gauze, plated or silvered to prevent rust, "will last for several months, and in summer-time can be removed from the shawl and laid aside; but the shawl is often useful in all seasons.
Rule II. Active Exercise is an Essential Element in the Treatment of Comsumptives.—The conditions for obtaining a due supply of air imply in some measure the necessity for exercise. But there are varieties of exercise. Drs.Rush, Jackson, and Parrish, are in favor of riding on horseback, but this is a thing not practically to be carried out in the majority of cases, and, as I think, not absolutely necessary. Walking is the more natural exercise; it brings into movement every part of the body, more or less, and, leading to brisker circulation in every part, causes a more active nutrition generally. Of late years I have very much recommended tricycling to consumptive patients, and often with great benefit. In many instances it is better than walking exercise, giving more perfect change of air and scene with less fatigue.
The extent to which exercise should be carried will vary with the stage of the disease, and temporary accidents—such, for instance, as an attack of hæmoptysis—may, for the moment, stop it altogether. But, when exercise is advisable, the general rule is to recommend that it be carried out systematically, cautiously, and courageously, and that each exercise should be continued until a gentle feeling of fatigue is felt through the whole muscular system. Violent and unequal exertion of the upper muscles of the body is unadvisable. When restored from the fatigue of one exercise, another should be undertaken, and during the day this can not be too often repeated. If the day be wet, then the exercise should be effected by walking in a large room, or by engaging in some game, such as skittles, billiards, or tennis.
If, in his waking hours, the consumptive patient can keep himself occupied pretty freely in muscular labor, he secures the best sudorific for his sleeping hours that can possibly be supplied; for as the force of life is always expended in producing motion or action, so, to use the words of Dr.Metcalfe, "the proximate cause of sleep is an expenditure of the substance and vital energy of the brain, nerves, and voluntary muscles, beyond what they receive when awake; and the specific office of sleep is the restoration of what has been wasted by exercise." Cough is very much less frequent in the course of the night in him who has been subjected to exercise in the day; while sleep, when it falls, is more profound, more prolonged, and more refreshing.
In summer-time, when the temperature of the day is high, the morning and the evening time are the best adapted for the periods of out-door exertion. In the other seasons, midday is preferable, as a general rule.
I have been asked, often, whether dancing is good exercise for children and young persons of a consumptive taint. There can be no doubt that it is so when properly conducted. When dancing is carried
