EXERCISE AS A REMEDY. 635 



Whatever form of exercise is used, absolute regularity in attend- 

 ing to the calls of Nature must be observed. 



Disorders of nutrition are powerfully affected by exercise, 

 through the voluntary and involuntary muscles as well as 

 through the nerve centers. Respiratory exercises and the exer- 

 cises stimulating respiration and circulation are beneficial in 

 angemia, as are also the scientific application of massage and cold 

 water to promote tissue interchange. By quickening oxygena- 

 tion, the circulation, and the nutritive processes, moderate system- 

 atic exercise causes thin and poorly nourished people to gain in 

 weight as well as in vigor. 



In most wasting and febrile diseases, toxaemias and inflamma- 

 tions, the strength of the patient is needed to combat the circulat- 

 ing poison, heal the local lesions, and keep the vital processes 

 going, and for these reasons, as well as on account of cardiac 

 debility, muscular exercise is contraindicated, in some instances 

 even during convalescence. Heart failure after diphtheria from 

 changing from the recumbent to the sitting posture, and serious 

 and even fatal relapse following too early sitting up after typhoid 

 fever, are notable instances in point. Exercise of the unstri]3ed 

 muscles by friction and bathing may, notwithstanding, be ex- 

 tremely useful. It is noteworthy that under the supporting treat- 

 ment afforded by cold bathing with friction much greater liberty 

 is allowable. Not only do the patients bear well the lifting into 

 and out of the tub, but some eminent physicians do not hesitate 

 to let their typhoid patients sit up to adjust compresses to the 

 body, to step into the tub, and even to walk to it with some 

 assistance. 



Exercise in the open air is of the greatest utility in the 

 prophylaxis of phthisis. After the disease is developed exercise 

 must be used with more caution, and in such a way as not to put 

 great demands upon the vital powers of the patient. Moderate 

 exercise out of doors and gentle respiratory exercises may be 

 made beneficial, especially if directed to their gentle tonic effect 

 and toward the better aeration of the pulmonary tissue. 



There is a large class, especially among women, Avho habitu- 

 ally neglect exercise and lay up large amounts of reserve material 

 in the shape of fat, which becomes burdensome by its bulk, and 

 injurious by impeding the action of the organs in whose sub- 

 stance or vicinity it has been deposited. These people are not 

 always large eaters, but having accumulated a physiological 

 surplus, they have never been able to oxidize it. Exercise of 

 endurance and respiratory exercises are well adapted to aid in 

 burning up this surplus and to improve the health. It may, 

 in addition, be necessary to reduce the ingestive fluids and fat- 

 forming foods. 



