TEE EYGIENIC 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 res- 

 piration 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 ma- 

 terially 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 radia 

 tion 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 varia 

 tions. 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 scat- 

 tered 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 varia- 

 tions 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 



