THE HYGIENIC TREATMENT OF CONSUMPTION. 83 



boldly set open, and be kept open at the top all night. If they are to 

 be closed of necessity, a free chimney-draught must be procured, and 

 an Arnott's valve is always an advantage. The bed should be free of 

 curtains, but a single screen may be placed so as to ward off any direct 

 draught from the door or window. Warmth of body is best secured 

 by woolen bedclothes ; but, if the temperature of the air is below 60° 

 Fahr., it will, with advantage, be raised to that pitch by a fire in the 

 open grate. Gas should on no pretense be burned through the night 

 in this bedroom, and as few other lights as possible, for the patient re- 

 quires all the air that is to be had, and must not be carelessly robbed 

 of it. Above all things, the consumptive person should be the sole 

 occupant of his own bed and bedroom. To place such a one for sev- 

 eral hours close to another person, however healthy, is injurious to both, 

 but especially to the sick. No ties of relationship, and no mistaken 

 kindness, should cause this rule of isolation ever to be broken. 



It has been stated already that the room of the sufferer should be 

 large. It should include, whenever practicable, at least fifteen hundred 

 cubic feet of breathing-space, under all plans of ventilation. If more 

 space can be had, all the better. If less only is obtainable, then the 

 ventilation must be the more carefully attended to. 



When the patient has left his room in the morning — and he should 

 do so early — the windows and doors should be set open, and a current 

 of air be allowed to flow through it during the whole of the day. If 

 the air of the apartment be at a temperature below 60° Fahr., or loaded 

 with moisture, the fire should be lighted two hours before bedtime. 



Consumptive patients frequently ask, especially in winter-time, the 

 value of what are called respirators ; and I have known some poor peo- 

 ple purchase things of this description at what was to them consider- 

 able cost. The use of mufflers, which are, in fact, respirators, has been 

 known for ages ; and Dr. Hales, more than a century ago, recommended 

 a scientifically made muffler for persons obliged to enter into places 

 where noxious gases were given off. Dr. Beddoes, too, as Dr. Arnott 

 shows, pointed out, in the year 1802, that a few folds of gauze held 

 over the mouth and nose made the air warm and moist for respiration, 

 and that such mufflers were, therefore, useful to consumptive and 

 asthmatic persons. The object of the muffler or respirator is this : it 

 retains the heat thrown out in the expired air, and gives up this heat 

 to the cold air that enters in inspiration. In cold, dry weather, the 

 muffler is very useful, and should be worn by all phthisical patients 

 when out-of-doors ; but when the air is moist and cold it sometimes 

 is complained of as embarrassing the respiration. It should then be 

 thrown aside. Any patient may easily make one of these mufflers for 

 himself, for the cost of a few pence, out of a piece of fine wire gauze, 

 cut oval so as to cover the mouth and nose and fixed in the center of 

 a small Shetland shawl, so that it may be tied on like an ordinary com- 

 forter, with the gauze in the center for breathing through. The metal 



