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Analysis Of A Correspondence On Some Of The Causes Or Antecedents Of Consumption

From: Fourth Annual Report Of The State Board Of Health Of Massachusetts
Creator: Henry I. Bowditch (author)
Date: January 1873
Publisher: Wright & Potter, Boston
Source: State Library of Massachusetts

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119  

Miner. -- I have in mind one case where the hereditary predisposition was very great, the subject being Dr. A. M. O., of H , whose mother, two or three sisters, and a brother, died of it, and who had hemorrhage from his lungs, followed by pneumonia, about twenty years ago. He took cod-liver oil very freely, and some stimulants, after his recovery from the pneumonia for two or three years, and kept at the practice of his profession, over high hills and rough roads, and always at it; I might almost say day and night. He is now strong and well, and nearly fifty years of age. I have thought that his business, keeping him so much in the open air, and the oil and generous diet, with the care he has always taken to keep himself well protected by warm clothing at night and when the weather was severe, have been the means of warding it off. I have other cases of a similar character, and where the same medication and exercise in the open air, especially horseback-riding, have done much to prevent what otherwise seemed incurable. I have more faith in horseback-riding than in any other form of out-door exercise.

120  

Wilcox. -- Such means as are calculated to promote general health, and especially, a good appetite. I have a case under observation for the past year, in which there was positive evidence of tuberculosis developed in the upper portion of the right lung, in which there has been most marked improvement, though I will not yet say it is perfectly cured (a boy now sixteen years of age); by taking him out of school; by daily out-door exposure (except in the most inclement weather), and by making it a point that this exposure should, whether as an occupation or recreation have an object aside from the fact of its being for health. Added to this, he has taken, during the year, three bottles of Nichols' sirup of the hypophosphites of lime, soda, potash and iron.

121  

Metcalf. -- I think a permanent residence in a warmer climate, before the development, to any extent, of tubercle, has apparently prevented the occurrence of consumption in children hereditarily disposed. In a family in this town, of six children, all but one died of consumption, before arriving at middle life. He removed to New Orleans, and has constantly, except an occasional visit to New England, remained in the States of Louisiana and Mississippi. He has always enjoyed good health and never had any pulmonary troubles. I know "one swallow does not make it summer," but you will take my case for what it is worth.

122  

Knight. -- Clothing, diet, exercise; also, elevated location, with soft water.

123  

Wilmarth. -- The special means for prevention, I should divide under three heads; viz., diet, clothing and hygienic influences. We frequently find that children hereditarily disposed to consumption are undeveloped, physically; while the nervous system is unduly active, showing a precocity. This condition, if encouraged or allowed to continue, undermines the constitution, and impoverishes the health, by using the material through nervous activity, that should go to the growth of the body. A diet for such condition should supply the waste and build up the body. The supply of waste will best be accomplished by the articles containing more or less phosphorus, such as wheat (not flour), beans, fish, &c.; while the growth of the body requires, in addition to these, the albuminous, carbonaceous and fibrinous compounds such as we find in meat, eggs, milk, corn and vegetables. In choosing a diet, reference should be had to the condition of the bowels, which we often find in a constipated state. This should not be allowed, without a persistent, constant and untiring effort to overcome it. Avoid pastry and food that can be swallowed whole. Choose the food that will need chewing, and chew it thoroughly. Take plenty of time to eat, and eat at regular intervals. Fruit and berries may be used with the meals to advantage, the acidity of them moistening the fecal matter; and the small seed and skin promoting the peristaltic action of the bowels. Avoid much drink with meals, as it tends to wash down the food before it is properly masticated. Let supper be the lightest meal of the day, so that the stomach will not be obliged to work during sleep. Encourage the habit of daily evacuation. Perseverance in these matters will usually overcome the constipated habit, if other hygienic measures are brought to bear at the same time. Cathartics should not be depended upon to relieve the condition; they are only temporary in their action.

124  

The clothing should be neither burdensome nor scanty, but should be both light and warm. It should not be a ready conductor of heat, thereby causing the wearer to feel changes of temperature unpleasantly. Light woollen garments are more comfortable to the wearer, in this respect, than cotton, and I think, more conducive to health. Protect the extremities. Tight-fitting garments are neither comfortable nor healthful, and tight-lacing about the chest is positively injurious and ought to be discarded. Too much dressing about the neck is as injurious as too little. The practice of constantly wearing a hairy fur or woollen tippet, keeps the neck in a state of perspiration, and a person is thus always liable to take a cold, -- to settle in the throat and produce irritation, with cough. Hygienic influences. -- Under this head I would include air, exercise, sleep, restraint of injurious tendencies and the promotion of a healthy physical growth. The air should be pure, free from the influences of low lands or stagnant water, or impurities of decaying animal or vegetable substances; and it should be what is called a dry atmosphere. Such an air should be breathed freely, out of doors. Exercise, such as the system will bear without undue fatigue, should be taken every day. Special attention should be given to the healthy growth and enlargement of the chest and of the muscular system generally. A judicious use of calisthenic exercises would be very beneficial. Sleep should be encouraged in the early part of the night. If children are kept up late, it is at the expense of the nervous system, and the morning sleep does not fully compensate for the loss. Occupation of such children, until they are seven or eight years old, should be very light, mentally, with just enough physical employment to keep them out of mischief. It is better that they should not go to school before this age, and when they do go, the mental effort should be restricted to the physical capacity. I do not mean by this, to encourage habits of laziness, but to avoid what is too often the case, pushing a forward child. In choosing an occupation for after-life, one should be taken that avoids sedentary habits or close confinement. Trades where fine dust is a necessary attendant, should be avoided. Injurious tendencies are those which in any way weaken the constitution; such as overwork, overstudy, too much play excess of any kind, frequent or continued excitement. Anything which calls for an outlay of nervous force more than is conducive to health, should be restrained. Work, study, play and the excitement necessarily attending them, are healthful and needed to properly develop the system, and should be encouraged with alternations of rest, so that a healthy reaction, not an exhaustive fatigue, may follow.

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