The summer months of June and July show the largest numbers, and the months of December, January, and February lesser numbers. The decrease in August is explained in great measure by the diminution in attendance. It is possible that other elements of climate besides temperature may account for this difference between American and English figures.
33 Page 17.
34 Edinburgh Med. and Surg. Journ., vol. liv., 1840.
35 Brit. Med. Journ., Jan. 10, 1880, p. 53.
36 Mass. Med. Soc., 1860.
37 On Pulmonary Hemorrhages, p. 114.
A more correct opinion as to the effect of altitude is developing. Archibald Smith38 more than forty years ago testified to the good effects of removal from the coast to the high sierras of Peru in cases of phthisis with hæmoptysis. His own instances of great improvement following removal to high levels, 5000 to 8000 feet, are conclusive. He also gives instances where renewals of hemorrhagic attacks followed the return to the coast. It was the custom for physicians to send their consumptive patients to the sierras without reference to their hemorrhagic attacks.
38 Loc. cit.
Similar testimony is accumulating in this country. The Colorado regions are supplying, through their physicians, much material bearing upon the effect of altitudes on hæmoptysis. H. K. Steele of Denver, Col., writes, June, 1883, that "it is the opinion in the profession generally, and I endorse it, that this country acts beneficially in the hæmoptysis of phthisical patients." Jacob Reed, Jr., says39 that not only does the ascent to this altitude (6000 feet) not predispose to pneumorrhagia in consumptives, but that "hemorrhagic cases do well here; in most cases the bleedings becoming less frequent, in many cases ceasing altogether." By letter May, 1883, he says these cases number between 500 and 600, and he feels justified in the positive statement that not only does altitude not precipitate hæmoptysis, but that "those suffering from this symptom are benefited here, their bleeding becoming less frequent and less in quantity." He makes an exception of florid cases in active progress or old cavities waking up to new action.
39 "Altitude in Reference to Pneumorrhagia," an analysis of 70 cases, read at the eighth annual convention of the Colorado Med. Soc., 1878, p. 66.