The preferable climate for phthisis, or, The comparative importance of different climatic attributes in the arrest of chronic pulmonary diseases / by Charles Denison.

Charles Denison

Date:: [1887]

Credit: The preferable climate for phthisis, or, The comparative importance of different climatic attributes in the arrest of chronic pulmonary diseases / by Charles Denison. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$This increased action and the dilitation help to isolate caseous or tubercular portions, prevent the spread of infection, and promote the cicatrization or fibrination of these affected parts. Of course, in very acute conditions we are “on the other side of the fence, and it is rest which is needed.* * * § As to pneumonic and hemorrhagic cases, the writer’s later experience, and it has been considerable, tallies well with that tabulated in his report to the International Medical Con- gress of 1876, when records were presented of 202 consumptives who had spent a total of 350 years in Colorado. The pneumonic cases and the hemorrhagic (without cavity) were by far the best influenced of all varieties.] 4. The question of an altitude of immunity from phthisis is important, because there is strong presumptive proof that those climatic conditions which prevail where phthisis seldom or never originates are best suited to arrest the disease when it has commenced elsewhere. Reference must be briefly made to the considerable evidence of medical writers in favor of an altitude of approximate immunity from phthisis, which, with us in America, ranges not far from 8,000 feet in the southwestern part of the United States to about 4,000 on our north- ern boundary.]; As to the quality of the climate which affords this immunity, Jaccoud says: “Altitude is the most important element. . . . Climates with a high altitude, having tonic and ■stimulating effects, can alone confer on the inhabitants absolute or relative immunity from pulmonary phthisis. While altitude is the governing element, all the associated favorable conditions of the atmosphere, somewhat in the order in which we have named them, seem to go hand-in-hand until they reach the climax of success in conferring a more or less complete immunity from •consumption among the residents at the given altitude. In illustration of this influence, the records of the mortality from phthisis in the city of Denver during the last year might be cited. The Health Commissioner’s report gives the total number as 195 deaths, of which only five originated in Colorado.§ If the much better results were obtainable from the country, instead of from the city, and from a little greater elevation, say at or above 6,000 feet, the immunity would most likely be more apparent. IV. SUNSHINE AS OPPOSED TO CLOUDINESS. There is little necessity of advocating the utility of the sunshine. Proof is sufficient, but it is necessarily combined with that of other climatic attributes. Everybody acknowledges the goodness of sunshine, though in summer time they may have a personal preference for shade. Undoubtedly the effect of light upon man’s physical and moral wellbeing is analagous to the fructifying influence of the sun’s rays upon the vegetable kingdom. All life depends upon sunshine and, for successful existence, must have it. The proportion of sunshine to cloudiness depends on the length of day, the exposure of a given place, whether or not concealed in a valley, and on the cloudiness of the sky. The distribution of clouds in the United States is computed by the Signal Service Bureau in tenths of obscuration of the sky, and from these observations the percentage of cloudiness, and conversely of approximate sunshine, can be noted for the whole country. * Therefore, experience in high altitudes naturally leads to the appreciation of using restraint to chest move- ments in pneumonia. The cotton jacket, with pressure to the limit of comfort, is the writer’s custom in catarrhal or bronchial pneumonias of children, which are more apt to occur during extfemely cold weather in high altitudes. f It was the writer’s intention to give cases illustrating effects mentioned in different parts of this paper, but lack of time compels their omission. \ Jourdanet’s “ Le Mexique et l’Amcrique Tropicale.” Dr. Hermann Weber’s “Climate of the Swiss Alps.” Dr. S. Jaccoud on “ The Curability and Treatment of Pulmonary Phthisis,” pp. 286-295. The writer’s “ Rocky Mountain Health Resorts,” p. 94. Among other authors who have furnished proofs of an altitude of immunity, the following should be included : Drs. II. C. Lombard, C. T. Williams, Kuchenmeister, Bremer, Archibald Smith, Fuchs, Nubry, Spengler, Kirsch and Guilbert. * § It is unnecessary here to refer to the effect such imported deaths from phthisis have upon the mortality statistics of a given locality.$