Nightingale’s book contributed to a broad change in thinking about the relationship between respiration and disease. From roughly the time she wrote until the development of effective drug treatments for tuberculosis—beginning with the discovery of streptomycin, an antibiotic, in the nineteen-forties—open-air sleeping was one of the most frequently recommended therapies for pulmonary ailments of all kinds. (More radical interventions for tuberculosis included removing ribs, surgically collapsing diseased lungs, and severing the nerve that controlled the diaphragm.) Some sufferers believed that breathing cold air would cure them or relieve their symptoms, and they spent winter days wrapped in blankets on lounge chairs on porches at facilities like the Adirondack Cottage Sanitarium, in Saranac Lake, New York, which was founded, in 1884, by a great-grandfather of the cartoonist Garry Trudeau. Others sought relief by breathing hot, dry air; Scottsdale, Arizona, was known for years as White City, because of the many canvas tents pitched there by “lungers.”
In time, breathing itself came to be viewed as therapeutic. An article in Country Life in America from 1909 began:
“Sleep outdoors and be well.” This is the battle cry of an army of people who have “appeared in our midst” in little more than a year. They are twentieth-century crusaders whose Peter the Hermit is “oxygen.”
Foxcroft, a girls’ school in Middleburg, Virginia, which was founded in 1914, required boarders to sleep not in dormitory bedrooms but on open-air porches. People in the South had been sleeping on porches during hot weather for years, but Foxcroft students slept on theirs in cold weather, too, and they still do. “Sleeping porches are a distinctive part of our School culture and are instrumental in our mission to nurture healthy minds and healthy bodies,” the school’s Web site says today. Ann and I have a friend who graduated from Foxcroft in the seventies. She told me, “In the winter, we would dress up in our Lanz nighties and wool caps and heavy-duty socks and sweat pants, and cover ourselves with fourteen layers of blankets, but I loved it and, to this day, I keep a window open in our bedroom even when it’s freezing.”