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Page 7
Among women somewhat younger, as indeed among men, the American
observer whose recollection takes him back twenty-five years must
note a more hopeful change, a very decided average increase of
stature, not merely in height but in general development. This
change is to be seen throughout the whole country, and must be
taken first as a sign of improved conditions of food and manner of
life, and next, if not more largely, of the new interest and
partnership of girls in the wholesome activities of field and wood.
CHAPTER III.
ON THE SELECTION OF CASES FOR TREATMENT.
The remarks of the last chapter have, of course, wide and general
application in disease, and naturally lead up to what I have to say as
to the employment of the systematic treatment to describe which is my
chief desire. Its use, as a whole, is limited to certain groups of
cases. In some of the worst of them nothing else has succeeded hitherto,
or at least as frequently. In others the need for its application must
depend on convenience and the fact that all other and readier means have
failed. It is, of course, difficult to state now all the groups of
diseases in which it may be of value, for already physicians have begun
to find it serviceable in some to which I had not thought of applying
it,[11] and its sphere of usefulness is therefore likely to extend
beyond the limits originally set by me. It will be well here, however,
to state the various disorders in which it has seemed to me applicable.
As regards some of them, I shall try briefly to indicate why their
peculiarities point it out as needful.
There are, of course, numerous cases in which it becomes desirable to
fatten and to make blood. In many of them these are easy tasks, and in
some altogether hopeless. Persons who are recovering healthfully from
fevers, pneumonias, and other temporary maladies gather flesh and make
blood readily, and we need only to help them by the ordinary tonics,
careful feeding, and change of air in due season.
It may not, however, be out of place to say here that when the
convalescence from these maladies seems to be slower than is common, and
ordinary tonics inefficient, massage and the use of electricity are not
unimportant aids towards health, but in such cases require to be handled
with an amount of caution which is less requisite in more chronic
conditions of disordered health.
In other and fatal or graver maladies, such as, for example, advanced
pulmonary phthisis, however proper it may be to fatten, it is almost an
impossible task, and, as Pollock remarks, the lung-trouble may be
advancing even while the patient is gaining in weight. Nevertheless, the
earlier stages of pulmonary tuberculosis are suitable cases, and with
sufficient attention to purity and frequent change of air in their rooms
tubercular sufferers may be brought by this means to a point of
improvement where open-air and altitude cures will have their best
effects.
There remains a class of cases desirable to fatten and redden,--cases
which are often, or usually, chronic in character, and present among
them some of the most difficult problems which perplex the physician. If
I pause to dwell upon these, it is because they exemplify forms of
disease in which my method of treatment has had the largest success; it
is because some of them are simply living records of the failure of
every other rational plan and of many irrational ones; it is because
many of them find no place in the text-book, however sadly familiar they
are to the physician.
The group I would speak of contains that large number of people who are
kept meagre and often also an�mic by constant dyspepsia, in its varied
forms, or by those defects in assimilative processes which, while more
obscure, are as fertile parents of similar mischiefs. Let us add the
long-continued malarial poisonings, and we have a group of varied origin
which is a moderate percentage of cases in which loss of weight and loss
of color are noticeable, and in which the usual therapeutic methods do
sometimes utterly fail.
For many of these, fresh air, exercise, change of scene, tonics, and
stimulants are alike valueless; and for them the combined employment of
the tonic influences I shall describe, when used with absolute rest,
massage, and electricity, is often of inestimable service.
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