464 surgeons' reports — Michigan — foorth district. 



ons or hurtful substances, but renders tbe atu:ospbere inviftorating and braciug to tbose wbo bave 

 become debilitated from disease or depressed troui atmospbeiical beat. 



Imraediately ujwu tbe border of Lake Michigan, during- the summer, the winds are cool and 

 refreshing, auddnriug the winter are modified and >-oitened by passing over a sheet of water, in length 

 from eighty to a hundred miles, tbe average depth of which is 1,000 feet, and which never freezes 

 except at its borders. Moisture exercises and produces a marked influence over climate, rendering 

 locations more temperate, and is the obvious reason of seasons being more mild in the same par- 

 allels of latitude. The western winds, the course of which is for an immense distance over dry 

 land, and which contribute largely in summer to elevate the temperature and in the winter to 

 reduce it, after passing over the lake, reach the eastern shore modified in winter by the water hav- 

 ing imparted its latent heat to the colder wind, and in summer from its having given its moisture. 

 These equalizing influences thus act upon the atmosphere at diflereut seasons. Fruits of all kinds 

 are grown upon the eastern side of tbe lake, while they do not flourish on the western. The same 

 influences affect the climate on the western shore of the Atlantic Ocean in America, and on its 

 eastern shore in Europe ; on the latter, the west winds from the ocean render the temi)erature 

 more mild. Tbe climate of England and Ireland furnishes a striking contrast with the American 

 side of the Atlantic, as well as with the interior of Europe in the same latitude. # * # 



The counties situated immediately upon or near the shore of the lake are resorted to by inva- 

 lids from the Eastern States, more particularly by those afflicted with pulmonary diseases, and 

 generally wit i marked benefit. Many by making their permanent residence in the district have 

 believed themselves to have recovered from tuberculosis of the lungs. In such statements, due 

 allowance should be made for possible errors in diagnosis ; but cases have come under my imme- 

 diate notice in which I am satisfied that tubercles in their incipient stage have been checked, and 

 in others in which they have been lurther developed they have been rendered inoperative in their 

 progress, and life has been prolonged from the bracing influences of the climate. In confirmation 

 of these statements, I would direct your attention to tbe small ratio of cases of developed tubercu- 

 lous phthisis reported. 



Having no means of accurately estimating the mortality fiom phthisis in this city (Grand 

 liapids, now containing ten thousand inhabitants) lor tbe last twenty years, except from recollec- 

 tiou, I will nevertheless venture the opinion, which I think will be sustained by every practitioner 

 in the city, that the deaths from this disease will not in any one year exceed two per cent, of the 

 whole mortality. The most frequent diseases of the resi)iratory system are of a bronchial or 

 catarrhal character, being mostly cases of acute and chronic bronchitis. The most prevalent diseases 

 are of a miasmatic origin, the fevers being intermittent and remittent, but usually of a mild type. 

 Ohronic dysentery and diarrhoea are scarcely known. The degree of moisture of tbe atmosphere, 

 says Lebmann, is not without iufluence on the respiratory organs, and especially on the excretions 

 of carbonic acid. * * * The influence exerted by tbe moisture of the air on the respiratory 

 movements is not a question of mere conjecture, since it admits of direct observation. 



The view taken by Dr. Edwin Lee, of London, is that the choice of a climate should be deter- 

 mined by the patient's temi)erament, the condition of the system, and the more or less advanced 

 state of the disease. In general, warm and dry localities best suit persons of a lymphatic or scrof- 

 ulous constitution, where the circulation is languid. These, on the other hand, are often too excit- 

 ing for individuals of a sanguine or nervous temperament, in whom there is an irritability of the 

 air-passages, a disiiosition to inflammation or to hiemoptysis, with acceleration of the circulation ; 

 such patients would generally find themselves better where the atmosphere was somewhat moist 

 and not liable to great variations. A similar climate is likewise better adapted to patients in more 

 advanced stages of the disease. 



From the statistics collected by the late Dr. Drake, and al.so from the reports of the Army, the 

 proportion of deaths from phthisis proves to be greater in the South than at the North. 



I consider it is of great importance that the climate of this region should be made known, and 

 that the injudicions course of sending consumptive i)atients to some southern coast or island, where 

 they must forego the comforts of home, of family, and Iriends, may be thus avoided. 



This district is inhabited by an intelligent, temperate, frugal, and industrious people, mostly 

 Americans from New England ai.d New Yoik. Tiiey are generally agriculturists, with the excep 



