Climate and tuberculosis

Abstract

Climate appears to have considerably less influence on tuberculosis mortality than such factors as racial immunity and social conditions; there is none the less some evidence that warm, damp climates are associated with a relatively high tuberculosis mortality. Climatic stimulation has a definite place in the treatment of tuberculosis, but care must be taken not to expose to a highly stimulating climate patients whose powers of response are inadequate. In the selection of cases careful individualisation is necessary; dyspnœa from diminished vital capacity, cardiac arhythmia and nervous instability all tend to be increased with rise in altitude. No air in the world can make up for the absence of medical guidance and discipline which a well-conducted sanatorium provides. With some exceptions, cases with symptoms of activity are best treated in the first place at a low or moderate altitude; selected cases with adequate powers of response should subsequently be sent to higher altitudes. More sedative climates of the Mediterranean type are suitable for patients with bronchitis and emphysema but little or no tuberculous activity.