^fO. I AIR AND TUBERCULOSIS — HINSDALE 35 



The vicissitudes of sea-travel, the narrow cabins and the difficulty 

 of obtaining a suitable diet, even such common requisites as milk and 

 eggs, should be enough to condemn this plan. Tuberculosis patients 

 ought not to travel more than is absolutely necessary. Imagine the 

 bacteriological condition of a consumptive's stateroom, for instance, 

 at the end of a month's voyage ! What sea-captain or steward would 

 ever put such a cabin into a sanitary condition for the next pas- 

 senger ? 



The author has some experience of life at sea under both sail and 

 steam, although he has never taken very prolonged voyages. Taking 

 into account the character of the food supply and the necessity of at 

 least sleeping in small cabins and probably spending days in them, 

 with uncertain medical attention ; and, besides this, the dangers of 

 various kinds that pertain to seaports, the author feels bound to con- 

 demn sea voyages for the tuberculous in any stage. 

 " Non mutant morbum qui transemit mare." 

 MARINE CLIMATE OF ISLANDS 



It is far better for the tuberculous patient to remain on terra Hrrna 

 than to traverse the sea. Whatever is of value in the sea air can be 

 obtained in islands such as Ireland, the Isle of Man, the Isle of 

 Wight, Nantucket, the Isles of Shoals, Newfoundland, Long Island, 

 the Bahamas, the Canaries, the Philippines, Samoa, and many other 

 islands. 



Just as in the case of sea voyages, there are concomitant influ- 

 ences, many of which are notoriously unfavorable, that in themselves 

 over-balance any possible advantage from sea air. Take, for in- 

 stance, the problem as it presents itself in Ireland or the Isle of Man. 

 Among the various countries of the world Ireland stood fourth 

 in the order of mortality from tuberculosis, being exceeded by Hun- 

 gary, Austria, and Servia. During the last thirty-five years the 

 mortality in Great Britain has been reduced one-half among females 

 and one-third among males but, until 1907, there had been no such 

 fall in Ireland. 



Sir John Byers, of Belfast, in his address' entitled "Why is 

 Tuberculosis so Common in Ireland?" characterized its prevalence 

 in that country as " appalling." Among the nine causes which are 

 assigned for this condition of affairs attention is first directed to 

 the damp climate. An investigation of places with rather worse con- 



^ The Lancet, January 25, 1908. See also Alfred E. Boyd, M. B. : Tubercu- 

 losis and Pauperism in Ireland, British Journ. Tuberculosis, July, 1908, p- I59- 



