Whatever form of exercise is used, absolute regularity in attending to the calls of Nature must be observed.
Disorders of nutrition are powerfully affected by exercise, through the voluntary and involuntary muscles as well as through the nerve centers. Respiratory exercises and the exercises stimulating respiration and circulation are beneficial in anæmia, as are also the scientific application of massage and cold water to promote tissue interchange. By quickening oxygenation, the circulation, and the nutritive processes, moderate systematic exercise causes thin and poorly nourished people to gain in weight as well as in vigor.
In most wasting and febrile diseases, toxæmias and inflammations, the strength of the patient is needed to combat the circulating poison, heal the local lesions, and keep the vital processes going, and for these reasons, as well as on account of cardiac debility, muscular exercise is contraindicated, in some instances even during convalescence. Heart failure after diphtheria from changing from the recumbent to the sitting posture, and serious and even fatal relapse following too early sitting up after typhoid fever, are notable instances in point. Exercise of the unstriped muscles by friction and bathing may, notwithstanding, be extremely useful. It is noteworthy that under the supporting treatment afforded by cold bathing with friction much greater liberty is allowable. Not only do the patients bear well the lifting into and out of the tub, but some eminent physicians do not hesitate to let their typhoid patients sit up to adjust compresses to the body, to step into the tub, and even to walk to it with some assistance.
Exercise in the open air is of the greatest utility in the prophylaxis of phthisis. After the disease is developed exercise must be used with more caution, and in such a way as not to put great demands upon the vital powers of the patient. Moderate exercise out of doors and gentle respiratory exercises may be made beneficial, especially if directed to their gentle tonic effect and toward the better aëration of the pulmonary tissue.
There is a large class, especially among women, who habitually neglect exercise and lay up large amounts of reserve material in the shape of fat, which becomes burdensome by its bulk, and injurious by impeding the action of the organs in whose substance or vicinity it has been deposited. These people are not always large eaters, but having accumulated a physiological surplus, they have never been able to oxidize it. Exercise of endurance and respiratory exercises are well adapted to aid in burning up this surplus and to improve the health. It may, in addition, be necessary to reduce the ingestive fluids and fat-forming foods.
