It is not necessary to enter into any great detail as to sanatorium treatment, its broad principles are easily understood.
The sanatorium is situated, as a rule, amongst hills, in a district free from tubercular disease, where the air is pure and void of dust as well as of organic impurity, therefore remote from smoke, from factories, from railways, from high ways, from large towns. The elevation should vary from 1500 to 3000 or 4000 feet, the air should be dry and crisp, the soil dry and well drained. The building should have a southern exposure. It should be sheltered by hills from the wind while lying open to the south, and it should be so placed in relation to the hills that surround it that, while sheltered by them, it does not receive their drainage. The climate should permit the patient to spend most of his time in the open air. For this purpose the more extensive the private grounds of the sanatorium the better. In the best sanatoria an open verandah extends along the ground floor of the front of the building, so that patients may sit, or lie out, sheltered in all weathers, while in many the grounds are dotted with miniature chalets of single or double apart ments, which rest on pivots so that they may always be turned to the sun. As to internal arrangements, the aim is to have the patients' rooms as large as possible, light and sunny, flushed with fresh air, and so furnished and decorated as to keep as free of dust as possible, the rooms being so constructed that the bed may be in shelter though doors and windows be open. Corners, ledges, cornices, hangings, are unde sirable, because affording lodgment for dust.
A very important point in a well-constructed building is the deafening of the walls, so that the house is quiet, and one patient is not dis turbed by another.
The whole life of the patient is regu lated by the superintending physician, not in a merely general way, but in every detail, so that from day to day, one might say from hour to hour, each individual has laid down for him the circumstances most suitable for his condition.
In sanatorium treatment two things assume the very greatest importance : I. Fresh Air; II. Feeding.
The judicious management the patient is trained to bear open-air life in all weathers, the skin being in various simple ways, by water douching among others, toned up and braced. But it must be observed that the size and shape of the'patients' rooms, the position of the bed, and a host of other simple hut important pre cautions, not to speak of the constant medical supervision and control, enable this to be done quickly and safely. The patient at home, who, on his or her own initiative, and without pre caution or preparation, thinks to imitate sana torium treatment by throwing wide windows and doors, and sitting and sleeping in a draught, is behaving only like a fool and ignorant per son. But such persons are numerous.
The Diet patient is in a similar way gradually accustomed to taking large quantities of food, the quantity being gradually increased small frequent meals being preferable to infrequent large ones. In this respect the medical control becomes of inestim able value. The precarious fickle appetite, instead of being humoured and yielded to, is gradually overcome by the moral control of the physician, and in a short time an amount of food is eaten and digested and made use of that the patients' friends deem impossible and in credible. The improvement in the general nutri tion is immediate, and the effect on the progress of the disease very marked. The following is the arrangement of meals in most sanatoria: 7 to 8 a.m. Glass of milk, and coffee, cocoa, or tea ; white or brown bread and butter.
10 a.m. One or two glasses of milk with broad and butter, or soup and bread, or egg; perhaps a glass of wine.
1 p.m. Dinner : soup, two meat courses with vege tables, pudding; perhaps a little wine.
4 p.m. Afternoon tea, akin to early breakfast.
7 p.m. Supper of one or two courses, one hot one cold, with vegetables; perhaps a glass of wino.