AIR-HEALING.'
WITHOUT question, one of the greatest medical discoveries of modern times has been the use of mountain air as a healing agent, and especially as a healing agent in the most terrible of all diseases,—consumption. Of the potency of high air in affecting the human body, no one who has ever stood on a breezy mountain-top can doubt for a moment. Convey a man five, or even four, thousand feet above the sea, and unless he happens to have a weak heart, or to be in some other way abnormal, he will at once confess to feeling "a snap in the air" which makes life seem easier and pleasanter. If he is of the imaginative kind, he will talk about breathing champagne, or even mouth poetry about "ever delicately marching through the most pellucid air." 'The simplest way of testing this fact is to take a ticket by the St. Gothard route. At Lucerne let the inquirer, as he walks up and down the platform, consider how he feels. Let him repeat the process when an hour or two after he is performing the same process at Goschenert,—the station at the mouth of the main tunnel, situated about 4,000 ft. above the sea-level. It is a thousand to one, granted he is not constitutionally too per- verse for the trying of experiments, that he will say he feels particularly fit, and that the air is deliciously light and bracing. The doctors were not long in recognising this fact, and in applying it to their own uses. If the mountain air had these marked effects upon the human body, it was certain to be worth something as a curative agency. Accordingly, the effects of high air were scientifically investigated, and gradually certain results emerged, The most important of these was the fact that the high air had a very remarkable effect in the case of patients suffering from lung-disease, and that under its influence they occasionally made complete recoveries. What is the exact medical effect of mountain air on the diseased lung is not a question which can be profitably discussed here, but it may be noted that the mountain air seems to act in three ways. In the first place, there is less barometrical pressure in the air of the hills than in the air of the plains. But we all know how ill we feel when there is a low barometer and when the pressure of the atmosphere is increased. When, then, that pressure is decreased by going up a mountain, we feel well and in good spirits. It is, then, easier to live in high air than in low air, and hence the invalid Ends that in the mountains his impaired vital machinery is less heavily taxed. Next, mountain air is highly antiseptic. Go to a cheaet on some high pasture, and you may notice that even in the height of summer the flesh of a sheep or a cow can be cured by simply hanging the raw meat up in the open air. It dries to pemmican without ever becoming putrid. But since lung- disease is lung-decay, it is not difficult to understand the advantage of an antiseptic air. Note, too, that this antiseptic quality of the air is increased in the winter. Nothing is so antiseptic as a hard frost. Next, in most mountain-places there is a great deal of sunlight and sun-heat, and sunlight and sun-heat are essential sources of health. They are natural germicides.
• Aern.Therapeutiee I or, De Treatment of Lulig DifledSP14 by Climate. By Charlee Theodore Winiame. London Macmillan and 00, 1804. The book which forms the subject of this review chiefly consists of an examination of the various forms of mountain climate in their relation to the cure of lung-disease. The author, Dr. Theodore Williams, is in every sense competent to undertake the task which he has chosen, for he is admittedly one of the most learned and accomplished of our physicians, and his special line of medical practice has been diseases of the chest. Dr. Theodore Williams, as Senior Physician of the Consumption Hospital at Brompton, and as late President of the Royal Meteoro- logical Society, grasps his subject as it were at both ends, and is able to bring to bear upon his investigations a double dose of expert knowledge. But he has more than a statistical and book knowledge in regard to climate. He has himself visited most of the places which he deals with, and is thus able to speak with personal experience of the health-resorts he mentions. And here we should note that, though the most interesting and the longest portion of Dr. Williams's book is devoted to mountain climates, its scope is not confined to them, but embraces a consideration of all the climates which are supposed to have a beneficial effect upon lung- disease. "I am threatened with lung-disease; where ought Ito go to stop it?" That is for many men a question which, for the time, is the most important in the world. Certain patients will prefer not to worry about the answer, but will leave the matter entirely in the hands of the doctors. Others, however, will like to consider the matter for themselves, and these cannot do better than study the lectures which con- stitute the present volume. They are technical, but not too technical to be mastered in their general conclusions by the layman. It is for this reason, and because of the vital importance of the subject to so many English families that we step outside our usual course, and notice a purely medical work.
One of the most interesting portions of Dr. Williams's book is his account of the general results of his investigations as to the effects of different forms of climate on lung-disease. These forms were "high altitudes, sea-voyages, Riviera, home climates," and the eases examined were Glassed as im- proved," "stationary," and " worse " :— "The results are very striking. In general results the home climates yield the smallest percentage of improvement, and the largest of worst ; next comes the Riviera, not much better ; then, with a rise of 12 per cent, improved, are sea voyages, the percentage of worse being still large. High altitudes win easily in all categories, with their 83 per cent. improved, and onlybeen madeper cent, of worse. In local results the arrest cases have made a separate division, but they are also included under the im- provement percentage. We see here that the Riviera comes out worst, except for a large number of arrests. Next we find home climates, then separated by an interval of 14 per cent. more of improved, and 12 per cent. less of worse, are sea voyages. The high altitudes again come out facile princepe in all categories with favourable percentages nearly double those of the Riviera and home climates. Looking calmly at these results' it must be admitted that there is strong evidence in favour of high altitude treatment. The table does not profess to be perfect, but, con- sidering the number of cases included and the average length of residence, it affords some fair grounds of comparison. Our C0131- parisonB would be still more instructive if we could be certain that the patients pursuing different forms of climatic treatment conformed to the same rules of hygiene and dietetics, which is not always the case. Undoubtedly careful medical supervision should be carried out in all these cases, and one reason of the success of the high altitude treatment, as practised in the Alps, is that such supervision is easier and more complete than in the Riviera and in southern resorts."
It is then pretty clear that high air offers the best chance for a person attacked by lung-disease. But granted that the mountain cure is the thing, what mountain station ought to be chosen P Dr. Williams's book gives the facts that are required for determining where the particular case will be best likely to improve. Is it to be Davos or St. Moritz or Colorado, or again the Andes or the highlands of South Africa P Probably, delicate and middle-aged people will do best in Switzerland, and young and active ones in America. As yet the Andes have not been much used by European invalids ; but we can hardly doubt that they have a very great future as mountain health-resorts. There alone can you find a habitable city,- 13,500 ft. above the sea. We will conclude our notice of his valuable book by quoting what Dr. Theodore Williams has to say on the subject of the Andes :— "Extensive plains exist at high elevations, on which populous cities are built, and in some of these the climate is temperate and genial. Santa I% de Bogota, in New Grenada, with a population of 40,000, stands at an elevation of 8,648 ft., with a climate like that of Malaga, and an annual mean temperature of 590 F., the mean of each season hardly varying from that figure, and includ- ing scarcely any extremes. Quito, the capital of Ecuador, with a population of 80,000, is situated on the east side of Picinchilicha at 9,500 ft. elevation, has a climate a little warmer than that of Bogota, and which has been compared to perpetual spring, the mean annual and seasonal temperature being about 60° F. In Peru there is Arequipa at 9,000 ft., easily accessible from the Pacific ; and in the well-sheltered valley of Jauja lie Tarma and Jauja, at about 10,000 ft. elevation, health resorts of considerable repute, the former being used by the Peruvian Government as a sanitarium for military consumptives. Huancayo, to the north of Jauja, has a climate intermediate between Tarma and Jauja. In Bolivia we have the capital of La Paz (population, 78,000), at a height of 13,500 ft., with a more bracing climate than the above- mentioned. All these towns have tolerable, and in some cases excellent, hotela, and are connected with the Pacific ports by roads, and in some cases even by rail. The famous Oroya line, which crosses the Andes at a height of nearly 17,000 ft., nearly reaches Tarma and Jauja and connects them with Callao, the port of Lima. Communication with England is by the Royal West India mail steamer to Colon, thence by rail to Panama, and from this point by steamer to Callao, the journey from London lasting about six weeks. The advantages of the Andean climate are the combination of warmth and equability with rarefaction, and the striking effects of its influence on consumptives are to be seen in South America, also a few patients sent from Europe have testified to its beneficial results. The drawbacks are, the distance from England, the long and fatiguing journey, the possible ascent of passes of great altitude (some of these of 16,000 ft. and upwards) and consequent suffering from mountain sickness, and the Spanish food and cooking; so that the Andes can only be considereda fit resort for energetic young men, with limited tubercular lesions, capable of enduring fatigue, and able to accommodate themselves to conditions of life unlike those to which they are accustomed."
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