426  Sanatorium  Treatment  of  Consumption.  {^pteSberfim" 
sary  before  some  of  the  simplest  rules  are  fixed  in  the  minds  of  the 
invalid  and  his  friends. 
On  January  5,  1906,  the  class  numbered  fifteen  members,  and  all 
but  one  were  sleeping  out-of-doors.  The  single  exception  is  a 
patient  who  would  have  done  so  had  his  landlord  not  prevented 
him  from  putting  up  a  tent  on  the  roof.  At  present  he  sleeps  with 
his  head  out  of  the  window  of  his  bed-room.  One  of  our  class 
sleeps  on  a  balcony,  the  others  in  tents  placed  either  on  the  roof  or 
on  the  ground  near  the  house.  The  tents  have  generally  been  loaned 
— as  few  of  the  members  could  afford  to  buy  them.  An  ordinary 
7  feet  by  7  feet  wall  tent  with  a  fly  has  been  found  satisfactory. 
This  costs  only  $7.25.  Except  the  time  taken  for  meals,  bath  and 
exercise,  the  entire  day  is  spent  in  the  recumbent  or  semi-recum- 
bent posture.  A  comfortable  reclining  chair  is  furnished  each 
patient. 
The  prescribed  diet  consists  chiefly  of  milk,  bread,  fruit,  butter, 
and  oil.  Most  of  our  patients  drink  two  to  three  quarts  of  milk  a 
day.  In  a  few  instances  unsalted  butter  has  been  furnished  free. 
Cotton-seed  oil  has  been  found  to  be  a  satisfactory  and  inexpensive 
substitute  for  olive  oil. 
For  the  first  few  weeks  no  exercise  is  allowed,  and  later  only 
when  the  temperature  is  normal  the  entire  day.  Then  the  exact 
amount  of  exercise  is  prescribed.  The  patient  begins  by  walking 
five  minutes  in  the  morning  and  five  in  the  afternoon.  It  is  required 
that  a  watch  be  carried  and  the  exact  duration  of  the  walk  noted  in 
his  record  book.  After  exercising,  the  temperature  is  taken  and 
recorded.  If  rise  of  temperature  occurs  or  if  the  patient  becomes 
tired  the  amount  of  exercise  is  diminished.  If  the  patient  con- 
tinues to  improve,  the  exercise  is  gradually  increased.  Some  of  our 
patients  now  walk  several  hours  daily.  During  the  summer  and 
fall  our  fever-free  patients  enjoyed  the  privileges  of  the  Parker  Hill 
Day  Sanatorium. 
An  important  aid  in  maintaining  our  strict  hygienic  regimen  is 
furnished  by  the  individual  record  book.  The  form  of  record 
adopted  is  that  devised  by  Dr.  Minor,  of  Asheville.  Every  detail 
of  the  day  is  recorded  :  The  food  eaten,  including  the  total  amount 
of  milk  and  oil  taken;  the  number  of  hours  out-of-doors.  The 
temperature  and  pulse-rate  are  entered  and  the  quantity  and  char- 
acter of  the  expectoration.    The  patients  now  keep  out-of-door  life 
