As this disease is characterized in a remarkable degree by progressively increasing debility, no means should be neglected which will contribute in any degree to sustain the patient's strength and reinforce his waning vitality. A nourishing diet, abundance of sleep, cheerful surroundings, a plentiful supply of pure, fresh air, abundant daily exercise in the open air, particularly in horseback riding, exposure to the action of the sun's rays by exercise in the sunlight as well as by sun-bathing, and total abstinence from all depressing influences of every sort, are among the essentials of the hygienic management of this disease. Tonic applications of electricity and the judicious use of bathing, together with the daily employment of massage, frequent inunctions, and all other means of improving nutrition, are necessary parts of the successful plan of treating serious cases of pulmonary disease. Patients should be cautioned in regard to exercise, against exerting themselves to a degree to induce extreme fatigue, and to avoid violent exercises, of all sorts, such as running, leaping, walking, going rapidly up stairs, speaking in a loud tone, or singing for a long time, or in any other way overtaxing the respiratory organs. Care should also be taken to avoid exposure to sudden changes of temperature. Patients accustomed to a warm atmosphere most of the time should in cold weather wear a respirator. When out of doors, they should take especial care to breathe wholly through the nose so as to avoid bringing cold air in contact with the mucous membrane of the lungs, on account of its irritating character. An excellent form of respirator is shown in Fig. 309. By breathing through the respirator the air is warmed before it reaches the lungs, and thus injury is prevented. In the absence of a respirator, an ordinary cotton handkerchief may be used for the purpose with advantage, being tied over the mouth and nostrils in such a way that the air drawn into the lungs must pass through it.

Much undue stress has been laid upon the influence of climate in the cure of consumption. The idea has prevailed that certain climates have a special curative effect upon this disease; but there has been a controversy as to which is the exact climate which possesses curative virtues, since it has been observed that patients get well under the most diverse climatic influences. The diversity of opinion among physicians on this subject has caused some to advise patients to visit Florida, the West Indies, Mexico, and other tropical and semi-tropical regions, especially during the cold season of the year; while others have sent their patients to Minnesota and the Upper Lake regions, and even to more northern parts. A thorough discussion of the subject at a late meeting of the British Medical Association, in which Dr. Bennett and many other eminent physicians took part, led to the conclusion that the chief advantages derived from climates supposed to be favorable to recovery from this disease are uniformity of temperature and opportunity for abundant out-of-door exercise. Climates which are subject to rapid alternations of temperature, or in which the cold season of the year is so severe as to confine the patient within doors, or which in any other way interferes with daily and regular exercise in the open air, are unfavorable to this disease. We think, however, that many of the advantages of a change of climate may be obtained by careful management at home. In the summer season, in this latitude, a consumptive patient may enjoy nearly all of the advantages that can be obtained anywhere, especially if he is able to make a visit of six or eight weeks to the Upper Lake region during the latter part of July and August. In winter, by means of the respirator and proper attention to clothing, abundant, exercise can be taken out of doors; and with sufficient care in regulating the temperature and moisture within doors and securing good ventilation, almost as good conditions can be enjoyed as in any climate to which the patient could go. We speak from practical experience after having carried through several winters patients who have previously found it necessary to spend the winter season in a warm climate.

In conclusion, a word must be said with reference to some popular errors concerning the disease. One of the most prominent of these is the idea that the use of alcohol is one of the most successful means of checking the progress of the malady. Many physicians have encouraged this error, and not a few drunkards have been made such by a physician's prescription, the intent of which was to cure the patient of a grave malady, but the effect of which was to make him the victim of a terrible vice. Evidence is yet wanting to show that alcohol has any curative value whatever in consumption, and there is plenty of evidence to show that the habitual use of liquor is one of the surest means of producing this disease. Within the last few years cod-liver oil has become a fashionable remedy for disease of the lungs. It is now generally admitted, however, by the most intelligent and experienced members of the profession that the advantages claimed for this remedy are by no means substantiated by experience, and that its chief utility, if it has any, is simply due to its nutritive value as oleaginous food. As such, however, it is much inferior to good sweet milk or cream, or any other easily digested animal fat. This has been clearly shown by the experience of many physicians, and the time cannot be far distant when this nauseating and indigestible drug will occupy a much less prominent place than it has heretofore held. Preparations of malt and maltine have lately been introduced. We have used them to a considerable extent, and, we think, with advantage. Many practitioners do not hesitate to pronounce them vastly superior to cod-liver oil. They are certainly much more palatable, and disturb the digestive organs much less.

It is perhaps needless to say that the numerous quack remedies for consumption advertised in the newspapers are wholly without merit. There is no known drug which will cure this disease, or in any certain degree influence its progress. Numerous remedies have been recommended at various times as curative, but not one has thus far stood the test of experience. The reputation acquired by certain popular remedies are chiefly built upon fictitious cases and cases of individuals who may have recovered from some disease which was supposed by the individuals themselves to be of a consumptive character, but which was really of a much less serious nature. What has been said of quack medicines is also true of the numerous domestic remedies for this disease.