As one of the causes of lung disease is deficient exercise of the lungs, it naturally follows that suitable exercise of these organs constitutes one of the most important measures of treatment. The general means which may be employed for developing the lungs has already been described under the head of "Lung Gymnastics." Too much emphasis cannot be laid upon the importance of giving attention to these measures of treatment. The patient should make it a large part of his business each day to attend to his respiration. At frequent intervals he should expand his lungs to their full capacity (avoiding violent efforts, especially when there is danger of hemorrhage), repeating the exercise at frequent intervals through the day. One of the most observable features of this disease is progressively increasing rigidity of the chest walls and decrease of motion in the affected portions of the lungs. The loss of respiratory power is very readily shown by means of the pneumatometer, Fig. 312. A healthy adult will easily raise the column of mercury of the instrument to 60 or 100 degrees. But we have frequently found patients who could not produce an indication of more than two or three degrees, showing an almost entire loss of respiratory power. The diminished lung capacity is admirably shown by the spirometer, one form of which is shown in Fig. 313. Too little attention has been given in the treatment of consumption to regular and systematic efforts to develop the lung power and capacity, notwithstanding the full recognition of the fact, that their loss is one of the most marked features of the disease. Another means of increasing the lung capacity and power is special exercise, both passive and active, applied in such a way as to increase the strength of the respiratory muscles. Of active exercises some of the best are given under the head of "Swedish Movements." Figs. 332-234. Passive Movements consist chiefly in the rubbing and percussion of the muscles of the chest and back, and in the application to the patient, by an attendant for at least a half-hour daily, of some one of the most approved, forms of artificial respiration. That described elsewhere as Sylvester's method is very convenient for this purpose. Another measure which we would strongly recommend is the application of electricity to the muscles of the chest. The application should be made sufficiently strong to cause contraction of the muscles. The best mode of application is to place the positive pole between the shoulders, applying the negative along the spaces between the ribs so as to cause contraction of the intercostal muscles. The application should also be made to the pectoral muscles which form the fleshy part of the breast. In addition to the other measures described, probably the best of all means of expanding the chest and increasing lung powder is the pneumatic apparatus devised by Waldenburg, the construction and use of which has been described elsewhere. We have now used this apparatus in quite a number of cases and have obtained decidedly beneficial results. We regard it as one of the most important remedial appliances for use in such cases. It is, of course, too cumbersome and expensive to be adapted to the home treatment of this disease; but a simple form of the apparatus may be readily constructed by almost any tinsmith, which will enable the patient to derive nearly all the advantages of the pneumatic method of treatment.

Fig. 312. Pneumatometer.

Fig. 312. Pneumatometer.

Fig. 313. Spirometer.

Fig. 313. Spirometer.