The climatic causation of consumption : read in the Section of State Medicine at the Fortieth Annual Meeting of the American Medical Association, Newport, R.I., June, 1889 / by Henry B. Baker.
- Henry Brooks Baker
- Date:
- 1890
Licence: Public Domain Mark
Credit: The climatic causation of consumption : read in the Section of State Medicine at the Fortieth Annual Meeting of the American Medical Association, Newport, R.I., June, 1889 / by Henry B. Baker. 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.
6/42 page 4
![—'4 — ably, several reasons, such as the slow progress which any such truth has in gaining acceptance, even among the thinking classes; but, in my opinion, one chief reason for the non-acceptance of, and for the non-action in accordance with this great discovery, was the fact that no one knew the reason why residence on or near low, wet soil was a prominent cause of consumption. The as- sertion and proof that this was a true law, when no one could imagine a reason why, has not led to its acceptance in such a hearty manner as to make it a strong factor in controlling the actions of residents of even New England. So that, al- though the death-rate from consumption in many parts of New England has steadily declined, it has not declined as fast as a knowledge of such an important general law as that propounded by Dr. Bowditch might have led one to expect; and it is with a feeling of sadness that one knowing this must now read the lines written by Dr. Bow- ditch over a quarter of a century ago, and which glow with lofty sentiments of manly enthusiasm. Not but that his work was well and nobly done, but the sadness comes because mankind is so slow to heed the warnings of its best prophets. Dr. Bowditch said; When I revolved in iny mind the possibility of this being an exact representation of a great truth, and then thought of the vast influence the thorough knowledge of it must have upon our professional practice, and of the beneficial effects upon public hygiene that would perhaps result, in future, from an intelligent obedience to it by the community at large, it was the happiest and most satisfactory moment of my professional life. I remem- bered that over twenty thousand” consumptive patients had died in Massachusetts during the previous five years. I asked myself these questions: Supposing this town- ship represents the various townships of the State, and that they all have their varieties of soil, then if this town- ship’s statistics are true, and at least twice as many die in the wet as in the dry districts, may not similar results have occurred and perhaps be still occurring all over the State in which these twenty thousand human beings have been slain? Having arrived at this point, you will not be surprised at my asking, still further, this pregnant question: If our fathers and we had paid greater atten- tion to this law, and we had always resided in dry locali- ties, leaving the lower and moister for the purposes of business, perhaps, during the day, or for agriculture, should we not be saving over one thousand lives annu- ally in Massachusetts, which are now foolishly sacrificed? These questions I then answered but imperfectly, but sta- tistics since received, and of which I shall hereafter give you, I hope, more convincing examples, have only made me, each year, more firm in the conviction of the affirma- tive of these questions, at least in all their essential ele- ments.'^ The writer of this article accepts the evidence collated by Dr. Bowditch in Massachusetts, by Dr. Buchanan in England, and by Dr. William Pepper in Pennsylvania. I accept it because it seems convincing, because it has not been contro- verted, because it is in harmony with the several lines of evidence which I myself have collated, and ■■ In Registration Report, i8s7, we find that during the five years including 1853 to 1857, 23,280 died of consumption in Ma.ssachusetts, wMed. Com. Mass. Med. Soc., V0I. vi. Part ii, 1862, pp. 88, 89. because I think I know why it is true; and one chief object of the preparation of this essay is the hope that the reason why may be made plain, and that thereby the realization by mankind of the grand results aimed at by Dr. Bowditch maj be aided. In order to learn the reason for the truth set forth by Dr. Bowditch, let us first inquire what are the principal meteorological differences be- tween high and dry localities, and low and wet localities. CLIMATIC CHARACTERISTICS OF LOW AND WET, AND OF HIGH AND DRY LOCALITIES. Atmospheric Pressure.—It is at once apparent that between “high” and “low” localities there is, of course, the difference in atmospheric pressure ; but the difference in atmospheric pres- sure due to the few feet difference in elevation be- tween the best and the worst localities studied by Dr. Bowditch could not have had great influence. Atmospheric Humidity.—The next most notice- able element is the atmospheric moisture; and here, in my opinion, we strike the point from which our friends, in times past, have almost uniformly diverged from the path which would have led them to the truth. They have assumed, apparently, that a wet soil always tends to make a moist atmosphere over that soil, and although this is true if we speak only of the relative hu- midity (which is the per cent, of saturation of the air with vapor of water), it is not true if we speak of the absolute humidity (which is the amount of vapor of water which the air actually contains). Our predecessors have uniformly con- sidered only the relative humidity, while, as I hope to show, it is mainly the absolute humidity that has influence in the air passages ; for the reason that the air exhaled, having been in con- tact with the warm and moist surfaces in the lungs and air passages, leaves the body, uniformly, sum- mer and winter, at about the same temperature— near 98° F., and nearly saturated with the vapor of water at that temperature. According to Glaisher’s and Guy of s tables, air at 98° F., sat- urated with vapor, contains about 18.69. grs. ot vapor in each cubic foot of air. This being so, the quantity of moisture taken out of the lungs and air passages in excess of that inhaled de- pends, not upon how nearly saturated with vapor the air may be when it is inhaled—not upon its relative humidity, because if saturated at zero it can contain only ]/z gr. of vapor, at 32° only 2 grs., at 70° 8 grs., etc.—but the quantity of mois- ture exhaled in excess of that inhaled mainly de- pends upon the absolute humidity of the atmos- phere. If air at zero, saturated with vapor, is inhaled, each cubic foot of it when exhaled will abstract from the lungs and air passages about 18 grs. of vapor of water.'® What are the important influences connected](https://iiif.wellcomecollection.org/image/b22416341_0008.jp2/full/800%2C/0/default.jpg)
