SANITARIUM TREATMENT. — It is a conceded fact that, when possible to ob tain admission to a properly-conducted and scientific sanitarium, the tubercu lous improve more rapidly, and that the ultimate prognosis is more favorable than when treated under the best pos sible environment outside. Sixty-eight per cent. of wise and 33 per cent. of un wise patients recover from phthisis. Dr. Solly says: "Dr. Trudeau, Dr. Von Buck, and Dr. Bowditch all believe that they can obtain better results, other things being equal, in the sanitarium than outside. My own personal experi ence in sanitarium treatment, though not sufficient to furnish statistics, con firms the opinion; and I believe the great hindrance in all climates to getting better results is due to the mistaken re pugnance of most well-to-do patients to enter sanitariums, and to the criminal apathy of the State in neglecting to fur nish them to the poor, so that their use is extremely limited. My observations as to the influence of prudence upon the prognosis of phthisis corroborate these opinions of the value of sanitariums." Social surroundings, wise amusements, properly-arranged diet, hygienic sur roundings, methods of prophylaxis and intelligent care are all to be found in a more perfect condition in sanitariums than elsewhere.
From an analysis of the cottage sani tarium treatment of incipient tubercu losis as instanced by the Adirondack institution in New York, it is concluded that (1) tuberculosis, if diagnosed in its early stages, is curable in a large pro portion of eases; (2) it is, therefore, of vital importance that diagnosis be made early; (3) the best results in treating incipient tuberculosis are obtainable by the open-air treatment in special sani taria situated in good climates; (4) the best plan of construction for such sani taria is the cottage-plan or some one of its modifications. E. L. Trudeau (Prac titioner, Feb., '99).
In 95 per cent. of the cases of con sumption seen by physicians the pa tients are unable to afford treatment away from their homes. Arrest or cure of tuberculosis is a question entirely of nutrition, and, of the measures by which the general nutrition of the body may be encouraged, the first and most important is fresh air. The following directions
for home-treatment are given: The al manac is to be taken and the hours of sunshine counted. In winter two hours are to be cut off in the morning and one hour in the evening, and for the re mainder of the day the patient must be out-of-doors. If there is no possible arrangement for life out-of-doors, the patient must be put in a room with southern exposure, and the bed moved into the sunshine, with the windows wide open. If there is a balcony or veranda with a good outlook toward the south it should be arranged for the patient; if not, a shelter can be put up in the yard at a very moderate cost. On a well-padded lounge covered with a couple thicknesses of blankets the pa tient sits or reclines all day. Only on blustering, stormy, or very rainy days is the patient to remain in the house. No degree of cold is a contra-indication. This continuous open-air life at rest is the most powerful influence possessed to-day against the fever of tuberculosis. In any long series of eases the pa tients who do well are those who take plenty of food. Each case must be dealt with separately, but as large a quantity of food as possible should be given even, when possible, insisting on overfeeding, or stuffing. For some time persona] pa tients have been urged to accustom them selves to take raw eggs, beginning with I three times a day, and increasing until they can take 20 to 24 a day. If broken into a cup and sprinkled with a little pepper and .salt, the egg can lie readily swallowed without breaking the yell:. Osler (Phila. Med. Jour., NOV. 25. '99).
Ideal rest-cure arrangement: From a large beach-chair of wicker-work the seat is removed and the inner walls are lined with padding. A reclining-chair is placed with its Lack in the interior and the whole arranged so that the patient is protected from the wind and sun. There the patient installs himself for the day. S. A. Knopf (Medical Record, Jan. 27, 1900).