Page:Encyclopædia Britannica, Ninth Edition, v. 18.djvu/894

858 H T tt 1 b 1 vidual case ; but it is in this stage of the disease that the question of a change of .climate in the colder seasons of the year arises among those whose circumstances render such a step practicable. There can be no doubt that as regards Great Britain the removal of patients threatened by or already suffering from consumption to some mild locality, either in the country or abroad, proves in many instances most salutary. The object aimed at is to obtain a more equable climate, where the atmosphere may have a soothing influence on the respiratory organs, and where also open-air exercise may be taken with less risk than at home. Of British health-resorts Bournemouth, Hastings, Torquay, Ventnor, Penzance, &c., in the south of England, are the best known and most frequented, and although the climate is not so certain as in places farther south in Europe they possess the advantage of home residence, and may be resorted to by persons who are unable to undertake a farther journey. The climate of the Riviera (Maritime Alps) is of superior efficacy owing to its mild ness and the dry bracing character of its air, and, despite the long journey, is as a rule to be recommended as one of the best for the greater proportion of the cases of phthisis. The same may be said for Algiers and Egypt. Of recent years the air of elevated dry regions, such as Davos in the Alps and the Rocky Mountains in America, has been strongly recommended, and in not a few cases appears to be productive of good in arresting the disease at its outset, and even advantageous in chronic cases where there is no great activity in its progress. Of like value, and in a similar class of cases, are long sea-voyages, such as those to Australia or New Zealand. Nevertheless, there is no doubt that consumptive patients are often sent abroad manifestly to die. It may be stated generally (although doubtless there may be exceptions) that where the disease exhibits a decidedly acute form, even in its earlier stages, any distant change is rather to be discouraged ; while in the advanced stages, where there is great prostra tion of strength, with colliquative symptoms, the removal of a patient is worse than useless, and frequently hastens the end. Throughout the whole course of the malady the nutrition of the patient forms a main part of the treatment, and tonics which promote the function of the digestive organs are especially helpful. Codliver oil has long been held to be of eminent value, as it appears not merely to possess all the advantages of a food but to exert a retarding effect on the disease. Where it is well borne, not only will the weight of the body be found to increase, but the cough and other symptoms will markedly diminish. The oil is as a rule best administered at first in small quantity. The frequently employed substitutes, such as malt extract, tonic syrups, &c., although not without their uses, are all inferior to codliver oil. The occasional employment of counter- irritation to the chest in the form of iodine or small blisters is of service in allaying cough and relieving local pains. Respirators to cover the mouth and nose, and so con structed as to contain antiseptic media through which the air is breathed, are sometimes found to lessen cough and other symptoms of chest-irritation. Among the most serviceable drugs in the treatment of the symptoms of phthisis are the preparations of opium. Administered along with such agents as hydrocyanic acid and expectorants, they are eminently useful in soothing severe cough ; along with astringents they are equally valuable in controlling diarrhoea; while with quinine, digit alis, &c., they aid in allaying fever and restlessness and in procuring sleep. But besides these many other medi cinal agents, too numerous to mention here, are employed with much advantage. Each case will present its own features and symptoms calling for special attention and treatment, and details upon these points must be left to the advice of the medical attendant. (j. o. A.) END OF VOLUME EIGHTEENTH PRINTED FOR A. <t C. BLACK BY NEILL & CO. AND R. & R. CLARK, EDINBURGH.