Individuals predisposed to consumption should lead an exceptionally careful life in an equable climate and out of doors. Particular attention should be given to keeping the upper respiratory passages in a healthy condition and guarding against colds. Tuberculosis is a curable disease in its earlier stages. Spontaneous cure is an every-day phenomenon, and a large proportion of individuals dying of other diseases are found on autopsy to possess healed tubercular lesions in the lungs.
There is no successful specific treatment. Koch's tuberculin and its various modifications and the different antitoxins and antitubercle serums are being used, but are still in the ex perimental stage. and have to he administered with great circumspection. The treatment of consumption is in most cases best carried out in well-regulated sanatoria, where the patient's life and habits are under expert surveillance. The main objects in view are to place the sufferer in an environment favorable for the attainment of the best possible nutrition, to relieve the cough, sweats, and other wearing symptoms, and to give medicines that tend to check the progress of the disease. Fresh air is an essential consideration, whether treatment is carried on in sanatoria or at home. In general, a dry. germ-free bracing atmosphere. with an equable temperature and plenty of sunlight, where the patient can live practically out of doors, should be selected. There is no advantage in sending inevitably fatal cases away from home. :Moderately advanced eases are as a rule more comfortable in warm climates like that of Florida and South California. The sleeping room of the consumptive should be well ventilated. Nutrition should be kept up to a high point by a plentiful supply of good, easily digested food, given at frequent intervals and carefully adapted to the patient's digestive pow ers. eggs, koumiss, o• broths may be taken between meals, and when the stomach is not equal to solid food, a small amount of wine or'w•hisky may be given at meal time to stimu late appetite and digestion. Life should be out
of doors, but exercise should stop short of fatigue. The mental condition of the patient is of the utmost importance and cheerful surround ings and occupation should be chosen where pos sible.
Of the drugs that seem to have a definite cura tive value, the creosote group, cod-liver oil, and the hypophosphites are most valuable. Creosote, creosote carbonate, guaiaeol and guaiacol car bonate. given in gradually increasing doses, are of use in all stages, but particularly in the active inflammatory stages. They diminish cough very markedly. lodoform is sometimes given instead of ereosote. Cod-liver oil improves the nutrition and is especially useful in what is illy termed the pretubereular stage. It acts better in ehildren than in adults, and better in glandular and bone tuberculosis than in pulmo nary. The emulsified fats o• cream are good sub stitutes when cod-liver oil cannot be taken. Iron, arsenic, strychnine, and similar tonics are given according to indications. Besides general meas ures, special symptoms have to be watched and treated. Fever is combated by rest, fresh air, and small doses of quinine; severe cough by opiates; night sweats by belladonna, strychnine, and the mineral acids. Hemorrhage from the lungs calls for complete rest, large dotes of opium o• moridiMe, and suprarenal extract, with ice over the point of bleeding when it can be located. headache, indigestion, diarrlara, etc., are all present and have to be managed as in other diseases.
Attempts to treat the disease locally by means of inhalation of antiseptic vapors, and ozonized air, and later by the X-ray and concentrated sun light, have had a very small measure of success.
Tuberculosis attacks, primarily or secondarily, the lymph glands, bones, joints, intestines, peri toneum, brain, kidneys, bladder, spleen, liver, pericardium, heart, generative organs, and skin. Its manifestations in these situations are described in the articles on SCROFULA ; ADENITIS; PLEURISY: PERITONITIS • MENINGITIS: BRIGIIT's DISEASE; BLADDER; PERICARDITIS; etc.