In the cough of phthisis minute doses are of service, but in this particular disease morphine is frequently better replaced by codeine or by heroin, which checks irritable coughs without the narcotism following upon the administration of morphine.
The principal causes of death, both among the white and coloured inhabitants, are diseases of the lungs - including miners' phthisis and pneumonia - diarrhoea, dysentery and enteric. The death-rate among young children is very high.
The most important point in this treatment consists in forced feeding, the want of appetite which is so prominent in many cases of phthisis being regarded as an abnormal sensation not to be regarded; and under the forced feeding, combined with open-air life, many marvellous recoveries are recorded.
In phthisis also, although there may be some expectoration to bring up, yet a good deal of the irritation is in the lung substance, and the efforts of coughing are far greater and more continuous than are required for the removal of expectoration, and they simply exhaust the patient.
Recent investigations have shown an alarming increase in mortality from miners' phthisis in Cornwall, South Africa and elsewhere.
In the United States the bulb is given in doses of 2-2 drachms in cases of bronchiectasis and phthisis pulmonalis.
In dyspnoea due to emphysema, phthisis and asthma, strychnine is of service, given internally in doses of i to 3 minims of the liquor.
The result is that, both in physicians and in the public, a more hopeful attitude in respect of the cure of phthisis has led to a more earnest grappling with the infection in its earliest stages and in every phase, with a correspondingly large improvement in prevention and treatment.
Indeed, in such early stages, and in patients who are enabled to command the means of an expensive method of cure, phthisis is no longer regarded as desperate; while steps are being taken to provide for those who of their own means are unable to obtain these advantages, by the erection of special sanatoriums on a more or less charitable basis.