nature, shall also give the pathological appearances of some of the cases that have come under my observation. By negro consumption we mean a scrofulous affection which is principally fixed upon the deep seated lymphatic glands, the viscera of the thorax and abdomen, and upon the serous membranes lining these cavities; it is rarely the case that the superficial lymphatic glands of the neck, axilla or groin, are affected in this disease, and we are hence not often aided in our diagnosis by an examination of these parts. The disease consists essentially in an extensive tubercular disorganization of the viscera of the thorax and abdomen. The symptoms of this disease are not very prominent, but to one who has been in the habit of observing the general appearance and movement of those affected with it, they are sufficiently so to characterize it; and towards its close with much certainty. In the commencement, however, the symptoms are particu

larly obscure and doubtful, so much so, that the individual himself scarcely recognizes any alteration in his feelings. He has sufficient appetite, and performs his usual daily labor, and except for a sense of languor and debility, and some slight uneasiness in the chest and abdomen, he feels so well that he would make no complaint. But these symptoms gradually increase, perhaps for several weeks, when his spirits become affected, and with a dull inanimate countenance he still lingers on at work, performing his task with great difficulty: he now begins to attract his master's attention, and he is sent to his cabin, where he remains for several days without exciting any uneasiness about his recovery, for he eats heartily and does not complain except of some slight pain in his chest and abdomen, of weakness and of shortness of breath; but he is entirely unable to work, and has taken up the idea that he is poisoned, (and hence the name of "negro poison,") for it is an idea that invariably infests the minds of all those whom I have examined, whose age renders them capable of reflection. The master also is not unfrequently impressed with the same opinion, and attributes his disease to some article of a poisonous nature administered by a neighboring enemy. It is about this period of the complaint that the physician is sent for; or, as is often the case, that the patient is sent to the physician, and it is now that we can recognize the complaint at once; the symptoms have become sufficiently marked and decided to characterize it with great certainty. The skin is dry and ashy, and the countenance desponding. There is great muscular debility and inactivity, with slight emaciation, and always more or less pain in the chest and abdomen, accompanied with difficult respiration, or as they forcibly express it, "shortness of breath;" this last symptom is particularly manifest if they are hurried out of a walk, or caused to

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ascend a flight of stairs or other ascent. The tongue is generally pale and covered with a whitish fur, though seldom thickly coated; the pulse, if examined while the patient is in an erect position, is quick, hurried, and somewhat tremulous; in the sitting position much more natural; if the patient is made to walk to and fro quickly, the pulse is very much agitated, quick and tremulous; and the heart is often felt to throb and beat with force against the ribs, while the patient literally pants for breath. In some instances the sclerotica may now be observed to be of a pearly whiteness; the appetite remains good, and sometimes even voracious to the very last; the bowels are readily acted upon by medicines, and sometimes they are troubled with diarrhoea, particularly towards the close of the disease; in some instances there is a slight hacking cough with slight expectoration of mucus, and preternatural heat of the skin, with a slight febrile action of the pulse. In the last stages of the complaint, a dropsical effusion takes place into the cavities of the chest and abdomen, and not unfrequently in the pericardium, and sometimes extends to the lower extremities. In some instances this dropsical affection occurs earlier in the complaint. The patient at this time and even before, is particularly prone to sit for hours together, doubled up and leaning forwards with the elbows resting upon the knees, or the elbow upon the knee supporting the head, and to the last hour of life most of these patients prefer the sitting position. The next question, "Is this disease peculiar to the negro?" I unhesitatingly answered no; because I regard it as a scrofulous or tuberculous affection to which all the human race, as well as various other animals, as the horse, ox, sheep, birds, and even insects, are liable but certainly the black race is much more predisposed to that form of the disease which produces the above symp

toms than our white population; so much so, that among us it has taken the peculiar name of "negro consumption ;" and I am certain that until very lately, I have never met with a case among our white population that fully characterized this complaint. That scrofulous affection which is principally confined to the mesenteric glands and called tabes mesenterica, I have occasionally met with in our white race, as well as that called king's evil which principally shews itself in the superficial lymphatic glands, and also other scrofulous affections, as of the joints, eye, &c. But that deep seated and extensive scrofula of all the vital organs of the great splanchnic cavities which is so common and fatal among our black population-sparing neither age nor sex, and in some instances carrying off whole families in a few months, is rarely met with among the white race. This disease, therefore, though not peculiar to the black ruce, is perhaps with sufficient propriety called "negro consumption."

"Is it the same kind of disease known by the name of phthisis pulmonalis or consumption among the whites?" This question cannot be so positively answered; it is one upon which the most learned pathologists have differed and still differ. The question in another shape is, "are all tubercular diseases of the same nature" In the disease above mentioned, (as will be shown presently,) we have that diseased condition of the lymphatic glands which is called scrofula, and that condition of the lungs, liver, spleen, &c. which is called tuberculous disease, and therefore two diseases; or else what Dr. Duncan, Parr and others affirm on this subject must be true-"That each tubercle is a lymphatic gland in a diseased state, the consequence of scrofula;" and we have but one disease, namely, scrofula. Or else, if we have two diseases, they co-exist, increase and disorganize in the same