As™ptJembe?,hi9o™"}    Sanatorium  Treatment  of  Consumption.  423 
problem.  The  vast  majority  of  all  tuberculous  patients  must  be 
treated  in  their  homes."1 
The  success  of  the  sanatorium  and  climatic  treatment  of  con- 
sumption is  universally  recognized.  -Yet  the  essential  feature  of  the 
sanatorium  treatment  is  careful  regulation  of  the  details  of  the  daily 
life,  and  the  essential  feature  of  the  climatic  treatment  is  life  in  the 
open  air. 
In  warm  climates  and  in  cold,  at  low  altitudes  and  at  high,  con- 
sumption  has  been  successfully  treated  wherever  the  out-of-door  life 
has  been  adopted,  and  the  modern  method  of  treatment  followed. 
Since  1 891  Dr.  Bowditch  has  been  demonstrating  at  the  Sharon 
Sanatorium  that  consumption  can  be  successfully  treated  in  this 
supposedly  unfavorable  climate. 
Dr.  Millet,  of  East  Bridgewater,  was  the  first  to  advocate  ©ut-of- 
door  sleeping  in  a  harsh  climate.  In  January,  1900,  he  published 
an  important  paper  which  bore  the  significant  title,  "  The  Night- 
Air  of  New  England  in  the  Treatment  of  Consumption."2  It  would 
be  well  if  the  truths  contained  in  Dr.  Millet's  paper  could  be 
impressed  upon  every  physician  called  upon  to  treat  this  disease. 
Last  winter  I  became  acquainted  with  the  methods  used  by  Dr. 
C.  L.  Minor,  of  Asheville,  N.  C,  in  carrying  out  the  hygienic-dietetic 
treatment  among  private  patients  outside  of  a  sanatorium.  The 
regulation  of  the  daily  life,  the  discipline  enforced,  and  the  results 
obtained  by  Dr.  Minor  compare  favorably  with  those  of  the  best 
sanatoria. 
I  became  convinced  that  it  was  possible  to  carry  out  the  same 
system  in  the  homes  of  the  poor  even  in  a  crowded  city.  For  the 
opportunity  to  submit  my  plan  to  a  practical  test  I  am  indebted  to 
the  Rev.  Elwood  Worcester,  and  to  Emmanuel  Church  for  financial 
support. 
The  reason  that  the  results  of  home  and  dispensary  treatment 
1  Few  if  any  States  have  greater  facilities  for  sanatorium  treatment  than 
Massachusetts.  It  has  been  estimated  that  there  are  at  the  present  time  no  less 
than  14,000  consumptives  within  its  borders.  For  these  375  beds  are  available. 
In  other  words,  about  3  per  cent,  can  be  treated  in  the  State  sanatorium.  As 
consumption  is  a  disease  of  the  poor,  it  is  evident  that  most  of  the  cases  com- 
prising the  remaining  97  per  cent,  must  be  treated  in  their  homes,  if  they  are 
to  be  treated  at  all. 
2  Maryland  Medical  Journal,  January,  1900. 
