Again, the ages at which pneumonia is both most common and most deadly,
namely, under five and over sixty-five, are precisely those at which
this feature of exposure to the weather plays the most insignificant
part. Last and most conclusive of all, since definite statistics have
begun to be kept upon a large scale, pneumonia has been found to be
emphatically a disease of cities, instead of country districts. Even
under the favorable conditions existing in the United States, for
instance, the death-rate per hundred thousand living, according to the
last census, was in the cities two hundred and thirty-three, and for the
country districts one hundred and thirty-five,--in other words, nearly
seventy per cent greater in city populations.
How, then, did the impression become so widely spread and so firmly
rooted that pneumonia is chiefly due to exposure? Two things, I think,
will explain most of this. One is, that the disease is most common in
the winter-time, the other, that like all febrile diseases it most
frequently begins with sensations of chilliness, varying all the way
from a light shiver to a violent chill, or _rigor_. The savage,
bone-freezing, teeth-rattling chill which ushers in an attack of
pneumonia is one of the most striking characteristics of the disease,
and occurs in twenty-five to fifty per cent of all cases.
Its chief occurrence in the winter-time is an equally well-known and
undisputed fact, and it has been for centuries set down in medical works
as one of the diseases chiefly due to changes in temperature, humidity,
and directions of the wind. Years of research have been expended in
order to trace the relations between the different factors in the
weather and the occurrence of pneumonia, and volumes, yes, whole
libraries, published, pointing out how each one of these factors, the
temperature, humidity, direction of wind, barometric pressure, and
electric tension, is in succession the principal cause of the spread of
this plague. Many interesting coincidences were shown. But one thing
always puzzled us, and that was, that the heaviest mortality usually
occurred, not just at the beginning of winter, when the shock of the
cold would be severest, nor even in the months of lowest temperature,
like December or January, but in the late winter and the early spring.
Throughout the greater part of the temperate zone the death-rate for
pneumonia begins to rise in December, increases in January, goes higher
still in February, reaching its climax in that month or in March. April
is almost as bad, and the decline often doesn't fairly set in until May.
Public-domain text, read in full here on John Shaqi.
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