On Australasian climates and their influence in the prevention and arrest of pulmonary consumption / S. Dougan Bird.

Date:
1863
    detailed, a temporary removal from one European climate to another, however suitable it may be to the patient’s local complications, cannot in most cases be looked upon otherwise than as a palliative treatment, and not a curative means. And for this cause many of the most experienced physicians discountenance altogether the sending of patients abroad, except by way of amusement or distraction. But are we justified in attempting more than this, in acting upon the supposition that pulmonary consump- tion is, under any circumstances, a curable disease P Undoubtedly we are, for the dried-up cretaceous par- ticles which wTe sometimes see in the lungs of persons who have died from other causes are written evidence that tubercle has been formed in their blood and de- posited in their lungs, but, from some great and notable change in their constitution, has remained there (its animal part being absorbed) as a simple foreign body, without proceeding to its natural course of irritation, congestion, and ultimate destruction of the lung and life. In fact, the blood threw out the tubercle into the lungs, whose office is that of an eliminator of refuse and morbid matters ; and, no more being formed, from the circumstances which caused it being altered or done away with, the system had sufficient leisure and power to dispose of the limited local deposit. We have, then, these data on which to reason. The consumptive tendency and even actual disease may be rendered nugatory in their fatal effects; but this sel- dom takes place, as the European climate, habits of life, and national constitution impregnated with disease, are constant obstacles to such an event; and, accordingly,
    CURATIVE. the result of any treatment, however rational, is, in nine cases out of ten, but a temporary staving off of the fatal termination. I deduce from this, that to be curative to a case of incipient consumption contracted in Europe, the fol- lowing elements are needed in a change of climate :— That it should have an alterative action so complete ancl powerful that it will open not only a new leaf but a new volume in the patient's constitutional history; and so change and modify the course of his vital functions, and more particularly the operation of his glandular and secreting system, that the probability of his blood again assuming the conditions under ivhich tubercle was first formed will be very remote. If with this we can combine the minor but still im- portant elements of suitability to his particular local complications, so much the better. We cannot find climates that entirely answer these requisitions north of the equator, for reasons which we will enlarge upon in the next chapter; where I also hope to show my reader that in the temperate regions of the Austral- asian continent and islands, we find peculiarities of climate most remarkable in their contrast to those of any other countries, but especially to those of the same latitudes of the northern hemisphere : that, as might reasonably be expected, the change to these colonies is often to the European productive of a notable altera- tive effect on his constitution, and that this may be made the means of so modifying the tone of system of the scrofulous and consumptive invalid, that it will give him a probability of throwing off actual disease and of preventing its return that he could not obtain in any other way.
    CHAPTER II. THE CLIMATES AND VITAL STATISTICS OF THE NORTHERN AND SOUTHERN HEMISPHERES CONTRASTED, THE COLONY OF VICTORIA BEING PARTICULARLY INSTANCED AS A MEDIUM TYPE OF THE CHARACTERISTICS OF THE LATTER. EFORE proceeding to detail the peculiarities of the Australasian climates, it will be well first to consider why it is that we cannot obtain equal advan- tages nearer home; so we will shortly enter into the characteristics of the principal regions of the northern hemisphere, and their influence on fife and disease. The British Islands, from their insular position, their exposure to ocean winds, and the influences of the Gulf Stream, have a temperature changeable but moderate, an air usually moist and marine in its characters, and a large proportion of rainy or overcast days, especially during winter. As we have seen, the commonest and most fatal type of disease is some form of scrofula or tubercle, particularly the variety which attacks the lungs of young adults, and the reason of this in our particular case is as follows :— First, the almost universal constitutional taint in the population from the constant working 4 in and in ’ of the causes detailed in the last chapter. Second, the paucity and feebleness of our sunlight, especially during winter, which, by diminishing the facility of
    excretion of carbonic acid from the lungs and skin, and fostering in-door and indolent habits, predisposes to dyspepsia, melancholy, and passive local congestion of internal organs. Lastly, the constant likelihood of such predisposition being lit up into actual disease by exposure to wet and cold. But, by race, the Anglo- Saxon is robust, energetic, prone to action and exercise of his muscular system in out-door employments and sports ; and thus, counteracting the effects of climate, may enjoy a degree of health and vigour attainable by few other races, under any circumstances, in spite of dark dull weather, long winters, and short days. He, also, is in the habit of consuming a large proportion of animal food, which such a course of life enables him to digest and assimilate. But those who, from choice or necessity, lead a life of confinement and inaction during the loug and dreary winter, particularly if their food is improper or insufficient, expose themselves to a great probability of the induction of tubercular disease, which, in a sunnier climate, would be avoided. The influence of temperature in predisposing to such disease is a subject on which there is much popular misconception. We have ample evidence to prove that neither a low nor a high temperature are, in them- selves, predisposing or exciting causes, either of the diathesis, or its local manifestations. The natives both of arctic and tropical climes are, cceteris paribus, less sub- ject to tubercle than ourselves. In Iceland, Sweden, and Siberia, as few of the natives die of consumption as in the East Indies, Arabia, or tropical Africa. In the same way both such climates may be made even controlling audits in preventing its developement, though we can c
    hardly look upon them medically in this light. On the other hand, it is only when cold, being either excessive or prolonged in its operation on the system, becomes a depressing agent to the physical powers, that it can in- duce tuberculosis; and a prolonged high temperature, sometimes, so far from preventing its developement, only hastens it. In fact, the whole question resolves itself into one of idiosyncrasy—that is, individual peculiarity— about which no rule can be laid down. Now, in the Northern States of America, a race identical with our own, and even more addicted to the predisposing causes of tubercle, is exposed to what is called an excessive climate: ‘ for five winter months the Northern States arc ice and snow-bound, and in summer are exposed to a burning tropical heat. The east and south-east winds, loaded with the steaming vapours of the Gulf-stream, saturate everything with a dripping moisture; whilst the north wind, having passed over the huge continent of land to the northward, is so absolutely dry that it parches in summer and blights in winter all animal and vegetable creation.’ The national habits of life are more intellectually and less physically energetic than our own. Here we have both the predisposing and exciting causes of consumption even more highly deve- loped than they are in England; and, consequently, its ravages amongst young adults are perfectly frightful. How can we hope for the alterative effect of which we are in search by sending our patient to such places as Hastings, Torquay, Penzance, Jersey, or any locality within the influences of the Gulf-stream? To an islander the remedy is utterly disproportionate to the necessity of the case. These places have, indeed, a very uniform