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JAMA 100 Years Ago
May 27, 1998


Author Affiliations

Edited by Brian P. Pace, MA, Assistant Editor.

JAMA. 1998;279(20):1668B. doi:10.1001/jama.279.20.1668

It is probable that man was originally a tropical animal, perfectly adapted to his environment in a physical point of view, the natural product of evolution under the conditions in which he lived. Since he has emerged from his primal state and extended his habitat throughout nearly all latitudes and climates and has become a garment-wearing animal a host of unnatural and insanitary possibilities has arisen. The question of clothing, what to wear and how to wear it, has an importance altogether aside from the social and esthetic, and even from some of the ordinarily recognized considerations of comfort that commonly govern our selection. The hygienic choice of clothing, when it is not interfered with by conventional or economic or other factors, is usually a rule of thumb procedure, that takes little or no account of the chances or consequences of error. This is more especially true in our so-called temperate climates, where every extreme of temperature is experienced, often within the compass of a few days or weeks or in some localities even a day. The result is a sacrifice of human comfort, health and even of human life that is none the less formidable and real because it is unappreciated even by the victims themselves. The average layman's idea of hygiene is ordinarily that it is a matter that concerns diet, water-supply, drainage, etc., and the subject of clothing is one of the very last that occurs to him under this head. The relative importance attributed to these other matters by sanitarians encourages this error, and it may be asked whether, as physicians, we are not guilty of forgetting or condoning some of the commoner sins against good health in this regard; our familiarity with them has led to their neglect. We change our summer and winter costumes, for example, according to the calendar or our individual whims and feelings, and the result is often a crop of lung and bronchial affections and the aggravation of those already existing. According to RUBNER, the most recent writer who has treated the subject systematically, the average man is, as a rule, too warmly clothed in summer, and this, even with good ventilation, is an evil that should be avoided, and tends to increased perspiration and abnormal activity of the skin, which in many ways may lead to evil consequences. With ill ventilated clothing confining the perspiration and its excretions, we have a condition that interprets itself, often to our unaided senses, as hardly more compatible in principle with perfect sanitation than is an undrained cellar sending its exhalations into the living rooms above. . . .