the sound organ. Still, the actual waste of tissue is never perfectly repaired, and fragmentary lungs, supplying the undiminished wants of the whole organism, must necessarily do double work, and will be less able to respond to the demands of an abnormal exigency. But the lungs of a young child of consumptive parents are sound, though very sensitive, and, if the climacteric of the first teens has been passed in safety, or without too serious damage, the problem becomes reduced to the work of preservation and invigoration: the all but intact lungs of the healthy child can be more perfectly redeemed than the rudimentary organs of the far-gone consumptive; the phthisical taint can be more entirely eliminated and the respiratory apparatus strengthened to the degree of becoming the most vigorous part of the organism. The poet Goethe, afflicted in his childhood with spitting of blood and other hectic symptoms, thus completely redeemed himself by a judicious system of self-culture. Chateaubriand, a child of consumptive parents, steeled his constitution by traveling and fasting, and reached his eightieth year. By a relapse into imprudent habits, the latent spark, which under such circumstances seems to defy the eliminative efforts of half a century, may at any time be fanned into life-consuming flames, but in ninety-nine out of a hundred cases it will be found that the first improvement followed upon a change from a sedentary to an out-door and active mode of life. Impure air is the original cause of pulmonary consumption ("pulmonary scrofula," as Dr. Haller used to call it), and out-door life the only radical cure. The first symptoms of consumption are not easy to distinguish from those transient affections of the upper air-passages which are undoubtedly due to long confinement in a vitiated atmosphere: hoarseness, and a dry, rasping cough, rapid pulse, and general lassitude. Spitting of blood and pains in the chest are more characteristic symptoms, but the crucial test is the degree in which the respiratory functions are accelerated by any unusual effort. A common catarrh will not prevent a man from running up-stairs or walking up-hill for minutes together, without anything like visible distress; subjected to the same test, a person whose lungs are studded with tubercles will pant like a swimmer after a long dive, and his pulse will rise from an average of 65 to 110 and even 140 beats per minute. Combined with a hectic flush of the face, night sweats, or general emaciation, shortness of breath leaves no doubt that the person thus affected is in the first stage of pulmonary consumption. If the patient were my son, I should remove the windows of his bedroom, and make him pass his days in the open air—as a cow-boy or berry-gatherer, if he could do no better. In case the disease had reached its deliquium period, the stage of violent bowel-complaints, dropsical swellings, and utter prostration, it would be better to let the sufferer die in peace, but, as long as he were able to digest a frugal meal and walk two miles on level ground, I should begin the out-door cure at any time of the year, and stake my own life on the result. I
