Individual Prevention.—A mother with pulmonary tuberculosis should not nurse her child. An infant born of tuberculosis parents or of a family in which consumption prevails, should be brought up with the greatest care and guarded most particularly against catarrhal affections of all kinds. Special attention should be given to the throat and nose, and on the first indication of mouth breathing or any affection of the nose, a careful examination should be made for adenoids. The child should be clothed in flannel, and live in the open air as much as possible, avoiding close rooms. It is a good practice to sponge the throat and chest night and morning with cold water. Special attention should be paid to the diet and to the mode of feeding. The meals should be given at regular hours, and the food plain and substantial. From the onset the child should be encouraged to drink freely of milk. Unfortunately in these cases there seems to be an uncontrollable aversion to fats of all kinds. As the child grows older, systematically regulated exercise or a course of pulmonary (lung) gymnastics may be taken. In the choice of an occupation, preference should be given to an out of door life. Families with a predisposition to tuberculosis should, if possible, reside in an equable climate. It would be best for a young person belonging to such a family to remove to Colorado or Southern California, or to some other suitable climate before trouble begins. The trifling ailments of children should be carefully watched. In convalescence from fevers, which so frequently prove dangerous, the greatest care should be exercised to prevent from catching cold. Cod-liver oil, the syrup of iodide of iron and arsenic may be given. Enlarged tonsils should be removed. "The spontaneous healing of local tuberculosis is an every-day affair. Many cases of adenitis (inflammation of the glands) and disease of the bone or joints terminate favorably. The healing of pulmonary (lung) tuberculosis is shown clinically by the recovery of patients in whose sputa elastic tissue and bacilli have been found."
[214 MOTHERS' REMEDIES]
General Measures.—The cure of tuberculosis is a question of nutrition; digestion and assimilation control the situation; make a patient grow fat, and the local disease may be left to take care of itself. There are three indications:
First, to place the patient in surroundings most favorable for the greatest degree of nutrition; second, to take such measures as in a local and general way influence the tuberculosis process; third, to alleviate the symptoms. This is effected by the open air treatment with the necessary feeding and nursing.
At Home.—In the majority of cases patients must be treated at home. In the city it has many disadvantages. The patient's bed should be in a room where he can have plenty of sunshine and air. Two things are essential—plenty of fresh air and sunshine. While there is fever he should be at rest in bed. For the greater part of each day, unless the weather is blustering and raining, the windows should be open. On the bright days he can sit out-doors on a balcony or porch, in a reclining chair. He must be in the open air all that is possible to be. A great many patients spend most of the time out in the open air now. In the country places this can be easily carried out. In the summer he should be out of doors from eleven to twelve hours; in the winter six to eight at least. At night the room should be cool and thoroughly ventilated. "In the early stages of the disease with much fever, it may require several months of this rest treatment to the open air before the temperature falls to normal." The sputum is dangerous when it becomes dry. As long as sputum is moist the germs are held in the sputum; but when it is dry they are released and roam at will in the atmosphere and are inhaled. They are then ready to lodge themselves in suitable soil. Always keep the sputum (expectoration) moist, and then there is no danger.
Diet. Treatment.—The outlook in this disease depends upon the digestion. Nausea and loss of appetite are serious obstacles. Many patients loathe foods of all kinds. A change of air or a sea voyage may promptly restore the appetite. When this is not possible, rest the patient, keep in the open air nearly all day and feed regularly with small quantities either of buttermilk, milk, or kumiss, alternating if necessary with meat juice and egg albumin. Some cases which are disturbed by eggs and milk do well on kumiss. Raw eggs are very suitable for feeding, and may be taken between meals, beginning with one three times a day, and can be increased to two and three at a time. It is hard to give a regular diet. The patient should be under the care of a physician who will regulate the kind of diet, amount and change. When the digestion is good there is less trouble in feeding. Then the patient can eat meat, poultry, game, oysters, fish, animal broths, eggs. Nothing should be fried. Avoid pork, veal, hot bread, cakes, pies, sweet meats, rich gravies, crabs, lobsters.
[INFECTIOUS DISEASES 215]
Diet in Tuberculosis furnished us by a Hospital.—
May Take.—Soups.—Turtle or oyster soup, mutton, clam, or chicken broth, puree of barley, rice, peas, beans, cream of celery or tomatoes, whole beef tea; peptonized milk, gruel.
Fish.—All kinds of fresh fish boiled or broiled, oysters or clams, raw, roasted or broiled.