ing tuberculosis (1) in childhood, (2) in later life, who was fed on milk until about a year old from a cow that reacted to the tuberculin test at that time? It is believed the cow had tuberculosis during the whole lactation period, or longer. Child's parents are healthy, and the child at over two years of age appears to be strong and healthy. 2. If the child should develop tuberculosis what period in life is it most likely to occur? 3. Are the chances greatly increased that the child will develop T.B.? 4. What extra care, if any, should be exercised (1) in rearing the child, (2) through life? Please give details. Lawrason Brown, M.D., in his book "Rules for the Recovery from Tuberculosis," page 117, says: "To the average patient suffering from pulmonary tuberculosis there are two points which are far above all others in importance. The first is the question of cough, the second is the question of whether or not he has developed a cavity in his lungs." What if one has a cavity? 1. If one is rated a far advanced case, has a cavity supposedly well walled off, constitutional symptoms normal though raising an ounce of purulent sputum positive, can such an one become an arrested case? 2. What is meant by a chronic quiescent case? H. B. T. 1. The term "arrested case" is a purely arbitrary one and one of the rules governing its application is that the patient is either without expectoration or that whatever expectoration may be present is free from tubercle bacilli for at least three months. The physical signs must be "those of a healed lesion." 2. A chronic case may be quiescent in the sense that there are no acute symptoms, and the patient may be up and around daily and perhaps able to do a certain amount of work, but some persistent symptom like positive sputum, or the findings at physical or X-ray examination, may indicate that the process is still "potentially active" and the best classification that can be applied in such a case is "puiescent." TO THE EDITOR: 1. How can mental exertion interfere with recovery of a T.B. patient, and, in a general "Makes Life Worth Living" COMPOSURE both physical and mental-greatly aids in the physiological process of repair. For the bed patient, the convalescent, or the wounded, the SANITARY BACK REST can fill the day with pleasing variations and restful changes. Wide, roomy and non-slipping, it is adapted to any position from the upright sitting to the almost recumbent. Whether it be in the home, in the hospital or the sanitarium, the Sanitary performs a service appreciated by all alike. Special advantages are the quickly removable duck covering, noiseless wood ratchet and natural wood finish. Completely sterilizable. When dealing with Advertisers please mention JOURNAL OF THE OUTDOOR LIFE way, what is mental over-exertion for the tubercular? 2. I have always understood that 9835° is normal, but I notice in one of your recent answers you state that "99° F. is not as a rule considered fever." Why is not any elevation above normal fever? 3. Does normal temperature vary with the individual adult? How can one determine for himself what is his normal temperature? 4. For a year I have been having periodic returns of elevation of afternoon temperature varying from 9845° to 9925°. During most of this time have done no steady work and have followed pretty closely the rest cure ordinarily prescribed for an incipient T.B. Though in the year have gained about ten pounds, does not the continuance of fever indicate that there may be a mistake in diagnosis, especially since I have never had a cough, night sweats or pain in the chest? 5. What do you think of Florida as a yearround climate for the tuberculous? Is not the long term of warm weather a hindrance to recovery? S. M. 1. Mental over-exertion can raise temperature, increase the rapidity of the pulse, interfere with proper rest, impair appetite and digestion, and harm the patient generally. The point where over-exertion begins is hard to define in a general way and must depend upon the condition of the patient. The excitement or mental effort of interviewing a caller, reading a book, playing cards, etc., may be too much for some patients. 2. Because fever that has any serious significance usually does not stop at 99° F. 3. Yes, and 99° F. is usually the highest limit of normal fluctuation, in males, and a little higher in females. Extended observations during normal good health should establish the individual's normal range. 4. It is possible that there is some other cause for the temperature, and it would be wise to undergo further general diagnosis. 5. The daily routine of the patient is more important than location. Some patients in Florida do well if they have proper facilities for taking treatment. NOTE A full Question Box will be run next month. It was crowded out this month on account of lack of space.-The Editor. A Comforting Cup THIS IS ONE MODEL OF THE FAMOUS KALAMAZOO SANITARY RECLINING CHAIRS for use in open air. Any position, ranging from upright to full reclining, may be obtained without the use of levers or ratchets of any kind, and with practically no exertion on the part of the occupant. Can be used with or without awning. Nothing aids the invalid more than comfortable and convenient rest, which is especially true in tuberculosis. We guarantee these Chairs to be absolutely the most comfortable Reclining Chairs in the world, regardless of price. On account of their wonderful comfort, simplicity and great adaptability they are endorsed by leading physicians and sanatoriums everywhere. Seating is removable and the chair absolutely sanitary in every particular. Our Chairs may be folded in compact form for storage or shipment, without the removal of screws or bolts. The exceedingly low price brings them within the reach of all, as we have some ten different models, ranging from $3.50 to $25.00 each, and also adjustable sanitary Chairs from $1.25 to $2.00 each. Catalog No. 158, in colors, giving full description and prices, sent on request KALAMAZOO SLED CO., 605 Third St., Kalamazoo, Mich. When dealing with Advertisers please mention JOURNAL OF THE OUTDOOR LIFE And Tells You How to Win Your Battle with Tuberculosis Read THE BATTLE WITH TUBERCULOSIS AND HOW TO WIN IT By D. MacDOUGALL KING, M.D. Rupert Blue, Surgeon General of the U. S. Public Health Service, wrote of this splendid volume: "It is deserving of wide circulation." Dr. Edward Otis, of Boston, Mass., writes: "I have nothing but praise for it. All the statements are medically correct. The physician himself can learn much from it. A book of inspiration for the tuberculosis patient." Dr. Henry Sewall, of Denver, Colorado, says: "It is a gem of plain non-technical language, used with scientific accuracy." There are 258 pages of practical advice, written by a lung specialist who has been a patient among the tuberculous, and who knows both the patient's and the doctor's new point. The author is convinced that most cases of tuberculosis can be arrested if the patient will do what is wise. JOURNAL OF THE OUTDOOR LIFE, 381 4th Ave., New York City New (3d) Edition Thoroughly Revised and Enlarged RULES for RECOVERY from A LAYMAN'S HANDBOOK OF TREATMENT By LAWRASON BROWN, M.D. OF SARANAC LAKE, N. Y. 12mo, 192 pages. Cloth, $1.50, net The appearance of the third edition of this little book is an accurate indication of its value and success. Many changes have been made throughout to keep it thoroughly abreast of the times. Details about the values of actual foodstuffs have been added in a separate chapter and a liquid diet is outlined. The purpose of this work is to help the patient avoid blunders, to learn those things most necessary to expedite his recovery and safeguard those around him. Dr. Brown is recognized as one of our foremost clinical authorities on tuberculosis. He knows the problem that confronts the consumptive and in simple language he points out what, from his long experience, has proved to be best for the welfare of the patient. The book should not be read hastily and laid aside, but should be read slowly, chapter by chapter, day by day. When it has been carefully read in this manner, it should be used as a reference, a hand-book of the fundamental principles of the cure. The author makes clear the whys and wherefores of many rules given to patients. JOURNAL OF OUTDOOR LIFE 381 FOURTH AVENUE NEW YORK CITY The Administration of Tuberculin ¶ The scientific administration of tuberculin requires the most careful and exact clincal observations in order to prevent over-dosage. ¶ The observations must extend over a considerable time following the injection, and it has been found in practice that the record of symptoms during this period can be best kept by the patients themselves. ¶ A chart to be filled in by the patient affords the only safe and satisfactory method of reporting, since there is space for every symptom, and errors of memory and personal point of view can be eliminated. ¶ Such a record enables the patient to explain more clearly his condition after a dose of tuberculin, and enables the physician who is administering the tuberculin to graduate more carefully and properly the dosage. ¶ The ideal form is found in the Tuberculin Record published by the JOURNAL OF THE OUTDOOR LIFE. The book provides space for forty-two weeks, gives a sample chart properly filled out, and also two pages of instruction and advice to the patient about the necessity for absolute honesty and co-operation with the physician. The Tuberculin Record has gone through nearly a dozen editions. It has been extensively used at the Trudeau Sanitarium, at the Loomis Sanatorium, at Otisville, and at many other Sanatoriums, by tuberculosis clinics, day camps, dispensaries, hospitals, and by private practitioners. ¶ Price 25 cents each, singly or in quantities. JOURNAL OF THE OUTDOOR LIFE 381 Fourth Avenue, New York City |