THE HYGIENIC TREATMENT OF CONSUMPTION. 85 



on, however, it must be done in a very large room, freely ventilated, 

 and scrupulously free from dust ; for, the more exercise the body takes, 

 the more air it requires, and the less of incumbrances in the way of 

 mechanical obstacles to a free respiration. In damp days, when walk- 

 ing out-of-doors is impossible, the consumptive child may thus have 

 three hours' dancing with advantage ; not in stuck-up bowing and 

 scraping, finnicking, polite quadrillism, but in good active dances, that 

 make every limb feel pleasant fatigue. 



In the performance of muscular exercise let the consumptive never 

 encumber himself, nor check the free movements of his body, by strap- 

 pings, loads of clothes, carrying of weights, and the like. These are 

 but tasks ; they lead to unequal exertion in special sets of muscles, and 

 to an inequality of expenditure of power which ought to be avoided. 



A last consideration on the value of muscular exercise is, that it is 

 eminently useful in keeping the respiratory muscles in a state of active 

 nutrition. For, if to the loss of capaciousness in the lungs to receive 

 air there is added a daily increasing failure in the muscles by which 

 the acts of inspiration and expiration are carried on, it is clear that a 

 double evil is at work. Now, this double evil is most actively pre- 

 sented in consumption. As the respiratory muscles, together with the 

 other muscles, lose their tone, so do the general symptoms of exhaus- 

 tion increase in severity, sometimes without very marked change in 

 the pathological condition of the lungs. In sequence, day by day, as 

 the nutrition of these muscles decreases, and as they fail in tonic con- 

 tractile power, they gain in excitability ; so that the irregular spas- 

 modic contractions to which they are subjected in the act of coughing 

 are produced by the merest excitement, and the cough is more frequent 

 as it becomes more feeble. 



Rule III. A Uniform Climate is an Important Element in the 

 Treatment of Consumptives. — Consumptive patients are constantly 

 asking questions as to the value of a change of climate. The poorest 

 applicants for relief are anxious on this point, and are often ready at 

 once to contemplate emigration, if the merest hope is given to them 

 that such a course would prove beneficial. In considering climate, the 

 fact should be remembered that the main point to be obtained is to se. 

 lect such a part of the earth's surface as presents the nearest approach 

 to an equality of temperature. Different writers of eminence have 

 given the most contrary opinions on climate and consumption. Some 

 have recommended a warm climate,' others the polar regions. Both 

 parties have spoken from experience, and they are, in some measure, 

 both right ; for a climate equally cold and a climate equally hot are 

 each much more favorable than one in which there are constant varia- 

 tions, and where the thermometer in the course of the year ranges 

 many degrees from freezing-point up to 100° Fahr. or higher. Speak- 

 ing of 153,098 deaths from consumption occurring between the years 

 1841 and 1851, the Irish Census Commissioners observe : 



