74 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 63 



it is a general affection which requires general treatment. Of all infectious 

 diseases it is the one in which the individual resistance plays a deciding part. 

 Our first effort, therefore, is directed to improve general conditions and thus 

 to bring about a healing of the local focus by treatment of the entire system. 

 A rational local treatment is necessary as well, provided it is not tog one- 

 sided. 



In cases of spondylitis, or Pott's disease, the children wear jackets 

 having a large fenestrum cut anteriorly, as the vertebrae in children 

 are not much further removed from the surface of the abdomen than 

 from that of the back. After healing is verified by X-ray a celluloid 

 corset is worn. One or two years are required for the cure. Plate 

 29 shows a girl thus cured of pronounced Pott's disease with gib- 

 bosity, and paraplegia and muscular atrophy. There was complete 

 healing after fifteen months of the solar cure which the illustration 

 well shows. 



CASES OF HIGH ALTITUDE TREATMENT 



As illustrations of the good efifect of high altitude treatment, two 

 cases from the practice of the late Dr. Charles Theodore Williams, 

 of London, may be cited. They were both cured at St. Moritz 

 (6,000 feet). 



Miss C, aged i8, was first seen by Dr. Williams, July 20, 1887. 

 She had lost a sister from tuberculosis and she had a history of 

 cough and expectoration for five months and wasting and night 

 sweats for two months ; total loss of appetite and aspect very pallid. 

 Slight dulness, crepitation in first interspace to the right. Ordered 

 to St. Moritz for the winter. In the spring the patient spent six 

 weeks in Wiesen, elevation 4,760 feet. She entirely lost her cough 

 and expectoration, gained twenty-four pounds in weight and became 

 well bronzed, looking the picture of health. Her chest increased 

 enormously in circumference a'nd measured, on full expiration, five 

 inches more at the level of the second rib than before she left 

 England. She stated that she had burst all her clothes. Careful 

 examination at the end of eleven months, when these later notes 

 were taken, showed great development of the thorax and hyper-reso- 

 nance everywhere, but no abnormal physical signs. After more than 

 three years in England the chest measurement had somewhat de- 

 creased. 



Another patient, Miss R., aged 21, was seen in November, 1879, 

 with a history of cough with expectoration, loss of flesh, night 

 sweats, pain in the left chest and evening pyrexia of a month's dura- 



