THIS 
CONSTITUENTS OF CLIMATE, 
WITH 
SPECIAL REFERENCE 
TO THE 
CLIMATE OF FLORIDA. 
BY 
FREDERICK D. RENTE' A. ]£., M. D., 
Member of Board of Managers of Hudson River State Hospital; of the Council of the 
University of the City of New York; of the New York County Medical Society; of 
the New York Neurological Society; of the New York Medical Journal 
Association; Corresponding Member of the New York Medico- 
Legal Society; Honorary Member of the North Carolina 
State Medical Society, etc., etc. 
FROM AUGUST NO. RICHMOND AND JOURNAL. 
LOUISVILLE, KY.: 
RICHMOND AND LOUISVILLE MEDICAL JOURNAL BOOK AND JOB STEAM PRINT, 
104 Green Street, 2d door west of Post-office. 
1878. J±J lEw lEw _Al_ Q? -A... 
Please make the following corrections before reading: 
Page 18, line 17, for misral read mistral. 
Page 22, line 7, for begets read beget. 
Page 23, line 4 of foot-note, scratch out more after were, and 
erase the comma after perhaps more. 
Page 39, line 12, for humous read humus. 
Page 40, for Halleck in foot-note read JEallock. 
Page 55, line 21, place a comma after the word day. T ZEE IE 
CONSTITUENTS OF CLIMATE, 
WITH 
SPECIAL REFERENCE 
TO THE 
CLIMATE OF FLORIDA. 
BY 
FREDERICK D. LENTE\ A. M., M. D,. 
PALATKA, FLORIDA. 
FROM AUGUST NO. RICHMOND AND LOUISVILLE MEDICAi~4QD RNAL 
LOUISVILLE, KY.: 
RICHMOND AND LOUISVILLE MEDICAL JOURNAL BOOK AND JOB STEAM PjAnTS 
104 Green Street, 2d door west of Post-office. 
1878. THE CONSTITUENTS OF CLIMATE. 
In a paper which I had the honor of reading before the 
American Public Health Association two years ago, in Boston, 
I made the attempt to enlighten the public, and especially the 
medical public, on the subject of the climate of Florida, its 
adaptability as a health resort, and especially to remove certain 
unfounded ideas and prejudices which have become wide-spread 
and deeply-rooted in northern communities. It is somewhat 
surprising that this should be the case with medical men, since 
positive information on the subject has always been accessible 
to them in the volumes of the “ Medical Statistics of the U. S. 
Army,” the “Army Medical Reports” and the “Reports of the 
Adjutant-General’s Office,” embracing statistics covering a space 
of more than forty years, which are, of course, thoroughly un- 
prejudiced. They are particularly full of information regarding 
the meteorology and endemic influences of Florida. For some 
years past, however, a number of northern physicians have spent 
winters or portions of a winter in Florida, and the number is 
yearly increasing. The verdict of these has been uniformly 
favorable, as also that of the various surgeons of the army who 
have been stationed there, some of them for several years, 
during the Seminole war. The earliest visitors and the various 
adventurers who landed on the shores of Florida, and who left 
us any written evidence of their experience and sentiments, have 
spoken in the most enthusiastic terms of her climate. The 
numerous writers on the subject in the present century have 
expressed themselves in a similar manner, and indeed it seems 
almost impossible to one who has lived several winters in Florida, 
in describing the beauties or the advantages of her climate, not to 
drift into the same strain. Something of it will be noticed even 
in the formal reports of some of the older army surgeons. But 
I propose to avoid this, and to deal with plain facts as far as 
possible, and leave my medical brethren to draw their own con- 
clusions. CONSTITUENTS OF CLIMATE. 
I am disposed to think that there is a desire for further in- 
formation on this subject, from the fact that my first paper was 
copied entire or by large extracts in various journals, and that 
frequent inquiries are now made for the reprints, which were 
long ago exhausted; while a longer residence in Florida, and a 
more extensive acquaintance with those who have tested the 
winter climate for several years, will enable me to speak with 
more confidence on certain topics than I was able to do at the 
date of my first publication. 
The question of climate is confessedly a difficult one to man- 
age, and the amount of definite, practical knowledge which one 
is able to gather on the subject from the numerous publications, 
some of them quite voluminous, is very small. In truth, the 
more one reads and the more facts he gathers from various 
sources, the more difficult the task of collation and inference 
becomes, since these observations are so conflicting and the 
various theories so confusing that it seems well nigh impossible 
to deduce any valuable therapeutical conclusions from them. I 
have addressed myself to this task for the past few years; have 
studied all the works on Florida from that of Le Moyne, who 
visited it in 1564 as artist to the expedition of Laudonnidre 
to the latest accessible publications, including all the records 
bearing upon the subject in possession of the War Depart- 
ment, the library of the Surgeon-General and other depos- 
itories at Washington; have conversed with the Surgeon-Gen- 
eral, the Assistant Surgeon-General, and other medical and line 
officers who have been stationed in Florida, and who have had 
experience of both her summer and winter climate; with many 
of the scientific and medical residents in the State; with some 
of her representatives in Congress; and have had the opportu- 
nity, during the past three winters, of seeing and conversing 
with a large number of intelligent visitors and invalids who had, 
many of them, sought health in various quarters of the globe, 
and whose evidence regarding the comparative value of climates 
I consider more valuable than that from any other source; since 
they have no interest in any particular locality, except so far 
as it has been conducive to the object in view. Among these, 
when they have remained in Florida a sufficient length of time CONSTITUENTS OF CLIMATE. 
5 
to form anything like an accurate judgment, there has been a 
remarkable unanimity of opinion in favor of her climate. The 
opinion of the hundreds who are scattered over the country, 
who have spent a month, or a few weeks, or one winter even 
in the State, going generally to only one point, is not worth 
taking into consideration; yet we have an abundance of contri- 
butions from this source in the Press of the country, and many 
form their judgment from these effusions. Florida has been 
poetically described as the “ Italy of America.” But those who 
have fully tested the climate of the various Italian resorts will 
consider it anything but flattering to Florida. If space will 
permit, this comparison will be further alluded to. 
There are indications at present that our ideas on the intri- 
cate subject of climate are assuming a more definite shape, are 
becoming crystallized, as it were, around one central point, which, 
if true, will save us a good deal of perplexity and responsibility 
when we are asked by our patients the important question: 
“What climate will suit my case?” Is there any special 
property of climate which we may seize upon as the test of 
superior fitness for our purpose as therapeutists? I have 
reference now to one disease—Pulmonary Consumption in its 
various forms. These indications are that the public and the 
profession are arriving at the conclusion that the climate 
which will offer the greatest inducements to invalids to be out 
in the open air, or which will enable them to breathe it con- 
stantly and without danger of chilling the surface, or, in other 
words, that which furnishes the greatest amount of pure air, is, 
to speak in general terms, the one to be preferred, paying due 
regard, however, to the various constituents of climate which 
may influence the quality of the air. Let me briefly refer to 
several publications in the journals of three different coun- 
tries, all falling within the last few months, for these straws 
show which way the wind blows. In an article in the No- 
vember number of the “Popular Science Monthly,” by Dr. 
Felix L. Osgood, entitled “Modern Troglodites,” the author 
quotes the following from the report of the celebrated German 
surgeon, Langenbeck, on Small-Pox: “ I have cut up more 
human bodies than the ‘ Old Man of the Mountain’ with all his 6 
CONSTITUENTS OF CLIMATE. 
accomplices; and, speaking only of my primary object, I must 
confess I am no wiser than before. But, though the mystery 
of small-pox has eluded my search, my labors have not been in 
vain. They have revealed to me something else, the origin of 
consumption. I am sure now of what I suspected long ago, 
viz., that pulmonary diseases have very little to do with intem- 
perance, or erotic escapes, and much less with cold weather, but 
are nearly exclusively (if we except tuberculous tendencies in- 
herited from both parents, I say quite exclusively) produced by 
the breathing of foul air. The lungs of all persons who had 
worked in close workshops and dusty factories showed the 
germs of the fatal disease, while confirmed inebriates who 
had passed their days in the open air, had preserved their 
respiratory organs intact, whatever inroads their excesses had 
made on the rest of their system. If I should go into practice 
and undertake to cure a consumptive, I should begin by driving 
him out into the Deister (a densely wooded mountain range 
of Hanover) and prevent him from entering a house for a year 
or two.” 
The drift of the whole article is to prove, as he does by argu- 
ments and interesting anecdotes, many of them familiar perhaps 
to most of my readers, that dwelling as far as possible in the 
open air, whether cold or warm, and breathing it day and night, 
regardless of the bug-bear of “ taking cold,” is the only pre- 
ventive or cure of consumption. In the same journal for De- 
cember is an article by Dr. Paul Niemeyer, entitled “Open Air 
and Health.” In this he speaks of certain “ throat and lung 
complaints which we physicians are daily more and more clearly 
tracing to inhalation of impure, vitiated air.” The burthen 
of his argument is fresh air and plenty of it. “The patient 
must keep the window of his bed-room open. Night air is 
fresh air without daylight; he who fears night air is like a child 
who dreads darkness. In a city, night air is always wholesomer 
than day air, being both purer and stiller.” In a late number 
of the “London Lancet,” Dr. Handheld Jones, an eminent Eng- 
lish physician, gives remarkable clinical evidence from hospital 
experience of the great value of what he terms hyper-ventilation; 
that is ventilation of sick rooms carried far beyond what the CONSTITUENTS OF CLIMATE. 
7 
great majority of us physicians, as well as non-professional per- 
sons, would consider judicious. The change in the aspect of 
cases, which were considered hopeless, from throwing open the 
windows of the wards, even in cold weather, was truly aston- 
ishing. Dr. J. Scnreiber, of the Vienna Faculty, in a recent 
address before the Austrian Meteorological Society, translated 
by Dr. Geddings, of Aiken, for the “ Richmond and Louisville 
Medical Journal,” also calls attention to the same subject, and 
concludes by saying that “ the term climatic,” which has hither- 
to been employed to denote a vague, indefinite specific, of which 
no rational account could be given, appears now as something 
infinitely clear and very simple, being in fact nothing more 
than pure air uncontaminated by miasma, with no organic 
or inorganic substances, and one in which meteoric precipitation 
(rain) is not unduly deficient. He shows that it is neither 
warm air necessarily, nor cold air, nor dry air, nor moist air 
that is wanted, but air in abundant quantity. 
I do not mean to say that there is anything particularly novel 
in the above ideas. Individual efforts in this direction have 
been made for many years. Several years ago a physician in 
California would not allow his consumptive patients to sleep 
even in a tent, but put them to sleep under the trees in the 
dry, pure air of the locality where he resided. Dr. MacCormac, 
an English physician of note, insisted, many years ago, that if 
people would sleep with open doors and windows, there would 
be no consumption; the hyper-ventilation of Handheld Jones. 
This, then, is the key-note of the climatic cure of consumption, 
scrofula, and allied diseases. It is not wonderful that air 
should be so essential to the proper treatment of these affections, 
since a deprivation of pure air has long been recognized as the 
principal factor in their generation. It is hardly necessary to 
argue this point, but a few illustrative examples may not be 
out of place. In the report of the health of the Royal Navy 
for, 1860, “ accounts'1 are given,” says M. Simons (“American 
Journal Medical Sciences,” January, 1872,) “of a form of con- 
gestive pneumonia of the apex of the lung, which had much the 
character of incipient phthisis, which was attributed to the 
overcrowding of the men in berths between decks, the hammock 8 
CONSTITUENTS OF CLIMATE. 
hooks being only fourteen inches apart. A great number of 
those who were invalided rapidly improved, when they were 
removed from the cause, and were able to rejoin the service.” 
“In one instance, in the Dublin House of Industry, where 
scrofula was so common as to be thought contagious, there were 
in one ward, sixty feet long and sixteen feet broad (height not 
given), thirty-eight beds, each containing four children. The 
atmosphere was so bad that in the morning the air was unen- 
durable.” In some of the schools examined by Carmichael, the 
food was excellent, and the only causes for the excessive preva- 
lence of phthisis were the foul air and want of exercise. This 
was the case also in the house and school examined by Neill 
Arnott in 1832. “Two Austrian prisons, in which the diet 
and mode of life were, it is believed, essentially the same, offer 
the following contrast: 
“ In the prison of Leopoldstadt, at Vienna, which was very 
badly ventilated, there died in the years 1834-1847 378 pris- 
oners out of 4,280, or 86 per 1,000; and of these no less than 
220 or 51.4 per 1,000 died from phthisis. There were no less 
than 42 cases of acute miliary tuberculosis.” 
“ In the well-ventilated House of Correction in the same city 
there were in five years (1850-1854) 3,037 prisoners, of whom 
43 died, or 14 per 1,000, and of these 24 or 7.9 per 1,000 died 
of phthisis.”* It would be useless to take up space in multiply- 
ing these instances. But perhaps some of my medical friends 
who follow Niemeyer will say the majority of cases of phthisis 
are not tubercular, but inflammatory, and are therefore not due 
to this cause. But few cases of consumption, I think it is safe 
to say, result from cold, or the inflammatory chest affections 
commonly ascribed to exposure, in otherwise healthy subjects. 
There is predisposition, which is the result doubtless almost 
invariably of faulty habits of life, resulting among other things 
in imperfect nutrition, debility, deficient aeration of blood, etc.; 
and the deprivation of a due amount of pure air, especially 
while sleeping, and during the most of the twenty-four hours 
in winter, is no doubt the most important factor in the pro- 
duction of this lowering of vitality; the first step towards the 
* Manual of Hygiene. Parkes. CONSTITUENTS OF CLIMATE. 
production of tubercle and scrofula. The medical profession is 
becoming fully alive to the importance of thorough ventilation 
in the treatment of disease, as the almost perfection, in this 
respect, of many of our recently-constructed hospitals fully 
attests. 
Closely connected with the amount of out-door air which an 
invalid will get at a winter resort is the temperature. Let us, 
therefore, first turn our attention to the winter and spring 
temperature of Florida, and compare it, as well as its equability, 
with that of other places. I have abridged the following table, 
by Dr. A. S. Baldwin, published in the Proceedings of the Flor- 
ida Medical Association, 1874-75: 
6 
h-t 
Ph 
m 
j Summer. 
j Autumn. 
Winter. 
Year. 
Jacksonville 
70 06 
81.82 
70.35 
56.33 
69.38 
St. Augustine 
68.54 
80.27 
71.73 
58 08 
69.61 
Pal at k a 
70.62 
83.57 
70 20 
57.18 
69.64 
New Smyrna, Indian River... 
71.80 
79.14 
62.43 
63.22 
69.17 
Florida 
71 62 
80 51 
71.66 
60.04 
70 95 
Referring to the winter and spring months, the temperature 
of Florida may, in general terms, be compared to that of a 
typical May and September in the Northern States, with some 
quite warm and some quite cool variations, which will again be 
referred to. There is a very erroneous idea prevalent with 
regard to the temperature of the month of April, and the first 
warm weather of March is apt to drive invalids off to seek a 
cooler climate, under the impression that the heat must neces- 
sarily be oppressive. Though the temperature of April, as 
indicated by the thermometer, may be considerably higher, it 
is not infrequently a more agreeable month than February or 
March, as was the case this year. The following table was 
furnished me from the signal office at Jacksonville, for which 
I am indebted to the kindness of Mr. F. Z. Gosewisch, the 
signal officer: 
1873. 
1874. 
1875. 
1876. 
1877. 
1878. 
March 
58.9 
66 0 
60.1 
60.9 
60 8 
65.4 
April 
69 1 
70.0 
62.8 
68.8 
68.2 
71.3 
MEAN TEMPERATURES. 10 
CONSTITUENTS OF CLIMATE. 
The heat in the sun is, except during the morning and late 
in the afternoon, often somewhat oppressive, but there is almost 
always a sufficient sea breeze, commencing at 9 or 10 o’clock 
A. M., and lasting until sundown, to render it very pleasant in 
the shade. This, indeed, is the case even in the summer months, 
and the testimony of Northern people who reside in Florida 
the whole year, is that the early morning, the late afternoon, 
and the evenings are not unpleasantly warm, as a general rule; 
that is, when one has free access to the easterly wind which 
generally prevails as a sea-breeze at pretty regular hours. The 
army records show that the thermometer in Florida rarely rises 
as high as in most of the Northern States and Canada, but of 
course the heat is more continuous. A temperature, however, 
which would be felt as very oppressive in the Northern States, 
except on the seacoast, is in Florida quite endurable, owing, no 
doubt, to the peculiar configuration of the State, jutting out, 
as it does, in a narrow strip into the ocean, and with rivers or 
other considerable bodies of water scattered liberally over it3 
surface. The isothermal of 70°, the April temperature of 
Palatka, passes through that place, through Galveston, New 
Orleans, Teneriffe, Alexandria and Canton. 
Equability of Temperature.—Writers on medical climatology 
were at one time disposed to regard this as the most important 
quality; but, as in the case of dryness, moisture, rain-fall, 
and other characteristics, it is now thought advisable to define 
the degree of equability. Many travellers who have spent but 
a short time in Florida, and who have been led to look for per- 
petual spring, have been surprised at the not infrequent changes 
in certain months, and have disseminated erroneous ideas as 
regards their frequency and severity. The diurnal range for 
Florida is 13° to 14°, and for Palatka still less; while those 
variations, which occur at longer or shorter intervals, are 
within moderate limits, so as not only not to produce unpleasant 
effects on the most delicate invalids, but are decidedly bene- 
ficial, especially to the worst cases of pulmonary disease, acting 
as a tonic and tending to vary the monotony, which, in tropical 
climes, is so injurious. Nothing acts so unfavorably on all forms 
of invalidism as monotony of any kind. In tropical countries, CONSTITUENTS OF CLIMATE. 
11 
where these changes are so rare that no provision against cold 
is made, except to bring a small brazier of coal in the invalid’s 
room, they are to be deprecated. But in Florida they .are 
pretty uniform, and the wood-fires in the open fire-places, with 
which the hotels and boarding-houses are well furnished, are 
greatly enjoyed by all persons, sick and well. The evenings 
and nights are so cool throughout most of the winter, and even 
early spring, that a wood-fire is commonly seen in the sitting- 
rooms. 
Turning to the evidence of army officers, Dr. Southgate 
remarks, in his report: “ Rarely is the change so great as to im- 
press the individual in fair health uncomfortably, and the invalid 
has invariably sufficient warning to guard against it.” Sur- 
geon-General Lawson, speaking from an extended personal 
experience, says: “ The climate of Florida is remarkably equa- 
ble and proverbially agreeable, being subject to fewer atmos- 
pheric variations, and its atmospheric ranges are much less than 
n any other part of the United States, except a portion of the 
coast of California.” 
Sir James Clark, in his well-known work on Climate, 
remarks: “A long residence in a very equable climate is not 
favorable to health, even with all the advantages of exercise in 
the open air. A moderate range of temperature and of atmos- 
pheric variation seems to be necessary for the preservation of 
health.” Turning to a more recent authority, 1877, and one of 
the best, Dr. Charles Th. Williams,* referring to the invalid’s 
dread of cold changes, says: “And herein lies their mistake; 
for if our invalids could indeed find a lotus-eater’s land 
In which it seemed always afternoon, 
All around the coast the languid air did swoon, 
I would predict that the results on their health would be rather 
pernicious than otherwise, and loss of appetite and diarrhoea 
would probably be induced.” This constitutes one of the prom- 
inent distinctions between a tropical and a semi-tropical clime; 
between the West Indies or Nassau, for instance, and Florida. 
A good deal of attention has lately been devoted to high alti- 
tudes for consumptives, and various theories have been advanced 
* Influence of Climate in Pulmonary Consumption. 12 
CONSTITUENTS OF CLIMATE. 
to explain the effect of elevation. Thus, Miihry thinks the 
effect is due mainly to the necessity for greater expansion of the 
chest in consequence of the rarefaction of the air ; while Weber 
ascribes it to a cause, among others, just the reverse—the supe- 
rior oxydizing power of the air from the presence of much 
ozone, thus lessening the amount of air necessary, and thus 
requiring less expansion, placing the crippled organ in a com- 
parative state of rest, as it were. But all the theories have 
been disproved by further observations. “ It was soon demon- 
strated,” says Schreiber (op. eit.), “ that the altitude at which 
this immunity commenced varied with latitude, being higher 
the nearer we approach the equator, which could not be the case 
if the above theory were correct, the law of diminished pressure 
being everywhere the same.” “An inquiry instituted in Sax- 
ony, at the expense of that government, proved that elevation 
had nothing to do with immunity, very high localities in the 
Erz and Baesengeberge exhibiting a large percentage of 
phthisis as soon as the inhabitants turned their attention to the 
industrial arts, such as mining and the manufacture of china; 
while, on the other hand, the percentage in the lowlands was 
diminished when the people were engaged in agriculture and 
cattle-raising.” In other words, that it was the abundance of 
good air and not any peculiar property of it which effected the 
good results. Nor are the assertions of writers as to the com- 
plete immunity of the natives of high altitudes in other parts 
of the world, in the Jauja mountains of Peru, for instance, con- 
firmed by later observers, although all agree that consumption 
is rare;* but so it is in Florida among the white race; the dis- 
ease in the exceptional cases being, as a general rule, induced 
by bad food and bad habits. In fact, it is now sufficiently well 
demonstrated that it is to be found everywhere. Bichard Payne 
Cotton, M. D., Senior Physician to the celebrated Brompton 
Hospital, England, says:f “And here I would make a passing 
remark on the now rapidly dying-out question, that there is 
* “ Lombard’s Statistics,” says "Williams, “give us a phthisis mortality of 
5 per cent, up to nearly 4,000 feet.” Dr. Ludwig found a case of consumption 
in the Engadin, which boasts of entire immunity, who had never lived at a 
lower level than 4,000 feet. 
f British Medical Journal, 1877. CONSTITUENTS OF CLIMATE. 
13 
anything in any one climate, wherever it may be, which is 
opposed to the development or even the increase of tubercular 
disease—consumption exists everywhere. There is no favored 
spot where it is not. There is no 'promised land’ for our con- 
sumptive sufferers where they will fail to meet consumptive 
sympathizers.” The valuable statistics which we get from the 
Army Medical Reports of England demonstrate this con- 
clusively. It has been long thought that intensely cold coun- 
tries, near the poles, for instance, were absolutely free from 
phthisis. But, notwithstanding the positive assertion to the 
contrary, the Army Reports tell us that, "with the exception of 
epidemics, diseases of the chest furnish the largest quota of 
mortality,” and mention that “consumption is common.” So 
is it in Shetland and Iceland, according to the excellent author- 
ities quoted by 0. T. Williams (op. eit.). "The Army Medical 
Reports,” says Parkes (Practical Hygiene), " show how little 
reliance can be placed on the cold-immunity theory, for it 
appears that the mortality in Bengal from phthisis is almost 
precisely the same as in Canada (1.70 and 1.71 per 1,000, 
respectively). " In the Presidency of Madras, which is an 
exceedingly hot region, our Army Reports,” says Williams, 
" assign one of the lowest phthisis mortalities of all the coun- 
tries where the British army is stationed; while among the 
Sepoys, the mortality from this cause is even less.”* "But,” 
* In 1870 the deaths from consumption in the United States amounted to 
nearly 70,000, more than double the number from any other cause. In the 
different States the mortality from consumption, taken from Dr. Bizzell’s 
report (Medical Association of Alabama), is as follows: In Maine, 1 to every 
3.9 deaths from all causes, or 1 to every 315 of population ; New Hampshire, 
1 in 4.5, 1 death to 334 of population ; District of Columbia, 1 to 4.6, or 1 to 
298 of population. The mortality from phthisis in the States of Vermont, 
Rhode Island, Connecticut, Delaware, New York, New Jersey, Ohio, Pennsyl- 
vania, in fact, every State and Territory of the Union north of the 38th paral- 
lel, ranges from 1 in 3.9 in Maine to 1 in 11.9 in Kansas ; and in no State north 
of this does the mortality fall so low as 1 in 12, save in the Territory of Wy- 
oming, where the statistics are too scant to be worth much. In Minnesota it 
is 1 in 7.6 deaths from all causes; in California, 1 in 7.2; in Arizona it is only 
1 in 250 from all causes; in New Mexico, it is 1 to 26 2; Nevada, 1 to 20.5; 
Florida, 1 in 17.3; Texas, 1 in 16; Louisiana, 1 in 10.3; Georgia, 1 in 15.6; 
Alabama and Arkansas, each, 1 in 14.2; Mississippi, 1 in 13.2; South Caro- 
lina, 1 in 11.2; North Carolina, 1 in 8.6; Virginia, 1 in 7.2. 
We see from this table that in all the States east of the Mississippi, Florida 
has the smallest mortality from phthisis; and a considerable share of this 
mortality should be attributed to persons coming into the State from other 
States and dying there, many of them in a hopeless condition on their arrival 
Allowing for this, the rate is probably as low as in New Mexico or Nevada. 14 
CONSTITUENTS OF CLIMATE. 
he says, “the crowning objection” (alluding to the diminished 
pressure theory) “ appears to come from Asia, from the Kirghis 
land. According to M. Maydell, this vagrant population of 
over a million in number are quite exempt from phthisis, 
although they live, not in Himalayas or Andes, or on Alps, but 
on a steppe one hundred feet below the sea level.” The forego- 
ing facts will give some idea of the difficulties which environ 
this subject of the effect of climate on consumption. Take the 
famous health resorts of the south of Europe, for instance. “In 
Nice,” says Dr. Meryon (“London Lancet,” July, 1850), “more 
natives die of phthisis than in any town in England of the same 
population.” In no country, says Dr. Pollock, is consumption 
so rapidly fatal as in Genoa, Florence, and Naples (“ Medical 
Gazette,” volume xlvi). In Madeira, consumption is frequent 
among the natives. In Australia, to which many of the 
English resort for the relief of consumption, it is quite common. 
But, of course, in all these places we must make due allowance 
for the condition and habits of the people as a factor in the 
development of phthisis. 
With regard to the elevated regions, about which so much is 
written now, and which are becoming so fashionable, for the 
sway of fashion is omnipotent and omnipresent, it is worthy of 
note that in almost all, if not all of them, diseases of the res- 
piratory organs are very prevalent. Speaking of the Peruvian 
mountains, where it has been asserted the natives are almost 
entirely free from disease, Williams writes: “ The diseases most 
prevalent are those of the respiratory organs, such as catarrh, 
pharyngitis, pleurisy, pneumonia, pleuro-pneumonia, and are 
all marked by an adynamic type.* Diseases of the brain 
* “ It has been long observed that the inhabitants of elevated mountain 
districts appear to be peculiarly exempt from consumption, and an attempt 
has been made of late to turn this observation to practical account by recom- 
mending such localities as health resorts for the phthisical. It is, however, 
more than doubtful if the fact that the hardy mountaineers who inhabit Al- 
pine districts, and whose lives are passed under the most favorable hygienic 
conditions as regards pure air and exercise—the natural prophylactics against 
tubercular disease—are rarely attacked by consumption, can be regarded as a 
proof that these localities are therefore suitable winter resorts for patients 
already phthisical, and whose state of health would, in such elevated and 
oftentimes intensely cold and variable climates, probably confine them to the 
house in the new sanitariums of the Engadine, or other Alpine resorts, during 
the greater part of the winter.” Madden (op. cit). CONSTITUENTS OF CLIMATE. 
15 
and spinal cord are common.” Similar reports, except the fre- 
quency of pneumonia, come to us in the American Army Med- 
ical .Reports from all the posts situated on these high elevations 
(5,000 to 7,000 feet). Neuralgia and rheumatism are very 
common in those altitudes, and nervous diseases are aggravated. 
Dr. Dubois, of San Rafael, says (“ Medical Record,” March, 
1872,) the same of that region, although it is highly commended 
for other affections. Another peculiarity of these elevated 
regions, of all very dry regions generally, is the extraordinary 
range of temperature. Thus, Assistant Surgeon J. H. Patzki, 
writing from Fort Fred. Steele, Wyoming Territory, says “a 
daily range of 40° is frequently observed, of 50° not rarely, 
and of 60° occasionally ” (e. g., Aug. 9, 1874, max. 86° min. 
26°).* In these regions there is also a peculiar fever prevalent, 
which is serious, and not infrequently fatal. It is known all 
over the United States, in the mountains, even at moderate ele- 
vations, and is called by the people and by the medical men 
“ mountain fever.” It has usually been described as a typhoid 
fever, but the medical officers of the army have established the 
fact that it is a remittent and of malarious origin. 
Before dismissing the subject of the effect of high altitudes, 
which, by the by, have very different effects as to respiration, 
etc., on different individuals, it may interest those who send 
their patients to these places to know the effect elevation pro- 
duced on a medical man and how he treated it. Assistant Sur- 
geon W. H. Gardner, U. S. A., stationed at Fort Union, New 
Mexico, thus relates his own case: 
“Shortly after arriving at the post, I was attacked with a fullness in the 
head, ringing in the ears, mental hebetude, and confusion of ideas, dizziness 
and headache. Thinking these symptoms might be caused by constipation, 
dyspepsia, or torpidity of the liver, I took a mercurial purgative, and fol- 
lowed it by a dose of Rochelle salts, which relieved the fullness of oppression 
for a day or two, but it at once returned, the dizziness and confusion of ideas 
increased, and a feeling of numbness and tingling commenced in the fingers of 
the left hand, and gradually spread until it involved the whole left side, even 
the muscles of the tongue being involved in the paralysis, so that I could not 
* Dr. Gehring, of Denver City, graphically describes the risk of sending 
patients to these elevated regions (Territorial Medical Society, 1873). He 
says if he has vigor and digestive force, and “if his disease is not too far 
advanced, let the patient be sent to Colorado ; without it let him be advised 
to remain at home. Our Territory is like a wild steed. If you can tackle 
him he will carry you out of your difficulties; if you can not, he will break 
your neck.” CONSTITUENTS OF CLIMATE. 
articulate. There was also oppression of breathing, throbbing of the carotids, 
and slight dilation of the pupils. The only medicine handy at the time of 
my first attack was a bottle of chloroform ; and thinking the symptoms might 
be due to spasm of the cerebral or pulmonary veins, I poured a drachm or two 
on my handkerchief and inhaled it, when the disagreeable symptoms promptly 
subsided. The next day, on my visit to Dr. Moffat, of our corps, I told him 
of my troubles, and he thought they were due to malarial poisoning, and 
advised me to commence a course of quinine and arsenic, which 1 at once did, 
taking twelve grains of quinine and one tenth of a grain of arsenic each day. 
But, in the course of five or six days, while under the full influence of these 
remedies, I had another attack in all respects similar to the first, coming on 
after a hearty dinner, which was relieved by a prompt emetic. Shortly after 
this second attack, I was sent for to attend a case, at Mora (fifteen miles north- 
west of the post, about four hundred feet higher in altitude), and while there 
alone, I had another attack, more severe and prolonged than the other two, 
and upon this occasion 1 certainly thought there would be another vacancy 
in the medical corps to fill, for I took emetics, bromide of potassium, 
and chloroform ad nauseam, without the effect. The symptoms went off 
before morning ; but w hen I got back to the post, I brought the Darwinian 
theory to bear on the case. Ita: It the environment of an animal be sud- 
denly changed, and the animal does not change his habits to suit his environ- 
ment, it will be speedily eliminated. The only radical change in environment 
which I could detect here was decreased atmospheric pressure from increased 
altitude, and consequently deficient ox3'genation of the blood. The indica- 
tion, therefore, was either to supply the deficiency of oxygen to the blood, or 
to reduce the volume of blood to the decreased amount of oxygen. The latter 
alternative seemed the easiest and most certain. I therefore decreased the 
amount of my nitrogenous food, and made up the quantity by laxative veg- 
etables and fruits, and have been in good health ever since. I have seen two 
cases since, in every respect similar to mine, and they have promptly sub- 
cumbed to the treatment indicated; that is, decreasing the amount of blood to 
the decreased amount of oxygen by cathartics and decreased animal food.” 
Dr. Charteris, in a clinical lecture at the Glasgow Royal 
Infirmary, lately remarked : “The benefits of warm climates 
and of well-known health resorts for phthisis simply consist in 
this, that out-door exercise can be indulged in those with greater 
impunity and with less chance of in any way lowering the 
vitality.”* This is the gist of the whole matter of climate. 
Though patients with pulmonary troubles can bear cold if they 
will, and do improve and recover in the coldest climates ; though 
they even do better, as a general rule, in a rather large class of 
cases, in a moderately cool climate, if not moist; though they 
recover in mountain ranges from six to ten thousand feet above 
the sea level; yet I am confident that, in the end, it will be 
found that the majority of consumptive invalids will do better 
* “ Preference should always be given to those winter resorts,” says Mad- 
den, “Health Resorts of Europe and Africa,” 1876, “ which present the great- 
est inducements and opportunities for open-air exercise; and no small part of 
the benefit derivable from removal to a southern health resort results from 
the opportunies afforded in the latter of being much in the open air.” CONSTITUENTS OP CLIMATE. 
in a moderately warm and moist climate like that of Florida 
than in any other variety, because nearly all such invalids 
shrink from moderate degrees of cold, and even if they have 
sufficient vitality, have not enough energy, will, or persever- 
ance to brave any considerable degree of cold day and night, 
as they must do to get the benefit of the climate. A climate 
must not only be such as to render it safe for them to be out at 
all suitable hours, but to entice them out, to make them ashamed 
to stay in-doors. A mean winter temperature of about 48°, 
and spring temperature of 55°, which is that of the winter 
resorts immediately north of Florida (of course it is far colder 
at Asheville and similar stations) is too low to entice many of 
the feeble invalids out of doors, except on calm, sun-shiny days. 
But in some of them, as at Aiken, this degree of cold is much 
enhanced, as far as the sensations of the invalid are concerned, 
by the winds which frequently prevail.* At such times most 
invalids will, therefore, be found hovering over the comfortable 
wood-fires, just as they do here when one of our cold transitions 
occur, and will be pretty sure to keep all the apertures of their 
chambers closed at night, thus depriving themselves, during by 
far the greater part of the twenty-four hours, of the principal 
means of cure. 
The mean temperature of these six months in Florida is, by 
our tables, about 63°; and, during about five-sixths of the days, 
the sun shines so brightly, the air is so balmy, the song of the 
birds so enlivening, and the orange trees, in their delicious bloom 
or laden with their golden fruit, lend such a charm to the out- 
look from the windows, that the most indolent or the most cold- 
blooded invalid feels little inclined to stay in-doors. Contrast 
such a winter with that of the boasted and time-honored resorts 
of Southern France and Italy, even in their most protected 
cities. I will say nothing of their spring, for no one who has 
ever tried it, or has inquired of any reliable authority about it, 
would trust himself there after the first of March. Even in 
the most sheltered localities, as at Cannes and Mentone, a 
change, on one of the most pleasant days, from the sunny to 
* Dr. Kane estimated that it made a difference of 40° in the polar regions 
when he turned his face instead of his back to the wind. 18 
CONSTITUENTS OF CLIMATE. 
the shady side of the street, often produces a shiver, and ren- 
ders necessary for an invalid an extra covering ;* while in all 
the resorts of the Eastern Riviera this is always the case. At 
sunset one must rush home and in-doors for his life ; nor does 
any prudent man dare to ride out in the afternoon without the 
wraps he would require in his northern home. Such is the 
case even in Algiers, which is a superior climate to that of the 
north shore of the Mediterranean. My friend, Dr. W. F. 
Jenks, informs me that, while walking into the city, in an 
uncomfortably hot sun, he always carried a thick overcoat on 
his arm, for the moment he struck the shady side of one of the 
narrow streets, a shiver passed through his body; and, while 
riding, he always provided himself and family with thick wool- 
len wraps for the change which was sure to take place near sun- 
set. “ Though the temperature of Hy&res in winter, as marked 
by thermometer, is not low, the air is sharp and often cold. The 
misral is not infrequently painfully experienced, especially in 
January, February, and March. In spring, the sun acquires great 
power, and its influence, alternating with the occasional cold 
winds, produces frequent and rapid changes of temperature 
very trying to those in health.” Speaking of Nice, the same 
author says :f “ In winter there is a difference of 12° to 24° 
between the temperature of places exposed to the south and the 
north, between those in the shade and the sun.” In Florida, 
during most of the warm and pleasant days, one may not only 
be out at sunset on land, but with equal comfort on the water. 
I have frequently called the attention of persons to this contrast 
with the European climates when we were returning from a row 
at sunset; some of us in midwinter, in our shirt-sleeves. Had 
there been any considerable degree of dampness in the air, this 
would not have been prudent or comfortable. But one seldom 
* There is a saying in Rome that “ only dogs and strangers go on the shady 
side.” Dr. Dubois, of San Rafael, says of the much-vaunted Mentone: “I 
remember a number of chilly, windy days, which, without the ordinary con- 
veniences for making fires, were spent wrapped up in overcoats, and in en- 
deavoring to make a fire, that should remind us of home, with several baskets 
of olive-wood.” Such is the opinion of those who winter at similar Euro- 
pean resorts, most of which are more exposed than Mentone, unless they hap- 
pen to be on the sunny side of the house. 
f Edwin Lee, Prize Essay, London. CONSTITUENTS OF CLIMATE. 
19 
feels any dampness on sunshiny days. Those who have never 
been south, and who are shivering in a winter temperature of 
10° to 30°, may think that 48° or 55° would be abundantly 
warm to insure ability and inclination to exercise in the open 
air; but while a winter temperature of that degree in New 
York or Boston would seem like summer, it is considered in 
Florida, even by sound persons, as entirely too cool for com- 
fort. A person requires much warmer clothing in the South 
than at the North, at the same temperature. The air here 
during the greater part of the winter, with the exception of a 
brief series of days now and then, when an almost summer 
temperature is reached, is, in connection with the pleasant sur- 
roundings, exhilarating, not debilitating. It is a great mistake 
to suppose that warmth, per se, is inimical to health or strength; 
heat is, not warmth; such a temperature is only such as nature 
requires to keep all the organs in a healthy state of action. 
The warm weather of the spring and autumn at the North, and 
even the comparatively hot weather of summer are the healthiest 
seasons. Persons make themselves uncomfortable by fuming 
over the thermometer, but they don’t get sick, or not sufficiently 
to send for a doctor. But unusual summer heat or winter cold, 
long continued, equally tends to swell the bills of the doctors 
and the undertakers. 
There is a remarkable unanimity, within the last few years, 
in the opinions of the medical reporters from all sections of our 
country, from the Atlantic to the Pacific, from the level plains 
and the highest altitudes, from very cold and moderately cold 
regions, on this point, that only cases of incipient phthisis, 
that is, tubercular phthisis, are likely to be permanently bene- 
fited, and almost all of them warn against sending cases of 
advanced disease, even when not much enfeebled. Dr. Gleitz- 
mann, of the Sanitarium at Asheville, N. C., seems to be of a 
different opinion. He says (Trans, of the Med. and Chir. Fac- 
ulty of Md., 1875, p. 204) : “ The patient, after returning 
home” (from southern climates), “has not acquired that power 
of resistance which alone can prevent a new bronchial catarrh 
or fresh catarrhal inflammation attacking the alveolae of the 
lungs. As much as ever, he is exposed to the same danger of a 20 
CONSTITUENTS OF CLIMATE. 
relapse from the same causes, or is perhaps inclined to it in a 
still higher degree, as the warm, humid atmosphere has served 
more to enervate than to invigorate the system.” He quotes 
Madeira as the type of such southern climates. On the con- 
trary, the reporters from the cold regions, as in Minnesota, and 
the less severe regions further south (see Transactions of State 
Medical Societies and Army Reports) say that invalids, even 
after a residence of several years, and a subsidence of all the 
symptoms, are very apt to relapse on returning home, and fre- 
quently regain their health on repairing again to the colder 
regions; and they strongly urge invalids to remain permanently, 
or for a long time, at least, after the subsidence of all bad symp- 
toms. Sometimes these climates fail for a year or more, or a 
series of years, to fulfill the expectations of the physicians there 
and their patients, and from causes not always fully explicable. 
Thus, in Minnesota, for instance, this was found to be the case. 
And the Committee on Climatology, Epidemics, and Hygiene 
proposed a question as to the cause to the physicians of the 
State. “The question,” says the committee, “originated in the 
belief that the climate of this State, from some cause or other, 
operated less favorably on consumptive patients than formerly.” 
The answers were all, except from one who had no phthisical 
patients, in the affirmative, that the climate had lost its usual 
effect. “ Dr. J. E. Finch had several consumptive patients 
under notice, all of whom failed with unexpected rapidity on 
the approach of spring, Some of these had come to Minnesota 
with the disease in its early stages, and had been so much ben- 
efited by a residence here as to believe themselves quite recov- 
ered.” Some inscrutable agency was at work, which may 
influence any climate at times, whether hot or cold. This ques- 
tion, that is, as to the failure of all climates to relieve a very 
large majority of cases in the later stages of consumption, may 
be considered settled. But when confidence in the “ hyper- 
ventilation ” system becomes general among the public and the 
profession, we may reasonably expect a far better showing from 
climatic treatment. In the meantime, the warmer and pleas- 
anter climates will naturally succeed better than the colder, 
notwithstanding the alleged superior qualifications of the latter 
in other respects. CONSTITUENTS OF CLIMATE. 
21 
Malaria.—This is a topic which inevitably enters into the 
discussion of all southern climates. So much has been said 
about it both in and out of Florida, and there have been so 
many misrepresentations about it as to render necessary a more 
extended notice than it received in my first paper. A great 
injury has been done to Florida as a winter resort unwittingly, 
both by physicians and laymen, who have been accustomed to 
associate the idea of this State with that of swamps, alligators, 
and fevers, and wittingly by those who think it their interest to 
misrepresent facts.* It is a matter of the first importance that 
physicians at least should have correct ideas on this subject, 
otherwise patients are apt to be debarred from deriving benefit 
from the very best season of the year here, the spring months. 
In the first place, tourists travel almost always along the water 
courses, and seeing them, on either side, bounded apparently 
by interminable swamps, are apt to form an erroneous idea of 
the extent of the swamps of Florida. They usually form only 
a narrow belt along the river, and immediately behind are the 
pine lands, except when a strip of hammock intervenes, often 
the tops of the pines being visible over the swamp.f In many 
of these swamps the tide ebbs and flows, and they rarely give 
rise, even in summer, to any serious form of fever. In the 
second place, the sickly complexions and gaunt forms of many 
of the native Floridians, who are met with at the landings, are 
apt to suggest the continued inroads of malaria. But these 
appearances are due not so much to the climate as to their pecu- 
liar mode of life, their scanty clothing, sufficient for three- 
fourths of the year, but not for the winter months; their 
unsuitable habitations, but especially their food and drink. From 
* It is the custom of many persons living at Florida resorts, off the St. 
John’s river, to represent, for very obvious reasons, to tourists, that fever pre- 
vails there the year round, and that it is dangerous to visit it at any time. 
In this manner they have excited alarm in the minds of those proposing to 
come to Florida, and have diverted them to other southern resorts ; thus, in 
the end, injuring themselves as well as others. Hotel runners and the agents 
of steamboat lines running to other localities all aid more or less in this fraud- 
ulent attempt to secure custom. 
f A great advantage of the peculiar distribution of the different kinds of 
land in Florida is, that the hammock or richest lands and the pine are in such 
close proximity, that the farmer can work in the former by day and retire to 
his house in the latter at night, where he is comparatively secure from the 
danger of malaria or any dangerous form of it. 22 
CONSTITUENTS OF CLIMATE. 
early childhood they live on sweet potatoes and the everlasting 
hominy and grease, the melted fat of pork stirred liberally in 
hominy, not always well boiled. This they become so fond of 
that they do not care for anything better, although game and 
fish surround them almost everywhere. This food, and their 
drink from the shallow wells, or the dark-colored water of the 
sluggish brooks, begets dyspepsia, or as they term it, “bilious- 
ness,” and then come “ Tutt’s liver pills,” or some powerful 
cathartic, which affords temporary relief. The people in the 
cities and villages, and the families of northern men along the 
water courses, who have brought up their children there, but 
who live differently, present an entirely different appearance. 
In this village they will compare favorably with those in any 
northern town. James Johnson ascribes the horrible aspect of 
the inhabitants of the fertile but malarious plains of Lombardy 
mainly to the same causes. Their food and drink are even 
worse than that of the Floridians in quality, as are also their 
houses. Sir James Clark, on investigating the cause of a con- 
siderable prevalence of consumption in the Island of Madeira, 
found that it was due almost entirely to the habits of life of the 
poorest peasantry, among whom almost all the cases occurred. 
They are “ hard-worked and miserably nourished, badly clothed 
and worse lodged; their beds consist of pallets of straw raised 
a foot or so from the ground, damp during nine months of the 
year.” So we infer that a location is not necessarily unsuitable 
for invalids because the appearance of the inhabitants is unfa- 
vorable, or because a considerable amount of disease prevails, 
even the very disease for the alleviation of which the invalid 
desires a change. I quote the following paragraph from my 
former paper: 
As regards liability to disease in Florida, a careful examina- 
tion of the “ Medical Statistics of the Army,” extending through 
a long series of years, personal observation and conversation 
with medical and line officers engaged in the Seminole war, 
indicate a remarkable exemption throughout the State from 
malignant or even very serious diseases.* “At all seasons,” 
* Forry (Climate of the United States and its Endemic Influences) says 
alluding to St. Augustine: “This is only the second time that yellow fever 
has prevailed in this city for twenty years.” This refers to about 1840. Since CONSTITUENTS OF CLIMATE. 
says Forry, “with the exception of the northern division, the 
mortality is lower in East Florida than in any other class of 
posts.” He ascribes this, in a great measure, to “its being 
nearly in a state of nature.” In the “ Statistical Eeport of the 
Sickness and Mortality of the U. S. Army” from 1855 to 1860, 
is a table at page 163, which exhibits the mortality and 
sickness among the troops stationed at the interior gulf 
ports, and embracing, especially, as regards the former, the 
most unhealthy part of the peninsula. The number of cases 
for the year is 19,312; the deaths 119, or 0.61 per cent. 
There were but four cases of congestive fever, none of which 
died. They could hardly have been of the severe char- 
acter of those met with in other Southern States. If we take 
into account the very unfavorable circumstances surround- 
ing the small commands scattered over this area, the bad water, 
poor food at times; hard work, and continuous exposure, the 
small percentage of mortality is remarkable, and shows that 
although the cases reported for treatment are numerous,* the 
diseases of all kinds were very amenable to treatment and 
'1857 there has been no yellow fever in East Florida, except two or three 
cases brought to Gainsville a few years ago from Pensacola, where it is apt to 
be conveyed from Havana, until last summer, at which time all the conditions 
for its spread were more, perhaps more, rife than they had ever been. Both 
Fernandina and Jacksonville were in a most unsanitary condition, when a 
case, through a careless quarantine, was brought into the former place; so 
long a period of exemption having naturally caused a great relaxation in 
vigilance. The severe lesson which these cities have received will insure strict 
attention to quarantine regulations for some years to come. The authorities 
of Jacksonville have been prompt and liberal in voting a large appropriation, 
and have already made extensive sanitary improvements, and the work still 
goes on. It is hoped and expected that next winter will find these cities as 
free from fevers of all kinds as usual at this season. It is a remarkable fact, 
and indicates how little yellow fever is disposed to spread in Florida, that in 
the several months during which it prevailed in Jacksonville, with unre- 
stricted intercourse (except during a brief period with Palatka), with all 
places along the river, steamers plying to and fro daily with freight and pas- 
sengers, not a single case occurred at any point along the St. Johns south of 
Jacksonville, and only one case, as far as I am aware, on any boat. This 
occurred in the person of the pilot of the Volusia, while I was on board. He 
returned to his residence in Jacksonville, and died there. In 1857 a few cases 
were brought to this place, but, though no precautions were observed, it did 
not spread to any other person. The recent epidemic did not attack a very 
large number of persons at Jacksonville, and the expediency of declaring the 
disease epidemic at all was debated for some time by the authorities. At Fer- 
nandina, though the number of cases was large (about 1,200), the mortality 
was small; about 60, so far as I have been able to learn, indicating a compar- 
atively mild form of the fever. 
* Soldiers report for relief from duty for the most trivial affections. 24 
CONSTITUENTS OF CLIMATE. 
rapid cure, as all the military operations went on successfully, 
notwithstanding this large amount of sickness. The very small 
percentage of deaths from diseases of the respiratory organs is 
especially noteworthy—only 13 cases among the 19,000 of all 
diseases treated. Notwithstanding the dampness, rains and 
exposure, there were only 33 cases of pleuritis and 25 of pneu- 
monia. “I have served in Florida,” says Surgeon-General 
Lawson (letter to the Hon. D. L. Yulee, U. S. Senate, 1855), 
“ and have served also with an army on the northern frontier, 
and from my experience of the influence of climate and active 
operations of the army in the field on the health of soldiers, I 
have no hesitation in expressing the belief that, had the troops 
engaged in the Florida war been engaged for the same length 
of time in active operations, in winter and summer, on the 
frontiers of Canada, though the cases of disease might have been 
less numerous, the mortality would have bfeen infinitely greater 
than was experienced in Florida.” 
Of course there are here, as in other States, healthy and un- 
healthy areas, and areas where the summer heat is found to be 
more intolerable than in others. It behooves the settler, there- 
fore, or the invalid, if he proposes to make the State his 'per- 
manent residence, to look well to this circumstance. Along the 
St. John’s river and its vicinity, malarious diseases are, during 
the summer and autumn, more prevalent in some localities than 
in others, and especially where numbers of people locate at 
once, and commence clearing the hammocks and swamps on a 
large scale, in order to form a village or “ settlement.” Places 
which have been reputed healthy have become the reverse, from 
admitting the sun’s rays suddenly and extensively to a surface 
previously shaded by the forest and undergrowth, and from 
turning it up with the plow. This is a well-known fact. A 
remarkable instance of this action over a large extent of coun- 
try is the unusual prevalence of malaria during the past eight 
or nine years over a large portion of the Northern and Eastern 
States, and some of the Western States. It is not the forests 
which have been cut down, but during all this period, until 
within the past twelve months, when rains have been more fre- 
quent, an unexampled drought has prevailed winter and sum- CONSTITUENTS OF CLIMATE. 
25 
mer, only surface rains having occurred, but not sufficient to 
penetrate to the sources of springs and wells, so that these 
gradually dried up, and on several occasions farmers were com- 
pelled to take their cattle long distances to brooks to give them 
water. The snows have also been very deficient in winter, not 
sufficient to wet the subsoil. Large surfaces, therefore, which 
had always been kept cool and moist in summer by springs, 
became dry, and wherever there was an impervious subsoil or 
rock, there the malaria was generated. This has been, in my 
opinion, the most potent if not the only factor in the causation 
of the marked increase of fevers in all these areas. 
But tourists and the great majority of invalids are only con- 
cerned with the winter climate of Florida; and while it can not 
be denied that persons may contract ague here in any season of 
the year, just as they are doing all over the country, especially of 
late, yet it is so rare among visitors that it need not, and should 
not, enter into the calculations of those whose condition calls 
for a winter residence in a mild climate. No climate on earth 
is perfect. Persons who have suffered for years from malaria at 
the North have recovered from its effects here; the escape from 
the injurious influence of a severe winter and a changeable 
spring having improved the tone of the nervous system. The 
writer affords an illustration of this. Having suffered for a 
long time from malarious fever among the picturesque and for- 
merly salubrious highlands of the Hudson, he was strongly ad- 
vised by his medical friends at the North not to remain longer 
on the St. John’s than the first of April. He did, however, 
remain until near the middle of May, has continued to remain 
late in the spring for three years, and has entirely recovered 
from his malarious torments, though failing to get relief pre- 
viously even in Saratoga. As another illustration of the im- 
munity from fever here in the winter, enjoyed by Northern vis- 
itors, it may be worthy of mention that of the large number of 
employes of the hotel in which the writer boards, and the pro- 
prietor’s family, scarcely a case of fever has occurred in three 
years, although they remain until May, and most of them are 
by no means very careful of their health. 
It is well known among physicians that other causes than CONSTITUENTS OF CLIMATE. 
miasm or the emanations from swamps, are capable of produc- 
ing, and are actually producing every day, symptoms precisely 
analogous to those of intermittent fever, and which yield to the 
same treatment; and it is well that visitors to Southern resorts 
should understand and remember this: first, that they may, as 
far as possible, avoid these causes; and, secondly, that they may 
not be frightened away from a pleasant and suitable locality 
under the fear that their symptoms are caused by influences 
arising from its surroundings, instead of, perhaps, their own 
want of prudence.* Some experienced and thoughtful physi- 
cians, who have so constantly observed malarious attacks arising 
from causes which could not possibly be connected with marsh 
miasm, have gone to the extreme of denying that the latter ever 
has anything to do with these attacks. Dr. Black, of Ohio, has 
read two interesting papers on this subject before the American 
Medical Association; and facts, furnished by high authority, 
abound all through medical literature which tend to support 
his views. But, as usual in such discussions, the medium course 
is the safest. The fact, however, that so much doubt should 
have been engendered in the minds of medical men indicates 
that, at least, sometimes, and I think frequently, intermittent 
fevers, and malarious attacks allied to them, occur from causes 
having no necessary connection with marsh miasm; also, that 
when the effects of miasm have long disappeared from the sys- 
tem, these causes will re-develop the disease. Among these 
numerous agencies may be mentioned, in general terms, any 
cause which tends to lower vitality; want of proper food, nerv- 
ous shocks, exposure to wet, or to severe cold, or long-continued 
cold, depressing emotions, excessive diurnal variations of tem- 
perature, etc. Dr. Black lays great stress on the latter. Some 
of these causes will develop malarious symptoms de novo, while 
some will only re-develop them when they are slumbering. A 
notable example of the latter, the effects of cold on a popula- 
* Patients with pulmonary disease ought also to be informed by their phy- 
sicians that chills and fever, which are precisely like the miasmatic as re- 
gards their phenomena, are apt to occur as an incident of their disease. But 
in such cases, medical advice should always be sought, as it is important to 
determine whether there is or is not a malarious complication. CONSTITUENTS OF CLIMATE. 
tion, occurred in the practice of the writer a few years ago. 
There had been a great prevalence of malarious fever during 
the summer and autumn, but cooler weather and finally frosts 
caused their disappearance to a considerable extent. But in 
midwinter an unusually low temperature continued for a num- 
ber of days, and immediately after there was a great increase 
in our fever cases. The effect was precisely what we have wit- 
nessed in summer after a prolonged hot and dry term. There 
is not space to multiply cases, which might be done to any ex- 
tent. I will only mention one striking instance. The son of a 
distinguished practitioner of New York City, himself a physi- 
cian, young and robust, never having suffered from any form of 
malaria, was called to Bloomingdale to assist in a surgical oper- 
ation. On his way he was caught in a sudden cold shower, and 
his feet and legs got quite wet. It was necessary that he should 
wait with the patient two hours, but on his return home he 
changed his clothes. On the following day he was seized with 
a chill followed by fever, and for months he suffered from inter- 
mittent fever, and finally, after the failure of drugs to give per- 
manent relief, he went to Europe, and recovered there. The 
converse of this proposition is also true; malarious fever will, 
after the failure of quinine and other supposed specifics against 
miasma, yield suddenly and permanently to nervous shock; for 
it is to this, I think, that we must attribute those recoveries 
which take place after swallowing some huge or some particu- 
larly disgusting dose, as a pint of vinegar, or live earth-worms 
taken in molasses, in the virtue of which the vulgar have such 
implicit belief, and perhaps also in part to the mental impression 
derived from this confidence. A medical friend of the writer, 
after having suffered more or less for years from malarious fever, 
and losing nearly all his hair, was cured by the advice of an 
old nurse, who told him to apply a wilted tobacco leaf over his 
abdomen. He had never used the weed in any form, and in a 
few hours he was more wilted than the leaf, but his old enemy 
was vanquished from that day. In fact, the disease commences 
in a morbific influence of one kind or another on the nervous 
system, and is cured by such remedies as act on this system, 
which have no specific influence on the blood and no antidotal 28 
CONSTITUENTS OF CLIMATE. 
effect whatever. This morbific influence is often exerted on the 
cutaneous surface, and may be prevented, to a great extent, in 
a malarious region by wearing woollen next the skin, and by 
fires night and morning, especially when the diurnal range of 
temperature is unusually great, which preventives, the best we 
have, can not be said to exert any influence on marsh miasm. 
Quinine, when taken as a preventive, and it is a more or less 
reliable one, acts by fortifying the nervous system against de- 
pressing influences, and not through any supposed neutralizing 
effect on a specific poison circulating in the blood. So much for 
malaria, which has become an interesting topic in all parts of 
the country of late, in the parlor as well as in the doctor’s 
office; and to which the writer regrets having felt himself 
obliged to devote so much space. 
Rain-fall and other Hygrometric Conditions.—Very little 
space need be devoted to rain-fall, since it is now conceded that, 
in the first place, the mere amount of rain in the year, or in 
the winter, without a statement of its distribution over the months 
and even the days, is of no value ; and, in the second place, that 
a certain amount of rain, if it falls rapidly, and does not recur 
at too short intervals, is beneficial in various ways, but espe- 
cially as one of the best purifiers of the atmosphere, dissolving 
gases, and carrying down with it dust and animal and vegetable 
impurities. In some localities there is almost no precipitation of 
moisture (rain-fall), yet the air is constantly loaded with moisture 
almost to saturation.* With regard to the hygrometrical con- 
dition of the air of Florida, almost as erroneous ideas exist as 
* “At Cannes,” says Madden (Health Reports of Europe and Africa), “ the 
amount of rain-fall is about five inches more than in London; but notwith- 
standing this, Cannes has incpmparably a dryer climate than London; the 
number of rainy days in the former being 52, while in the latter it amounts to 
78.” 
Catania, a noted health resort of Sicily, has 78 inches in the year, and yet 
there are fewer rainy or cloudy days there than in almost any of the noted 
European resorts, from the fact that almost all the rain falls in a month or a 
month and a half. 
The extremes of precipitation are the deserts, where there is none at all, 
and on the Khasya Hills, 200 miles from the city of Bengal, where 000 inches 
fall annually. Cameron, Manual of Hygiene. CONSTITUENTS OF CLIMATE. 
in the case of malaria. Dr. Walton’s charts* give us some 
curious information, and indicate how little value is to be at- 
tached to the amount of rain-fall as a climatological fact. Thus 
Aiken, whose reputation is based principally on the dryness of 
its climate, has nearly one-third more rain in the winter and 
spring months than Palatka; while Alexandria, noted for an 
excessively moist climate, situated as it is “ on a low, sandy 
peninsula between the sea and the wet swamp known as Lake 
Mareotis,” has less than one-third as much rain as Aiken, and 
slightly less than half as much as Palatka. Mentone also has 
more rain than Palatka, and double the amount of St. Augus- 
tine. The tables of Dr. Baldwin, a most careful observer, give 
for the five months from November to March, inclusive, 21.3 
rainy days out of 121 days, one day in six; though it did not 
rain all day on many of these days, such an occurrence being 
not very common in a semi-tropical climate, even in summer. 
“ Whilst on the northern lakes,” says Forry (op. cit.), the an- 
nual ratio of fair days is only 117, on the coast of Florida it is 
250, and at Fort- King” (now Ocala), “ in the interior, it is 
309.” From twenty-five years’ observations, says Dr. Baldwin, 
January has had an average of 20.3 clear days; February, 
29.5; March, 20.4; April, 25; May, 22.1. For the whole 
year, 235 clear days. This was in Jacksonville. 
Relative Humidity.—A much more important constituent of 
climate than rain-fall is the amount of moisture suspended in 
the air. When the air is saturated with moisture, we say it 
contains 100 per cent.; when one-half or one-quarter saturated, 
50 or 25 per cent. But as air at one temperature is capable of 
holding more or less moisture than at other temperatures, in 
order to compare the humidity of different climates, we must 
take into account the temperature also ; and when the calcula- 
tion is made with reference to this, we call it the relative humid- 
ity. But, like the rain-fall, the tables of relative humidity seem 
to fail in giving a very correct idea of climatic humidity; and, 
as we shall presently see, it is desirable to take into account a 
* A Comparison of European and American Climatic Resorts, with original 
Charts in Colors. George E. Walton, M. D. 1877. 30 
CONSTITUENTS OF CLIMATE. 
variety of other indications. Thus, Dr. Geddings* gives a 
table comparing the relative humidity of three prominent South- 
ern health stations. Aiken, 64.04; Asheville, N. 0. (reported 
a dry climate), 70.10; Jacksonville, Florida, 69.72; according 
to Dr. Baldwin, 69.90. For my own observations, I had used 
for two winters Saussure’s hygrometer, until I found, by com- 
parison with those of others and from other indications, that it 
was not reliable. During the months of February, March, and 
April, 1878, using a Mason’s psychrometer (wet and dry bulb) 
and comparing my observations with those of the signal officer 
at Jacksonville, the relative humidity for three months in 1878, 
is for that city 66.2; according to Dr. Baldwin’s observations 
for several years, 62.6; while for Palatka it is 61.3. Palatka 
is undoubtedly a dryer climate than the stations on the river 
further north, fogs less frequent and less persistent. Dr. Ged- 
dings also gives a table comparing the humidity of Aiken with 
that of eight prominent European health resorts; from which 
table it appears that the humidity of Florida for the year is less 
than in five out of eight (including Mentone), while Aiken has 
less than six out of the eight. Almost all of our American 
resorts appear to have the advantage over their European com- 
petitors both as regards relative humidity and rain-fall. Recog- 
nizing, however, the difficulty in forming any correct judgment 
as to the comparative dryness of climates from these scientific 
data, Dr. Geddings proposes certain other tests, the most of 
which, it must be conceded, are pretty reliable; for instance, he 
says, the mean relative humidity of Aiken being only 64.04, 
that place, according to Vivenot’s classification, would rank only 
as “ moderately dry,” but tested by the more popular signs 
which he gives, “ it would be considered very dry.” These 
signs are, of a moist climate, heavy dews, frequent fogs, melting 
of salt, vapor condensing on walls, steel and iron quickly rusting, 
rapid formation of mould, mosses flourishing, perspiration re- 
maining long on the skin. Dr. Madden (op. cit.) says also: 
“ The extreme humidity of this climate (Madeira) is shown by 
the impossibility of keeping steel instruments free from rust, or 
of preserving any musical instruments in tune, or any article of 
* “Aiken as a Health Station.” Charleston Medical Journal, 1877. CONSTITUENTS OF CLIMATE. 
31 
clothing, however carefully packed, from being injured by the 
dampness of the air, as well as by the exuberant tropical 
vegetation,” etc. Examining the effects of moisture during 
the winter and spring months in this village, dews are fre- 
quently heavy. During my first winter here, however, dew 
did not commence to deposit until near twelve o’clock at 
night. During the past two winters it commenced earlier. 
Fogs are infrequent, and when they occur, are almost invariably 
dissipated by the sun at an early hour, before invalids have had 
their breakfast. Nearer the mouth of the river, they last 
longer, and are more frequent. Salt never melts, and never 
causes any inconvenience from dampness. I have not seen 
vapor condensing on the walls or stair-rails but once in three 
winters. I take no precaution against the rusting of my steel 
instruments in winter or spring, and they are free from rust in 
the spring. Mould seldom iorms here, so far as I have ob- 
served. We must plead guilty to mosses. The Tillandsia 
TJsneoides, or Spanish moss, which, as Dr. G. remarks, “ adds 
so much to the solemn grandeur of our Southern forests,” is ad- 
mired as much as any of the novelties which a new-comer sees 
here. Undoubtedly, this does not grow in a dry atmosphere. 
But there seems to be something more than moisture which is 
conducive to its growth, since a tree standing by itself on high 
and dry ground and unprotected from the sun, is frequently 
covered by a more dense growth than many of the same species 
standing in a wet swamp, to which the rays of the sun have but 
slight access. As regards the deficient evaporation from the skin, 
a few notice it occasionally, but the majority do not, probably be- 
cause there is generally more or less breeze. Dr. Geddings then 
gives the popular characteristics of a dry climate; but, as these 
are mainly the opposites of those of a moist climate, it is only 
necessary to allude to three—the “ desiccation of meats and their 
slower decomposition ”; “ the certainty with which matches 
take fire even in unheated rooms ”; and “ the frisure of women’s 
hair, the crimps and curls retaining their form for days.” As 
regards the first test, it is a fact which I confess astonished me, 
that beef, when hung up in a current of air, will keep longer than 
in a like temperature at the North, and that venison will desiccate 32 
CONSTITUENTS OF CLIMATE. 
on the surface, and keep much longer than beef. As regards 
the second, I rarely, if ever, find one of the commonest matches, 
kept in an open box on the first floor in my house and at the 
hotel, miss fire. I have had trouble with a similar article in 
my office in New York. I have never heard any complaints 
fiom the ladies about their hair, but they might not think it 
worth mentioning to a doctor. Dr. Madden alludes to the diffi- 
culty in Madeira of keeping musical instruments in tune. There 
is a difference in this respect between Florida and some dryer 
climates, especially as regards catgut, but not enough to cause 
any very great inconvenience, and there is very little influence 
as regards pianos. I have not observed any damage to 
clothes packed and left through the summer. The writer has 
thought it of sufficient importance to notice in detail these tests, 
the best we have at present, and he is certain of the correctness 
of his statements, according to his own observation, and that of 
others here to whom he has submitted these questions. And we 
also find that this corresponds with what we should infer from 
a comparison of the relative humidity as taken from different 
records, with Vivenot’s classification, which is as follows : Mod- 
erately dry, 56° to 70°; moderately moist, 71° to 85°; excessively 
moist, 86° to 100°. The relative humidity for the year being 
69.6 (March, 67.5, lowest; September, 76.8, highest*). This 
brings the climate very nearly under the head of moderately dry. 
It is to be hoped that the above facts will go far towards 
refuting the wild statements which have been indulged in very 
generally with regard to the excessive moisture of Florida cli- 
mate, as well as to the presence of malaria. “ While many 
authorities concur,” says, Dr. C. T. Williams,f “ in the superi- 
ority of dry to moist air, there are none the less some who 
assert, with equal positiveness, the reverse. In fact, the evi- 
dence on this point is conflicting; and this is no doubt due in 
part to the fact that humidity is a relative term, and that the 
degree of humidity has not been stated or studied with sufficient 
precision.” Those who seek anxiously for dry climates overlook 
perhaps the fact that a certain degree of moisture in the air is 
* Baldwin, op. cit. 
f Lettsomian Lectures. British Medical Journal, 1876. CONSTITUENTS OF CLIMATE. 
33 
absolutely necessary to prevent a great diurnal range of tem- 
perature, which these same persons equally deprecate. In 
Florida, for instance, were it not for a certain amount of 
moisture in the air, and a certain amount of deposit of dew, 
instead of a fall of 13° or 14°, we should have one of 30° or 
40°, probably. The fall is 40° in the dry climate of Upper 
Egypt; and in sandy deserts, as Sahara, where the dryness is 
absolute and radiation at night unrestricted, the temperature 
falls to 32° F.; the temperature ranging during the day in the 
shade above 100° F. On our Western plains, the range is some- 
times 60° F., so that the body is almost burned up by day and 
frozen by night. In Florida, as we have seen by previous state- 
ments in this paper/the moisture is just sufficient to temper the 
heat during the day by evaporation, and by condensation and 
the checking of radiation to limit the cold at night. Even the 
summer heat is in this manner, and with the aid of a pretty 
steady prevalence of east winds, rendered very tolerable, the 
evenings and nights even pleasant. 
Purity of the Air.—In estimating the climatic advantages of 
different health resorts, too little attention has been heretofore 
devoted to what may be technically called the purity of air. 
The common idea of purity has been freedom from unpleasant 
odors; yet the gases, which these odors indicate, are the least 
injurious of serial impurities, and rarely exist in sufficient con- 
centration to do barm. The chemist spends a considerable por- 
tion of his time in his laboratory, surrounded by various gases 
in a far more concentrated form than they are met with in the 
atmosphere (if we except a few which are never found in the 
atmosphere), and comes out unscathed. The gases from a sul- 
phuric-acid factory on the Hudson river have destroyed trees 
for long distances, and even on the opposite bank of the river, 
and yet, on examining the workmen in the factory, I could not 
find that they were much inconvenienced by them after becom- 
ing accustomed to the irritation of the laryngeal mucous mem- 
brane. Carbonic-acid gas, which enjoys the reputation of being 
the most dangerous, rarely exists even in the most crowded 
rooms in dangerous quantity, and is not of itself poisonous. 
The difference in the amount of gas in city and country is not CONSTITUENTS OF CLIMATE. 
material; for instance, Lake of Geneva, .0439 in 100 volumes of 
air; Chambeisy, .0460; various parts of London, .0300 to .0420 
(Angus Smith’s tables). The air in different theatres in Lon- 
don at night varied from .101 to .320. It has been com- 
monly supposed that the 260 out of 300 prisoners confined in 
the Black Hole died from inhaling carbonic-acid gas, or from 
the deficiency of oxygen caused by its presence. But later 
observations, and especially experiments on living animals (Gav- 
arret and Hammond), indicate that they died as much from the 
poisonous effects of organic matter in the air as from the excess 
of carbonic acid or deprivation of oxygen. Mr. Ernest Hart* 
says : “ The captives in the Black Hole in Calcutta did not per- 
ish (or even suffer) for lack of oxygen.” We must then look 
to the solids and not to the gases of the atmosphere for the 
causes of disease. Tyndall has lately alluded to the important 
fact that equally expert experimenters in treating fluids by sim- 
ilar methods for the destruction of these organisms, have failed 
to arrive at the same results; for which he assigns the reason 
that the air is in one locality purer; that is, less infected with 
germs than in others, and that the different fluids experimented 
upon were therefore contaminated by them in different degrees. 
Pasteur, says Tyndall, found the Glacier air of the Mer de 
Glace, and equally in the caves under the Observatory of Paris, 
free from germs of putrefaction. It is these germs, and these 
only, which these scientists have demonstrated to be the princi- 
pal, if not the only cause, of putrefaction and decay in organic 
substances; and, as we may infer, of the suppuration, gangrene, 
septicaemia, and the consequently increased mortality of inju- 
ries, and wounds, and surgical operations in camps and hos- 
pitals ; ihat is, where patients are more or less crowded, which 
the reasoning and the patient experiments of the celebrated 
surgeon of Glasgow have almost abolished by his process for 
destroying the vitality of these germs in the air in the imme- 
diate vicinity of wounds and operations; the operations being 
now carried on in an antiseptic atmosphere produced by a fine 
spray of carbolic acid or thymol. The destructive diseases of 
vegetable life have also been successfully assailed through the 
* Manual of Public Health, London, 1874. CONSTITUENTS OF CLIMATE. 
35 
knowledge derived from Pasteur’s experiments. These very 
important facts, established through the genius and patient in- 
dustry of the French savant, may yet enable us to limit the 
action of epidemics now so destructive to human life; for 
Schroeder and von Dusch have found that atmospheric germs 
may be excluded by a cotton filter, and it has, long ago, been 
asserted, and to a certain extent proved, that the cause of mala- 
rious manifestation, whatever that may be, can also be excluded 
from a room by a similar contrivance, as a thin cotton screen 
placed in the open windows.* It has heretofore been an unac- 
countable fact that diphtheria and similar diseases prevail to a 
far greater extent and with far greater destructiveness in some 
localities than in others not very distant, and whose hygienic 
conditions are similar or even superior;f that cholera and yel- 
low fever, for instance, sometimes assail and prove more fatal 
in portions of a city supposed to be in a superior sanitary con- 
dition, and assail or only moderately afflict those in such a con- 
dition as seemed particularly to invite disease.$ 
In a warm and moist climate like that of Florida, we should 
expect to find putrefaction and decay particularly active, but 
the facts are, so far as my observations have extended, tftat is, 
in this village and along the river for some distances, that milk 
sours and meat putrefies at a lower temperature, or sooner in 
* A thick belt of trees, and of the sun-flower plant will also intercept these 
germs. The eucalyptus has lately become especially the subject of experi- 
ment wherever it will grow. It is not certain whether it acts simply as a 
filter, like other trees, but more effectually because its foliage commences close 
to the earth, or whether the effect is jointly due to this and some specific in- 
fluence in virtue of its remarkable balsamic odor; perhaps, in wet locallties 
also, to its draining property; its extraordinarily rapid growth necessitating 
a great supply of moisture from its roots. 
f The Report of the Boston Board of Health states that diphtheria has pre- 
vailed to a greater extent in the better districts of the city. 
X One must not infer that this statement invalidates any of the cautions 
which sanitarians are now so industriously urging on the public with regard 
to the importance of cleanliness and disinfection as a means of arresting dis- 
ease or limiting the spread of epidemics. It must be understood that these, 
though occurring not infrequently, are exceptional cases, and are still inex- 
plicable, but which present indications assure us will soon be better under- 
stood. 36 
CONSTITUENTS OF CLIMATE. 
the same temperature in the northern sections of our country 
than here. We have already described the behavior of fresh 
meat when exposed for some time to currents of air. Applying 
the preceding considerations to these facts, we must conclude 
that the air here, though moderately warm and damp, condi- 
tions which, of course, give particular activity to germs, must 
be notably free from those agents of decay and putrefaction; 
and we should also infer that wounds would progress in a par- 
ticularly satisfactory manner, which is a fact; also that diphthe- 
ria* is unknowrf, as is genuine cholera, typhoid fever, and 
erysipelas rare, and scarlet fever rare and mild. Whether the 
purity of the air here, that is, its comparative freedom from 
putrefactive germs, and its exemption from those diseases, bear 
the relation of cause and effect, can not yet be demonstrated, but 
it may reasonably be inferred.f At all events, a belief in this 
relation is fast establishing itself in the minds of some of our 
* In the year 1876, according to the Report of the Brooklyn Board of 
Health, there were, in that city alone, 2,329 cases of diphtheria and 812 
deaths. In 1878 this disease, according to the “ Le Progrds Medical,” carried 
off 2,393 persons in Paris. M. Besmer observes that density of population 
has little if any influence in determining the disease, but poverty is very 
distinctly concerned in promoting its development. This, if so, speaks well 
for the purity of the air here, for there is poverty enough among the native 
inhabitants. Bad drainage is thought in this countr}7 to have an important 
influence in promoting the disease, and there are cities in this State which 
will afford unusually fine examples of this, and yet we see no diphtheria. 
f The army surgeons during the late war found that a thorough application 
of carbolic acid to the streets, lanes, yards, and houses of districts infected by 
yellow fever in New Orleans, decidedly limited the spread of that disease; 
and the practice has been continued there ever since. 
Surgeon-Major Tuson, Sixteenth Royal Cavilry,has frequently observed, 
says the “London Lancet,” the beneficial effects of burning fires in the epi- 
demics of cholera in India. But as in the case of the use of carbolic acid, it 
must be done thoroughly. The author cites instances in which the disease 
apparently speedily succumbed after thorough fumigation of the affected vil- 
lages and streets. The piles of wood were placed at short intervals of space, 
and kept burning for forty-eight hours; the sulphur is sprinkled on so as to 
keep up continuous fumes, while the houses are at the same time carefully fu- 
migated. The process is disagreeable to the sense of smell, as is the carbolic 
acid, but not dangerous if intelligently supervised. Carbolic acid vapor and 
sulphurous-acid gas are the most destructive agents against these “ seeds of 
disease.” CONSTITUENTS OF CLIMATE. 
37 
ablest thinkers, as Nott, Sansom, Huxley, Tyndall. “ It has 
been established beyond all doubt,” says Schrcefler (op. cit.), 
“that these organic substances, be they the gaseous products of 
putrefactive processes in the animal or vegetable kingdom, or 
vegetable germs, or microscopical animalcules floating in the 
atmosphere, do reach the lungs in the current of air inspired, 
and are there capable of doing great mischief.” “The observa- 
tions of Schroeder, and especially of Pasteur,” says Parkes (op. 
cit,.), “are likely to have an important influence on the doctrines 
of etiology.” “ The septic condition of the air, as Dr. Sander- 
son has termed it, derives importance from the possibility of its 
being concerned in the production of some of the so-called 
zymotic diseases.” 
When we know that wounds and sores on the surface of the 
body are so injuriously affected by these germs or “ seeds of 
disease,” and that so great a change in the result of surgical 
operations can be wrought by preventing their access to raw 
surfaces, we may well imagine how injurious an influence may 
be produced on ulcerations and other diseased processes going 
on in the lungs, whenever these bodies are abundant in the 
air, which is constantly brought in contact with them through 
respiration. 
Ozone.—This agent is supposed to be closely connected with 
the purity of the atmosphere, being apparently a more active 
form of oxygen, and converting injurious substances floating in 
the air into inert compounds. The subject is, however, in a 
rather chaotic state as yet. Within the last year or two numer- 
ous observations in different parts of the country have been 
made by medical men mostly; but it is extremely doubtful if 
any of these have much practical value, from the fact that we 
are not yet in the possession of any reliable test, of one which 
will give the reaction of this agent and of no other which might 
be confounded with it. Schonbein’s papers have usually been 
employed, but so many other bodies are present in the air which 
are capable of producing a similar reaction, especially nitrous and 
hypo-nitrous acids, and even nitric acid and peroxide of hydro- 
gen, that we cannot be certain of the amount or even the exist- 
ence of ozone. Houzeau’s test is claimed to be less open to this 38 
CONSTITUENTS OF CLIMATE. 
objection, the iodized red-litmus paper; but Professor Leeds, of 
the Stevens’ Institute of Technology, who has experimented 
largely with ozone in Hoboken and in the Adirondack Moun- 
tains, informs me that this paper, in an artificial atmosphere of 
peroxide of hydrogen, gives the reaction of ozone, and that it is 
also not sufficiently sensitive. He states that peroxide of hy- 
drogen has lately been detected in the atmosphere for the first 
time by Struve, a Russian chemist. Schreiber, in his recent 
paper (op. cit), reiterates the assertion often made before that 
pine forests are instrumental in the production of ozone. He 
says : “ It has been the custom for quite a long time to recom- 
mend the pine woods as a place of residence for pulmonary in- 
valids, but the ‘ why ’ of the process has only recently been 
discovered. The turpentine exhaled from these forests possesses 
to a greater degree than all other bodies the property of con- 
verting the oxygen of the air into ozone, and as the latter 
destroys organic matter, the air of such forests must be, and 
consequently is, conducive to respiration.” 
This was Scbonbein’s idea, because the oxydation of turpentine 
oil and other essential oils in the air caused the characteristic 
reaction of ozone on iodide of potassium. But “ the nature of 
this compound has lately been examined by Kingzett* (Chem. 
Soc. J [2] xij, 511), who finds that it cannot be either ozone or 
peroxide of hydrogen, because it is destroyed at the boiling 
point of oil of turpentine (160°), at which temperature ozone 
and H. P. are permanent. Moreover, it resists, to a certain 
extent, the action of sodium thiosulphate, and its solution in 
water retains its properties after long-continued boiling.” “Mr. 
Burgess, the inventor of the process for making paper from 
wood, found that the introduction of a few drops of oil of tur- 
pentine into his bleaching-room would not only prevent the fur- 
ther formation of ozone, but would even destroy that already 
existing.”f It is very likely, however, that the terebinthinate 
odor is, of itself, rather soothing to diseased respiratory mem- 
branes ; but it is so diluted that, at a very short distance from 
the forest, it is lost entirely; and to be benefited at all, the 
* See Watts’ Die. of Chemistry. Sec. Suppt. 
f Amer. Jour, of Med. Sciences, 1874, p. 420. CONSTITUENTS OF CLIMATE. 
patient must live pretty much all the time in the midst of the 
trees. 
The character of the soil and subsoil is of almost as much 
importance, in some parts of the country, of more importance, 
indeed, than the conditions of the air. Dr. Bowditch has pub- 
lished some valuable statistics on this point. A soil retentive 
of moisture, or a stiff’ and clayey subsoil impervious to it, and 
not thoroughly drained, is always prejudicial to the health of 
the inhabitants. Parkes* says of soils : “ Some soils absorb and 
retain water more than others." “ Sand absorbs very little," 
water passing through rapidly; “ clay ten or twenty times more; 
and humous or common surface soil more than forty or fifty 
times as much as sand.” “ The sands are therefore the healthi- 
est soils in this respect. In hot countries, the sand is objec- 
tionable on account of its heat, unless it can be covered with 
grass. The effect of glare on the eyes is obvious, and in the 
tropics this becomes a very important point. If a spot, bare of 
vegetation and with a white surface, must be used for habita- 
tion, some good result may be obtained by coloring the houses 
pale-blue or green.” “ The amount of dust given off from soils 
is not a matter of slight moment.” With regard to permea- 
bility, no soil is better capable of fulfilling this requirement 
than that of Florida, as sand is the predominating and some- 
times the only ingredient in the localities where invalids con- 
gregate, although it is not fair always to judge the soil of 
Florida any more than the other constituents of her climate by 
appearances. In some localities the soil, which has the appear- 
ance of almost pure sand, being quite productive. But every- 
where the soil is permeable. Palatka, unlike any other locality 
in the State, is covered with a sod of green grass, for which 
exception no one has been able to offer any conclusive explana- 
tion. This obviates here many of the objections urged by Dr. 
Parkes to sandy surfaces. The comparative exemption from 
dust is no mean advantage to invalids suffering from lung or 
throat difficulties or weak eyes. Some southern resorts, other- 
wise unobjectionable, being rendered entirely unsuitable from 
* Manual of Practical Hygiene. London, 1866, p. 267, et Seq. 40 
CONSTITUENTS OF CLIMATE. 
this cause. We all know the serious effects produced on the 
lungs of artisans working at dusty trades. 
Another topic deserves mention here ; it cannot strictly be 
called a constituent of climate, but it has a great deal to do with 
the success of climatic treatment—the advantages which any 
particular location may present for occupation and social enjoy- 
ment, and without crowding the invalid class in too circum- 
scribed a space. Patients must have some occupation and 
amusement, and the more the better. Brooding and idleness 
are always dangerous to invalids. Boating, shooting, fishing, 
riding, especially horseback, excursions, reading (but not too 
much of it) should be encouraged as far as the strength of the 
invalid will admit. Some will always find occupation and in- 
terest anywhere, while the great majority require to be induced, 
encouraged; and, of course, the more varied the means the bet- 
ter the chance of success. Thus, a residence on a river or lake, 
especially if they are thoroughfares for commerce and travel, is 
preferable, caeteris paribus, to inland localities, since the 
choice of sport and recreation is more varied. Patients should 
be taught to exert themselves to become interested in what is 
going on around them in their new residence.* Lanier, the 
poet, who has written a very interesting work on Florida, him- 
self an invalid, forced to resort thither for his own safety, says, 
in giving the same advice: “The field of Florida in these mat- 
ters” (agriculture and products) “is yet so new, so untried by 
the resources of modern agricultural improvement as to be full 
as fascinating, if one should get one’s interest aroused in it, as it 
was in the old days when the Spaniards believed it to be full of 
gold and pearls.” If the invalid cannot feel satisfied away 
from home, cannot keep his mind from brooding over his busi- 
ness interests or family affairs, he had better return to these, 
and avoid the unnecessary sacrifice of money and home com- 
forts. In fact, before he leaves home “ full note,” says Williams 
* In the case of Florida, I would advise the visitor, in order to become more 
interested in the industries, the occupations, the products, the sports of the 
State, to take the “ Florida New Yorker,” or the “Agriculturalist,” the “Semi- 
Tropical Magazine,” one of the best periodicals in the country of the kind, 
one or all of these, or the “ Forest and Stream,” and to read “ Halleck’s Camp 
Life in Florida.” CONSTITUENTS OF CLIMATE. 
(op. cit.), “must be taken of the patient’s inclinations, means, 
and, above all, of his disposition and temperament; and exile 
must not be decreed to those who are incapable of making 
themselves happy under the changed conditions of life, or all 
our scientific grounds for a climatic decision may collapse like a 
house of cards.” 
The question of the sources of the water supply of a health 
resort is a most important one, and should always be ascertained, 
if possible, by physicians who give advice on the subject of 
change of air. More attention is now being devoted to sewage 
contamination on account of the many serious accidents occurring 
at northern watering-places within the last few years. But there 
are other sources of contamination, especially in southern re- 
sorts, which should receive more attention than has been accorded 
them. It is well known that water, contaminated by vegetable 
organic matter, as well as by minerals, as the salts of lime, pro- 
duces dysentery and diarrhoea, but it is not so generally ad- 
mitted that it may also give rise to malarious fevers. It is 
important that this fact should be generally recognized by those 
living in malarious localities, since water may contain the seeds 
of disease in winter as well as in summer. Want of space will 
only allow of allusion to a small number of arguments and facts 
which support this theory. As a general rule, people consider 
water which is transparent and has no unpleasant odor or taste 
safe. But physicians and scientists know that these are not 
reliable tests. All sorts of dangerous impurities may lurk in 
such water, while a comparatively repulsive-looking water may 
be wholesome to those accustomed to it, as the water of some 
rivers. When water contains a great deal of organic matter, 
as when it permeates a rich vegetable soil, it is brown or yellow, 
as the waters of the Ocklawaha and St. John’s rivers, and may 
contain as much as 15 to 30 grains to a gallon. Water from 
marshes may contain from 75 to 100 grains. “ It is a very gen- 
eral belief,” says Parkes (op. cit.), “ among the inhabitants of 
marshy countries that the water can produce fever. On making 
some inquiries of the inhabitants of the highly malarious plains 
of Troy during the Crimean war, I found the villagers univer- 
sally stated that those who drank marsh water had fever at all 42 
CONSTITUENTS OF CLIMATE. 
times of the year, while those who drank pure water only got 
fever during the late summer and autumnal months. The same 
belief is prevalent in the south of India, and in Western Can- 
deisch, Canara, Balaghut, and Mysore, and in the deadly Wy- 
naad district.” “ It is notorious,” says Mr. Bettington, of the 
Madras Civil Service, “ that the water produces fevers and 
affections of the spleen.” He presents conclusive evidences of 
it. Parkes adduces similar evidence from various parts of 
France, and from what happens on ships furnished with river 
water.”* He also states that the fevers produced by impure 
water are more fatal than others. It is not the 
malarious affections which have been so prevalent in the city of 
New York, in the older as well as in the newer districts, have 
been caused by the Croton water bringing the malarious germs 
from the sources of the streams; the severe droughts of sum- 
mer and very small supply of snow in winter, characterizing the 
last eight or nine years, having caused, as has already been 
stated, an unusual development of malarial fever, rendering 
many localities, which had been proverbially healthy, just the 
reverse. 
The water of many wells in Florida is clear and sweet, and 
therefore regarded as perfectly suitable for drinking and cook- 
ing, but a proper examination would show it to be entirely unfit, 
though less so than that from the shallow wells and brooks so 
frequently used by the country people. It was supposed that, by 
boring down to or through the coral rock underlying the State, 
a safe drinking-water would be obtained. This water, after a 
small amount of sulphuretted hydrogen gas has passed off, is 
beautiful and palatable, and far better than any well or spring 
water; but it gives, on chemical analysis, too large a percentage 
of salts and of organic matter to render it perfectly safe, though 
it is a very fair substitute for rain water when this cannot be 
obtained. The latter is the only safe water to use in Florida, 
and no doubt in large portions of many of our Southern States. 
Bain water should always be filtered. Kedzie’s filter, animal 
charcoal, gravel, and sand, is generally used here. But an in- 
* Practical Hygiene, London, 1866, p. 56. CONSTITUENTS OF CLIMATE. 
genious person, who cannot afford this, can make one for him- 
self. It should be borne in mind, however, that, after a time, 
the filter itself may become a source of contamination, and the 
charcoal should occasionally be removed, spread out, and ex- 
posed to the air.* 
Food—the kind and quality, and the manner of its 'prepara- 
tion—is a matter of no small importance to an invalid; and no 
climate, however suitable in other respects, is proper for him if 
he cannot obtain good and decently-cooked food. Many come 
to Florida with so little money that they must obtain board 
where the food is such that they cannot eat it, or if they do, it 
causes dyspepsia and an aggravation of their already existing 
disease. In this case I usually advise them to go home. Good 
food can be had anywhere in the State and at reasonable rates; 
so can wines, medicines, and all the comforts of life, which was 
not the case a few years ago. Perhaps one article ought to be 
excepted, for some localities, milk. But this will probably soon 
be obtainable in larger quantity and better quality, as cows 
need only to be fed with nutritious food to give good milk, 
whether they are in Florida or New York. The amount and 
kind of food, however, should be adapted to the great change 
of temperature to which the invalid has been subjected. This 
is seldom thought of, and when nature attempts to prompt him, 
her hints are misunderstood, and, after a few weeks’ residence, 
he complains of loss of appetite for his accustomed articles of 
food; he cannot relish his usual quantity of beefsteak or roast 
beef twice a day; he becomes dissatisfied, and wishes a change. 
He should remember that less food and a different kind is re- 
quired in a warm climate; less meat, and the lighter kinds, 
poultry, fish, eggs, vegetables, fruits. A want of observance of 
rules of diet induces “ biliousness,” dyspepsia, and perhaps diar- 
* Palatka is supplied with large wooden cisterns, and there is an abundant 
supply of rain water for all purposes. The healthfulness, for which this place 
has always been noted, both in winter and summer, is no doubt largely due to 
this fact. It had, however, this reputation amoDg our officers even during 
the Seminole war, and was on this account selected, in preference to posts 
higher up the river, for the site of a general hospital. The first purchase of a 
settler ought to be a cistern holding from 800 to 1,500 gallons, costing from 
thirty to fifty dollars. 44 
CONSTITUENTS OF CLIMATE. 
rhcea, and as a physician is seldom consulted, except in severe 
cases, all this is attributed to the climate, and perhaps to ma- 
laria, and Florida has to bear the odium of this as she does of 
all the other imprudent acts of invalids and tourists. 
A few words are necessary with regard to the clothing suita- 
ble for a Florida winter. It may be inferred, from what has 
been said with reference to variations in temperature from time 
to time, that a considerable variety of clothing should be at the 
command of the invalid. Thicker clothing is required in Florida 
than in New York at the same temperature. Linen clothes, for 
invalids at least, are seldom wanted. That which is suitable 
for moderate winter or early spring weather at the North will 
be best. One should have a thick and a thin overcoat. Flan- 
nels or merinoes should, of course, be worn at all times, and 
underclothes of different weight should be provided so as to be 
prepared for all emergencies. 
Of the diseases which may he benefited by"change of climate, 
and especially by Florida climate, only one has yet been men- 
tioned—pulmonary consumption, because the question of change 
of climate arises far more frequently with reference to this than 
any other, and yet this powerful therapeutic agent is more suc- 
cessful in the cure of almost any other disease than this. It 
would be otherwise, however, were the cases properly selected, 
if the remedy were resorted to in the early stages of the dis- 
ease, if the climatic change were aided, as all writers urge that 
it should be, by other therapeutic measures, and by judicious 
advice as to the mode of life suited to each particular case, and 
to the adopted climate. 
It is notorious that large numbers are annually sent to the 
South who are entirely unfit to leave home on account of the 
advanced state of the disease or extreme debility. By what 
symptoms, then, or conditions of the patient are we to be influ- 
enced in deciding the important question as to whether he 
should or should not leave his home ? Some physicians are 
apparently guided by the local condition, the amount of disease 
existing in the lung; some by the general aspect and symptoms 
presented ; some by both; while others, it is to be regretted, seem 
to be guided by no principle at all, allowing their patients to CONSTITUENTS OF CLIMATE. 
45 
follow, to a great extent, their own inclination, to drift about 
according to their own caprice, or the notions of their family, or 
of friends who have been benefited perhaps by some particular 
climate which happened to suit their case. Some seem not 
to have the nerve, the moral courage to announce to the hope- 
ful friends that the case is hopeless, and that it would be 
cruel to banish the patient from home; and thus so many 
distressing cases fall into the hands of those of us whose lot it 
is to minister to the last sufferings, mental and physical, of those 
whose fate it is to die away from the comforts of home and 
friends, and thus is the reputation of climatic treatment depre- 
ciated. A good deal of unnecessary stress is, it seems to me, 
laid on the fact of the disease being in the so-called “ third 
stage ” as a condition unsuited for change, especially a change 
to a warm, sedative climate. It has prevented many from avail- 
ing themselves of the advantages of change who might have 
been much benefited ; the third stage, or stage of softening, 
being often the curative means which nature adopts to get rid 
of dangerous deposits in the lungs. The extent or condition of 
the cavity, or of the foyer 'purulent, should be carefully deter- 
mined. A large cavity, or one not circumscribed by a limiting 
membrane, or invading the lung in different directions, or 
accompanied by an unfavorable condition of the general health, 
would contraindicate change. But the simple fact that soften- 
ing has commenced, that a cavity exists, or even more than one, 
that the third stage has arrived, should not, per se, condemn a 
patient. All physicians who have made many autopsies, or who 
have dissected extensively, must have met with not a few in- 
stances of the healing of cavities in the lung, or in both lungs. 
H. Bennet observed numerous instances of the healing of the 
cavities in the lungs of old women who died at the Salp6tri£re 
in Paris. MM. Ferrus and Cruveilhier noticed the same fact 
in the Salp6tri6re and Bicdtre in the bodies of both sexes. 
While “ M. Beau states that 157 out of 160 who died in his 
wards in Salp6tri&re had cicatrices in the apex of one or both 
lungs.” M. Prus found similar traces. There are certain cases 
of phthisis which may be recognized at a glance as unsuitable 
for change, whatever may be the condition of the lungs; in 46 
CONSTITUENTS OF CLIMATE. 
fact, when physical examination reveals but trifling change, as 
where there is excessive emaciation, a serious alteration of the 
composition of the blood, as indicated by a peculiar pallor, fail- 
ure of digestion and nutrition, diarrhoea, hectic fever, frequent 
pulse, profuse expectoration, exhausting sweats, accelerated 
breathing, inability to exercise to any extent. It is not neces- 
sary that all this formidable array of symptoms should be pres- 
ent to warrant an unfavorable opinion on the part of the 
physician as regards change of climate. The most superficial 
examination is sufficient to enable one to judge of the future of 
these cases. Numbers of these invalids are, nevertheless, 
allowed to go, let us not say are sent, hundreds of miles from 
home. This is one reason why climatic treatment so often fails. 
Another prominent cause of failure is the advice commonly, 
almost universally, given by physicians to “ trust to the climate,” 
to “ avoid drugs and doctors.” An immense number of drugs 
have, doubtless, already been found useless, perhaps worse than 
useless, and it is natural that the patient should be told to avoid 
them. But a remedy which, in one climate, has proved value- 
less, might be of decided value in another and under changed 
circumstances. A mere change of air and scene may, and often 
does, prove all that is necessary in a few cases of incipient dis- 
ease ; but, as a very general rule, invalids require more or less 
medication at one time or another during the winter. Compli- 
cations, some of which may be incident to the change of climate, 
food, water, etc., and especially to the fatigue and excitement of 
the journey, require attention. Invalids are notoriously care- 
less and reckless, and require to have some one at hand with 
authority to check them. All writers on climate have warned 
against this proclivity to trust too much to climate. Sir James 
Clark says: “ In the first place, I would strongly advise every 
person who goes abroad for the recovery of his health, whatever 
may be his disease, or to what climate soever he may go, to 
consider the change as placing him merely in a more favorable 
situation for the removal of his disease; in fact, to bear strictly 
in mind that the beneficial influence of sailing and of climate 
requires to be aided by such a dietetic regimen and general 
mode of living, and by such remedial measures as would have CONSTITUENTS OF CLIMATE. 
been requisite in his ease had he remained in his own country. 
All the circumstances requiring attention from the invalid at 
home should be equally attended to abroad. If, in some things, 
greater latitude may be allowed, others will demand even a more 
rigid attention. It is, in truth, only by a due regard to all 
these circumstances that the powers of the constitution can 
be enabled to throw off, or even materially mitigate, in the 
best climate, a disease of long standing.” “It was, indeed, a 
matter of surprise to me, during my residence abroad, to ob- 
serve the manner in which many invalids seemed to lose sight 
of the object for which they left their own country—the recovery 
of their health.” “The more common and more injurious devi- 
ations from that system of living which an invalid ought to 
adopt consist in errors of diet, exposure to cold, over-fatigue, 
and excitement in what is called ‘sight-seeing/ frequenting 
crowded and over-heated rooms, keeping late hours,” etc. 
Williams (op. cit.) remarks: “Climate is only one portion 
of the system of attack which we organize against the dread 
foe which decimates our population, and would be worth little if 
not combined with medicine and hygiene, and a determined will 
to wrestle bravely against the home-thrusting enemy.” Dr. T. 
G. Horn (Trans. Colorado State Med. Soc.) thus discourses: “ In- 
valids, as a class, are generally careless, self-willed, and unrea- 
sonable. Many naturally so; more made so by instructions 
given them by their physicians East telling them almost inva- 
riably that they will not need to consult a physician here, but 
* go into the mountains/ 1 live out of doors/ etc. So, with his 
pocket full of prescriptions from home, the poor sufferer rushes 
madly into this altitude, and without proper medical advice, 
soon rests in his grave.” The following remarks of Eorry, than 
whom no one is better qualified to give advice in this connec- 
tion, are so apposite that I quote them at length : “ Let not the 
invalid, however, trust too much to change of climate. Unfor- 
tunately for the character of the remedy, it has been recom- 
mended indiscriminately and without proper consideration. It 
has been too often resorted to as a last resource or a forlorn 
hope; or, in cases susceptible of alleviation or permanent cure, 
it has been wholly misapplied. One person is hurried from his 48 
CONSTITUENTS OF CLIMATE. 
native land with the certainty of having his sufferings increased 
and his life shortened, instead of being allowed to die in peace 
in his own family; while another, who might derive much ad- 
vantage from the change, is sent abroad wholly uninstructed in 
regard to the selection of a proper residence or ignorant of the 
various circumstances by which alone the most suitable climate 
can be rendered beneficial. It is one of our most powerful 
remedial agents, and one, too, which, in many cases, will admit 
of no substitute. But much permanent benefit will result 
neither from travelling, nor change of climate, nor their com- 
bined influence, unless the invalid adheres strictly to such regi- 
men as his case may require. This remedy—change of cli- 
mate—must be considered in the light of all other therapeutic 
means, and to insure its proper action, it is requisite that the 
necessary conditions be observed. The patient should, in a 
measure, regard the change of climate as merely placing him 
in a situation more favorable for the operation of the remedies 
demanded by his disease.” 
Another cause of failure is this : patients with only a mod- 
erate amount of disease often improve so much in one winter 
that they, and sometimes also their physicians, yielding to a nat- 
ural desire of the invalids to remain at home, permit them to 
do so during the second or third winter. The consequence is 
that a catarrh, or pneumonia, or some complication incident to 
the climate and to overwork, or possibly only the devitalizing 
influence of a cold and damp winter, causes a relapse which is 
fatal, or insures a travel over a still longer road of invalidism 
than before. No matter how slight the evidences of phthisis 
in a young person may be, especially if there be hereditary pre- 
disposition, he should be fully impressed with the idea that his 
change of base must not be for one or two seasons, but proba- 
bly for several, however flattering may be the results of the first 
or second season. 
It has been deemed advisable to introduce the above cautions, 
which every prominent writer on this subject has felt con- 
strained to employ, because such incalculable harm has resulted 
from the prevailing habit among medical men of advising their 
patients against availing themselves of that which is absolutely CONSTITUENTS OF CLIMATE. 
49 
necessary to the success of climatic change in the great majority 
of instances—proper medical supervision and prescription. In 
the first place, patients leaving home in a feeble condition, travel 
rapidly down to Florida, not resting, as they should, on the way, 
and arrive more or less exhausted by the j ourney, and then, instead 
of perfect rest for a day or two at least, and in bed if necessary, 
they drag themselves about, and sometimes do not get thor- 
oughly rested for weeks. Sometimes from a too sudden change 
from a very cold to a warm temperature, gastric or hepatic 
troubles arise, and require treatment. Some patients with hec- 
tic fever, with a temperature ranging from 103° to 104°, pursue 
the same course, struggling to make a show of strength, and 
determined not to give up, when they should be in bed and 
taking the proper remedies. Sometimes a harassing cough, 
contracted perhaps from the exposure of their journey, or on 
some pleasure trip, or in sight-seeing, drives away their own 
sleep and that of their neighbors night after night, yet they are 
deluded into asserting in the morning that they have had a 
“ pretty good night,” their whole aspect denying the assertion. 
Profuse and exhausting sweats are allowed to go on unchecked by 
remedies, or are tampered with as are their other complications, 
not infrequently by domestic remedies, or the advice of sympa- 
thizing acquaintances. Dyspeptic symptoms often arise from 
injudicious eating, or perhaps as a consequence of their disease, 
and interfere with nutrition during the whole winter perhaps. 
Loss of appetite, especially during the latter part of the winter 
often troubles the invalid. Diarrhoea is a not infrequent com- 
plication, which is generally neglected until it becomes a serious 
matter. These are a few of the many exigencies which may 
require the attention of a judicious physician, and of one on 
the spot. Dr. J. R. Nichols, in his recent pamphlet (Essay, 
read before the Essex North Massachusetts Medical Society, 
May, 1878), truly says : “After you have reached Florida, you 
can no longer safely rely upon any advice you may obtain from 
your home physician in response to your representations to him 
by letter. If you need advice, seek it of some of the very able, 
cultivated, experienced resident physicians where you may 
stay.” 50 
CONSTITUENTS OF CLIMATE. 
The occurrence of these various complications, and the want 
of proper advice as to their management, lead to another preva- 
lent and dangerous habit of invalids, which, more than any 
other, perhaps, opposes their efforts and sacrifices in search -of 
health. Experiencing aggravation of some of their symptoms, 
or the advent of new annoyances, they arrive at the conclusion 
that they have not found the proper location, and seek some 
other, to go through a similar experience, perhaps; thus they 
go on, wasting the winter in experiments, and finally return 
home in the spring no better, probably worse. Whereas, a lit- 
tle judicious medical advice or caution, in the first instance, 
might have put them on the road to the melioration or cure of 
their complaint. 
Among the diseases for which a climate like that of Florida is 
particularly suitable may be enumerated Bright's disease in its 
earlier stages; for, as in the case of tubercular phthisis, it is 
worse than useless to send the very advanced cases. Throat 
and bronchial affections—these usually recover rapidly. But 
now and then a case of “ sore throat ” is sent as a curable one, 
when there is tubercular ulceration of the epiglottis, conse- 
quent on disease of the lungs, of which the patient has been kept 
in ignorance. These are, of course, hopeless, and very much 
damage the reputation of climatic treatment; cases of uncured 
;pneumonia, consolidation, which has survived the usual treat- 
ment and has left the invalid feeble, short of breath, with cough, 
loss of appetite, etc. Dr. Bizzell (Trans, of Med. Asso. of Ala- 
bama) says: “ Such cases recover almost magically in the warm, 
mild air of Florida children of strumous or tubercular dia- 
thesis, particularly those convalescing from measles, scarlatina, 
or whooping-cough; rheumatism and neuralgia. It may be 
thought singular that the former should be decidedly benefited 
here, owing to the amount of moisture supposed to exist in the 
air. But thefact is that, without any medication, it does yield, 
and sometimes rapidly. This may be added to the evidence 
already adduced in my first letter to prove that the climate is 
not so moist as has been represented; that form of dyspepsia, 
which may be called nervous, and which is becoming more and 
more common every year, as the nervous system is more and more CONSTITUENTS OF CLIMATE. 
51 
overtaxed, and which often promptly yields to the bromides, is 
alleviated in Florida; many of the nervous and neuralgic symp- 
toms attending uterine disease, or surviving its successful treat- 
ment (as far as local lesions are concerned), do well. Patients 
convalescing unsatisfactorily, in a cold climate, from almost any 
exhausting disease, even from malarial affections (witness the 
writer’s own case), will find a change to a temperature which 
will enable them to derive the benefit, through a long winter, of 
constant fresh, open air, extremely beneficial. Very old persons 
without any disease will have their lives prolonged and rendered 
more comfortable by a winter residence in the mild, genial air 
of Florida; especially old men, who suffer from bladder and 
■prostatic troubles. “Lastly, Florida offers a haven of rest and 
quiet for that condition which is unfortunately becoming so 
prevalent among the restless, driving denizens of our Northern 
towns and cities, which comes under the comprehensive desig- 
nation of nervous prostration; what Handfield Jones terms cer- 
ebral paresis, and which was thus described by James Johnson 
nearly fifty years ago: 1 There is a condition of body interme- 
diate between sickness and health, but much nearer the former 
than the latter, to which I am unable to give a satisfactory 
name. It is daily and hourly felt by tens of thousands in this 
metropolis (London) and throughout the empire; but I do not 
know that it has ever been described. It is not curable by 
physic, though I apprehend it makes much work for the doc- 
tors ultimately, if not for the undertakers. It is that wear 
and tear of the living machine, mental and corporeal, which 
results from over-strenuous labor or exertion of the intellectual 
faculties rather than of the corporeal powers, conducted in anx- 
iety of mind and bad air.’ For this cerebral consumption, as 
we may justly term it, Florida affords as healing a balm as for 
the pulmonary variety.”* 
These cases are met with every year in increasing numbers in 
men of great business capacity and untiring energy and indus- 
try, in all kinds of business and in all the professions; men 
ambitious of wealth or distinction, often goaded on by the neces- 
* Florida as a Health Resort. By F. D. Rente, N. Y. Med. Jour., Noy, 18, 
1876. 52 
CONSTITUENTS OF CLIMATE. 
sity of supplying the extravagant wants of large and expensive 
families; heads of our great corporations, railways, trust com- 
panies, insurance companies, etc.; men not content with the 
management and responsibility of one such organization, but 
often at the head of several, whose mental powers have been at 
their utmost tension, with very rare intervals of relaxation, for 
years. Sad it is to witness the wreck of such minds. In the 
light of this experience, we are almost disposed to regard the 
invention of the telegraph, and especially of the ocean tele- 
graph, which enables us and forces us to compress so much 
business into so small a space of time, as a very equivocal bless- 
ing. The facilities for accomplishing, and the inducements for 
undertaking, increased work and responsibility, thus multiplying 
year by year, it does not require a prophet to predict a yearly 
increase of nervous diseases and cerebral wrecks if our people 
generally, our educated and mercantile classes, are not aroused 
to the necessity for a decided reform in their reckless career. 
Dr. Nichols says, in his recent pamphlet (Essay read before the 
Essex North Mass. Med. Soc., May, 1878): “ Without further 
remark, we will say now, that for that class of ailments depend- 
ing upon abnormal nerve functions, no climate is better calcu- 
lated to afford relief than that of Florida. The poor, broken- 
down man of business, the nervous wife and mother, wearied 
and worn with household cares and duties, will find in this de- 
lightful air a balm well calculated to restore nerve action to its 
healthy conditions. The rest, the mental and physical rest, 
which comes even during a brief residence in Florida is, in our 
view, one of the most remarkable results of its climatic influ- 
ence.” “ The best possible medicine for weak nerves is out-of- 
door life in a climate not subject to violent changes; such a 
climate is afforded by Florida in winter.” 
These conditions of the nervous system are not only of them- 
selves of the most serious import, but still more so when we 
consider that they are very frequently only the forerunner of 
phthisis. This disease begins usually in impairment of nerve 
power, with exhaustion from overwork, mental or physical. 
“ In fact,” says Edwin Lee (Fiske Fund Prize Essay), “ the de- 
stroyed illusions, the deceived hopes of the realizations of expec- 
tations too often exaggerated by vicious systems of education, CONSTITUENTS OF CLIMATE. 
53 
the difficulties and anxieties which so often beset the path of 
life, etc., may well be regarded as mainly instrumental in the 
production of organic diseases, and especially of pulmonary 
consumption.” 
It is the duty of the physician to be watchful of the develop- 
ment of such cases, especially in phthisical families. These 
symptoms, of what has been termed the pre-tubercular stage, 
are generally quite obvious—failing health, loss of appetite, of 
interest in events or surroundings, dyspepsia, lassitude, some- 
times anaemia, but no physical signs. These are the cases for 
cure by change of climate. “ The number of cases like these,” 
says Dr. Geddings (op. cit.), “ is simply enormous, and the phy- 
sician who, forgetting that his mission is to avert disease, as well 
as to cure it, sounds no note of warning, is not only derelict in 
duty, but guilty of negligence, for which the term criminal is 
none too harsh. Year by year cases come under the writer’s 
observation, where neglect on the part of the physician to give 
this warning, or its disregard when given, has caused a sacrifice 
of human life which might have been prevented.” 
We have said that patients must not rely too much on cli- 
mate ; neither must they expect too much. This also has led to 
frequent disappointment and a failure to appreciate the benefit 
of climatic change. A decidedly consumptive invalid comes to 
Florida, and because he has not regained his health and strength 
in the spring, he concludes that the change has done him little 
or no good. Perhaps he feels little or no better. Yet he does 
not know how much worse he might have been had he remained 
at home. He comes to Florida to avoid dangers to which a 
northern climate would have exposed him, and if he gain3 
nothing more than the escape from these dangers, catarrhal 
troubles, pneumonia, pleurisy, bronchitis, etc., he has been well 
paid for his sacrifice. 
A medical invalid thus philosophizes on the subject: “ One 
chief object in spending the winter in Florida is this: a man 
with chronic disease should be satisfied if, during the winter, he 
merely keeps his enemy at bay. He is content if his disease, his 
enemy, makes no progress there, while, during the spring and 
summer, he tries to get well. In this the climate of Florida 
helps him; it is the best place in which the invalid can put his 54 
CONSTITUENTS OF CLIMATE. 
disease into winter quarters previous to undertaking the sum- 
mer campaign. And if life is to be a constant retreat, a run- 
ning fight with and from death, this is a strong fortress into 
which he may retire, and from which he may often set his enemy 
at defiance.” 
With regard to the proper time for going to Florida, one 
may go from the first to the middle of November if his condi- 
tion requires so early a retreat from inclement weather. If, 
however, he has only a limited time at his disposal, he had 
better wait until the first of February. The oranges are then 
in perfection, and the weather also. If he does not wish to 
spend the whole of a long winter and spring in Florida, and 
cannot remain at the North, or if he pines for a change, he 
may go up to Aiken, or he may stop at Aiken in the early part 
of the winter. October is delightful there, and there is usually 
no cold to interfere with an invalid until Christmas, and often 
later. “This,” says Dr. Geddings (op. cit.), “is undoubtedly 
the finest portion of the year, the air being just cold enough to 
act as a tonic without chilling, or in any way adding to the 
discomfort of even the most sensitive invalid.” Aiken has also 
one of the finest hotels in the southern country. 
When shall one leave Florida on his return north?—is a more 
important question. The warning has been repeated again and 
again by all writers on climate: “Don’t get home too early.” 
But still the fatal mistake continues to be made, and the sacri- 
fices and benefits of a whole winter are often thrown away by a 
premature return in the spring. Quite a long spell of warm 
and beautiful weather in April, or even in March, which often 
characterizes our treacherous northern climate, when the grass 
becomes green and the early flowers put forth their petals, and 
the birds begin to sing, beguiles the invalid or his friends, who 
long to see him home among them again, into the belief that an 
early summer is at hand, and he hastens away from his safe 
retreat, to be greeted, on his arrival, with a cold and chilling 
blast, not seldom with sleet or snow, and to experience perhaps 
weeks of weather more dangerous than that of mid-winter. 
This the writer experienced even in May last. Better remain 
at home all winter than return too early in spring. 
Palatka, Florida. CONSTITUENTS OP CLIMATE. 
Note on Sea-SicJcness.—The question whether it is preferable 
to travel by land or by sea naturally presents itself to the in- 
valid and the tourist. Railways are usually preferred, many 
fearing to face the dangers of the sea and the horrors of sea- 
sickness. As regards danger to life, that of the sea is certainly 
not greater, according to statistics, than by land. There are 
many advantages of travel by sea. The fatigue is less; the 
comfort is usually greater; the danger of taking cold and of ex- 
posure generally is less, or precautions against it are more under 
the control of the individual. The voyage is almost always 
beneficial to the consumptive or bronchitic invalid; the cough 
is for the time arrested. Even if the invalid suffers from 
sickness, it is only a temporary suffering, and does not increase 
his disease. If he is so feeble as to render a sea voyage dan- 
gerous, he is unfit to travel at all, and should remain at home. 
As regards sea-sickness, this may be in many cases entirely 
prevented; in others promptly cured, or greatly mitigated. I 
have elsewhere* written at considerable length of the treatment 
of nausea and vomiting from various causes. For the preven- 
tion of sea-sickness I employ bromide of potassium or calcium 
in full doses, half a drachm, three times a day, for about three 
days before the day of sailing, or enough to get the system 
fully under the influence of the drug at that date, as evidenced 
by a feeling of pleasant drowsiness. I keep this influence up 
by one, two or three doses a day after sailing, especially if the 
sea is high. Some persons prevent sickness by wearing Jobard’s 
belt buckled as tightly around the waist or pit of the stomach 
as can be borne with comfort. Ladies can bear it better than 
gentlemen. These can be had at Tiemann & Co.’s, 67 Chatham 
street, New York. The invalid should, if the weather permit, 
keep on deck, and, if threatened with sickness, in the recum- 
bent posture, and take the meals on deck. If he takes his 
meals in the saloon, he should not linger a moment after he has 
finished a moderate meal of plain food, but go in the open air, 
and lie down if threatened with nausea. 
* Treatment of Vomiting by Electricity. Archives of Electrology and Neu- 
rology, 1874. New York Medical Journal, November, 1876. Medical Record, 
June 22, 1878. CONSTITUENTS OF CLIMATE. . 
Among the numerous cures, I know of none equal to elec- 
tricity. A person can get a small, inexpensive Gaiffe battery 
for from five to ten dollars, which requires no destructive acids 
to run it, which any one may learn to apply moderately well 
very soon. A flat sponge moistened well or a wet napkin should 
be wrapped around the brass cylinder electrodes, not inserted 
into them, so as to furnish a large surface. One of these should 
be placed on the epigastrium, the other opposite, over the spine 
or solar plexus, and the latter, during half the time, over the 
seventh cervical vertebra. The electricity may be continued 
for half an hour or an hour in bad cases, only strong enough to 
give a pleasant sensation. Apomorphia in very minute doses 
(the homoeopathic triturations furnish the most convenient form) 
is well worthy of trial. For sleeplessness associated with sea- 
sickness, chloral hydrate may be taken (in a wafer to prevent 
nausea) in doses of ten to fifteen grains. A stop-cock cork- 
screw may be put into a bottle of dry champagne; this kept in 
ice, and small doses taken every half hour or so, especially in 
debilitated subjects. By strictly observing the above precau- 
tions and remedial measures, sea-sickness may be prevented, or 
cured in most cases, not in all. Those who get sick upon com- 
ing in sight of the steamer, or thinking of the voyage, had 
better take to the railway.