In winter, the body and limbs, from the root of the neck to the toes and elbows, and in many cases to the wrists, should be covered, next the skin, with some woollen material, such as lamb's wool or flannel.

In summer, the material may be lighter, as merino, and need not cover the limbs.

The same woollen dress should not be worn both night and day, but should be changed for a woollen sleeping vest of the same material as that worn during the day. (See Sleep.)

Having provided that the skin is so covered that it is protected against sudden changes of temperature, all other clothing should be limited to that which is sufficient to preserve a comfortable feeling of warmth under the different changes of the season and of the weather.

It is most important to keep the arms warm, especially in those with delicate lungs. Cold arms act as refrigerators to the blood immediately before it is discharged by the large veins into the heart and lungs.

Over-clothing, i.e., such as keeps the body perspiring while at rest, or produces perspiration under very slight exertion, should be avoided, especially over-clothing of any one part of the body, by which it is kept hotter than the other parts.

A most valuable addition to other clothing in very cold weather is a wash-leather vest with sleeves, to be worn over the woollen vest and under the cotton or linen shirt.

It is of the greatest importance to keep the feet dry, and as warm as the rest of the body. If the weather is damp, this can only be done by wearing goloshes when out of doors. (See Bathing.)

A careful analysis made by me of a large number of cases of Winter Cough, Catarrh, Bronchitis, Emphysema, and Asthma, showed that fresh colds were the only causes which brought on or aggravated the cough in 72 per cent, of the cases, and the most frequent and potent causes of these fresh colds, as stated by the patients themselves, were: -

1. Sudden changes of temperature in 21 per cent.

2. Fogs and damp in 19 per cent.

3. Draughts of cold air in 16 per cent.

4. Cold winds in 10 per cent.

5. Getting wet in 14 per cent.

6. Wet feet in 17 per cent.

And these causes of fresh colds were found to be the potent provokers of short breathing. This important list is no less striking for the powers for evil which it is shown to possess, than for the remarkable simplicity of the evil powers themselves.

If, then, these unfortunate sufferers from Winter Cough could have been protected from sudden changes of temperature, fogs, mists, cold winds, draughts, wet feet, and wet coats and dresses, 72 per cent, would have kept free from their coughs, It would be strange if we could not find means of protection against such common-place influences. In truth there is no deficiency of means of protection against them, and it is because of the very common-place character of these means of protection, and of the influences themselves, that both are so much neglected and under-valued.

But as 72 per cent, of the cases of Winter Cough which I analysed might probably have been prevented by attention to these common-place things; let us give a few minutes to their consideration.

Sudden changes of temperature. This is the most difficult to avoid of any on the list. The occupations and amusements of all classes involve such changes, and we cannot stop these occupations and amusements, even were it desirable to do so. The workshop, the counting-house, the committee-room, the opera-house, the ballroom, must be warm when the outer air is cold, and changes from one to the other cannot be avoided. But very much can be done to prevent the body from feeling these changes. The first and most important thing is the complete envelopment of the body and limbs in wool next the skin, thus interposing a bad conductor of heat between the surface of the body and the outer air. It is surprising that, even at the present day, this simple and common sense protection is neglected by so large a number of persons both of the educated and of the uneducated classes. It is not sufficient for the purpose in view that a little body-vest should be worn, just big enough to cover the thorax and abdomen, leaving the extremities unprotected. It should be insisted on by medical men that the arms and legs require to be protected from sudden transitions of temperature as well as the trunk.

In fashionable life the greatest practical difficulty we have to encounter is the question of exposing the necks and shoulders of ladies in evening dress. It is useless to order body-clothing of wool to the throat, and to expect that ladies will give up a fashion which has been followed and thought charming in all countries and all ages. The difficulty is, however, to be got over pretty well. Every lady in evening dress should carry with her, as invariably as she does her pocket handkerchief, a Shetland shawl, or a mantilla of wool or fur, of a size and shape to cover all those parts not protected by woollen underclothing, and it should only be removed while actually within warm rooms, and should be kept at hand to be replaced on passing through passages, or if the rooms become cold, or if sitting in draughts.

The main source of protection, then, against sud den changes of temperature to the surface of the body, is to be found in a complete covering of wool next the skin. But besides this, much greater attention than is common should be paid to putting on and taking off complete and efficient over-clothing when going from hot to cold and from cold to hot temperatures. This is particularly neglected by the working classes, and by girls and boys at school.

What I have said with regard to sudden changes of temperature will apply equally to two other causes of fresh colds on our list, viz., draughts of cold air and cold winds. Both are to be deprived of their sting by proper clothing of the skin and mucous orifices.

Getting wet, and wet feet, occupy a very serious place in our list, and there is no doubt that damp and cold, applied to the general surface, is a most efficient means of producing chill and vital depression, with congestion of the internal organs.

Even if all the clothes on the body are wet, no harm will come as long as they are kept warm; and this suggests the very great value, to all persons liable to exposure to wet, of light waterproof over-alls. They may either be put on to keep the underclothing dry, or, if the underclothing has become wet, either by weather or by perspiration, they may le put on to prevent too rapid evaporation, and consequent reduction of temperature, especially when the person is about to remain still after getting warm with exercise. In this variable climate, therefore, school girls, governesses, shop and factory girls, and all women whose occupations call upon them to brave the weather, ought to carry with them complete waterproof mantles, made as light as possible, but extending from the neck to the ankles, which can be put on or not as required; and boys and men similarly exposed should carry waterproof over-alls.

But if wet and cold to the surface of the body is a fruitful source of catarrh, "wet feet" - which means wet and cold feet - is a still more prolific source. There is no external influence which so surely produces congestion of the naso-pulmonary mucous membrane as wet and cold to the soles of the feet. There is nothing so universally neglected, and yet there is nothing more easy to avoid. Warm socks, horsehair soles, goloshes, provide efficient protection against wet and cold feet. It does not seem to be half understood that, although a shoe or a boot may not be wet through, if the sole is damp it will, by conduction and evaporation, most effectually carry away the heat from the sole of the foot, and, therefore, it ought never to be worn after exercise is over.

We have still one item left on our list - viz., Fogs and Damp air, which were the things most inclined to make the breath short in 24 per cent, of the cases, and the most potent causes of fresh colds in 19 per cent. I have particularly remarked, that although the smoke and other irritating matters constituting fog are unquestionably very injurious, it is the moisture and cold of the fog which are the qualities most potent for mischief to the naso-pulmonary tract. There is but one means of depriving a fog or mist of its injurious properties, and that is a respirator; and the same may be said of the changes of temperature of which I spoke just now; a respirator is the only means of protecting the respiratory passages from the effects of transitions of temperature in the respired air.

Although it is quite proper to cover the neck and throat lightly, I am decidedly of opinion that hot wrappers round the neck are objectionable; they produce congestion of the nasal and faucial mucous membrane and thus dispose to the very complaints they are supposed to prevent. (See the Author's "Lectures on Winter Cough, Catarrh, Bronchitis, Emphysema, Asthma," delivered at the Royal Hospital for Diseases of the Chest; 3rd edit. Churchill.)

I am glad to find the use of respirators, which I have so long advocated, well demonstrated in one of Professor Tyndall's beautiful lectures. (See Appendix.)