CONSUMPTION. 195 



Imperfect digestion, and the resulting mal-nutrition, favour the occurrence of 

 the disease. It is probable that a bad set of teeth, by preventing the proper masti- 

 c; it i<>u of food, is not without its influence. Some doctors lay great stress on a 

 driiciency of fat in the system, as a cause of consumption. It is an undoubted fact 

 that most consumptives have a great dislike to fat, and will not eat it unless abso- 

 lutely made to do so. 



\V:int of proper ventilation and fresh air undoubtedly tend to produce this 

 disease, hence its frequency amongst those whose occupations compel them to remain 

 shut up in the same room for many hours at a time. It is of common occurrence in 

 ill-ventilated institutions where many people are gathered together. For the main- 

 tenance of health a liberal supply of pure fresh air is essential. 



It has always been a disputed point whether the practice of wearing stays 

 favours the development of consumption, but the weight of evidence goes to show 

 that it has no such tendency. 



It is an undoubted fact that consumption is more frequent in temperate climates 

 than in very cold or very warm ones. It is by no means common in Russia and 

 Canada, notwithstanding the long continued cold, nor is it prevalent among the 

 nations of the tropics. Some favoured spots are stated to be free from phthisis, for 

 example, the islands of Lewis and Mull among the western isles of Scotland. In 

 Ireland too the disease appears to be singularly rare. Probably the most antagonistic 

 influence to the existence of consumption is exercised by the climatic conditions of 

 extreme altitudes. We are told that in localities in the Andes, 7,000 feet and up- 

 wards above the sea-level, where the air is dry, the temperature about 60 in the 

 shade, and the sky sunny throughout the greater part of the year,' consumption of the 

 lungs is known only as an exotic. 



There is strong evidence to show that humidity of the air exerts a powerful in- 

 fluence in the production of consumption. It is undoubtedly common in Holland 

 and other countries liable to damp fogs and an atmosphere saturated with moisture. 

 In many towns in England the death-rate from consumption is in inverse proportion 

 to the dry ness of the site. By many it is considered that a judicious system of 

 sub-soil drainage would in time almost stamp out our national malady. 



Severe mental depression, as from anxiety, grief, or over-study, seems to have 

 considerable influence in some cases. Phthisis is by no means uncommon among the 

 inmates of lunatic asylums. 



Phthisis may follow other diseases, such as measles, and typhus or typhoid fever, 

 scarlatina, and repeated attacks of bronchitis. In some instances it is probably set 

 up by over-suckling. On the other hand anaemic girls rarely suffer from it, though 

 they are often supposed to be consumptive. The poorness of blood appears to have a 

 land of protective influence. 



In former days it was supposed that consumption was contagious or infectious, 

 but this is an exploded idea. At the same time a phthisical patient should not be allowed 

 to occupy the same bed as a healthy person. A widow or widower whose partner may 

 have died of consumption is not more likely than any one else to suffer from it. 



The general symptoms of consumption are cough, expectoration, spitting of blood, 

 shortness of breath, night^sweatings, and general wasting. Some or all of these are 



