The leader., 1904-06-18

ily protected from rain, and, IL neces-
sary, from direct draft Furthermore,
the patient can be gradually accus-
toned to the exposure, If that is neces-
sary, and there is no doubt that the
doctor will often meet with oppose
ton from the family which can only
gradually be overcome as the improv-
ing condition of the patient allays the
fears and traditional opposition which
many people show to an abundance Of
air.
The furnishing of this house should
be Of the simplest. A rug by the beds
side, O. table, chair or two, and the
bed. The bed should be simple iron
bed, with comfortable mattress and
springs. The covering should suit the
Temperature, and be so arranged as to
prevent the patient becoming uncov-
cred during sleep. A sleeping bag or
some similar device may be employed
for this purpose. The night clothing
should be of flannel, certainly SO If ithe
patient Is sweating atnight. 1k II
1t is obviously useless to attempt to
heat such q structure as the one sug-
gested, and usually the patient win re-
quire nothing more than an abundance
of clothing. Even in / the coolest
weather nothing more than a hot-wa-
ter bag Is required. The patient should
look upon this house as his home, and
here he should spend his nights and
those portions of the day which are
spent indoors. -
The plan, as outlinetl above. is mere
ly a suggestion. the details must be
varied to suit the circumstances of
each case. It may, for example, seem
best to keep. the patient upon the large,
rear porch of a fiat building, or. upon
the roof of the house. In other cases
1t will be necessary to use a room In
the house, although this should be
avoided. If possible. The essential
thing is to supply the largest pos
sible amount of the best possible aif.
The next Important question is that
of proper food in sufficient amounts
Because of the great variety of indi-
vidual tastes and preferences, or the
frequency WILL WHICH VIC Thu uOI0s vi
less complete failure of appetite and
the great differences in the digestive
powers of the different patients, It is diff
| fcult to lay out any general scheme.
Here, even more than with. the ques-
ton Of air supply, is 1t necessary to
individualize. Each patient should be a
| subject of special study. The patient
should take as much food as he can d.
gest, and usually this is more than the
appetite demands. The food should
be varied in character, simply pre-
pared, and attractively served, Due
attention should be paid to supplying
the various food elements, but the al
buminoids and fats are best supplied
in rather larger proportions than in
the dietary of normal Individual. Be-
cause of the usually feeble appetite, the
food is best served at frequent inter-
walls; for example, the three usual meals
and lunch in the middle OF the fore
noon, about four in the AFTERNOON, and
again before retiring. The amount taken
each time must be varied to suit the
circumstances, but with patience the
amount can be gradually increased I'M
til the total in each "a hours is salts
factory. Care must be taken not to
overdo the matter of feeding, and the
CASTRO intestinal tract must be watched
for evidences Of indigestion, and the
| faces should be examined at intervals
for undigested food particles. 1t Ii
manifestly both useless and harmful
to put into the digestive tract mate
rial in quantities or of qualities which
cannot be handled. The directions
given to the patient should be very
definite and specific. so much of this,
so much of that, ETC., and at such
and such fixed hours Both patient and
doctor should realize that these direc-
lions will often need changing from
time to time, and the doctor should see
the patient at frequent intervals, to see
that all is going we'll with the diges-
tive organs, and that the food sup
ply is sufficient and of proper charac-
ter. The proper feeding of these cases
is the most difficult problem of all,
and requires more patience and intel
ligence than all else combined
The third question Of Importance is
that of exercise. What patients should
exercise, how much, and in what ways!
1t may be laid down as general rule
that cases of tuberculosis with a tenn
perature should not exercise. When
the temperature disappears. exercises
| should be employed, but the amount
and character should be adapted to
each case, and varied from time to
time as the case requires. AS a gem
eral rule, the exercise should be mild,
and for short periods, and always in
the open air. Patient should always
stop well before exhaustion.