"As might naturally be expected, the seasons exercised a very marked influence upon the deaths from consumption. During the mild months of autumn, succeeding the warm season of summer, the deaths attributed to consumption amounted to only 23,010; with the cold of winter the mortality from this cause increased, so as to present a return of 38,956; but with the harsh, trying weather of spring it rose to 51,334, and in summer fell again to 39,798."
This statement represents a very important truth. It is certainly best for the patient if the temperature, while equal, be also temperate; but a mean temperature of 35° on one side, or 75° on the other, is preferable to one varying constantly, to-day at 60° Fahr., to-morrow at 40°, and a few days later at 80°.
From the experience gained in taking charge of a large number of consumptive patients it becomes a remarkable and highly-instructive task to learn the influence of climatic changes on the symptoms of the disease. I can usually predict, almost with certainty, the history I am to hear from the consumptives who are coming before me. If for some days there has been uniformity of temperature, and the weather has been mild and dry, so that an airing each day out-of-doors has been effected, the visit is quite a cheery one; all seems better; the medicines are said to agree. The cough is less troublesome, the body is warmer, and hope, diffusing an inward sunshine, lights up each face with brightness and activity. In frosty days, too, when the air is dry and the temperature continues even, the symptoms are often equally favorable; but during periods, so common in this country in the spring and in the beginning of winter, when the atmospheric variations are sudden, marked, and often repeated in the course of a few weeks, the general aspect of affairs is widely different. I have heard on these occasions almost every patient complaining; the symptoms are all exaggerated, the mind discontented. There is a general request for a change in the medicine. Something is asked for that will soothe, for the nights are passed indifferently. It is useless to comply always with these demands, since the exaggerated train of complaints has a general and common cause; but now and then the modification of symptoms is so great as to call for a modification of treatment. During these variations of season, deaths from consumption are most prevalent.
Thus an equable temperature is of great moment, and should always be sought after by the phthisical sufferer. If he can not remove from his own locality, and if the variations in it are considerable, he must take the best precautions at his command. In-doors it is not difficult to sustain a pretty even temperature, varying from 55° to 60° Fahr. Out-of-doors, something must be done by attention to clothing, and by the use of the respirator. The most marked variations, however, occur in the night, and hence the importance of keeping up an equality of warmth in the bedroom, in the manner already described.
