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cases to cause an increase in appetite, a consequent gain in
weight, and an improvement in general well-being.
Rest
Although the pulse and temperature are within normal limits,
and the patient appears well, active disease may be present, and
it is reasonable to suppose that by giving a course of very complete
rest, some improvement or healing of a lung lesion will
follow. A minimal activity of the body means a minimal activity
of the basal functions and a consequent occasion for repair of
damaged lung tissue.
That this does occur may be shown by serial radiographs
taken over a period; progressive healing of lesions and disappearance
of cavities can be observed. The patient gains in weight,
physical lung signs disappear, and a great improvement in general
well-being is noted by the patient. The complete rest is
naturally followed by very slow graduated exercise, first in sitting
up then in getting up.
Such repair seems to happen more easily in localised early
exudative lesions, especially in young adults. Indeed, intensive
prolonged immobilisation of the body often avoids the necessity
of inducing collapse of a lung, itself a method of complete rest,
with its risk of failure or complications. When the treatment has
been explained to them, the majority of patients are willing to
undergo its admitted rigours, in a number of cases with very
beneficial results.
One method of assessing the type of case likely to respond
to this treatment, and its ultimate value, that is the estimation of
blood sedimentation rates, is not yet available. The services of a
trained laboratory assistant would enable these investigations to
be carried out.
Bacteriology.
Monthly examinations of sputum are made at each clinical
examination of the patient, and during the year 689 specimens
were examined microscopically, besides examination of pleural
fluids.