NA TURE 



35 



THURSDAY, MARCH 9, 191 1. 



WHAT CONSUMPTIVES OUGHT TO KNOW. 

 ' x) Advice to Consumptives, Home Treatment, After- 

 Care and Prevention. By Dr. Noel Dean Bards- 

 well. Foreword by Dr. C. T. Williams. Pp. xv + 

 144. (London : A. and C. Black, 1910.) Price 

 IS. 6d. net. 



(2) Consumption, its Prevention and Home Treat- 

 ment. A Guide for the Use of Patients. By Dr. 

 H. Hyslop Thomson. Pp. 75. (London : Henry 

 Frowde, and Hodder and Stoughton, 1910.) Price 

 2s. net. 



(3) Open Air at Home : Practical Experience of the 

 Continuation of Sanatorium Treatment. By Stan- 

 ley H. Bates. With introduction by Sir James 

 Crichton-Browne, F.R.S. Pp. 62. (Bristol : John 

 Wright and Sons, Ltd. ; London : Simpkin, Mar- 

 shall, Hamilton, Kent and Co., Ltd., 1910.) Price 

 2s. 6d. net. 



(4) The Expectation of Life of the Consumptive after 

 Sanatorium Treatment. By Dr. Noel Dean Bards- 

 well. Pp. V+130. (Edinburgh, Glasgow, and 

 London : Henry Frowde, and Hodder and Stough- 

 ton, 1910.) Price 35. 6d. net. 



/^NE of the most important features of the modern 

 ^^^ crusade against consumption is the attempt that 

 has been made by those who are actively engaged in 

 treating patients in sanatoria to make provision for 

 the training of these patients in suitable methods of 

 carrying on home treatment, after-care, and preven- 

 tion. These skilled men see that it is impossible for 

 most of the patients who have come under their 

 charge to remain in the sanatorium for a sufificient 

 length of time to ensure complete or permanent cure, 

 and they desire to make the sanatorium a school in 

 which the patient may be trained so to live and regu- 

 late his work that he may become and remain a useful 

 and productive member of society. No one is better 

 able to give such advice than is Dr. Bardswell, the 

 medical superintendent of the King Edward VH. 

 Sanatorium, and in the little unpretending book (i) 

 now before us we have in few words and practical 

 form just such advice as the consumptive requires. 

 Dr. Bardswell begins by pointing out the difficulties 

 of laying down general rules for the treatment of 

 individual patients, but shows that when principles 

 are sound the details can gradually be fitted in ; the 

 general principles as laid down by Dr. Bardswell are 

 the following : — 



" I. Raising the general health of the consumptive 

 to its highest possible pitch, thus restoring his power 

 of resistance and arresting the disease. 



"2. Maintaining it there long enough to justify 

 the assumption that the disease is cured." 



Dr. Bardswell indicates that although the first part 

 of the process may be effected during a stay of some 

 three to six months in a sanatorium, the second por- 

 tion of the cure rests with the patient himself, the 

 twelve months following the patient's discharge from 

 the sanatorium being the really critical period of 

 treatment. 



NO. 2158, VOL. 861 



Fresh air, without cold or discomfort is his first re- 

 quirement ; open windows, shelters and chalets, half- 

 holidays and holidays in the open, and a change of air 

 whenever possible. Health resorts and sea voyages, 

 if judiciously indulged in, may be very useful, but 

 they are by no means essential, and, indeed, where 

 they involve fatigue may be actually harmful. The 

 chapter on food is extremely practical and very con- 

 densed, and those interested in the subject may well 

 peruse it carefully. Dr. Bardswell is of opinion that 

 the consumptive is best without any alcohol at all, 

 though he thinks that when convalescence has been 

 thoroughly established there may be 



"no harm in substituting a glass of beer or some 

 light wine for the milk at meals. This is as far as 

 I would go. Spirit in any form and at any time, but 

 especially so between meals, should be absolutely 

 avoided." 



In the suggestive chapter on rest and exercise it 

 is laid down that anyone suffering from pulmonary 

 tuberculosis, or who has so suffered, should abstain 

 entirely from any game or sport which entails sus- 

 tained and severe physical exertion or sudden and 

 violent muscular effort, whilst the ordinary indoor 

 recreations, unless they can be adapted to the open 

 air in fine weather, should certainly be demitted dur- 

 ing treatment and convalescence. Smoking, especially 

 before meals, should be avoided except in great 

 moderation. Moreover, if there is any tendency to 

 weakness of the throat smoking is absolutely nega- 

 tived. 



It will be seen that Dr. Bardswell is essentially 

 practical in directing special attention to those points 

 concerning which the consumptive so often requires 

 advice and encouragement. Hints as to clothing, an 

 account of the sanatorium treatment, the principles 

 of which have to be carried out in the patient's own 

 after-life until health is thoroughly established, occu- 

 pation, emigration, infection, disinfection, are all 

 carefully dealt with. The last couple of pages give in 

 concise and admirable form advice which will be use- 

 ful not only to consumptives but to those who, with- 

 out becoming valetudinarians, wish to remain physic- 

 ally and mentally sound and vigorous. The man who 

 lives by the thermometer and with the help of various 

 nostrums will find in this book nothing to encourage 

 him, but the man who believes in good, sound, 

 common-sense and a healthy, active life will derive 

 great encouragement from its perusal. 



(2) The reproach sometimes cast at the medical 

 specialist, that he is too theoretical and pays but little 

 attention to the practical details and surroundings of 

 his patient, can certainly not be laid at the door of 

 Dr. Hvslop Thomson, who, in a small compendium, 

 gives a series of very practical hints which may be 

 read with very great advantage by those who are 

 recovering from consumption. This little work is 

 another sample of the book that removes all excuse 

 for ignorance, even amongst the laity, of the more 

 important facts and factors to be noted and observed 

 concerning the cause, course, treatment, and result 

 of tuberculosis. Lowered vitality, inherited suscepti- 

 bility, exposure to infection, the nature of infection, 



r. 



