The crusade against unnecessary city smoke is more social than medical, and yet has a real interest for physicians. The direct harmfulness of smoke to the human organism is not wholly clear. It is certain, however, that smoke and other products of soft coal combustion vitiate the atmosphere and constitute an influence genuinely depressing to the organism. The skin and mucous membranes suffer and, in children especially, there is deficient oxygenation with anemia. To maintain the best health, city-dwellers seek for a time each year the soot-free air of the country. All forms of life, man included, are dependent on the sun's rays for their greatest activities. In the city whose sunshine is much of the time absorbed by a fall of coal smoke, child life is under average, and the children who can not for a time get out to the sunlit open country tend to be pale and
SMOKE. JAMA. 1905;XLIV(20):1619–1620. doi:10.1001/jama.1905.02500470047010
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