Dr. A. I consider equability as the most important condition of all; especially where the temperature ranges at about 60° of Fahrenheit. It not only diminishes the chance of aggravating pulmonary disease by preventing Catarrhs, but it serves to preserve a genial and regular action of the skin, to keep the balance of blood constantly on the surface, and to prevent any undue congestion of it in the lungs. Besides, it is acknowledged on all sides, that consumption is most prevalent in countries and districts which are subject to great and rapid changes of temperature, and that it is comparatively rare in those which are free from the diurnal changes and sudden transitions which so characterise that of our own island.
Mr. B. Nothing can be more convincing than such reasoning;—but tell me for what reason you consider the temperature of 60° as an essential condition under these circumstances.
Dr. A. It is evident that no climate, however equable it may be thermometrically, can be considered as such in a medical point of view, if its temperature ranges much below the degree I have mentioned; because in that case a material change must always occur whenever the invalid quits his apartment, and goes into the open air. So that I consider a cold climate must in effect be always regarded as a variable one.
Mr. B. But cannot this objection be obviated by suitable cloathing?
Dr. A. To a certain extent perhaps, but recollect if you please, that there is no furnishing a great coat for the lungs, to protect their structure against the diminished temperature of the air which is breathed.
Mr. B. What opinion have you formed respecting the effects of a marine atmosphere?
Dr. A. I apprehend that question cannot be fairly answered without a reference to the symptoms and circumstances of each particular case; generally speaking, I am induced to consider the air of the sea as not hostile to diseased lungs, except perhaps in those cases in which Hectic fever is fully established; but then again cases will sometimes occur which would appear to sanction a contrary conclusion. Thus much I should say was certainly true, that in such situations you will always experience more humidity, and that when the air is cold, that cold will in consequence be more intolerable, for the reasons I have before stated. On the other hand you must be aware that a marine situation will enjoy a more equable temperature[138] than one similarly situated, but remote from the ocean, and as far as that goes it will have its advantages.
Mr. B. I should much like to know what the continental physicians think of this circumstance, with reference to their own climate.
Dr. A. Upon that point you may be easily satisfied by referring to Dr. Clark's work on foreign climates.[139] He says that the physicians on the sea coast send their consumptive patients into the interior, and those in the interior to the shores of the Mediterranean or Adriatic. From Genoa they send them into the interior, deeming the sea air injurious to them. From Naples they frequently send such invalids to Rome. From Rome, on the other hand, they send them frequently to Cività Vecchia, on the shores of the Mediterranean; more frequently to the shores of the Adriatic, and, occasionally, even to Naples!