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cession on the part of outside influences in behalf of any man in the service, and I think that fact is the strongest evidence that our people are willing to rest their cases with the central office and allow it to select the men for important commissions unhampered by selfish intercessions.

CLIMATE AND MAN: WITH SPECIAL REGARD TO CLIMATE AND CLIMATIC ELEMENTS AS CURATIVE OR CAUSATIVE AGENCIES

OF DISEASE.*

By Dr. W. M. Wilson, Milwaukee, Wis.

The distribution of the climatic elements of a country determines its fruits and flowers, its industries and activities, and the character and temper of its people.

The world's greatest workshop is bounded by the tropics and the arctics, and neither the torrid zone, where life is made too restful by nature's bounteous provisions, nor the frozen North, where existence must be wrested from the unwilling sea and soil, is conducive to the highest development of the race. Practically all of the world's great industries are centered within the limits of the temperate zone, and thus far every effort to plant a great nation outside this narrow belt has proved a disastrous failure. Gigantic schemes, with elaborate and refined preparations for the colonization of the tropics, have always been met by the insurmountable barrier of death and disease, until the West Indies have come to be called the "Graveyard of Europe."

France has been one of the foremost nations in the promotion of these enterprises, and French literature is full of ingenious explanations for each successive failure, which, after a more or less devious path through the social and political questions of the time, usually arrive at the same fundamental conclusion, that the climatic conditions of the tropics are unsuited to European civilization.

An English authority, Benjamin Kidd, has pronounced in no uncertain terms against the possibility of the white man ever being able to pass the tropics, assuming that past experience has

*Read at the Convention of Weather Bureau Officials, Milwaukee, Wis., August 27-29, 1901.

shown beyond the shadow of a doubt that nature, by the interposition of the deadly climate of the tropics, has placed a natural barrier in the way of further progress in that direction which may not be passed with impunity. With all due regard to these eminent authorities, one who approaches this subject with an unbiased mind cannot fail to be impressed by the absence of any attempt to classify or analyze the characteristics of the various maladies which produce such disastrous results and the perfunctory way in which the whole responsibility is placed upon climatic conditions.

The influence of climate upon the origin and cure of disease is a question of very great importance, not only to promoters of industrial enterprises in tropical countries, but to the great army of health seekers that make annual pilgrimages to the famous health resorts in search of a climate which will restore youth or cure disease. It is a matter of common knowledge that most infectious diseases exist only within certain limited areas. Some have their home in the tropics; some, like tuberculosis, acknowledge no geographical limitation, and seem destined to overspread the whole world; while others, like diphtheria and smallpox, are gradually being crushed out by modern prophylactic methods, and may even be tending toward extinction. On the summit of high mountains infectious diseases are unknown, and in the "farthest north” the carth and air and sea are as free from harmful germs as though sterilized in the laboratory of the chemist.

The tendency of diseases to become localized in their distribution has given rise to a general belief that the cause for their origin and propagation must be found in the prevailing climatic conditions, and that for this reason certain climates, especially the tropics, are absolutely unfitted for the habitation of the white man, while others are endowed with healing qualities akin to those ascribed by the ancients to certain springs. During the past twenty-five years, however, scientific experimentation with reference to the origin and propagation of infectious diseases has revealed some startling truths, the discoveries in this field of research undoubtedly constituting the greatest achievements of modern medicine. It is now positively known that many of the diseases heretofore ascribed to climatic conditions result from the presence within the body of a specific germ or living organism, the life history of which is as well known as that of the most common insect, and that by proper hygienic precautions, one may live in the very presence of this most deadly enemy in comparative safety.

The discoveries have a most important bearing upon the subject of medical climatology; for, while climatic conditions may in a measure favor the development and activity of the germs of discase, the responsibility for their invasion of the human body is thus shifted from impersonal, irresponsible climate to a responsible individual, who, when having knowledge of the proper prophylactic measures to be employed, fails in the necessary hygienic precautions, must suffer the consequences of neglect. The thinkers of to-day are gradually reaching the conclusion that the healthfulness of any locality or section is not so much a matter of climate as a matter of hygiene; and when medical science shall have studied the diseases indigenous to the tropics with the same zeal and success that has attended the investigations into the etiology of the ailments of the temperate zone, one can live in a tropical country, inder proper hygienic precautions, perhaps with less personal comfort, but certainly with no more danger, than in the most favored spot in our own country.

Smallpox has few terrors for the present generation, but this scourge has claimed its victims by the tens of thousands. It is not climate, but scientific sanitation and hygiene, that has wrought the change. Yellow fever will no more wreck our Southern cities when the breeding pools of the mosquito are eradicated; and when the so-called climatic diseases of the tropics are as well known and the proper precautions observed that “graveyard of Europe," the West Indies, will become the veritable garden of the world, and the words "acclimated” and “immune” will disappear. from our language.

Climate as a cure for disease, in the broadest sense, rests upon the same general principle. A specific disease must be reached by a specific remedy, and, strictly speaking, climate, so far as known, possesses no qualities which would entitle it to such a position in the materia medica. The claims made by the promoters of certain health resorts that the richness of the air in ozone, the resinous gases from the pines, the peculiar purity of the atmosphere in a particular locality, or the elevation or aridity of the air acts as a specific in certain diseases, are not generally based upon scientific investigation, and usually have their origin in the fertile brain of the advertisement writer.

It is common knowledge that the principal components of the atmosphere are in practically the same proportion the world over, that the amount of moisture varies with the locality and season, and that rarefaction results from an increase of elevation; and

while it is true that elevation tends toward increasing lung capacity and that excessive humidity retards in a measure the excretory action of the skin, it has not been shown that the absence of moisture has any specific influence upon those diseases for which a dry climate is so frequently recommended, or that a rarefied atmo sphere is essential to the destruction of the germs of disease. On the other hand, there is ample experience to show that persons suffering from troubles associated especially with tuberculosis are frequently benefited by a residence in the humid air at the level of the sea as well as in the dry and arid atmosphere of our Western plains.

We must, therefore, look further than to mere climatic conditions for the cause of the cures which sometimes certainly do result from a change of residence. The human organism, both in health and disease, is so complex in its operations, so delicately poised, and the relation of the mind and body so interdependent, that environment, whether it be of climatic or of social conditions, while not acting directly, may, through the senses, exert a powerful influence upon the vital forces. This influence of environment is all the more potent in that class of diseases in which continued ill-health and lowered vitality allow the shattered nervous system to respond readily to external impressions, and in these cases a change of residence is frequently of the greatest benefit. Nature itself is the best doctor, and, when supported by environment and proper medication, may be relied upon to use all the forces at command against the inroads of disease. That climate may play an important part in the curative process is not denied, but that the climate of certain localities possesses any peculiar properties which act as a specific on certain diseases is neither borne out by scientific investigation nor unbiased experience.

In the selection of a place of residence, climate should be considered only in its effect upon comfort and congenial surroundings and with a view to a constant outdoor life. Pure air, which can be found almost any place outside of great cities, and the maximum amount of sunshine are the two essentials.

That the temperature is not important is shown by the excellent results obtained by a residence in the Adirondacks, where the cold of winter is frequently intense. That a dry atmosphere is not essential is evident from the equally good results obtained in the arid climate of our western resorts and the humid atmosphere of the Southern States. That rarefaction is not a requisite is shown by the cures effected both at sea level and at high altitudes. With complete relief from care and anxiety; good food, pleasant occupation, and a constant outdoor life, one may fight a winning battle against disease in almost any climate, whether it be in the arid, rarefied atmosphere of Colorado or New Mexico, the soft and genial warmth of Florida, or the more rigorous climate of the New England States.

SANATORIA.

EXISTING CONTINENTAL MODELS.* '

By MR. Cecil C. BREWER.

Existing sanatoria as to their plans may roughly be divided into two classes: Firstly, those built on a concentrated plan; and, secondly, those on the cottage or block system—that is to say, they vary from the large hotel-like buildings, such as Falkenstein and Hohenhonnef, in Germany, both having five floors, to Nordrach and the American cottage sanatoria, with quite small blocks, having two floors at most. In comparing the two systems, it must be remembered that Nordrach, perhaps the most successful of all these sanatoria, is on the cottage plan, and there can be no doubt that, from a purely medical point of view, this plan is best; but the disadvantages in working are many and obvious, both as regards convenience and economy.

The medical requirements are extremely simple. Every part of the building must be:

(1) Well ventilated.
(2) Free from dust and easily cleansed.

(3) Patients' rooms, in addition to abundant fresh air, must have as much sunlight as possible, and must be protected from cold winds.

(4) The building must be as sound proof as practicable.

The perfect sanatorium, therefore, will be the one that fulfils these requirements, and at the same time is convenient of management and supervision, provides reasonable comfort for patients in all weathers, and has not too much the appearance of a hospital or barrack, but which must not, on the other hand, degenerate into the hotel or hydropathic establishment.

*Paper read at a meeting of the Architectural Association. From "The Surveyor," December 5, 1902.

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