investigating hygienic modes of treatment. Each practitioner should, as his opportunities permit, observe as carefully the effects of his hygienic commands as he does those of the medicines he may prescribe. He should compare also the one mode with the other, and calculate in each case their relative advantages. In this way he will have the opportunity of detecting with greater accuracy the pure effects of medicines themselves; seeing that the action of medicines is greatly modified by the external conditions to which he who takes them is subjected.
Convinced of the importance of the above considerations, I have made it my business for thirty years past to mark out a series of hygienic rules for the treatment of consumptives; and as I have had the best and widest opportunities of carrying out these rules in practice, and as the results have been satisfactory, I lay the views published, originally, while I was one of the physicians to the Royal Infirmary for Diseases of the Chest, once again, and briefly, before the public.
In giving the following rules, I presuppose their general applicability to cases of consumption in all stages of the disease: in the premonitory stage; in the stage when the tubercular deposition is evident; and in the next stage, when the local mischief is much further advanced. In the last stage even, though hope is lost, many of the rules may still be followed out with advantage, for by them the course of the disease is smoothed, and sometimes life is prolonged. In like manner, the rules are generally applicable to those who by hereditary taint are as yet but predisposed to the disease.
Rule I. A Supply of Pure Air for Respiration is the First Indication in the Treatment of the Consumptive Patient.—In all cases of consumption, the attention of the physician should be at once directed to the quality of the air breathed by the patient.
In large cities, and even in small towns, it is next to impossible to get a constant supply of pure air in inhabited houses; for houses are built according to false notions of comfort. "What a nice, cozy room! "is a common expression applied innocently to every place where the greatest care has been taken to make an air-vault, without a "draught," and all ready for being charged with invisible impurities.
In a cozy room the consumptive is bound never to live, nor, indeed, in any one room for great lengths of time. So long as he is able to be out-of-doors, he is in his best and safest home. In the fields, on the hills, wherever the fresh air vivifies, where plants look most vigorous, and animals frisk about in the joy of health, there will the consumptive draw in his choicest medicine, there meet most advantageously the dangers of his disease, and there repair most easily the waste of tissue.
The inclemencies of the weather may temporarily, it is true, prevent the patient from his out-door existence. But even these inclemencies are not so much to be dreaded as confinement in a house. I have
