OPEN-MOUTH BREATHING.
I am not going to recommend the consumptive, nor any person, well or ill, to do all or much of his breathing through the mouth; on the contrary, I agree that the nostrils were designed to warm and filter the air, and that in general this is necessary. But there are times when the atmosphere does not require to be filtered and when it had better not be warmed; and I wish to do away with all fear of danger from casual or occasional open-mouth breathing, especially in the open air, and in winter, or at any season when there is freedom from dust, and regardless of the weather, and the time of day or night. For “sore” or irritated throat and bronchi, or oppressed lungs, I have found persistent open-mouth breathing of pure cold air curative in its tendency; and have myself, upon occasion, gone out on a winter’s night, to walk and breathe in this manner by the hour. Consumptives are often subject to attacks of dyspnœa (difficult breathing), but rarely, if ever, do they come on out of doors; it is rather, when, having been vouchsafed a little pure respiratory food, the lungs are again forced to respire the hot, poisoned, make-believe air of the home, that the congestion takes place. And this may be set down as the only danger in the premises, viz.: the return from the fresh, pure and bracing atmosphere without, to the over-heated and under-ventilated living-rooms. The remedy, then, for an attack under such circumstances would be found in throwing open the doors and windows—keeping
well wrapped or warm in bed—rather than in sealing the crevices and piling on fuel. Even pneumonia, most dreaded of “diseases,” in which the lungs are congested to engorgement, is now being successfully treated on this principle—the persistent open-mouth breathing of out-door air, if in the winter, or the same, drawn through an ice-packed refrigerator—(scrupulously clean and profusely ventilated), if the weather be warm; the patient, meanwhile, being warm in bed, though never sweltered with wraps [the aim being to balance the temperature, by cooling the head, heating the feet, and exposing and sponging the feverish surface, as may be indicated], and supplied with a proper face-piece to which is attached a flexible tube, through which the cold air is passed direct to the lungs; this manner of breathing to be constant and uninterrupted, hour after hour, and throughout the night, if necessary (never remittent), until the temperature of the patient, as indicated by the thermometer placed under the arm, is reduced to about the normal point (98.2° F.), and the pressure at the lungs relieved. The philosophy of this treatment is as evident as is that of the playing of an engine upon the hottest part of a fire.
A WORD ABOUT THE BED.
The bed and its covering constitute the night-clothes, and for the bed-ridden patient day-clothes as well. Therefore, we can hardly place too much importance upon the bed and its appointments. And yet, in view of all that has been said relating to cleanliness
and wholesomeness, in a general way, but few words are necessary to tell the story. The bed may be of straw, even, and still, if full, fresh, and well-made, be every way sufficient for comfort and health,—better, indeed, than a poor or long-used mattress of any sort;—a mattress of hair, cotton, or wool makes a complete bed. A feather bed is the worst of all. Whatever the bed may be, it should remain open and airing whenever the patient is out of it for any length of time; hence the bed-room should not be the sitting-room when avoidable. Patients confined to the bed altogether, should, if possible, have two—one for day the other for night use—each kept airing during all the time it is unoccupied, and, when practicable, placed in the open air and in the sunshine a portion of the day; the more the better. After the cotton or linen sheets, the covering (of as little weight as is consistent with comfort) should, in place of the common “comfortables,” consist of woolen blankets, which, being porous, are less “stifling” to the body (see foot-note, p. [171]), and permit of being readily cleansed and dried; and they should be thus treated as often as once in three or four weeks, at least, and oftener if the thorough airing recommended is not given them. The “sick-room” should be the “healthiest” room in the house—bright, sunny, and made as “cheery” as possible. No “long-faces” should enter it; there should be no “croning about”—no constant “how-do-you-feel-to-days,” nor subdued looks or airs. Carry along a happy, cheery face and tone, or keep out of the sick-room altogether. Above all, no mind-pictures
about eating, eating, eating—unless, the patient is past hope!
THE POSITION IN BED.
As well as when up and about, is a matter of importance to the sick or well. With the sick, the habit of “rounding up” to the disease is every way prejudicial. Consumptives are especially inclined to seek present ease to their ultimate hurt. It should be one of the aims, in “lung difficulties,” to increase the breadth of the chest in order to give more room for the expansion of the lungs; and this demands increased efforts to expand the lungs, and to push the shoulders back—gradually, very gradually, never to the extreme, but with steady persistence. No radical and immediate change must be looked for; none can be accomplished, in any direction, whether in the shape of the body, quality of lung tissue, or breathing power; but a gradual transformation may be inaugurated, and ensured by means of persistent effort, as the general health improves. It is best to lie, at least much of the time spent in bed, as nearly flat upon the back as possible, slightly inclining toward the side, or alternating between the two positions, with the head low; arms and legs “at ease,” the latter not drawn or “curled” up, but slightly relaxed. If the general regimen is strictly hygienic, the position as thus described will, so far from working any harm, prove of advantage—favoring free breathing, as well as the fullest rest of the body. Where there is shortness of breath and difficulty in