THE HYGIENIC TREATMENT OF CONSUMPTION. 91 



be exposed to cold or hard muscular work, like a draper's shop, or to 

 some occupation of an in-door character. By this grand, ignorant, and 

 fatal mistake, many victims are added to the list of the phthisical class 

 of the community. 



In many in-door occupations a double mischief is at work. The 

 patient is not only confined in an impure air, but is made also to inhale 

 some foreign agent, present of necessity from the character of his work, 

 and with which the air is charged. 



Some sedentary occupations beget a habit of muscular inactivity. 

 Unworked machinery always resumes work lazily, and muscles long 

 left to a passive nutrition respond slowly to the dictation of the will. 

 The physical inertia conquers the mental powers. Hence some pa- 

 tients can not be persuaded to give up their inactive pursuits, even 

 when they have the opportunity. To prescribe to these individuals a 

 walk of two miles a day is felt as a cruelty. Nor are these difficulties 

 met with only in anaemic young girls, bleaching in millinery establish- 

 ments, or in no establishments at all. They extend to men of various 

 sorts : to men of letters, to men given up to sheer indolence, and to 

 sedentary workmen, such as watch-makers, shoe-makers, and tailors. 



On the other side, almost all occupations implying muscular exer- 

 tion out-of-doors, without undue exposure to wet and damp, may be 

 pursued by the consumptive as long as possible, and with advantage. 

 Work keeps the mind occupied and in healthful tune. 



I remember a patient once who, in the first stage of consumption, 

 insisted on coming into town each morning from a considerable dis- 

 tance in the country, to look after his business, and to return home 

 again in the afternoon. It mattered not that the sky looked threat- 

 ening, for he was not afraid of such a trifle, although he thoroughly 

 knew his critical condition. When expostulated with by his advisers 

 (and, I am ashamed to say, by myself, for I was ignorant then of the 

 truths I now state), his reply was : " My brothers and sisters have all 

 died of consumption ; they were coddled up, nursed, carried about, 

 confined to bed, and bound in the cords of helplessness by the kind- 

 est hands, to the satisfaction of the doctor and of all concerned. But 

 they soon died. I inherit the proclivity to the same disease, and I 

 too shall die ; I know it ; but my course is different, for I have 

 made up my mind to die in harness ; I have kept at my business in 

 resistance to all entreaties, and I am the only one of the family left." 

 The plan adopted by this man was right ; he bore the brunt of the 

 disease for months, and is alive and occupied still. 



I recommend all in whom consumption is hereditary, whose occu- 

 pation is in the open air, to take to heart the motto of this man, to 

 make up their minds " to die in harness." They will live the longer 

 for the resolution. 



At the same time, as there is a medium in all things, so is there in 

 work and exercise. Excessive and violent muscular fatigue is next 



