TUBERCULOSIS 177 



capacity. During this inspiration he raises his arms from his 

 sides to a horizontal position. He holds the breath for a moment 

 and then lowers the arms during the act of expiration, which 

 should be somewhat more rapid. 



" The second exercise is like the first, except that the upward 

 movement of the arms is continued until the hands meet over 

 the head. 



" In the third exercise the patient stretches his arms out as in 

 the position of swimming, the backs of the hands touching each 

 other. During the inspiration the arms are moved outwards and 

 finally meet behind the back. They are brought forward again 

 during the expiration. This exercise can be greatly facilitated 

 and made more effective by the patient rising on his toes during 

 the act of inspiration and descending during the act of expira- 

 tion. Each respiratory act should be followed immediately by 

 a secondary forced expiratory effort." 



Exercises of this kind should not be taken soon 

 after eating or when greatly fatigued. Abundant 

 ventilation of sleeping- and living-rooms and sun-baths 

 will do much to invigorate the system. When practi- 

 cable, delicate children and individuals already infected 

 by the tubercle bacillus should have the advantage of a 

 favourable climate, such as that of portions of Colo- 

 rado, New Mexico, or Arizona, where one may be 

 out-of-doors nearly every day in the year, and where 

 the continued sunshine and pure invigorating air often 

 work wonders in the way of re-establishing the health 

 of such persons. 



To further enforce the statements made in this 

 chapter, I take the liberty of quoting from a recently 



