s very seldom
that death comes by interference with the breathing space. In fact,
while regarded as a lung disease, we are now coming to recognize that
the actual cause of death in fatal cases is the overwhelming of the
heart by the toxins or poisons poured into the circulation from the
affected lung. The mode of treatment is, therefore, to support the
strength of the patient in every way, and measures directed to the
affected lung are assuming less and less importance in our arsenal of
remedies. Our attitude is now very similar to that in typhoid, to
support the strength of the patient by judicious and liberal feeding, to
reduce the fever and tone up his blood-vessels by cool sponging,
packing, and even bathing; to relieve his pain by the mildest possible
doses of sedatives, knowing that the disease is self-limited, and that
in patients in comfortable surroundings and fair nutrition from eighty
to ninety per cent will throw off the attack within a week. So
completely have we abandoned all idea of medicating or protecting the
lung as such, that in place of overheated rooms, loaded with vapor by
means of a steam kettle, for its supposed soothing effect upon the
inflamed lung, we now throw the windows wide open. And some of our more
enthusiastic clinicians of wide experience are actually introducing the
open-air cure, which has worked such wonders in tuberculosis, in the
treatment of pneumonia. In more than one of our New York hospitals now,
particularly those devoted to the care of children, following the
brilliant example of Dr. William Northrup, wards are established for
pneumonia cases out on the roof of the hospital, even when the snow is
banked up on either side, and the covering is a canvas tent. Nurses,
physicians, and ward attendants are clothed in fur coats and gloves, the
patients are kept muffled up to the ears, with only the face exposed;
but instead of perishing from exposure, little, gasping, struggling
tots, whose cases were regarded as practically hopeless in the wards
below, often fall into the sleep that is the turning point toward
recovery within a few hours after being placed in this winter
roof-garden.

In short, our motto may be said to be, "Take care of the patient, and
the disease will take care of itself."

Though pneumonia is one of our most serious and most fatal of diseases,
yet it is one over whose cause, spread, and cure we are obtaining
greater and greater control every day, and which cer