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The Sanatorium Treatment of Consumption

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THE SANATORIUM TREATMENT OF CONSUMPTION.

Within quite recent years special institutions, at first only for paying patients, later for the poor also, have been opened for the treatment of consumption. These institutions are usually built, not, like most hospitals, in the centre of great populations, and where the people live who need the treatment, but away from popu lous places, in the healthiest obtainable situa tions. The patients, that is to say, must forsake business and home and their usual surround ings, and resort to such a place chosen for its salubrity. Hence the term "Sanatorium" has been employed. In these sanatoria the patients are, during the whole time of residence, and in every detail, under the full control of the medi cal man who is the chief authority in the estab lishment. The whole manner of life is regu lated, from morning to night—what and when the patient shall eat or drink, how he shall be clothed, bow much, if any, walking he shall do, how long he shall spend in bed, whether he shall be allowed to engage in conversation, and so on ; all is regulated by the physician. Now this is nothing new in the case of the person who is acutely ill, or who is confined to bed. But up to recently the ordinary consumptive went about his business as long as he could, taking certainly what medicine he'was ordered, and as much change to the country, or by a sea voyage, as was possible to him. So he went on till, in course of time, increasing exhaustion, haemorrhage, or one of the multitudinous pos sible complications laid him by the heels, and he became, by inevitable necessity, restricted to his room or his bed, in preparation for his still narrower abode. But it is something new that the person threatened with consumption should give up for the time his business--un less, like a writer of books, he can take it with him—leave home, repair to some place where every condition of health is fulfilled, and place himself wholly in the hands of a physician who shall regulate, without thought of demur on his part, every minute of his day, while he is yet only threatened, and is able to go about quite freely, and his strength is yet comparatively little impaired. It is this that is the new thing,

and not the principles of treatment. The new thing, in short, is the attitude of the public towards the disease. And this new attitude is, in turn, due to the fact that it has dawned upon the public mind that the disease—con sumption—is curable. So long as the public believed it to be incurable, in spite of all the doctors said, so long did they resign themselves to the inevitable, and sought only to carry on their work and to refuse to believe that they were seriously ill. But the idea of curability having penetrated the public mind, attempted self-deception is given up, and the public is becoming willing in yearly increasing numbers to fulfil the conditions of cure, however arduous or sacrificing they may be, and patients are presenting themselves at such institutions, will ing to surrender themselves, for six, nine, twelve months or longer, completely to the control of medical authority, in the hope of thereby eradi cating the disease.

Now while this idea, that consumption is curable, is new to the public mind, it is not a new thing in medicine. Paradoxically enough it was the post-mortem table which afforded the conclusive evidence of cure. Over and over again hospital pathologists had observed and recorded, in the cases of patients who had died from causes wholly unconnected with the lungs, that many showed evidences, quite conclusive, of disease of the lungs, such as scars of healed tubercular . ulcers, cavities, and so forth. Further, it was recognized, even by the ancient physicians, that residence in elevated situations, purity of air, and abundance of good living were the essential things in the treatment of consumption. But it was not till 1854 that a complete demonstration was given of the fact that success was not to be looked for unless these rational principles of treatment were per sistently and methodically carried out under strict trained supervision. This demonstration was given by a German physician, Dr. Her mann Brehmer, who in 1859 founded the earliest private sanatorium at Goerbersdorf in Silesia, near the Bohemian frontier.

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