Page:Popular Science Monthly Volume 30.djvu/99

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THE HYGIENIC TREATMENT OF CONSUMPTION.
87

The reasons why consumptives feel the effects of climatic changes so much are sufficiently obvious. The effects of such variations are felt, indeed, in the best health; for the body is in some measure both a barometer and a thermometer; at all events, it is subject to the same influences, the lungs being in all cases the parts most affected. With the temperature moderately high and the air dry, the physiology of respiration is carried on easily and well. The amount of oxygen taken in is ample; the expiration of water, carbonic acid, and ammonia is free; the pulmonic circuit of the blood is unimpeded; the exhalation of water from the skin is unchecked; and the radiation of heat from the body is moderate. Let these atmospheric conditions suddenly change for those in which the temperature is 35° Fahr., or less, and in which the air is charged with watery vapor, and the conditions of life are materially modified. The supply of oxygen taken into the lungs is less; the process of absorption of such oxygen by the blood is less; the expired products are lessened; the pulmonic circulation is impeded; the watery exhalation from the skin is, in part, suppressed; the radiation of heat from the body is much more rapid; and, as a result of all, the whole man, body and mind, is enfeebled in force and in vitality. This is the course of things in a healthy man during atmospheric variations. It is left with the reader to trace out the exaggerated evil of these changes in those who, at the most favorable times, are existing with the lungs reduced in capaciousness and the respiratory muscles in power.

I shall recommend no particular place as a resort for consumptives; for I wish not to enter into disputation on this point. But here is the formula for an hypothetical Atlantis for consumptives: It should be near the sea-coast, and sheltered from easterly winds; the soil should be dry; the drinking-water pure; the mean temperature about 60°, with a range of not more than ten or fifteen degrees on either side. It is not easy to fix any degree of humidity; but extremes of dryness or of moisture are alike injurious. It is of importance in selecting a locality that the scenery should be enticing, so that the patient may be the more encouraged to spend his time out-of-doors in walking or riding exercise. A town where the residences are isolated and scattered about, and where drainage and cleanliness are attended to, is much preferable to one where the houses are closely packed, however small its population may be.

In speaking thus of the value of an equal climate, I am guided chiefly by the facts daily presented to me in relation to climatic variations on patients living in these islands. Some authors, however, infer from mortality returns, gathered from various quarters of the world, that variations of climate do not materially affect the disease, but that it is uniformly more fatal in cities than in the country. In England the excess in cities is equal to twenty-five per cent.

The facts are not opposed to the value of climatic uniformity. On