NO. I AIR AND TUBERCULOSIS HINSDALE 3 1 



plained above, it may now truly be said that " the air is a physical 

 mixture with the definiteness of composition of a chemical com- 

 pound." ' 



Since the introduction ' into medical practice of oxygen com- 

 pressed in cylinders its use has been tried in tuberculous cases, but 

 no satisfactory results have been obtained and its use is discontinued, 

 except, so far as we know, in the hands of charlatans. 



The inhalation of oxygen gas may not per sc exert any curative 

 action on a tuberculous lung, but that fact should not lead us to the 

 conclusion that the voluntary respiration of an increased quantity 

 of air is not beneficial. It is stated that the air in the central parts 

 of the lungs is richer in carbonic acid than that found in the larger 

 tubes and hence deep inspiration followed by deep expiration causes 

 a larger amount of the air richer in carbonic acid, to be exhaled. 

 From this the conclusion is drawn that increased chemical change 

 will result, for if the carbon dioxide be removed from the air cells 

 its place will be filled by quantities of the same gas which will escape 

 from the blood. Furthermore, the removal of carbon dioxide from 

 the blood facilitates and makes possible those metabolic changes 

 which with a supply of suitable food improve nutrition. 



Nowadays we often speak of oxygen as synonymous with atmos- 

 pheric air and in this sense we give it a prominent place in pulmonary 

 therapeutics. We are tempted to reproduce the placard of an old 

 boot-maker and chiropodist of fifty years ago which read : 



The best medicine! Two miles of oxygen three times a day. This is not 

 only the best, but cheap and pleasant to take. It suits all ages and con- 

 stitutions. It is patented by Infinite Wisdom, sealed with a signet divine. 

 It cures cold feet, hot heads, pale faces, feeble lungs and bad tempers. 

 If two or three take it together it has a still more striking effect. It has often 

 been known to reconcile enemies, settle matrimonial quarrels and bring 

 reluctant parties to a state of double blessedness. This medicine never fails. 

 Spurious compounds are found in large towns ; but get into the country 

 lanes, among green fields, or on the mountain top, and you have it in perfec- 

 tion as prepared in the great laboratory of nature. 



Before taking this medicine . . . should be consulted on the understanding 

 that corns, bunions, or bad nails, prevent its proper effects. 



' See the recent monograph by Benedict, F. G. : The Composition of the 

 Atmosphere with Special Reference to Its Oxygen Content, Carnegie Insti- 

 tution of Washington, Publication i66, 1912. Review in Journ. Amer. Med. 

 Ass., Jan. 25, 1913. 



' The late Dr. Andrew H. Smith, of New York, was the first in the United 

 States to use Oxygen in medical practice, i860. " Oxygen gas as a Remedy in 

 Disease," A. H. Smith, 1870. 



