Page:The American Cyclopædia (1879) Volume V.djvu/286

 282 CONSUMPTION Asiatic states, where the laws are so imper- fectly administered that the lives and property of foreigners could not be safely left to depend upon them. The ordinary duties of consuls relate merely to commercial affairs, such as the authentication of a ship's papers, receiving and certifying protests of masters of vessels or other persons respecting losses at sea, and giving consular certificates for various pur- poses. It is also required of consuls to attend to and provide for disabled seamen of the country to which they belong, and to send them home at public expense. They are also ex- pected to take charge of stranded vessels or property belonging to their countrymen, in the absence of the master or other legal represen- tative of the owner, and also to take care of the property of citizens of their respective countries who die within their consulates. In the consular convention between France and the United States of 1788, it was provided that our consuls should have judicial power for the settlement of disputes between the master and his crew in relation to wages or other matters strictly belonging to the interior of the ship. It has also been provided in subsequent treaties with several other European nations that consuls shall have jurisdiction over dis- putes between masters, officers, and crews of national vessels, while in a foreign port, on questions of wages, shipment, and discharge of seamen. The duties of consuls of the Uni- ted States are defined in several acts of con- gress, embracing what has been above speci- fied. Instructions in writing are generally given to them on their appointment. They must be recognized by the authorities of the country to which they are sent, and receive an exequa- tur before entering upon their duties. A con- sul is not, by the law of nations, entitled to the privileges of a public minister, and is sub- ject to the laws of the country where he resides. In the Turkish dominions consuls enjoy the same immunities as ministers at Constantinople. CONSUMPTION, in popular acceptation, and as used by physicians, a term denoting certain af- fections of the lungs, involving in general more or less destruction of these organs, together with progressive emaciation, and in a very large pro- portion of cases ending fatally. The term has been sometimes used to denote affections of other organs, but its meaning is now restricted as just stated ; and although the word pulmo- nary is often prefixed, this word is understood wherever the term is used alone. The name derives its significance from the consuming effects as regards the lungs, and the wasting of the whole body. Another popular term is u the decline,' 1 which has a similar significance. A technical name is phthisis, or phthisis pul- monalis, the etymological sense of which is the same as consumption. Tuberculous or tuber- cular disease of the lungs, and pulmonary tu- berculosis, are other synonymes, relating to certain characteristic morbid products within the lungs. There are still other designations which late writers have proposed, namely, tu- berculous pneumonia, cheesy pneumonia, chron- ic lobular pneumonia, and catarrhal pneumonia. All these concur in calling the disease a pneu- monia, that is, an inflammatory affection of the lungs ; and the different words prefixed are in- tended to distinguish this disease from other forms of pneumonic inflammation. The im- portance of this disease is evident when its fatality and prevalence are considered. The proportion of recoveries from it is small. It prevails to a greater or less extent in almost every portion of the globe, and if those dis- eases which prevail as epidemics or endemics be excluded, it occasions a larger proportion of deaths than any other disease. Statistics show that of the population of Great Britain, France, Germany, and Russia, numbering less than 200,000,000, the annual deaths from this disease are about 870,000; and that of the people inhabiting the globe at least 3,000,000 die each year from this disease. In the great majority of cases consumption is of long dura- tion; it is therefore eminently a chronic af- fection. There is, however, an affection called acute consumption, acute phthisis, or acute pulmonary tuberculosis, which runs a rapid course. It is always fatal, and the duration may not extend beyond a few weeks, and sometimes death takes place within a few days from the first manifestations of disease. This affection is extremely rare. Prominent symp- toms are rapid breathing, distress from a sense of the want of breath (dyspnrea), a livid colora- tion of the lips and face, together with more or less cough and expectoration. With these symp- toms are associated high fever, as denoted by the pulse and the temperature of the body, great prostration, loss of appetite, and pro- gressive exhaustion. After death the lungs are found filled with small round bodies which, from their resemblance in size to millet seeds, are commonly known as miliary tubercles. Other names are gray tubercles and semi- transparent granulations. The latter name is applicable to them only at an early period after their production. In a short time they become opaque and comparatively of soft con- sistence. Some pathologists of late propose to limit the term tubercles to these bodies, and consider that their presence is essential in or- der to constitute a truly tuberculous affection. Consumption in its ordinary form, that is, as a chronic affection (the sense in which the term will be used in the remainder of this ar- ticle), is distinguished by other and widely dif- ferent changes found after death. Generally the lungs contain cavities more or less numer- ous and varying in size, called by the older writers vomicce. These are irregular in shape, and frequently they communicate with each other. Of course they involve an amount of destruction of the pulmonary structure propor- tional to their number and size. In addition to cavities, usually portions of the lungs are found to be solidified by the presence of a