4 A HISTORY OF NATIONAL TUBERCULOSIS ASSOCIATION 



pulse and fever, then depletion was demanded by frequent bleeding, low diet, 

 and purges; if in the debilitated state, i. e., with weak, small pulse, with or 

 without night-sweats and hemoptysis, then a sustaining treatment was indi- 

 cated full diet, alcohol, tonics. In either condition the radical treatment con- 

 sisted of exercise in the open air, graduated so as to induce fatigue active 

 exercise if possible, passive, if necessary. In the question of food and air and 

 exercise, it is remarkable how exactly his ideas coincide with ours to-day a full 

 hundred years after." 



The next distinguished student of tuberculosis, one whom we 

 may justly call a pupil of Laennec, was Samuel George Morton, 

 who published his book on pulmonary consumption in I834. 1 Other 

 names which should not be forgotten as American pioneers of the 

 study and treatment of tuberculosis are Leonard Hopkins (1750- 

 1801), James Jackson, Jr. (1810-1834), William W. Gerhardt 

 (1809-1872), Austin Flint (1812-1886). The latter was the first 

 to propose the term "cavernous respiration" for the character of 

 the breathing heard over pulmonary cavities, a form of breath- 

 ing distinctly different from so-called tabular breathing. He also 

 introduced the term "broncho vesicular respiration" to indicate 

 the breath-sounds over areas more or less infiltrated with disease, 

 yet not so consolidated as to produce the tabular quality. 



The first systematic movement toward the study of the causes 

 and prevention of tuberculosis in the United States in relation 

 to topography, geography, and climatology was made by Dr. 

 Henry Ingersoll Bowditch between the years 1850 and 1860. He 

 was then busily engaged in correspondence with medical men 

 throughout New England to determine, if possible, the factors 

 which favored the production of pulmonary diseases. Dr. Bow- 

 ditch was particularly anxious to determine the relation of soil 

 moisture to the prevalence of tuberculosis. 



The first authentic record of the use of the open-air treatment 

 for tuberculosis in the United States dates back to about 1808, 

 when Nathaniel Bowditch, the celebrated mathematician, father 

 of Dr. Henry Ingersoll Bowditch, mentioned above, and grand- 

 father of Dr. Vincent Y. Bowditch, of Boston, treated himself by 

 that then unique method. Professor Nathaniel Bowditch, having 



1 Morton, Samuel George: "Illustration of Pulmonary Consumption; Its 

 Anatomical Characteristic Causes, Symptoms and Treatment," Key and 

 Biddle, Philadelphia, 1834, p. 183. 



