- Email: [email protected]
DRAUGHTS OR SHOULD I CLOSE THE WINDOW ?
806
the meeting centred round the need for treatment facilities and the lack of help for and interest in drugtakers. Doubts were openly expressed both about the ability of the group to achieve anything and about the motives of those attending it. at
With the passage of weeks and the establishment of a regular time and place for meetings, a pattern emerged. A regular group of helpers, usually 6 but often more, attended weekly. A nucleus of 7 or 8 heroin users attended regularly. Another 12 came intermittently, particularly to use the good offices of the Association to make contact with general practitioners willing to prescribe legal heroin in small daily doses when a local policy of containment came into force. Inevitably, a fringe group of people with disordered personalities attended, but these were felt by the heroin users to have different problems.
"
been accepted. They have forged the first links in the chain of rehabilitation. No claims are made for the group as an effective form of treatment of drug dependence, but it keeps heroin users in touch with the ordinary, adult society they are in danger of rejecting completely. It offers help and support in an atmosphere of acceptance, where criticism can be a twoway process. If it does nothing else, it gives for two hours each week an opportunity to discuss personal problems, with perhaps a remote chance of gaining insight. Its real significance is that it is a therapeutic activity in which lay people can share because they are laymen. Perhaps it is this link with the community that can offer new hope for the young heroin user. ness
This work was undertaken as an extramural activity while I was in receipt of a grant from the Medical Research Council.
To write in terms of results would be misleading, since the group has been meeting for less than five months.
Points of View
However, of the 7 heroin users now attending regularly, 1, with the help and encouragement of his general practitioner, has given up heroin, and 2 are gradually reducing their dose. 2 occasional attenders, introduced through the group to general practitioners willing to
prescribe, have also come off heroin. Meetings are entirely informal. Discussion can be on any topic, but centres round the problems of work and the attitudes of families and society. They are held on one evening a week at 8 P.M., and close at 10 P.M. Specific requests for help are always discussed fully and an attempt is made to provide what is required. Often the request is for intercession with the doctor
increase the dose of heroin or modify what is felt to be his punitive attitude. Such requests are always discussed with the doctor; often there is a failure on the part of the patient to communicate his needs, and the help given is in the role of
simple
to
messenger.
The number and range of
practitioners,
1
helpers theological student,
grows. 2 general 1 teacher, and 2
housewives with adolescent children attend regularly. The group now acts not only as a forum for airing grievances, criticising society, and asking for help, but as a channel of communication for explaining national and local policy on drug dependence and for keeping abreast of local arrangements. It is
lighten
hoped to arrange a rota of helpers, not only to a weekly commitment, but also to increase the
heroin users’ range of contacts with adults with roots in the community and to increase the number of adults with first-hand knowledge of addicts’ problems.
Helpers have many difficulties. Nearly all identify with parents at first. Most find themselves trying to defend the society so ferociously criticised by the people they are trying to help. All find that the logical arguments for normal " behaviour which they can produce count for nothing in face of the importunate demands for attention and affection they meet. They find themselves torn between the impossibility of meeting often unrealistic, demands for work, shelter, heroin, and the equal impossibility of abandoning these young people. Yet, with continued attendance, the demands-the testing out— diminish, and it is possible to offer the reaction of a normal adult to a heroin-user’s opinion without evoking outright rejection or dismissal. The helpers have, despite their adulthood, conventionality, and undoubted " square"
DRAUGHTS OR SHOULD I CLOSE THE WINDOW ?
S. LEVIN M.B. W’srand, M.R.C.P.E. D.C.H.
V. CORNICK Dip. Med. Techn. JOHANNESBURG, " And he
said, Open
SOUTH AFRICA
the window."—2
Kings,
XIII, 17.
The concept of illness-inducing draughts is ultimately derived from maleficient demonic influences, a cultural inheritance from the ancient Middle East. In fact it makes no difference to a room whether its windows are open or closed. The demons have evidently lost their potency these days, while bacteriological colony-counts remain relatively stable in houses and apartments irrespective of whether the windows are open or closed.
Summary
INTRODUCTION
TWENTY years ago I (S. L.) tried to outwit the examiner in the M.B. examination. He had asked me to examine a man with a scrotal swelling, and I well remember walking to a nearby window and closing it; only then did I approach the patient. The examiner appeared studiously bland but I fancy he must have been impressed; at any rate it showed in the final mark. Since then I have continued to note the frequency with which windows are closed by mothers when their children are approached for physical examination. " It’s to keep out the draught ", they explain. Or they may say " I’m just being careful; better play safe." One may contest this point by asking " But how do you know that closing windows is playing safe ? Maybe it is being negligent ? Perhaps opening them to fresh air is being careful while closing them is dangerous ? " This suggestion is always dismissed as not worthy of consideration. " And just what do you mean by this term draught ? is met by a standard reply: a draught is a gust of wind which may precipitate illness, especially in infants; it does so particubeen larly if the child has just had a bath, if his hair has washed, if he has the sniffles or a cough or if his " resistance is lowered " or he is " run down ", whatever that "
may
mean.
In such circumstances the
draught
can cause a
cold,
807 or pneumonia (worse still, double pneumonia). Nor is this view limited to the laity. Doctors and nurses commonly entertain similar ideas, perhaps thoughtlessly-a part of their cultural heritage-or perhaps from conviction.
chill,
There is still a medical undercurrent that facial palsy may be caused by a gust of air blowing on the face through the open window of a car in motion. Doctors out
commonly warn patients to " keep draughts ", while royalty, if we
of
can trust
Press reports, also suffer from which occasion colds and chills
draughts (though never
a
coryza
or
American microdemon
rhinitis).
(part of an advertisement for
an antibiotic) Words are important because they Abbott Laboratories, Johannesburg suggest ideas which may not in fact be valid. The terms cold and chill suggest atmospheric associations lacking in words like coryza or rhinitis, while the expresFig. 1—"My name is Legion, for we are sion fresh air suggests very different Babylonian demon many."-Mark, V, 9. British Museum inferences from its equivalent, draught. In a psediatric practice there is no condition quite as malign or ubiquitous as a draught. Lack- significantly violent term, suited to nullify the violent of the wind-demon. ing a knowledge of pathology or bacteriology, the public disturbances In the ancient Middle East infants were especially prone invokes as causes of illness factors stemming from folk to injury by draughts (wind, Lilith) for the first 40 days of medicine and cultural influences, and no such factors life, and to this very day babies in parts of Persia and North even begin to rival the propensity of draughts as causes Africa are not removed from the secluded safety of their huts of disease. or habitations for the first 40 days of life. Lest we laugh, let
ETYMOLOGY
It is all the more remarkable, therefore, that the subject of draughts has been almost totally ignored by orthodox medicine. (Such unexpected hiatuses do happen occasionally: for example, by far the commonest medication used for infants is Woodward’s gripe water, yet textbooks of paediatrics published since 1870 and medical journals contain no articles on this product.) Likewise, there is no article on draughts to be found in any medical journal. The Index Medicus is devoid of entries on this topic and virtually no references to the subject could be found in old or recent major texts on paediatrics or medicine. A pxdiatric textbook of 1906 devoted half a page to draughts claiming, inter alia, that a 2-year-old boy’s rheumatism had resulted from sitting in front of an open door. In the 1920s another textbook contained a short paragraph on the deleterious effects of draughts, though it was emphasised that lack of fresh air was more important as a cause of illness: this paragraph survived until the 1933 edition. The rest is silence; even Abt’s Pediatrics in 8 volumes (1923) has not a word on draughts. The subject could not be found in texts on industrial health and preventive medicine. Nor is the word included in books on the etymology of medical terms. Butterworth’s Medical Dictionary lists draught as a dose of medicine, and Dorland’s Medical Dictionary defines draft
similarly. Thus
doctor knows what every layman knows: draughts cause colds, chills, and disease. Public knowledge is ultimately a cultural inheritance and draughts are ultimately nothing other than evil demons flying in through a window, injuring or killing an infant and immediately escaping via another window or door. The word has been used in the context of a current of air only since the 18th century. Its philological origin is in the ancient Teutonic dragan (= to draw), but its idea stems from immeasurably older traditions and its roots are probably to be traced to Babylonia and Sumeria where the chief draught was the chief demon, Lilith, whose name in Sumerian, lilitu, meant wind. To this day women croon a lullaby (a lili-aby) not to soothe their babies, but to keep lili (Lilith) at bay. Her influence, wind, can penetrate an infant’s abdomen, where its tempestuous rage results in the evening " colic that babies are alleged to have; and this wind has to be " broken "-a no
it be remembered how often in Johannesburg, London, or New York are we asked by mothers whether they can take their infants out now that they are 6 weeks old; and 6 weeks is just about 40 days. Even some doctors advise mothers not to take infants out of the house for 6 weeks. But can it be true after all ? Do draughts, wind, gusts of fresh ( ?) air aggravate or cause illness ? From time to time one reads-in the lay Press rather than in medical journalsthat trials in Salisbury, Wiltshire, have demonstrated that volunteers with coryza, placed within tunnels and facing blasts of cold air, do not get significantly worse than volunteers not facing such draughty challenges. Sure, ’tis an ill wind that blows nobody any good; some do get a windfall and others the ill of the ill wind. Can these particular ill winds, these draughts, be identified so as to make medical sense? Can it be that the demonic draughts of yesteryear are nowadays wafted in as minidemons, microdemons, microbes (fig. 1) ? If windows are opened, do new germs come in, as one mother asked, or do old ones go out ? We decided to try to find out. COLONY-COUNTS
During November, 1967, we distributed to the homes of private patients in good socioeconomic circumstances sets of four blood-agar petri dishes. These were to be placed on a table in a child’s bedroom after the windows had been alternately closed or open for 24 hours. At the same time in the evening, when the day’s dust had settled and the children were in bed, a petri dish was exposed for 15 minutes, collected the next day and taken to the laboratory. Sometimes within 4 days, and nearly always within a week, four plate exposures were completed after the windows had been open or closed for 24 hours. Frequent visits to the home ensured that all contaminated plates were replaced before exposure. Investigations involved thirty-one homes, including large houses in extensive grounds and cramped apartments in heavily populated areas. After 48 hours’ incubation bacterial colonies were counted (fungal colonies were ignored): the colony-counts were similar in the two open and the two closed " window days " and there are no real differences between the four (fig. 2). Surprisingly, colony-counts in homes did not differ significantly from those
chair
or
808 and for disturbing them sufficiently to alter colony-counts grossly. In this respect the cogent factor is not wind but turbulence. The colony count will doubtless rise if winds of sufficient force enter a room and disturb the settled dust. Even with the windows closed the same effect will result from other turbulence such as human movements, coughing, sneezing, and, as is well known, bed-making. Is it so certain that draughts can only be interpreted in folkloristic terms, involving wind, demons, and ultimately germs and colony-counts ? How much are draughts to be seen as spreading their malign influences via chills-interpreted as hypothermia? We would dismiss this view as superficial and misplaced. It appears to have cogency in cold countries where wintry street gusts are associated with the usual winter epidemics of sniffles. Conclusions of post hoc ergo propter hoc are inevitable and the frosty draughts become the causes of illness. But, except in instances of neglect or exposure (hypothermia, frostbite) these chilly frosty draughts produce microbic illnesses, thus again exposing the real nature of these draughts, microbic in character and hence ultimately demonic. In folkloristic terms, and in the usual household situation, chilly draughts cause not hypothermia and frostbite but coryza and rhinitis, and note
the " -itis ". of
Chilly draughts also remind the recipient winter, when vegetation decays, when
animals hihfmatf when the wnrici files
in apartments, either high up or low down. A bacterial of uniform distribution envelops Johannesburg.
pall
DISCUSSION
For fresh-air fiends, and even for those of us who have long believed that fresh air is preferable to stale air, it comes as a disappointment to learn that it does not much matter whether a room’s windows are open or closed. We may believe that there are no diseases where it is better to stay in a stuffy room; we may be amused to observe how nurses invariably close nearby windows when about to set a sterile tray or trolley. But in fact it makes little bacteriological difference whether air be fresh or stale; it seems that the bacterial populations of homes is rather like their human populations: reasonably stable. Visitors come and go but the family, including the bacteriological family, remains unchanged. The bacteriological families were relatively peaceable; there were no streptococcal colonies and only a few staphylococcal colonies (including Staphylococcus aureus) to be found among the thirty-one homes in the series. Most of the colonies consisted of the usual micrococci, Bacillus subtilis, and Gram-negative bacilli. We made no effort to culture anaerobic organisms. One might imagine that with windows open, the sun’s rays might more easily kill off these various organisms; alternatively, might they not rather incubate them? It seems, however, that the sun is not a potent factor in either respect. There are probably lots of other variables responsible for keeping the bacteriological families stable
a
little. A chilly draught is here a breath of death, again a reminder of a demonic angel of death. In summer the hypothermic hypothesis falls down altogether and, in fact, window closing for draughts is a summer disorder (in winter windows are almost permanently closed). It is when it is warm, even hot outside, that mothers will hasten to protect their children from
draughts. Those whose culture is not heavily indebted to Semitic demonic influences do not have the window-closing mania. Bar.tu women do not close windows when a child is about to be undressed for examination whereas European women do so almost as a reflex action. Atmospheric temperature has no effect on colonycounts (fig. 3). Nov. 15, 16, and 17 were warm days while the next 3 days were cold. A total of eleven agar plates were exposed during these 6 days, the windows having been open throughout, but though " chilly draughts" were entering on the last 3 days, the six plates affected showed colony-counts in much the same groupings as the five plates exposed to warm draughts ". Also, those children sleeping with windows open during the 3 cold nights fared no differently clinically from the children who slept with windows open on warm nights. "
We thank the director of the South African Institute for Medical
Research, Johannesburg, for placing the Institute’s services at our disposal. Requests for reprints should be addressed to S. L., 67 Jenner Chambers, Jeppe Street, Johannesburg, South Africa.
the meeting centred round the need for treatment facilities and the lack of help for and interest in drugtakers. Doubts were openly expressed both about the ability of the group to achieve anything and about the motives of those attending it. at
With the passage of weeks and the establishment of a regular time and place for meetings, a pattern emerged. A regular group of helpers, usually 6 but often more, attended weekly. A nucleus of 7 or 8 heroin users attended regularly. Another 12 came intermittently, particularly to use the good offices of the Association to make contact with general practitioners willing to prescribe legal heroin in small daily doses when a local policy of containment came into force. Inevitably, a fringe group of people with disordered personalities attended, but these were felt by the heroin users to have different problems.
"
been accepted. They have forged the first links in the chain of rehabilitation. No claims are made for the group as an effective form of treatment of drug dependence, but it keeps heroin users in touch with the ordinary, adult society they are in danger of rejecting completely. It offers help and support in an atmosphere of acceptance, where criticism can be a twoway process. If it does nothing else, it gives for two hours each week an opportunity to discuss personal problems, with perhaps a remote chance of gaining insight. Its real significance is that it is a therapeutic activity in which lay people can share because they are laymen. Perhaps it is this link with the community that can offer new hope for the young heroin user. ness
This work was undertaken as an extramural activity while I was in receipt of a grant from the Medical Research Council.
To write in terms of results would be misleading, since the group has been meeting for less than five months.
Points of View
However, of the 7 heroin users now attending regularly, 1, with the help and encouragement of his general practitioner, has given up heroin, and 2 are gradually reducing their dose. 2 occasional attenders, introduced through the group to general practitioners willing to
prescribe, have also come off heroin. Meetings are entirely informal. Discussion can be on any topic, but centres round the problems of work and the attitudes of families and society. They are held on one evening a week at 8 P.M., and close at 10 P.M. Specific requests for help are always discussed fully and an attempt is made to provide what is required. Often the request is for intercession with the doctor
increase the dose of heroin or modify what is felt to be his punitive attitude. Such requests are always discussed with the doctor; often there is a failure on the part of the patient to communicate his needs, and the help given is in the role of
simple
to
messenger.
The number and range of
practitioners,
1
helpers theological student,
grows. 2 general 1 teacher, and 2
housewives with adolescent children attend regularly. The group now acts not only as a forum for airing grievances, criticising society, and asking for help, but as a channel of communication for explaining national and local policy on drug dependence and for keeping abreast of local arrangements. It is
lighten
hoped to arrange a rota of helpers, not only to a weekly commitment, but also to increase the
heroin users’ range of contacts with adults with roots in the community and to increase the number of adults with first-hand knowledge of addicts’ problems.
Helpers have many difficulties. Nearly all identify with parents at first. Most find themselves trying to defend the society so ferociously criticised by the people they are trying to help. All find that the logical arguments for normal " behaviour which they can produce count for nothing in face of the importunate demands for attention and affection they meet. They find themselves torn between the impossibility of meeting often unrealistic, demands for work, shelter, heroin, and the equal impossibility of abandoning these young people. Yet, with continued attendance, the demands-the testing out— diminish, and it is possible to offer the reaction of a normal adult to a heroin-user’s opinion without evoking outright rejection or dismissal. The helpers have, despite their adulthood, conventionality, and undoubted " square"
DRAUGHTS OR SHOULD I CLOSE THE WINDOW ?
S. LEVIN M.B. W’srand, M.R.C.P.E. D.C.H.
V. CORNICK Dip. Med. Techn. JOHANNESBURG, " And he
said, Open
SOUTH AFRICA
the window."—2
Kings,
XIII, 17.
The concept of illness-inducing draughts is ultimately derived from maleficient demonic influences, a cultural inheritance from the ancient Middle East. In fact it makes no difference to a room whether its windows are open or closed. The demons have evidently lost their potency these days, while bacteriological colony-counts remain relatively stable in houses and apartments irrespective of whether the windows are open or closed.
Summary
INTRODUCTION
TWENTY years ago I (S. L.) tried to outwit the examiner in the M.B. examination. He had asked me to examine a man with a scrotal swelling, and I well remember walking to a nearby window and closing it; only then did I approach the patient. The examiner appeared studiously bland but I fancy he must have been impressed; at any rate it showed in the final mark. Since then I have continued to note the frequency with which windows are closed by mothers when their children are approached for physical examination. " It’s to keep out the draught ", they explain. Or they may say " I’m just being careful; better play safe." One may contest this point by asking " But how do you know that closing windows is playing safe ? Maybe it is being negligent ? Perhaps opening them to fresh air is being careful while closing them is dangerous ? " This suggestion is always dismissed as not worthy of consideration. " And just what do you mean by this term draught ? is met by a standard reply: a draught is a gust of wind which may precipitate illness, especially in infants; it does so particubeen larly if the child has just had a bath, if his hair has washed, if he has the sniffles or a cough or if his " resistance is lowered " or he is " run down ", whatever that "
may
mean.
In such circumstances the
draught
can cause a
cold,
807 or pneumonia (worse still, double pneumonia). Nor is this view limited to the laity. Doctors and nurses commonly entertain similar ideas, perhaps thoughtlessly-a part of their cultural heritage-or perhaps from conviction.
chill,
There is still a medical undercurrent that facial palsy may be caused by a gust of air blowing on the face through the open window of a car in motion. Doctors out
commonly warn patients to " keep draughts ", while royalty, if we
of
can trust
Press reports, also suffer from which occasion colds and chills
draughts (though never
a
coryza
or
American microdemon
rhinitis).
(part of an advertisement for
an antibiotic) Words are important because they Abbott Laboratories, Johannesburg suggest ideas which may not in fact be valid. The terms cold and chill suggest atmospheric associations lacking in words like coryza or rhinitis, while the expresFig. 1—"My name is Legion, for we are sion fresh air suggests very different Babylonian demon many."-Mark, V, 9. British Museum inferences from its equivalent, draught. In a psediatric practice there is no condition quite as malign or ubiquitous as a draught. Lack- significantly violent term, suited to nullify the violent of the wind-demon. ing a knowledge of pathology or bacteriology, the public disturbances In the ancient Middle East infants were especially prone invokes as causes of illness factors stemming from folk to injury by draughts (wind, Lilith) for the first 40 days of medicine and cultural influences, and no such factors life, and to this very day babies in parts of Persia and North even begin to rival the propensity of draughts as causes Africa are not removed from the secluded safety of their huts of disease. or habitations for the first 40 days of life. Lest we laugh, let
ETYMOLOGY
It is all the more remarkable, therefore, that the subject of draughts has been almost totally ignored by orthodox medicine. (Such unexpected hiatuses do happen occasionally: for example, by far the commonest medication used for infants is Woodward’s gripe water, yet textbooks of paediatrics published since 1870 and medical journals contain no articles on this product.) Likewise, there is no article on draughts to be found in any medical journal. The Index Medicus is devoid of entries on this topic and virtually no references to the subject could be found in old or recent major texts on paediatrics or medicine. A pxdiatric textbook of 1906 devoted half a page to draughts claiming, inter alia, that a 2-year-old boy’s rheumatism had resulted from sitting in front of an open door. In the 1920s another textbook contained a short paragraph on the deleterious effects of draughts, though it was emphasised that lack of fresh air was more important as a cause of illness: this paragraph survived until the 1933 edition. The rest is silence; even Abt’s Pediatrics in 8 volumes (1923) has not a word on draughts. The subject could not be found in texts on industrial health and preventive medicine. Nor is the word included in books on the etymology of medical terms. Butterworth’s Medical Dictionary lists draught as a dose of medicine, and Dorland’s Medical Dictionary defines draft
similarly. Thus
doctor knows what every layman knows: draughts cause colds, chills, and disease. Public knowledge is ultimately a cultural inheritance and draughts are ultimately nothing other than evil demons flying in through a window, injuring or killing an infant and immediately escaping via another window or door. The word has been used in the context of a current of air only since the 18th century. Its philological origin is in the ancient Teutonic dragan (= to draw), but its idea stems from immeasurably older traditions and its roots are probably to be traced to Babylonia and Sumeria where the chief draught was the chief demon, Lilith, whose name in Sumerian, lilitu, meant wind. To this day women croon a lullaby (a lili-aby) not to soothe their babies, but to keep lili (Lilith) at bay. Her influence, wind, can penetrate an infant’s abdomen, where its tempestuous rage results in the evening " colic that babies are alleged to have; and this wind has to be " broken "-a no
it be remembered how often in Johannesburg, London, or New York are we asked by mothers whether they can take their infants out now that they are 6 weeks old; and 6 weeks is just about 40 days. Even some doctors advise mothers not to take infants out of the house for 6 weeks. But can it be true after all ? Do draughts, wind, gusts of fresh ( ?) air aggravate or cause illness ? From time to time one reads-in the lay Press rather than in medical journalsthat trials in Salisbury, Wiltshire, have demonstrated that volunteers with coryza, placed within tunnels and facing blasts of cold air, do not get significantly worse than volunteers not facing such draughty challenges. Sure, ’tis an ill wind that blows nobody any good; some do get a windfall and others the ill of the ill wind. Can these particular ill winds, these draughts, be identified so as to make medical sense? Can it be that the demonic draughts of yesteryear are nowadays wafted in as minidemons, microdemons, microbes (fig. 1) ? If windows are opened, do new germs come in, as one mother asked, or do old ones go out ? We decided to try to find out. COLONY-COUNTS
During November, 1967, we distributed to the homes of private patients in good socioeconomic circumstances sets of four blood-agar petri dishes. These were to be placed on a table in a child’s bedroom after the windows had been alternately closed or open for 24 hours. At the same time in the evening, when the day’s dust had settled and the children were in bed, a petri dish was exposed for 15 minutes, collected the next day and taken to the laboratory. Sometimes within 4 days, and nearly always within a week, four plate exposures were completed after the windows had been open or closed for 24 hours. Frequent visits to the home ensured that all contaminated plates were replaced before exposure. Investigations involved thirty-one homes, including large houses in extensive grounds and cramped apartments in heavily populated areas. After 48 hours’ incubation bacterial colonies were counted (fungal colonies were ignored): the colony-counts were similar in the two open and the two closed " window days " and there are no real differences between the four (fig. 2). Surprisingly, colony-counts in homes did not differ significantly from those
chair
or
808 and for disturbing them sufficiently to alter colony-counts grossly. In this respect the cogent factor is not wind but turbulence. The colony count will doubtless rise if winds of sufficient force enter a room and disturb the settled dust. Even with the windows closed the same effect will result from other turbulence such as human movements, coughing, sneezing, and, as is well known, bed-making. Is it so certain that draughts can only be interpreted in folkloristic terms, involving wind, demons, and ultimately germs and colony-counts ? How much are draughts to be seen as spreading their malign influences via chills-interpreted as hypothermia? We would dismiss this view as superficial and misplaced. It appears to have cogency in cold countries where wintry street gusts are associated with the usual winter epidemics of sniffles. Conclusions of post hoc ergo propter hoc are inevitable and the frosty draughts become the causes of illness. But, except in instances of neglect or exposure (hypothermia, frostbite) these chilly frosty draughts produce microbic illnesses, thus again exposing the real nature of these draughts, microbic in character and hence ultimately demonic. In folkloristic terms, and in the usual household situation, chilly draughts cause not hypothermia and frostbite but coryza and rhinitis, and note
the " -itis ". of
Chilly draughts also remind the recipient winter, when vegetation decays, when
animals hihfmatf when the wnrici files
in apartments, either high up or low down. A bacterial of uniform distribution envelops Johannesburg.
pall
DISCUSSION
For fresh-air fiends, and even for those of us who have long believed that fresh air is preferable to stale air, it comes as a disappointment to learn that it does not much matter whether a room’s windows are open or closed. We may believe that there are no diseases where it is better to stay in a stuffy room; we may be amused to observe how nurses invariably close nearby windows when about to set a sterile tray or trolley. But in fact it makes little bacteriological difference whether air be fresh or stale; it seems that the bacterial populations of homes is rather like their human populations: reasonably stable. Visitors come and go but the family, including the bacteriological family, remains unchanged. The bacteriological families were relatively peaceable; there were no streptococcal colonies and only a few staphylococcal colonies (including Staphylococcus aureus) to be found among the thirty-one homes in the series. Most of the colonies consisted of the usual micrococci, Bacillus subtilis, and Gram-negative bacilli. We made no effort to culture anaerobic organisms. One might imagine that with windows open, the sun’s rays might more easily kill off these various organisms; alternatively, might they not rather incubate them? It seems, however, that the sun is not a potent factor in either respect. There are probably lots of other variables responsible for keeping the bacteriological families stable
a
little. A chilly draught is here a breath of death, again a reminder of a demonic angel of death. In summer the hypothermic hypothesis falls down altogether and, in fact, window closing for draughts is a summer disorder (in winter windows are almost permanently closed). It is when it is warm, even hot outside, that mothers will hasten to protect their children from
draughts. Those whose culture is not heavily indebted to Semitic demonic influences do not have the window-closing mania. Bar.tu women do not close windows when a child is about to be undressed for examination whereas European women do so almost as a reflex action. Atmospheric temperature has no effect on colonycounts (fig. 3). Nov. 15, 16, and 17 were warm days while the next 3 days were cold. A total of eleven agar plates were exposed during these 6 days, the windows having been open throughout, but though " chilly draughts" were entering on the last 3 days, the six plates affected showed colony-counts in much the same groupings as the five plates exposed to warm draughts ". Also, those children sleeping with windows open during the 3 cold nights fared no differently clinically from the children who slept with windows open on warm nights. "
We thank the director of the South African Institute for Medical
Research, Johannesburg, for placing the Institute’s services at our disposal. Requests for reprints should be addressed to S. L., 67 Jenner Chambers, Jeppe Street, Johannesburg, South Africa.