With the Compliments of DE. W. OLEITSMANN. 
WESTERN NORTH CAROLINA 
AS A 
Health Resort. 
BY 
W. GLEITSMANN, M. D., 
Physician in Charge of the Mountain Sanitarium for Pulmonary 
Diseases, 
ASHEVILLE, N. C. 
Read before the American Public Health Association, November, 1875, at Baltimore, 
and Reprinted from the Philadelphia Medical and Surgical 
Reporter, February, 1876. 
BALTIMORE: 
PRESS OF SHERWOOD & CO. 
1876. WESTERN NORTH CAROLINA 
AS A 
HEALTH RESORT. 
The tendency of climatological science in our time is mainly 
directed to the study of the different constituents of climate, in 
order to ascertain thereby the fitness of special localities to certain 
classes of disease. The present sketch originated in the desire 
to make a small contribution to this department of our science, 
by furnishing a few data concerning a region heretofore unknown 
in its climatic relations to a great number of our people. 
Western North Carolina, with the adjacent parts of North- 
western South Carolina and Northeastern Georgia, contains the 
southern extremity of the Appalachian chain, which extends in 
a continuous range to the north, through the whole eastern part 
of the Union. The highest elevations of the whole chain are 
found in its southern part, and especially in western North Car- 
olina, thereby imparting special peculiarities of climate. The 
region which directly occupies our attention is bounded east and 
west by high mountain ranges, sloping gradually down, in the 
extreme north, to the southerly extension of the great Virginia 
valley, and declining very abruptly to the lowlands in the 
south. The boundary on the west is formed by the Unaka, 
Great Smoky, the Bald, Iron and Stone mountains, their high- 
est ridge coinciding with the State line between North Carolina 
and Tennessee. To the east we find the Blue Ridge proper, 
with the highest elevations east of the Rocky Mountains ; Black 
Dome being 6,707 feet above the level of the sea. The Blue 
Ridge in this section is the watershed between the Atlantic 
Ocean and the Mexican Gulf. All the streams having their 
sources east of the ridge empty into coast rivers, which flow, 
after short courses, into the Atlantic ; whilst to the west all the 
water flows into the Tennessee river, a tributary of the Ohio, 
and finds its outlet through the Mississippi into the Gulf of 2 
Mexico, Six principal streams break through the high western 
mountain barrier, among them the Tennessee river itself; and 
this peculiar feature contributes greatly to the variety of the 
different valleys, and enhances the beauty of the landscape. 
Prof. A. Guyot, of Princeton College, New Jersey, who explored 
this country some time ago, published a series of measurements 
he had taken. In this list, fifty-one mountains, rising over 
6,000 feet above the sea-level, are mentioned. 
Western North Carolina embraces an area of about five thou- 
sand square miles, and has its greatest extension from north 
to south. The length, from Virginia to Georgia, is about one 
hundred and eighty miles, while the breadth varies from twenty 
to fifty miles. The whole country is undulating, and perfectly 
level places, even of small extent, are rarely to be found. It 
can neither be called a valley nor a high plateau, as several high 
mountain-ranges, of which the Balsam Mountains are the most 
prominent, traverse it from northwest to southeast, and the spurs 
of which, extending all over the country, are the cause of its 
irregularity. The high barrier in the west, formed by the Great 
Smoky Mountains and their continuation, runs from southwest 
to northeast, and breaks the force of the northwest storms so 
frequently occurring, and so well known for their severity all 
over the eastern portion of our continent. 
The geological character is, in general, of primary formation, 
which gives to the water a purity and softness highly appreciated 
by strangers. Springs are numerous, and greatly add to the 
richness of vegetation, which clothes all the mountains to their 
very summits. The mountains are all covered with timber, and 
a great variety of species presents itsejf to the eye of the botan- 
ist.* The soil is rich, and especially on the summits of the 
hills, a fact which, although surprising at first sight, is easily 
explained by the circumstance that the decay of leaves and veg- 
etable matter is left undisturbed by the hand of man or the 
washing of rains. The clearness of the atmosphere, on bright, 
*Prof. W. C. Kerr, State Geologist, says, in his report just published, that 
of species found in the United States, east of the Rocky Mountains, there are— 
Oaks, 
22, 
and 
19 
in North Carolina. 
Pine trees, 
8, 
44 
8 
Spruces, 
5, 
44 
4 
44 44 
Elms, 
5, 
44 
3 
44 44 
Walnuts, 
2, 
44 
2 
44 44 
Birches, 
5, 
44 
3 
44 44 
Maples, 
5, 
44 
5 
44 44 
Hickories, 
8, 
44 
6 
44 44 
Magnolias, 
7, 
<4 
7 
44 44 3 
sunny days, makes the mountains appear much nearer than they 
are in reality, and often deceives in estimation of distances. 
If we enter into special investigation of the individual cli- 
matic factors, we have the longest series of observations made by 
the volunteer observer in Asheville, for the Smithsonian Insti- 
tute, extending over a period of nearly eight years. This place 
is the principal town of Western North Carolina, being situated 
in the wide valley of the French Broad river, 2,250 feet above the 
ocean, and 250 feet above the river. It is located on an irregu- 
lar plateau, extending from the base of the last spurs of the 
Black Mountain, and is the true representative of a mountain 
climate. The place, owing to its southerly location (35° 36' 
north latitude), possesses the great advantage of being less subject 
to those great extremes of temperature under which the East- 
ern and Western States of the Union suffer so much. The 
importance of this subject may justify an explanation, by some 
details and figures, in proof of the correctness of my assertion. 
Asheville is famous for the coolness of its summers, the temper- 
ature of 90° being recorded only once in the whole period of 
eight years. The thermometer seldom rises above 85°, and the 
highest temperature in 1815 was 86° ; 1874, 88° ; and 8° the 
lowest point reached by the mercury in the Winter of 1874-75. 
The average summer temperature is 70.7°; and if we compare 
the extremes of heat and cold in cities having an equal or sim- 
ilar summer mean, the Chief Signal Office Beport for 1874 
furnishes us the following interesting data, for the period from 
October 1st, 1873, to September 30th, 1874:— 
Ashevi 
Sandy 
Long B 
Clevela 
New Y 
Detroit 
Chicagt 
Denver 
Colorac 
St. Pau 
o 
“o 
M 
«H 
w 
QD 
p D 2 O noVS-’ C. O 
• * O • P • • 
t-* o OS-t® ®HKOCO 
Average 
woo to A A obob<* 
Summer 
Temperature. 
i-j-1-1 
oooooeo®®® 
©>-‘t©«5~aOSCSrf*®SGD 
Highest 
n. 
Summer 
Temperature. 
lO W Ol 
Cl O O C5 Ol OJ QT 05 • 
How often 
ET.. 
Temperature 
« . 
T- • 
above 90°. 
1 1 1 1 
| 
OS~JH-‘Ci©tf‘-00<J<}GO 
Lowest 
Winter 
'WJ 
Temperature. 
OOKK 
OS rf* l-i (—*■ 
How often 
£*:::::: 
Temperature 
** ~ ** £ 
CO ***** * 
below 0°. 
H-k t—*■ 
tOH-*i-*OCDOOOOGOOOCO 
Range of 
lOOOCCQT-^^OO-KjOiO 
Temperature 
for whole Year 
This table, which could easily be enlarged, shows in strong 
figures the uniformity of climate at Asheville. But places with 
even a lower summer mean than Asheville show a considerably 4 
higher extreme, as we learn from the meteorological report of 
Professor G. T. Kingston for the Dominion of Canada for 1874. 
The whole number of stations was fifty-three, all of which have 
a lower summer mean than Asheville. Of these stations, 
twenty-six showed over ninety degrees temperature ; and of 
twenty-eight stations in Ontario, twenty-one gave the same 
thermometric result, over ninety degrees. We would obtain a 
similar table in a contrary direction, by taking the winter mean 
of Asheville (37‘8°) as a standard of comparison with other 
places of the same mean winter temperature. Let it, however, 
suffice to say that these observations are corroborated by the 
records of the different volunteer stations in Western North 
Carolina, as published in Professor Kerr’s report. It can fairly 
be said that this region, and especially Asheville, has one of 
the lowest extremes of summer temperature, and that few places 
are found on the eastern side of the continent combining such cool- 
ness of summer with mild winters. Places of the same elevation 
show a still greater difference in our favor. 
Another feature of interest presents itself in a comparison, 
during a long period, of the diurnal ranges of the thermometer 
in places at the same or higher altitude. As the Chief Signal 
Office Report for 1874 does not contain records of the maximum 
and minimum temperature at stations of a similar elevation, it 
is necessary to take stations which, though located higher, have 
the range during a full year recorded. In the following places, 
in Colorado, Dakota and Wyoming, the daily range of the 
thermometer over 20° has been calculated and placed in subdi- 
visions of 5°, from 20° upward to 00° ; and the same has been 
done for Asheville, for the years 1878 and 1874. (See table on 
page 5.) 
This table needs no commentary, but speaks for itself. Whilst 
the highest daily range at Asheville was but once in two years 
over 40° (and then only 41°), Colorado Springs shows the same 
range thirty-three times in less than one year ; Denver twenty- 
nine times in 1873, and thirty-one times in 1874, etc., and both 
run in decreasing number up to the high range of between 55° 
and 60°. It is here necessary to state that in the extremely dry 
regions of Colorado and the Western territories crossed by the 
Rocky Mountains, the cold air and change of temperature are 
much less perceptible ; an observation which, to a certain ex- 
tent, is also made here. 5 
Diurnal 
Range, in 
degrees, F. 
NUMBER OF 
OCCURRENCES OF THE DIURNAL RANGE IN 
1 Colorado Springs, 
1874, 
10 mo. and 6 days. 
Denver, Col. 
Fort Sully, 
rt 
O 
Q 
Cheyenne, 
W. T. 
JO 
p* 
ac 
<5 
d 
1873 
1874 
1873 
1874 
1873 
1874 
1873 
1874 
20°-25° 
46 
58 
55 
74 
70 
66 
63 
46 
30 
25°-30° 
47 
59 
68 
49 
80 
71 
83 
28 
18 
30°-35° 
52 
59 
77 
43 
51 
67 
63 
14 
14 
35°-40° 
72 
55 
60 
47 
36 
34 
50 
1 
4 
40°-45° 
33 
29 
31 
18 
16 
16 
26 
1 
45°-50° 
19 
6 
• 
11 
4 
6 
4 
5 
50°-55® 
3 
1 
1 
1 
55°-60° 
2 
.. 
l 
1 
Records of the other climatic elements in this region are 
scarce, and the fullest are those of the rain-fall, and its amount 
in inches for a period of several years, in Professor Kerr's re- 
port. We here learn that of eighteen stations in the whole 
State, only one has a lower amount of rain-fall than Ashe- 
ville, viz : Greensboro, which shows but 19.9 inches, whilst 
Asheville has 39.4, or as a mean of 8 years, 40.2 inches. 
All stations of Western North Carolina have considerably 
more, ranging from 48.5 to 72.8 inches ; the average for the 
whole western division being 58.2 inches. Our place, therefore, 
shows a very favorable ratio in comparison with the surrounding 
country and the State in general. The pressure of vapor, its 
weight, the absolute humidity, have, to my knowledge so far, 
not been measured ; but the observations of daily life, the rapid 
drying of roads after a rain-fall, the conservation of meat hanging 
in the open air, etc., indicate but a small amount of moisture 
suspended in the air. The unusual rain-fall and general atmos- 
pheric conditions of this summer deprived researches into the 
relative humidity (saturation at 100) entirely of their value. 
Instituted only a short time, the mean of three observations for the 
time at which patients generally move about in the open air, 
viz: noon, 2 and 4.15 P. M., give for the month of October 
SO^0 and for the whole month 64° relative humidity.* 
If after these considerations, we regard the climate of this 
section as a whole,we find all the theoretical requirements of a 
mountain climate existing in their proper relation. It is not 
here in place to urge in detail the beneficial effects of elevated 
regions on the large class of sufferers from pulmonary phthisis. 
*Note : The average relative humidity for the first quarter of 1876 was 59.8°. But as it is not yet known and universally acknowledged that 
the decrease of the occurrence of phthisis is greatly dependent 
upon elevation above the sea-level, and the consequent lower 
barometric pressure of the atmosphere, it will not be out of the 
way to quote, from the extensive literature of this subject, some 
few works which may aid those wishing to make investiga- 
tions in this direction.* The practical application of these 
theoretical researches, viz., the treatment of consumptives by a 
protracted sojourn in elevated places, is being, and has been for 
some time past, carried out on a large scale in Europe and other 
parts of the globe. According to a recent compilation, there arc 
now 123 mountain resorts in existence in Europe, at elevations 
from 1,500 to 4,000 feet and over. Our section has a great advan- 
tage over many European resorts, which are, without exception, 
situated in more northerly latitudes. Although phthisis is ob- 
served in countries with most heterogeneous temperature, it will 
nevertheless be in many cases desirable to send such patients to 
a locality of moderate thermometric range and extremes ; as 
sudden changes often prove causes of fresh colds or intercurrent 
affections. In the South the rays of the sun have greater power ; 
insolation, generally more powerful in the mountains, is in- 
creased, and affords a most valuable medium for the invalid in 
winter. He is thereby enabled to move about, or to sit in 
sheltered sunny places on winter days, and enjoy without injury 
the salubrious influence of fresh air. The relations of ozone in 
the air have not been as yet investigated, but all conditions for 
its production are present—as abundance of vegetation, of water 
* Fuchs : Medizinische Geographie, 1853. Muehry, A.: Climatologische Un- 
tersuchutigen, oder Grundzuege der Climatologie; Leipzig and Heidelberg, 
1858. Muehry, A: Climatographische Uebersiclit der Erde; Leipzig und 
Heidelberg, 1862. Jourdanet, D : Les Altitudes de l’Amerique Tropicale ; Paris, 
1861. Jourdanet, D.: L’air Rarefie; Paris, 1862. Jourdanet, 1).: Le Mexique 
et l’Amerique Dyricale; Paris, 1864. Hirsch, August: Handbuch der His- 
torisch Geograpliischen Pathologie, n Band; Erlangen, Fr. Enke, 1862-1864. 
Smith, Archibald: Climate of the Swiss Alps and of the Peruvian Andes com- 
pared ; Dublin Journal, 1864, 1866. Schnepp, B.: Etudes sur les Climats, etc.; 
Paris, 1865. Weber, Hermann: On the Influence of the Alpine Climates on 
Puhnouary Consumption; British Medical Journal, 1867, vol. n. Weber, Her- 
mann: On the treatment of Phthisis by Prolonged Residence in Elevated Re- 
gions ; Transactions of the Medical and Chirurgical Society in London, vol. 
liii, 1869. Kuechenmeister, Fr.: Die Hochgelegenen Plateaus als Sauatorien fuer 
Schwindsuechtige; Wien, 1868. Kuechenmeister, Fr.: Ueber das Vorkommen 
der Lungenschwindsucht, etc.; Dresden, 1869. Spenglcr: Die Landscliaft Davos; 
Basel, 1860. Drysdale, Charles B : Alpine Heights and Change of Climate in 
the Prevention and Treatment of Pulmonary Consumption, London, 1869. 
Lombard: Les Climats des Montagues; third edition, Geneve, 1873. Biermann, 
A.: Hochgebirge and Lungenschwindsucht; Leipzig, Otto Wigand, 1874. 
Scrivener: On the Bolivian Andes; in several journals. By Myself: Nature and 
Curability of Pulmonary Phthisis; Richmond and Louisville Medical Journal, 
July, 1875. Altitude and Climate in the treatment of Pulmonary Phthisis; 
Transactions of the Medical and Chirurgical Faculty of Maryland, 1875. electric tension and great evaporation. The purity of the air is 
another element of value in mountain districts. Low tempera- 
ture, dryness, greater amount of ozone, are not favorable to the 
development of micrococci and bacteria; and the processes of 
putrefaction, fermentation and moulding are diminished or en- 
tirely absent. Diseases originating from their products do not 
exist, or cannot gain a foothold ; no manufactories contaminate 
the atmosphere, and the patient inhales with delight the pure 
air. The mountain climate in general exerts a tonic influence 
over the whole system, induces greater activity of all organs 
and functions, and imparts strength. The desire for food is in- 
creased, and the latter better digested and assimilated. The 
psychical influence of the beauty and grandeur of nature has 
undoubtedly a beneficial effect on the depressed human mind. 
Before ventilating the question as for which diseases this cli- 
mate can be advised, it is necessary to state that one great 
attraction of the future is not develoj)ed at all at present. 
Western North Carolina has the greatest abundance of mineral 
springs, which, with very few exceptions, have never been ana- 
lyzed, and the medical use of which has never been thought of 
or attempted. Without having paid, so far, special attention to 
this point, I counted over half a dozen such springs in the imme- 
diate neighbourhood of the town of Asheville. There are alkaline, 
chalybeate, and sulphur springs to be found, but none of them 
are properly set or utilized. Five miles from this town is a 
good and abundant sulphur spring, which, many years ago, 
attracted a great number of visitors. A large hotel, capable of 
accommodating two hundred guests, was erected, and the grounds 
nicely laid out; but since the house was destroyed by fire, in 
1860, the springs and property are neglected and unused. The 
warm springs in Madison county, thirty-six miles west of Ashe- 
ville, are the only ones now extensively visited, and have proved 
beneficial in many cases to which they are adapted. There is 
no doubt that, as soon as attention is once properly directed to 
this subject, these resources will soon be developed and made 
available to the sick. 
Although, for sometime to come, we must depend solely on 
nature’s abundant gift of climate, we find many instances in 
which this proves efficacious and beneficial. Among constitu- 
tional disturbances, we may mention nervous prostration from 
overwork, insufficient nutrition, anaemia after severe sickness, 
chlorosis, dyspepsia, and malarial cachexia. It has already 8 
been mentioned that improvement in digestion and assimilation 
takes place here as a rule, and my own experience corroborates 
the assertion of other observers. I would here observe, witliou 
further specifying the effect of the climate on such patients, 
that a certain amount of strength must still be left them, in 
order that they may obtain relief. The individual organs should 
not be so debilitated or degenerated that the result of treatment 
will be prevented by the impossibility of stimulating their func- 
tions. Malaria and its consequences are unknown here, and a 
recovery from its manifold sequelm can safely be expected. 
Finally, this region has an important value in relation to 
diseases of the respiratory organs, and amongst them more es- 
pecially to pulmonary phthisis. Patients for whom climatic treat- 
ment in elevated regions is indicated, find here all the necessary 
conditions in their fullest extent. The best results are attained 
in defective development of the thorax in young people, either 
hereditary or brought about by disease, or too rapid develop- 
ment. This is the frequently occurring so-called atony of the 
lungs, with want of full breathing, and mechanical predisposi- 
tion to disease of the apex of the lungs. To these patients cli- 
matic treatment almost invariably offers a cure, and even a few 
months of such treatment, under proper control, suffice to produce 
better complexion, greater strength, more energy in the perform- 
ance of the functions in general, and increased capacity of lung. 
Phthisical catarrh of the apices and chronic infiltrations of the 
lungs are also proper conditions for treatment by mountain cli- 
mate ; but the latter should not be so extensive as to make 
breathing rarefied air dangerous, or to prevent the energy 
necessary for constitutional reaction in general. The same may 
be said of cases where the breaking down of tissues has already 
set in. The selection of such patients should be made with 
care. Taken as a whole, the expression may be allowed that 
our region will be found advantageous for the majority of those 
cases which are suited for treatment in elevated regions, uniting 
as it does, by its situation, by far the greatest number of the 
desiderata of a mountain climate. 
The accommodations for the reception of invalids are slowly 
but steadily increasing. There are now three hotels and a num- 
ber of boarding houses in town for visitors, besides the Mountain 
Sanitarium, especially designed for the treatment of invalids. 
Asheville will be, before long, the center of three railroads, and 
there is no doubt but that a bright and promising future is in 
store for this beautiful, sunny country.