Many asthmatics are comparatively comfortable during the day, the
attacks coming on toward evening or during the night. In this case, the
evening meal should be light and easily digested, the heavy meal being
taken at noon.
Hot stuffy rooms increase the disorder and plenty of fresh air should
be secured both by night and by day.
Many of these individuals make no exertion, fearing to bring on an
attack.
Exercise, particularly of the lungs in breathing, should be gradual
at first and be increased as improvement is shown. Exercises directed
to expansion of the deeper cells of the lungs and to equalize the
circulation throughout the entire system will call the excess of blood
from the bronchial tubes and in many cases will cause the difficulty
to disappear. A forceful, equalized circulation, with regulation of
digestion, will do more for asthma than any known agency.
[Sidenote: Tuberculosis]
Derangements in digestion, common in this affection, are due to several
conditions.
The increased temperature is caused by the efforts of the system to
counteract the poisons produced by the action of the bacillus. The
increase in temperature in the stomach lessens the secretions and the
peristaltic action, causing the food to ferment and to be vomited or to
pass practically undigested into the intestine, thus throwing an excess
of work on the intestinal secretions.
The bacilli-laden sputum, if swallowed, is apt to produce disorders of
the stomach. This still further complicates the question of digestion.
Malnutrition, because of these derangements, increases the unfavorable
outlook for the patient in this disease. Hence the diet, especially in
chronic cases, is of great importance.
When means are ample, the question is much simplified, because by
travel, change of scene, and pleasant surroundings the appetite is
stimulated and greater variety in the diet can be gained. For those in
moderate circumstances, save when free sanatoriums exist for the care
of the tuberculous, it is most difficult to keep the diet from becoming
monotonous and wearisome.
The appetite, especially in young people, is apt to be capricious, and
it is important that the food be served daintily to tempt the patient
to eat.
Growing children crave sweets and as these furnish energy they may be
allowed to tuberculous children, in moderation, if they seem to be well
assimilated. Any interference with digestion, however, must be guarded
against.
It is better to give food in smaller quantities and oftener in order
to guard against disturbed digestion from overloading the stomach. For
this reason also it is better to give the heartiest food during the
forenoon when the temperature is lowest.
Milk, butter, cream, olive oil, bacon, and cod-liver oil furnish the
fat needed by the system in the most easily digested form and should
be taken freely, if there is no irritation in the stomach which will
prevent their assimilation. Variation in their use will often secure
greater tolerance.
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