THE ADVANTAGES AND DISADVANTAGES OF HIGH ALTITUDES IN DISEASES OF AIR-PASSAGES

T. G HORN
1890 Journal of the American Medical Association  
In presenting this subject to this honorable body of professional men, I wish to say in the very beginning that I am to a great extent sim¬ ply giving my own convictions, based upon some fifteen years' experience in an altitude ranging from five thousand to ten thousand feet above sea level, and do not expect to be sustained in gen¬ eral by climatologists. It is a fact admitted by all physicians, special¬ ists or other, that in all diseases of the air-pas¬ sages, and especially so in catarrhal,
more » ... ly so in catarrhal, bronchial, and similar diseases of the mucous membrane, as well as in incipient phthisis, the first object to be secured is a climate that will permit a free outdoor life in a pure air, Intense or even moderate heat, if persistent, throws a ph}rsiological strain on the liver, skin and digestive system, and thus prevents proper nutrition, so essential to improvement in disease under consideration. Again, intense cold throws a physiological strain on the lungs and kidneys, and also inter¬ feres with open air exercise, so necessary in such diseases ; therefore a climate in which the winter is not very cold and the summer not very warm, should be selected for our patients suffering from disease of the air-passages. We claim these pre¬ requisites in the mountain climate, and particu¬ larly so in the Rocky Mountains. As we rise above the sea level to an altitude of five thou¬ sand feet, we meet with two important meteoro¬ logical conditions : the air becomes more and more rarefied, and the heat diminishes, indepen¬ dently of the more or less obliquity of the sun's rays, until we reach a point, known to us as tim¬ ber line, where the sun's heat is insufficient to melt the snow, and we have the privilege of look¬ ing upon the "beautiful" at all seasons of the year. Dr. J. Henry Bennett says, in one of his valu¬ able articles on climate, that ' ' mountain climate has of late been much recommended for phthisis; that two conditions, namely, purity of air and sparseness of human habitation, are quite suffi¬ cient to account for the rarity of phthisis amongst their inhabitants, and for the improvement of the phthisical who resort to them." I venture the assertion that the improvement of the phthisical and the absence of phthisis among the residents of the mountain country, depends largely upon the condition of the atmospheric exhalations of the mountains, the equable temperature, the cloudless days, the electrical current eight to ten miles eastward from the base of the mountains, the absence of humidity in the atmosphere, the unresisting desire to get out doors, the refreshing, exhilerating influence of exercise, the strength¬ ening of lung tissue caused by compulsory ex¬ pansion while taking exercise in such altitudes, the increased strength of the digestive organs, the assimilation of food, continued muscular de¬ velopment, the attractive, constant and varied scenery, water derived from the eternal snows and ice of the mountain gorges, pure as the crys¬ tal formation found imbedded in the granite sides of these majestic rocks, carved and formed into beautiful domes and terraces by the Great Archi¬ tect of the universe. These are some of the ad¬ vantages of high altitudes in diseases of the airpassages more apparent, in my opinion, than the want of subjects. In specifying or classifying disease peculiar to the air-passages, benefited by high altitudes and advantages of different locali¬ ties in same, or differing but little in altitude, I must confine myself to experience alone, and will give such diseases and stage of disease, which are found to be more susceptible to the salutary in¬ fluence of climate in named altitudes. We will take, first, the class known as con¬ sumptives. This is truly a wide field and covers the entire universe. A class of patients attract¬ ing the attention of every physician in the world, and especially the United States. First we select the hereditary tendency, those showing the first symptoms of this dreaded disease, the morning cough, the earliest physical signs of chronic tu¬ berculosis of the apex, without the general ap¬ pearance of the usual disturbance produced by this disease in the first stage. This class of pa¬ tients make rapid progress in altitudes ranging Downloaded From: http://jama.jamanetwork.com/ by a University of Calgary User on 05/25/2015
doi:10.1001/jama.1890.02410360007001a fatcat:4qluupdua5ho3ozmvt7oehsmam