524 Dr. Rattray on the effects of Change of Climate [June 16, 



those bronchial attacks so apt to break up old and cause the deposition of 

 new tubercle. Might we not wisely imitate this oftener than we now do 

 in practice ? The increased pneumatic capacity of the chest indicates a 

 decrease in the quantity or bulk of blood in the lungs equivalent to the 

 increase in the quantity of air. If, for example, the latter is increased by 

 30 cubic inches, this implies a permanent withdrawal of 16*62 ounces of 

 blood from the lungs to the skin and liver. Now if we can imitate Nature's 

 operations, and, by increasing the temperature of a sick-room or ward in 

 this the temperate climate of England, can convert it into a local subtro- 

 pical or tropical climate, we withdraw no inconsiderable amount of blood 

 from the lungs to the skin and liver, thus relieving its overburdened capil- 

 laries, permitting freer access of air, and so aiding the respiratory process 

 — a safe and sure mode both of relieving dyspnoea and cough, and aiding 

 the vis medicatrix. 



In tropical hygiene the law appears equally suggestive. Is not the de- 

 crease in the quantity of carbon which the lungs can throw off, by 1^ oz., 

 an indication of the necessity for regulating the diet both as to quantity 

 and kind, and especially of making it less carbonaceous 1 When this is 

 attended to, and for other reasons already alluded to, the quantity of 

 oxygen taken in by the lungs is sufficient to enable them to throw off their 

 allotted portion of carbon. Even when the diet is unaltered, the function- 

 ally excited and vicariously acting skin, liver, and perhaps kidneys may 

 be able to eliminate surplus carbon up to the above-mentioned amount, 

 and perhaps a little beyond it. But this doubtless has a certain and pro- 

 bably individually varying limit ; and from a prolonged and excessive 

 ingestion of highly carbonaceous food in the tropics, all three organs are 

 apt to suffer from overwork, as may also the lungs in endeavouring to aid 

 them by accelerated and perhaps forced respirations. The importance of 

 keeping the lungs, the great carbon-eliminator in all climates, and the skin, 

 one of the chief in the tropics, in a state of the most perfect functional 

 activity possible, especially in the tropics, will be equally apparent, as 

 will also, in disease of any one of them, the indication with regard to the 

 rest ; and, considering the great importance of the skin in acting vicari- 

 ously for the lungs as an eliminator both of carbonic acid and water, the 

 necessity for constantly keeping it in healthy action during disease of the 

 latter organs, especially phthisis, will appear imperative. 



The following Table will show the relation of the frequency of the respi- 

 rations to the period of the day in the tropics. 



