To all who are afflicted or threatened with pulmonic troubles the climate of Minnesota becomes, in view of its reputed freedom from this scourge, an interesting subject of inquiry.

For a long time it was maintained that this disease was not affected by climate, but that it was the child of other causes, and that its cure was impossible; and dread of its visitation became as great as at the approach of any of the great maladies afflicting mankind.

Later and wiser investigation has proved it to be so much controlled by climate that it may be practically located on a chart of the globe, if all the climatic conditions are fully known. Of course, it is not absolutely confined to any given limit, more than is the yellow fever, which sometimes makes its appearance as high as the forty-second degree of latitude, while its actual home, so to speak, is, on this continent, below the thirty-fifth parallel.

In a medical chart of this country, which we had occasion to examine many years since, the district where consumption attained its maximum range was outlined along the coast, beginning with the State of Maine, having a semi-circular sweep to Fortress Monroe in Virginia, with an inland limit varying from one to two hundred miles. This is well known, now, to all the medical profession, to be the territory where phthisis pulmonalis has greatest sweep, and this is conceded to be, for the most part, caused by the marked peculiarities of climate existing over all this area. These peculiarities have, in some of the immediately preceding chapters, been duly though briefly set forth, and we now proceed to the consideration of the sanitary value of the Minnesota air and its effects on lung diseases as experienced by sufferers and observed by others, together with some of its leading characteristics.

If it has been sufficiently shown that the temperature of the district in which consumption prevails most is a highly variable one, passing almost daily from a low to a high point in the thermometric scale, with the prevailing winds to be those in which east largely enters; and that these winds come laden with a cold moisture, borne from off the surface of the North Atlantic, which, when exposed to their sweep, chill the person and pave the way to colds, catarrhs, rheumatism, pneumonia, and a score of other ills scarcely less harassing and destructive, and all of which give rise to the “great destroyer,” as it has been sometimes called. If, as we have said, these points have been proved to be the leading ear-marks of this special locality, what, we may ask, are the characteristics, briefly stated, of the climate of the State, which is known to be comparatively free from, and, in very many instances, to have wrought for the sufferer a complete restoration of health and strength? They have been seen to be almost the exact antipodes of that of the consumptive district before named. Instead of the northeast wind, there is the northwest, or at least the prevailing winds from some point into which west enters; bringing, in place of the cold, humid atmosphere of the North Atlantic, the dry continental winds from the interior, which, in conjunction with the high altitude and peculiar geographical position of the State, give, instead of the extreme variable temperature, an equable and a relatively dry atmosphere, having a bracing, tonic effect on the whole man, affording opportunity for unrestrained exercise in the open air, causing good digestion to wait on appetite, and with these the advent of fresh wholesome blood, which is the physician to heal the diseased portions of the lungs, and restore healthful action to all of the inflamed parts.

In confirmation of the high value of this State as a residence for invalids of the class to which special reference is made, we extract from the last census report the following statistics, showing the average number of deaths from consumption in the following States to be

One in 254 in Massachusetts,
One in 473 in New York,
One in 757 in Virginia,
One in 1139 in Minnesota.

This speaks for the climate more of praise than it is possible for any scientific speculation to do, since it is the practical and final test as well as the most satisfactory.

Undoubtedly, the relative disproportion would be very much greater if the number of deaths of those who go from other States, after it is too late for them to receive any benefit, could be eliminated from the actual number that die from among the inhabitants themselves. The question may arise right here among some of the more skeptical, how it is that any of the population are afflicted with this disease, if the climate is such an enemy to it? We answer that full half of the deaths reported from phthisis are of those who come too late as before stated and a fourth of the whole number we know to be from among those who are not natives, but yet are of the regular inhabitants, whose lives have been prolonged here, and who from improper exposure or neglect of wholesome rules (which they at first rigidly followed, but growing better, neglected to maintain), have paid the penalty. Not over one-third of the entire list of inhabitants of the State, up to the present time, are natives; hence deaths from consumption among the remaining two-thirds cannot be attributed, by any fair inference, to the direct influence of the climate. This still leaves a fourth of the whole number of deaths from this scourge to fall on those who “are to the manner born.” This is a very trifling percentage, and might be waived as not being a fraction sufficiently important to merit much attention; but we may frankly admit that these cases appear here, and are the result of a want of a perfect equability in the climate, and to this extent it must be held answerable. We might, however, conclude that even this final fraction could be accounted for in the hereditary taint, but we forbear, as we likewise do to claim entire exemption here from this complaint. No climate, perhaps, in any portion of the whole habitable earth, could be found to be utterly exempt. Then, too, consumption is to general debility a natural sequence, almost as much as flame is to powder when exploded; and as there are likely in all climates, however favorable, to be found worn-out and exhausted humanity, why, there must be expected untimely deaths culminating in this disease.

The curability of consumption is now a settled question. Every medical student has either seen for himself or been assured by his professor that post mortem examinations have disclosed this truth beyond all cavil. Numerous cases might be cited where, at an early period in life, tubercles had formed, and by-and-by, probably in consequence of a change in the habits of life, these disappeared, leaving naught but old cicatrices as evidence of their previous diseased condition. These tubercular deposits must have disposed of themselves in one of three ways: first, they might soften down and be expectorated; second, they might soften and be absorbed; or, thirdly, they might become calcined and remain as inert foreign material. In many cases all these processes might unite in the removal, and a long life follow, as is well known in some instances to be true.

An eminent instance in point occurs to us as we write, and which is worthy of citation in these pages. The lamented Rev. Jeremiah Day, once President of Yale College, when a young man, had “consumption,” and was expected to die, but by a rigid observance of the laws of health, and self-imposition of stated exercise of a vigorous nature in the open air, he, by these means and without much of travel, restored his debilitated frame and healed the diseased lungs, and died at the rare age of ninety-five, having lived a life of uncommon usefulness and activity. He could not have accomplished his restoration without many and daily sacrifices compared with the lot of his fellow-men. A post mortem showed plainly that both apices of the lungs had been diseased.

There are many cases, of which no knowledge exists outside of a small circle, of restored health, though with impaired power of respiration and consequent endurance of great hardships, which latter, of course, must be entirely avoided by those thus situated. There is, too, even greater liability to a fresh attack than with persons who have never been afflicted, but the vigilance necessary to maintain health fortifies against its repetition.

One of the essentials in effecting a cure is FRESH AIR; and if this can be had in such form as to give more of oxygen the vital element than is usually found, the healing processes must be accelerated, beyond doubt. The family physician will tell you this. Now, under what circumstances is a larger amount of oxygen found? What climate affords most, all other things being equal? It certainly is not a hot climate, nor a variable moist one such as prevails all over the consumptive district which we have indicated at the beginning of this chapter. It is found in a cool, dry climate, and this condition is had in Minnesota with greater correlative advantages than in any other section of the Union known up to this time. The atmosphere is composed of two gases, oxygen and nitrogen, and in every one hundred parts of common air there are about seventy-five parts of nitrogen and twenty-five of oxygen, subject to expansion from heat and of contraction from cold. This accounts in part for the general lassitude felt in a warm atmosphere, while a corresponding degree of vigor obtains in a cold one. The condensation, the result of a cool temperature, gives to the lungs a much larger amount of oxygen at a single inspiration, and, of course, for the day the difference is truly wonderful. The blood is borne by each pulsation of the heart to the air-cells of the lungs for vitalization by means of the oxygen inhaled the only portion of the air used by the lungs giving it a constantly renewing power to energize the whole man. If a cold climate is attended with great humidity, or raw, chilling winds, the object is defeated and the diseased member aggravated, as would also be the case even if the climate was not a cold, raw one, but was a variable cold one; as then the sudden changes would induce colds, pneumonia, and all the train of ills which terminate in this dire calamity we are so anxious to avoid.

Equability and dryness are the essentials of a climate in which consumptives are to receive new or lengthened leases of life.

The following testimony is of such a high value that no apology need be offered for its introduction here. It is, in the first case, from one who was sick but is now well, and, in the other, from a party whose observation and character give weight to opinions.

The able and celebrated divine, the Rev. Horace Bushnell, D.D., of Hartford, Conn., in a letter to the Independent, says:

“I went to Minnesota early in July, and remained there till the latter part of the May following. I had spent a winter in Cuba without benefit. I had spent also nearly a year in California, making a gain in the dry season and a partial loss in the wet season; returning, however, sufficiently improved to resume my labors. Breaking down again from this only partial recovery, I made the experiment now of Minnesota; and submitting myself, on returning, to a very rigid examination by a physician who did not know at all what verdict had been passed by other physicians before, he said, in accordance with their opinions, ’You have had a difficulty in your right lung, but it is healed.’ I had suspected from my symptoms that it might be so, and the fact appears to be confirmed by the further fact, that I have been slowly, though regularly, gaining all summer.

“This improvement, or partial recovery, I attribute to the climate of Minnesota. But not to this alone, other things have concurred.

“First, I had a naturally firm, enduring constitution, which had only given way under excessive burdens of labor, and had no vestige of hereditary disease upon it.

“Secondly, I had all my burdens thrown off, and a state of complete, uncaring rest.

“Thirdly, I was in such vigor as to be out in the open air, on horseback and otherwise, a good part of the time. It does not follow, by any means, that one who is dying of hereditary consumption, or one who is too far gone to have any powers of endurance, or spring of recuperative energy left, will be recovered in the same way. A great many go there to die, and some to be partially recovered and then die; for I knew two young men, so far recovered as to think themselves well, or nearly so, who by over-violent exertion brought on a recurrence of bleeding, and died. The general opinion seemed to be that the result was attributable, in part, to the over tonic property of the atmosphere. And I have known of very many remarkable cases of recovery there which had seemed to be hopeless. One, of a gentleman who was carried there on a litter, and became a hearty, robust man. Another, who told me that he coughed up bits of his lungs of the size of a walnut, was there seven or eight months after, a perfectly sound-looking, well-set man, with no cough at all. I fell in with somebody every few days who had come there and been restored; and with multitudes of others, whose disease had been arrested so as to allow the prosecution of business, and whose lease of life, as they had no doubt, was much lengthened by their migration to that region of the country. Of course it will be understood that a great many are sadly disappointed in going thither.

“The peculiar benefit of the climate appears to be its dryness. There is much rain in the summer months, as elsewhere, but it comes more generally in the night, and the days that follow brighten out in a fresh, tonic brilliancy, as dry, almost, as before. The winter climate is intensely cold, and yet so dry and clear and still, for the most part, as to create no very great degree of suffering. One who is properly dressed, finds the climate much more agreeable than the amphibious, half-fluid, half-solid, sloppy, gravelike chill of the East. The snows are light a kind of snow-dew, that makes about an inch, or sometimes three, in a night. Real snowstorms are rare; there was none the winter I spent there. A little more snow, to make better sleighing, would have been an improvement. As to rain in winter it is almost unknown. There was not a drop of it the season I was there, from the latter part of October to the middle, or about the middle, of March, except a slight drizzle on Thanksgiving Day. And there was not melting snow enough, for more than eight or ten days, to wet a deerskin moccasin, which many of the gentlemen wear all winter.”

The Rev. H.A. Boardman, D.D., of Philadelphia, writes under date of October, 1868, to a public journal, the following: “The question is often asked, ’how far is St. Paul to be recommended as a resort for invalids?’ If one may judge from indications on the spot, invalids themselves have settled this question. I have never visited a town where one encounters so many persons that bear the impress of delicate health, present or past. In the stores and shops, in the street and by the fireside, it is an every-day experience to meet with residents who came to Minnesota, one, two, five, or ten years ago, for their health, and having regained, decided to remain. I have talked with some who, having recovered, went away twice over, and then made up their minds that to live at all they must live here.”

The statements of these observing and reflecting men are of the first importance, and require no scientific deductions to prove the benefit certain classes of consumptives may receive by a residence in Minnesota; but if it is found that whatever of data in meteorology there is bearing on the climate of this State, confirms the universal public judgment, this then becomes a matter of most agreeable interest.

It seems that the dryness and equability are the important features, as before observed. A gentleman, given somewhat to investigation, made the statement to us, while in St. Paul, that he had carefully watched the ice-pitcher on his table during the summers, and that it was rare that any moisture accumulated upon the outside of the same, as is commonly the case elsewhere. This is itself a most interesting scientific fact, and completely demonstrates the great dryness of the atmosphere during even the wet season of the year, as we have found the rain-fall in summer to be about two-thirds of the whole annual precipitation. Physicians have not generally thought that the summer atmosphere of this State was any improvement upon that of other localities of like altitude, judging from the rain-fall, which, being up to the average of this latitude elsewhere, left as much of moisture, they have concluded, floating near the surface as at other points, and they are led to send patients into less dry districts, or even, as is sometimes the case, to the sea-shore. Graver mistakes could not well occur than these, and it is to be ascribed to the little definite knowledge we as a people have on medico-meteorology. Except for debilitated constitutions, which, it is true, precede many cases of consumption, the sea-shore is to be avoided, especially in every instance of diseased lungs. Doubtless, the habit of advising a trip to the sea-side for the relief and cure of whooping-cough in children has led in great part to this error. The trip to the mountains, if a location is well selected, is likely to be, and usually is, in summer a real benefit. But then, the physician should know something of the reputation of the particular locality to which he sends his patient. To illustrate: suppose a patient afflicted with phthisis is sent to the White Mountains, and in company or alone, he reaches that region, and we will assume that he settles down at the “Profile House,” or at any portion of the hills on their eastern slope, or immediate vicinity, and the result is almost certain to be unfavorable, since constant showers and violent changes of temperature are transpiring throughout the entire summer. If, however, a moderate elevation, away from the immediate influence of the mountains, out of the range of the frequent showers, with a southwest exposure of landscape, where the cool westerly winds have play, decided advantage will come to the sufferer. It would not likely be at once perceptible, but a gradual toning up of the system might be looked for, with an improvement of the general health. Indeed, any change to either the sick or overworked, for that matter, who are able to withstand the fatigue of a journey, is of benefit, even if the climate and location are not improved, as it is well known that a change of scene is a relief and recreation to the mind, which often plays an important part in the recovery of invalids. We all remember the story of the prisoner who had been condemned to suffer death, and at the appointed hour was led blindfolded to the dissecting hall, where were assembled the physicians who were to conduct the experiment. Being duly disrobed and placed, he was informed that an artery was to be opened, and left to bleed till life expired. An incision in the flesh at the back of the neck was made, as a mere feint, and warm water allowed at the same moment to trickle slowly down his shoulder and back, when, in a brief time, spasms set in, and death ultimately followed.

This gives a clear view of the will power inhering in the mental man, and its wonderful influence on the body. Sudden news of misfortune, or great attacks of fear, have produced instant prostration and bodily suffering, and these cases occur so frequent that all within the range of an ordinary life are familiar with them.

An English author speaks of the potent power of the mind over the body, and declares that the act of coughing can be, very often, wholly restrained by mere force of will. This should not be lost sight of by any who are attacked with colds or bronchial troubles, or even in the incipient stages of lung difficulties; as thereby they may lessen the inflammation, and defer the progress of the disease. We have seen people, who, having some slight irritation in the larynx, have, instead of smothering the reflex action, vigorously scraped their throats, and coughed with a persistence entirely unwise, inducing inflammation, from which they might date, perhaps, their subsequent bronchial troubles. It is not in coughs alone that the will exerts a mastery. In a case of fever, by which an elder brother was brought very low, scarce expected by either his friends or physician to survive, a neighbor calling, was allowed to enter the sick-room. The patient was too ill to take much notice of the visitor, and the visitor likely felt that what he might say would not effect the result, and, being rough in manners and coarse of speech, bawled out, in a loud tone, that “he wouldn’t give much for his (the patient’s) chances,” and stalked out of the room. Happening to be present, and fearing the effect of this ill-bred visitor’s remark, we drew near the bedside to hear the prostrate invalid whisper out that he was determined to live, if only to spite the old fellow. His recovery seemed to date from that event, and in a few weeks he was in possession of good health.

Consumption is divided into several classes; the more common forms are the inflammatory, the hereditary, the dyspeptic, and the catarrhal. There are others, but these suffice for purposes of brief mention of the leading characteristics of all cases.

The inflammatory is often the more difficult of management than that of the others, as its attack is violent and prostrating to such a degree as to render the usual aids of exercise and diet out of the question, for the most part. Long journeys, for any purpose, are to be avoided, though removals from the immediate sea-coast, to some dry, sandy section in the interior, within a hundred miles or so, is advisable. The robust and strong are equally subject to this class of consumption. Contracting a violent cold, such as might be taken when in a state of excitement and great perspiration in a ball-room or at a fire, and without sufficient protection pass out into the chilling air, inflammation of the lungs immediately takes place, and the chances are great of either a fatal termination of life or a shattered constitution.

The hereditary class are more frequent, and, by proper treatment of themselves, many may attain to a comparatively long life, and be able to do much of valuable service, if their employment takes them out in the open air. Of course many, inheriting this disease and having enfeebled constitutions, cannot be saved, let what will be done, and it is probably a wise provision that they are not. Consumptives should be careful to remember their great responsibility in forming alliances whereby this terrible evil is perpetuated. There should be some law enacted prohibiting the marriage of confirmed cases of scrofula, consumption, and insanity, even though complete recovery be had, as frequently happens in these difficulties.

The dyspeptic cases are numerous, and arise usually from general debility, caused by insufficient or unwholesome diet, close apartments, a too sedentary life, long depression of spirits, coupled with, perhaps, uncleanliness and irregularities, all contributing to this result. These can all be relieved, and many fully restored, if taken in season, by a counter course of living.

The catarrhal forms of consumption are more difficult to treat, and, in numberless instances, baffle all medical skill, and that is very trifling, which can be applied directly to the seat of trouble. Repeated “colds in the head,” taken and neglected, become by-and-by confirmed, and pass from the rank of common colds to that of chronic catarrh. Indeed, catarrh is no more or less than a chronic cold in the head; but after the lapse of time, and this may vary in different persons, from one to a score or more of years, it assumes a more virulent character, involving, perhaps, the whole of the breathing apparatus. Its encroachments are insidious, and often are lightly considered, but the general tendency of all cases of catarrhal affections is to the lungs. Sometimes this approach is by a sudden leap, in consequence, probably, of a fresh stock of “cold,” from the mucous membranes of the nasal organs to the lungs, and we have in such cases known one of the most eminent physicians of the country to declare, when examinations were made at this juncture, that “catarrh had nothing to do with it.” This but illustrates the fallibility of men, and we should never be surprised when confronted with any fresh testimony tending to confirm this truth.

The dry catarrh, while more aggravating, is less fatal, and life is more secure, and not as offensive either to friends or themselves, while other classes of this disease are offensive and more malignant. It is very obstinate, and yields to no treatment of a specific kind that we know of. The same general course should be pursued, however, as with dyspeptic consumptives. The entire medical fraternity are at their absolute wits’ ends, so far as any specific is concerned, for this almost universal disease. We say universal, since it is within our knowledge to be largely true, though, while in a mild form, little heed is given it, and generally the party would deny its presence, even while more than half conscious that it might exist. In addition to a generous diet, fresh air, and other matters, of which we shall speak more in detail as we proceed, a nasal douche before retiring, of tepid water, with salt enough added to make a weak brine, as half a teaspoonful to a tumbler, will be in most instances of some benefit. Inhalation and nasal baths must be the specific means of reaching and alleviating this disease.

Thousands annually die of consumption springing out of this malady. Time, it would seem, must discover to the race some more efficient remedy than is now known.

Cold, humid, and variable climates give rise to and feed this disease, and a change to an equable, warm, or a cool and dry temperature, is essential.

Where heart disease is complicated with consumption, a warm, dry climate is best; and in some cases, too, as where bronchitis exists in great disproportion to the amount of tubercular deposit and inflammation of the lungs, the climate of Florida during the winter would be more bland and agreeable than that of Minnesota, but each individual varies so much in constitutional character, that no positive rule can be laid down by which any one case can be judged. This comes within the province of the family physician.

We cannot too strongly urge upon the medical faculty, as well as the friends of the afflicted of whom we have written, that delays are dangerous. Early action on the first manifestations of lung troubles and tendencies is necessary if lives are to be saved. It is hard to turn from the beaten path and enter new, even when larger health is hoped for and needed, yet that should be resolutely done, though it were far better the confining and unhealthful course had not been originally entered upon.