NO. I AIR AND TUBERCULOSIS — HINSDALE II3 



of a patient with a very limited lesion is an unknown quantity and 

 has to be determined, whereas a patient with a lesion involving four 

 lobes may remain at work for some time and exhibit a good initial 

 resisting power. 



Dr. Paterson lays very great stress on the temperature taken in the 

 mouth. If this is or has been 99° F. or over during the week 

 preceding admission to the sanatorium, the patient is put to bed 

 after the journey. So long as the temperature remains at 99° F. 

 in the case of men or 99.6° F. in the case of women, the patient 

 is not allowed up for any purpose. So long as the temperature is 

 unaffected by exertion the patient is gradually allowed up for longer 

 and longer periods. Patients with apparently limited disease, but 

 who are in poor general condition and without fever, are allowed 

 to be up all day, but are not permitted to take further exercise 

 than is entailed by walking to and from the dining hall for their 

 meals. The remainder of the day is spent in resting. As their con- 

 dition improves they are allowed to walk half a mile a day, and so 

 on, until a distance of six miles a day is reached. The rate of in- 

 crease in the amount of exercise depends upon such factors as the 

 patient's disposition, weight and appetite. 

 The grades of work are briefly as follows : 

 (A i) Walking from one-half to ten miles daily. 



( 1 ) Carrying baskets of mould or other material. 



(2) Using a small shovel. 



(3) Using a large shovel. 



(4) Using a five-pound pick-axe. 



(5) Using a pick-axe for six hours a day. 



Patients in grades i, 2, 3, and 4, work four hours a day. 



The basket work in which about eight pounds of earth are carried 

 is considered the most important and, as a rule, patients spend far 

 more time in this work than in any other. It brings into use all the 

 muscles. 



Work has a wholesome effect on the mind. If the patient is at 

 first sullen and apathetic, the improvement in physical condition 

 quickly begets a lively and cheerful mental attitude, and one that 

 seeks work rather than to shirk it. 



During 1905 and 1906 the number of patients discharged from 

 this sanatorium was 164, and they all returned to their previous 

 occupations, whatever they happened to be, and not to light, outdoor 

 work. They were fitted by the line of treatment which we have de- 

 scribed for effective wage earning. 



