<?%^:-^'/^/!^ 
 
THE LIBRARY 
 
 OF 
 
 THE UNIVERSITY 
 
 OF CALIFORNIA 
 
 PRESENTED BY 
 
 PROF. CHARLES A. KOFOID AND 
 
 MRS. PRUDENCE W. KOFOID 
 
INFLUENCE OF CLIMATE. 
 
^^ ^-^^. 
 
 44 /^^^>^^^^^^^^5^ //^^y^ 
 
 //iyiJ^ 
 
 THE 
 
 SANATIVE INFLUENCE 
 
 OF 
 
 CLIMATE. 
 
 By Sir JAMES CLARK, Bart., M.D., F.R.S., 
 
 .PHYSICIAN IN OUDINARY TO THB QUEEN AND TO THE PBINCE ALBERT. 
 
 dTotivtl^ ^tJition. 
 
 LONDON: 
 
 JOHN MURRAY, ALBEMARLE STREET; 
 JOHN CHURCHILL, PRINCES STREET, SOHO. 
 
 1846. 
 
London :— Printed by W. Clowes and Sons, Stamford Street. 
 

 T^v 
 
 TO 
 
 JOHN FOEBES, M.D., F.E.S., 
 
 PHYSICIAN IN ORDINARY TO THE QUEEN's HOUSEHOLD, AND PHYSICIAN 
 EXTRAORDINARY TO THE PRINCE ALBERT. 
 
 My Dear Forbes, 
 
 The motives which induced me to dedicate to 
 you the former editions of this work operate with in- 
 creased force on the present occasion. Your labours 
 for the advancement of Medical science and literature 
 have been productive of great and acknowledged 
 benefit to the profession ; and the progress of time has 
 impressed me still more deeply with the value of a 
 friendship which, dating from our early youth, will, I 
 trust, continue a mutual blessing to the close of life. 
 
 That you may long be spared to prosecute your 
 useful labours, and to enjoy, in an honourable repu- 
 tation, the just reward of talents, industry, and integrity 
 of character, is the sincere wish of. 
 
 My Dear Forbes, 
 
 Your attached and faithful Friend, 
 
 JAMES CLARK. 
 
 London f May 2nd, 1846. 
 
 7 
 
Digitized by tine Internet Archive 
 
 in 2007 with funding from 
 
 IVIicrosoft Corporation 
 
 http://www.archive.org/details/climatesanativeOclarrich 
 
PREFACE, 
 
 In the successive editions of this work, I gave 
 such additional information as I had been able 
 to collect from authentic sources in the intervals 
 of publication. 
 
 The present edition will, I trust, be found in 
 all respects a material improvement on its pre- 
 decessors. Every article in the work has been 
 carefully revised ; and although I have seen no 
 reason to change my opinions on the characters 
 of the different climates treated of, the infor- 
 mation I have continued to receive from others, 
 added to my own increasing experience, has 
 enabled me with more confidence and precision 
 to lay down rules respecting the adaptation of 
 certain climates to the cure of particular dis- 
 eases. 
 
 Among the numerous friends whose residence 
 abroad has enabled them to supply me with 
 valuable information, I would here particularly 
 mention Dr. Combe, who passed two winters in 
 
VIU PREFACE. 
 
 Madeira ; Dr. Playfair, who resided many years 
 in Florence ; and Dr. Eenton, whose long resi- 
 dence in Madeira has enabled me to make the 
 article on the climate of that island one of the 
 most complete in the work. 
 
 Bournemouth has been added to the climates 
 of the South Coast. A short notice of the 
 climate of Egypt has also been given in the 
 present edition. The peculiar character of 
 that climate, and the facility with which Egypt 
 may now be reached, led me to think that 
 some notice of its winter climate would be 
 useful to many invalids, including some of 
 those returning from India to this country for 
 the benefit of their health. 
 
 In the article on the subject of Artificial 
 Climate, will be found some remarks on Ven- 
 tilation, to which I beg to call particular atten- 
 tion. The immense importance of pure air in 
 the preservation and improvement of health, is 
 only just beginning to be fully appreciated; 
 yet if there is one circumstance in relation 
 to the health of children, especially delicate 
 children, which demands more attention than 
 another, it is that of securing to them a constant 
 supply of pure air by night as well as by day. 
 
PREFACE. IX 
 
 Unfortunately, like every important improve- 
 ment or discovery in science, Ventilation has 
 to force its way through the obstacles which 
 ignorance and prejudice have almost always 
 opposed to the progress of science. 
 
 The work is divided into two parts. In the 
 First Part I have given some account of the 
 principal Diseases which are benefited by a mild 
 climate. This I found to be unavoidable; as 
 otherwise it would have been impossible to give 
 precise directions for the application of par- 
 ticular climates to the cure of particular dis- 
 eases ; and much more so to their varieties and 
 complications. 
 
 In my endeavours to distinguish the charac- 
 ters of some of these diseases in relation to the 
 effects of climate upon them, it may appear to 
 some that I have been unnecessarily minute: 
 but I have made such distinctions only as my 
 experience warranted ; and I feel satisfied that 
 without strict attention to these distinctions, 
 climate can never be successfully applied as a 
 remedial agent. 
 
 In treating of Consumption and Disorders of 
 the Digestive Organs, I have gone more into 
 detail than the nature of the work may at first 
 
 a 3 
 
PREFACE. 
 
 sight seem to require ; but the extreme fre- 
 quency of these diseases, and their close relation 
 to climate considered as a remedial agent, ap- 
 peared to me to deserve all the consideration 
 which I was able to bestow upon them. 
 
 Disorders of the Digestive Organs, from 
 their intimate connection with the origin of 
 consumption and tuberculous diseases generally, 
 claimed particular notice ; but they are on 
 other grounds no less entitled to attention, 
 seeing the amount of direct suffering and evil 
 which they produce, and the great advantages 
 to be derived, in the treatment of them, from 
 change of air and climate. 
 
 In my remarks on the nature of Consumption, 
 I have confined myself chiefly to a description 
 of the constitutional disorder which precedes 
 and is the essential cause of the pulmonary dis- 
 ease, and to the exposition of the causes which 
 give rise to that primary affection. It is only 
 by directing our attention to the sources and 
 early indications of the constitutional disease, 
 that we shall succeed in diminishing the pre- 
 valence of pulmonary consumption. 
 
 I feel satisfied that by adopting a judicious 
 system of hygiene from early infancy, a great 
 
PREFACE. XI 
 
 improvement may be effected in the health of 
 the higher and middle classes of society in this 
 country, and that a considerable proportion of the 
 children of delicate, and even of diseased parents, 
 may, by proper care, be reared so as to over- 
 come the hereditary disposition to disease. 
 The ultimate effect of this in diminishing the 
 vast and it is to be feared increasing preva- 
 lence of hereditary diseases, need not be pointed 
 out. 
 
 In the Second Part I have endeavoured to 
 determine the general physical characters of the 
 milder Climates of England and the South of 
 Europe ; to point out the manner in which 
 these climates are modified by local circum- 
 stances; and to compare them relatively to 
 their influence on disease. 
 
 Forming an Introduction to this Part, will 
 be found instructions respecting the necessary 
 preparation of invalids for a change of climate, 
 for their guidance on the journey, and while 
 residing abroad. During my residence on the 
 Continent I found these matters greatly neg- 
 lected. They are, however, of the very first 
 consequence to invalids, as without attention to 
 
Xll PREFACE. 
 
 them the best climate will be productive of 
 little benefit. 
 
 In the Appendix will be found a brief 
 account of the Climates of our Colonies in the 
 Southern Hemisphere ; a few practical remarks 
 on the application of some of the most efficient 
 Mineral Waters of the Continent to the alle- 
 viation and cure of the principal-diseases treated 
 of in this volume ; and a comprehensive series 
 of Meteorological Tables, with explanatory 
 notes. 
 
 For the greatly improved state of these 
 Tables in the present edition, I am indebted to 
 my friend Dr. Martin of Yentnor, who has, 
 with much labour and great care, re-calculated 
 a large portion of them : this had become neces- 
 sary from the accumulation of new and generally 
 more accurate observations. Some important 
 places have been introduced, and others of less 
 consequence omitted ; several of the Tables of 
 Temperature have been re-modelled, with the 
 view of rendering them more easy of reference ; 
 and a new Table, showing the mean height of 
 the barometer, has been added. 
 
 But with all the improvements which I have 
 been able to effect in it, the work is still to be 
 
PREFACE. Xlll 
 
 regarded only as an essay which future and 
 much more extended observations will be re- 
 quired to perfect. In its present state it will, 
 I hope, be found, what it has been my desire to 
 make it, a manual for the physician in selecting 
 a proper climate for his patient, and a guide to 
 the latter when no longer under the direction 
 of his medical adviser. 
 
 London, May 2, 1846. 
 
CONTENTS. 
 
 INTRODUCTION. 
 Infliience of Climate and Travelling on Disease. 
 
 PART I. 
 ON DISEASES. 
 
 Paob 
 
 DISORDERS OF THE DIGESTIVE ORGANS - 13 
 
 Gastritic Dyspepsia - - - - ib. 
 
 Atonic Dyspepsia - - - - 15 
 
 Nervous Dyspepsia - - - - 17 
 
 The more recent and simple cases of Dyspepsia- 24 
 
 The more protracted and complicated cases of 
 
 Dyspepsia - - - - 30 
 
 PULMONARY CONSUMPTION - - - 41 
 
 Tuberculous Cachexy - - - - ib. 
 
 Causes of Tuberculous Cachexy - - 45 
 
 Hereditary Origin - - - - 46 
 
 Exciting Causes - - - - 47 
 
 Change of Climate in Consumptive Diseases - 48 
 
 Choice of Climate - - - - 53 
 
 Artificial Climate - - - - 65 
 
 Respirator - - - - - 69 
 
 Ventilation - - - - - 70 
 
 Unhealthy Residences - - - - 76 
 
XVI CONTENTS. 
 
 Paok 
 
 DISEASES OF THE LARYNX, TRACHEA, AND 
 
 BRONCHI - - - - 80 
 
 ASTHMA - - - - - 86 
 
 Pure Nervous Asthma - - - - 87 
 
 Humid Asthma - _ . _ fj. 
 
 Cardiac Asthbia - - - - 88 
 
 GOUT - - - - - - i6. 
 
 CHRONIC RHEUMATISM - - - - 89 
 
 DELICACY IN CHILDHOOD AND YOUTH - - 91 
 
 Dyspepsia in Children - - - 93 
 
 CLIMACTERIC DISEASE - - - - lOl 
 
 DISORPERED health from VARIOUS CAUSES - 103 
 
 From a Residence in Hot Climates - - ib. 
 
 Convalescence, &c. - - . . 105 
 
 PART II. 
 
 ON climates. 
 
 introductory remarks - - - 109 
 
 Directions for Invalids going abroad - - ib. 
 
 CLIMATES OF ENGLAND - - - 119 
 
 London - - - - - ib. 
 
 TheSouthCoast - - -122 
 
 Hastings - - - - - 124 
 
 St. Leonard's - _ . > 127 
 
 Brighton - - - - - 129 
 
 Isle of Wight — Undercliff - - - 131 
 
 Bournemouth - - - - 142 
 
 South-west Coast - - - 145 
 
 Salcombe ----- 148 
 
 Torquay ----- 149 
 
 Dawlish - - - - - 151 
 
 EXMOUTH, SaLTEBTON - - - 152 
 
 SiDMOUTH - - - - - 153 
 
 Influence of the South-west Climate on Disease 1 54 
 
 Cornwall - . _ _ 159 
 
 Penzance - - - - - ib. 
 
CONTENTS. XVn 
 
 Paoe 
 
 West of England - - - - 167 
 
 Clifton - - - - - 168 
 
 Bristol Hot Wells - - - - 173 
 
 Island of Bute - . - . 175 
 
 Cove OF Cork - - - - 177 
 
 Winter Climates of England - 180 
 
 Summer Residences IN England - - 187 
 
 ChannelIslands - - - 188 
 
 Jersey - - - - - ib. 
 
 CLIMATES OF FRANCE - - - -193 
 
 South-West - - - - ib. 
 
 Pau - - - - - 194 
 
 South-East - - - .- 200 
 
 montpelier _ - . . 203 
 
 Marseilles - - . . 205 
 
 Hyeres _ - - - . 206 
 
 CLIMATE OF NICE - - - - 208 
 
 Villa Franca - - - - 218 
 
 Menton, San Remo - - - - 219 
 
 CLIMATES OF ITALY - - - - 221 
 
 Genoa ----- 222 
 
 Florence ----- 223 
 
 Pisa - - . . - 226 
 
 Rome ----- 228 
 
 Naples ----- 242 
 
 SUMMER RESIDENCE ON THE CONTINENT - 245 
 
 EnvironsofNaples: — - - - 247 
 
 Capo di Monte - - - - (b. 
 
 Sorento - - - - - ib. 
 
 Castelamare - - - - j5. 
 
 ISCHIA - - - - - ib. 
 
 Sienna - - - - - 248 
 
 Baths OF Lucca - - - - ib. 
 
 Switzerland - - - - 250 
 
 CLIMATE OF MALTA - - - - 253 
 
^Vll* CONTENTS. 
 
 Paob 
 
 CLIMATE OF EGYPT - - - -262 
 
 ATLANTIC CLIMATES - - - 271 
 
 Eastern Atlantic - . - 272 
 
 Madeira - - - - - t6. 
 
 Canaries ----- 294 
 
 Azores ----- 297 
 
 Western Atlantic - - - 304 
 
 Bermudas - - - - - ih. 
 
 Bahamas - - - . _ 308 
 
 West Indies - - - . 312 
 
 Jamaica - - - - - 328 
 
 Barbadoes ----- 330 
 
 St.- Vincent - - - - _ 332 
 
 Antigua - - - - . ih. 
 
 St. Kitt's ----- 333 
 
 Nevis - - - - - 334 
 
 APPENDIX. 
 
 CLIMATES OF THE SOUTHERN HEMISPHERE - 341 
 
 CapeofGoodHope - - . 342 
 
 Cape Town - - - - - ih. 
 
 Eastern Province - - . - 344 
 
 Australia - - . - 345 
 
 New South Wales - - - . n^ 
 
 South Australia - - _ . 343 
 
 Swan River - - - . 349 
 
 Van Diemen's Land - - . 350 
 
 NewZealand - - - . 355 
 
 MINERAL WATERS - - - .363 
 
 In Disorders of the Digestive Organs - - 364 
 
 Bronchial Diseases - - - 367 
 
 Asthma - - - - - 368 
 
 Gout - - . _ _ 359 
 
 Rheumatism - - - - - 370 
 
 Factitious Mineral Waters - - 371 
 
CONTENTS. ^ 
 
 METEOROLOGICAL TABLES. 
 L Mean temperature for the whole year, for each 
 
 SEASON, AND FOR EACH MONTH. 
 
 IL Difference of the mean temperature of each 
 
 SEASON AND OF EACH MONTH. 
 
 in. Mean daily range of temperature for the whole 
 
 YEAR, FOR EACH SEASON, AND FOR EACH MONTH. 
 
 IV. Mean successive daily range of temperature 
 
 FOR the WHOLE YEAR, FOR EACH SEASON, AND FOR 
 EACH MONTH. 
 
 V. Mean extreme range of temperature for the 
 
 WHOLE year, for EACH SEASON, AND FOR EACH MONTH. 
 
 VI. Mean height of barometer for the whole year, 
 
 FOR EACH SEASON, AND FOR EACH MONTH. 
 
 VII. Range of barometer for the whole year, for 
 
 EACH SEASON, AND FOR EACH MONTH. 
 
 VIII. Mean quantities of rain, in inches and parts of 
 
 INCHES, FOR THE WHOLE YEAR, FOR EACH SEASON, 
 AND FOR EACH MONTH. 
 
 IX. Average number of days on which rain falls 
 in the whole year, in each season, and in each 
 
 MONTH. 
 
 X. Meteorological table for Bute, from 1821 to 
 1839 inclusive, deduced from registers of 
 observations made (hourly for twelve of the 
 nineteen years) at iiothsay cotton-mills, 
 
 AND AT ASCOG, BY RoBERT ThOM, EsQ. 
 
 XI. Account of the temperature experienced by an 
 
 INVALID confined TO THE HOUSE AT NiCE AND 
 
 Torquay, compared with the temperature of 
 the external air. 
 
 Notes on the Meteorological Tables. 
 
THE 
 
 INFLUENCE OF CLIMATE, 
 
 INTRODUCTION. 
 
 The influence of climate over disease has been long 
 established as a matter of fact, and physicians have 
 from a very early period considered change of 
 climate and change of air as remedial agents of great 
 efficacy. This opinion is supported both by reason 
 and experience : — it is reasonable, for example, to 
 believe that a change of residence from a crowded 
 city to the open country, or from a cold exposed 
 part of the country to a warmer and more sheltered 
 situation — from a humid and confined valley to a dry 
 and elevated district, or the reverse — should produce 
 very sensible eifects on the living body ; and we find by 
 daily experience that such is the case. The marked 
 improvement in the health, produced by a change from 
 the city to the country, even for a short period, and 
 the great amelioration, and even cure, of various 
 diseases effected by a removal from one part of the 
 
 B 
 
2 INTRODUCTION. 
 
 country to another, are matters of daily remark. It may 
 suffice to mention, in reference to this fact, intermittent 
 fevers, asthma, catarrhal affections, hooping-cough, 
 dyspepsia, and various nervous disorders. These 
 diseases are often benefited, and not unfrequently 
 cured, after having long resisted medical treatment, 
 by simple change of situation ; or they are found to 
 yield, under the influence of this, to remedies which 
 previously made little or no impression upon them. 
 
 If such marked effects result from a change of so 
 limited a nature as has just been noticed, it might be 
 expected that a complete change of climate, together 
 with the circumstances necessarily connected with it, 
 should produce still more important results in the 
 improvement of health and the alleviation and cure of 
 disease. In this expectation also we are borne out 
 by experience. 
 
 Unfortunately for the character of Climate as a 
 remedy, it has too often been resorted to as a last 
 resource, and not unfrequently been misapplied in 
 cases wherein it would otherwise have been capable 
 of yielding essential service. Patients who might 
 derive much benefit from climate are often sent 
 abroad without proper directions regarding the situa- 
 tion most suited to their complaints, and altogether 
 uninstructed respecting various circumstances, a due 
 attention to which is necessary to give full effect to 
 the best-selected climate. 
 ^ It need not, therefore, excite surprise that success 
 
INTRODUCTION. 
 
 has not more generally attended the practice of 
 sending invalids abroad; nor even, that the result 
 should have been such as to bring the remedy into 
 unmerited discredit. The fault, however, is to be 
 sought for, not in the remedy, but in the manner in 
 which it has been applied. My own experience has 
 been amply sufficient to satisfy me, that, for the pre- 
 vention and cure of a large class of diseases, we 
 possess in climate, and even in the more limited mea- 
 sure of change of air in the same climate, an efficient 
 remedial agent ; and one for which, in many cases, 
 we have no adequate substitute. 
 
 On the Continent, the beneficial efifects of change 
 of air are duly estimated ; and the inhabitants of this 
 country, and more especially of this metropolis, are 
 now becoming fully sensible of its value. The daily 
 increasing size of our watering-places, and the de- 
 serted state of a great part of London during several 
 months, are sufficient proofs, not to mention others, of 
 the growing conviction that, for the preservation of 
 health, it is necessary to change, from time to time, the 
 relaxing, I may say deteriorating, atmosphere of a 
 large city for the more pure and invigorating air of 
 the country. When the extent of benefit to be derived 
 from this measure is fully estimated, no person whose 
 circumstances permit will neglect to avail himself 
 of it. It is, indeed, the best, if not the only cure, for 
 that destructive malady which may be justly termed 
 Cachexia LondinensiSj which preys upon the vitals, 
 
 b2 
 
4 INTEODUCTION. > 
 
 and stamps its hues upon the countenance of almost 
 every permanent resident in this great city. 
 
 But to be beneficial, the remedy, simple as it ap- 
 pears, must be directed with judgment and discrimi- 
 nation. For that numerous class of persons suffering 
 merely from a residence in the city, without any 
 decided disease, the mere change to the country may 
 be all that is requisite to restore their health ; it is 
 therefore of less consequence to what part they go. 
 But the case is very different with the invalid whose 
 sufferings are chiefly referable to some particular 
 disease. To him, the selection of his temporary 
 residence is not a matter of indifference. An 
 elevated situation, and a dry, bracing air, are proper 
 in one case ; a sheltered residence, with a milder air, 
 will be suitable to another : the sea-side may be the 
 situation indicated for a third; whilst a judicious suc- 
 cession of changes will often be preferable to a 
 residence in the best-chosen situation. In like 
 manner it is with the more important measure of 
 change of climate. The valetudinarian whose health 
 is deteriorated by severe study, or too close applica- 
 tion to business, and to whom relaxation of mind is as 
 requisite as change of climate, may generally be 
 permitted to choose the situation most agreeable to 
 himself. But the great difference which exists in the 
 physical characters of the climate of the places 
 frequented by invalids in the South of Europe, and 
 even in the southern parts of our own island, renders 
 
INTEODUCTION. 5 
 
 the selection of a winter residence a matter of vital 
 importance to the invalid suffering under formal 
 disease. 
 
 This subject has not hitherto received the attention 
 which it merits. The neglect of it I believe has 
 arisen in a great measure from the opinion which has 
 generally prevailed in this country, that the beneficial 
 effects of climate are evinced in consumptive diseases 
 chiefly. Such an opinion could have originated only 
 in a very limited acquaintance with the influence of 
 climate on disease. In dyspepsia, and disorders of 
 the digestive organs generally, with the nervous affec- 
 tions and distressing mental feelings which so often 
 accompany these ; in asthma, in bronchial diseases, 
 in scrofula, and in chronic rheumatism, the beneficial 
 efiects of climate are far more strongly evinced than 
 they are in consumption. In delicacy of constitution 
 and derangement of the system, more especially in 
 childhood and in youth, and which cannot be strictly 
 classed under any formal disease ; and also in that dis- 
 ordered state of health which occurs at a more ad- 
 vanced period of life, in which the powers of the 
 constitution, both mental and bodily, fail, and the 
 system lapses into a state of premature decay, climate 
 is a valuable remedial agent. 
 
 The undue confidence in the powers of climate as 
 a remedy in consumption, which has so long prevailed 
 in this country, is now in some danger of giving place 
 to the opposite and equally erroneous extreme of total 
 
INTEODrCTIOX. 
 
 distrust. This is chiefly in consequence of the 
 Statistical Eeports on the health of our troops, which 
 show that there is no immunity from this disease in 
 any climate ; nay, that it is unusually prevalent in 
 some of those places to which consumptive invalids 
 have been sent.* 
 
 It is to be remarked, however, that, when an inva- 
 lid is sent abroad for his health, he goes, by the 
 direction of his physician, to the climate best suited to 
 his particular case, and at the most favourable season 
 of the year. Moreover, he goes prepared to avail 
 himself of all the advantages of his new situation, and 
 to avoid, as far as possible, its disadvantages. Hence, 
 the influence of any climate upon such an invalid 
 must be estimated very differently from the influence 
 of the same climate on the permanent inhabitants, or 
 on our troops who are resident in it at all seasons. 
 
 * These reports, so admirably drawn up by Mr. Marshall, 
 Deputy Inspector-General of Hospitals, Colonel Tulloch, and 
 Dr. Balfour, are invaluable, and do infinite credit to the judg- 
 ment and discrimination of Lord Howick (who, whilst Secre- 
 tary at War, first duly appreciated their importance to me- 
 dical science), and to Sir James M'Grigor, who, with the able 
 assistance of the late Dr. Theodore Gordon, planned the annual 
 reports and topographical statements on which the Statistical Re- 
 ports are founded. These annual reports, which are highly 
 creditable to the medical officers of the army, wore first projected 
 by Sir James M'Grigor, on being placed at the head of the 
 Army Medical Department in 1815, and have been kept up on 
 an uniform plan since 1816, 
 
INTRODUCTIOX. 
 
 and are exposed to all its prejudicial influences for 
 years, as well as to many other causes calculated to 
 injure health.* 
 
 The great lesson which the Army Medical Reports 
 teach, in regard to consumption, is this : that, as it is 
 a prevalent and fatal disease in all climates, and among 
 all nations, our attention should be chiefly directed, 
 not to a state of disease which is incurable by climate 
 or any other means, but to the prevention and cure 
 of the disordered state of health which constitutes 
 the essential element of consumption. It cannot be 
 
 * Dr. Davy, in his recent work on * The Ionian Islands and 
 Malta,' gives some statements in reference to this subject which 
 are strikingly illustrative of these remarks. Our troops in Malta 
 he found subject to tubercles and tuberculous phthisis, while the 
 natives were comparatively exempt, and the English residents he 
 believed equally so, as during the whole period of his residence 
 in the island (eight years) he recollected only a single individual 
 who fell a victim to phthisis. The prevalence of the disease ex- 
 clusively among the troops Dr. Davy attributes to irregularities 
 of living and to the frequent vicissitudes of temperature to which 
 they are exposed on sentinel duty and in hot barracks and guard- 
 rooms, — the same causes which, in all probability, render con- 
 sumption so much more prevalent among the foot-guards stationed 
 in London than in any other corps of the army. — Notes and Ob- 
 servations on the Ionian Islands and Malta ; with some Remarks 
 on Constantinople and Turkey, and on the System of Quarantine 
 as at present conducted, by John Davy, M.D., F.R.SS. L. & E., 
 Inspector-General of Army-Hospitals, in 2 vols., Smith, 
 Elder and Co., 1842; a work containing much and various in- 
 teresting and scientific information on the Climate, &c., of the 
 Mediterranean. 
 
INTRODUCTION. 
 
 too strongly impressed upon the public, that until 
 pulmonary consumption is regarded as a secondary 
 disease, originating in, and consequent upon, a mor- 
 bid state of the system — often hereditary, but still 
 more frequently generated by an unheaUhy mode of 
 living — we shall make little progress in diminishing 
 the rate of its mortality. 
 
 I have thought it right to make these remarks, to 
 show that I have not overlooked the result of the 
 observations of the Army medical officers. These 
 reports contain much valuable matter on the geo- 
 graphy of disease, and on the causes of sickness and 
 mortality among our troops in different climates; 
 and there can be no doubt they will lead to the 
 adoption of measures for preserving and improving 
 the health of the Army. But as regards the influ- 
 ence of climate in the prevention and even cure of 
 disease, the information contained in these Reports 
 does not diminish our hopes of benefit from that 
 remedy, when the climate suited to the individual 
 case is selected, and all other necessary precautions 
 to secure its beneficial eft'ects are adopted. When 
 the remedy is judiciously employed in the constitu- 
 tional disorder which precedes consumption, there 
 will no longer remain any doubt of its beneficial 
 influence ; and what a single change of climate fails 
 to effect, a succession of such changes will often be 
 found to accomplish. 
 
INTPtODUCTIOX. 
 
 Travelling. — The mere act of travelling over a 
 considerable extent of country is itself a remedy of 
 great value, and, when judiciously conducted, will 
 materially assist the beneficial action of climate. A 
 journey may indeed be regarded as a continuous 
 change of climate, as well as of scene ; and consti- 
 tutes a remedy of unequalled power in some of those 
 morbid states of the system in which the mind suffers 
 as well as the body. In chronic irritation and 
 passive congestion of the mucous surfaces of the 
 pulmonary and digestive organs, especially w^hen 
 complicated with a morbidly sensitive state of the 
 nervous system, travelling will often effect more than 
 any other remedy. 
 
 But neither travelling nor climate, nor their com- 
 bined influence, will produce much permanent be- 
 nefit, unless aided by proper regimen, and directed 
 with due regard to the constitution of the patient and 
 the nature of his disease. And here I would com- 
 ment upon the error of expecting too much from the 
 mere change of climate. The air, or climate, is 
 often regarded by the patient as possessing some 
 specific quality, by virtue of which it directly cures 
 his disease. This erroneous view of the matter not 
 unfrequently proves the bane of the invalid, by 
 leading him, in the fulness of his confidence in cli- 
 mate, to neglect other circumstances as essential to 
 his recovery as that on which all his hopes are 
 fixed. 
 
 b3 
 
10 INTRODUCTION. 
 
 A residence in a mild climate will, no doubt, often 
 do much. Among other advantages, for example, it 
 will enable the invalid to be much in the open air 
 during a part of the year when, were he in this 
 country, he would be either confined to the house, or 
 exposed to an atmosphere more likely to increase 
 than mitigate his complaints. The exercise enjoyed 
 in a temperate atmosphere, while it gives tone to the 
 nervous system, improves the general health, and 
 relieves the affected organs, by promoting and main- 
 taining a more free and equable circulation in the 
 surface and extremities; and the constitution, thus 
 invigorated, may be enabled to overcome a disease 
 under which it would have sunk in less favourable 
 circumstances. The new scenes and the objects of 
 interest with which the South of Europe, more 
 especially Italy, abounds, exert a direct and bene- 
 ficial influence also on the mind ; and this influence 
 will in many cases be greatly assisted, in an indirect 
 manner, by the necessary abstraction of the invalid 
 from many causes of care and anxiety, — in other 
 words, from many sources of disease, to which he 
 would have been exposed at home. 
 
 These are some of the more obvious advantages 
 which the invalid may expect to derive from a resi- 
 dence in a foreign climate ; and they are assuredly 
 great : but if he would reap the full measure of good 
 which his new position places within his reach, he 
 must trust more to himself and to his own conduct. 
 
INTRODUCTION. 11 
 
 than to the simple influence of any climate, however 
 genial; he must adhere strictly to such a mode of 
 living as his disorder requires ; he must avail himself 
 of all the advantages which the climate affords, and 
 eschew those evils from which no climate or situation 
 is exempt ; moreover, he must exercise both resolu- 
 tion and patience in prosecuting all this to a suc- 
 cessful issue. 
 
 In the body of the work I shall have occasion to show 
 how the various circumstances connected with change 
 of climate, operate in the renovation of constitutions 
 broken down by the long continuance of chronic 
 disease : at present I wish rather to impress the mind 
 of the invalid with the danger of trusting too much 
 to climate. Here, as in every other department of 
 the healing art, we must be guided by experience, 
 and must rest satisfied with the amount of power 
 which the remedy concedes to us. The charlatan 
 may boast of a specific for many or for all diseases ; 
 the man of science knows that there exists scarcely a 
 single remedy for any disease which can warrant 
 such a boast ; and that it is only by acting on and 
 through the numerous and complicated functions of 
 the living body, in various ways and by various 
 means, and by carefully adapting our treatment to 
 the circumstances of each individual case, that we 
 can remove or check the disorders of the animal sys- 
 tem, more especially those which have long existed. 
 Let it not then be imagined that change of climate. 
 
12 INTRODUCTION. 
 
 however powerful as a remedy, can be considered as 
 at all peculiar in its mode of action, or as justifying, 
 on the part either of the physician or the patient, the 
 neglect of those precautions which are requisite to 
 ensure the proper action of other remedies. Had I 
 not considered Climate a remedial agent of great 
 value, and deserving the utmost attention of medical 
 men, the present work would not have been under- 
 taken; but I feel that I should be at once com- 
 promising the dignity and honour of my profession, 
 and acting in direct opposition to the dictates of 
 experience, if I admitted for a moment, that it is one 
 possessing specific powers, or which may be indis- 
 criminately employed, without regard to the general 
 and fundamental principles of medical science. 
 
 The importance which I attach to these consider- 
 ations, and the conviction that they are not suffi- 
 ciently attended to in the application of Climate as a 
 remedial agent, induced me to reverse the order in 
 which I treated the subject in the first edition of this 
 work, and to give some account of the diseases be- 
 nefited by change of climate, before describing the 
 difi'erent climates themselves. 
 
PART I. 
 
 ON DISEASES. 
 
 DISORDERS OF THE DIGESTIVE ORGANS. 
 
 The prevalence of disorders of the digestive organs, 
 and the great influence which they exercise over the 
 other diseases treated of in this volume, claim for 
 them the first consideration. I shall limit myself 
 chiefly, however, to the description of those features 
 of dyspeptic disorder by which the selection of the 
 climate adapted to each of its forms should be regu- 
 lated. 
 
 The morbid states of the digestive organs may be 
 classed under three heads : — Inflammatory, or Gas- 
 TRiTic Dyspepsia ; Irritable, or Nervous Dys- 
 pepsia ; and Atonic Dyspepsia, or that form, of the 
 complaint which depends chiefly on atony, or loss of 
 tone. 
 
 Although there are symptoms common to these 
 different forms of Dyspepsia, there are others peculiar 
 to each, and by which they are characterized. 
 
 In the Gastritic, or inflammatory species, the 
 
14 DISORDERS OF THE 
 
 tongue is generally large, and redder than natural, 
 especially towards the apex, where it is beset with 
 small elevated points of a still brighter colour. It is 
 also, for the most part, furred towards the base. In 
 the morning, on first awaking, it is apt to be dry, 
 more particularly in cases where the irritation ex- 
 tends to the duodenum and liver. The gums are 
 red, swollen, and spongy, and bleed easily ; the mu- 
 cous membrane of the throat is red, often dry and 
 shining, and aphthous ulcers are apt to form on the 
 tongue and inner surface of the mouth. The appe- 
 tite is good, often craving. There is a disposition to 
 thirst ; and pressure over the stomach generally gives 
 uneasiness. The bowels are generally constipated ; 
 the urine high-coloured or turbid; the skin dry, and 
 sometimes affected with eruptions, and the extre- 
 mities, although occasionally cold, are often hot and 
 dry, and especially in the night; whilst perspira- 
 tions are not unfrequent towards morning. 
 
 The eyes are injected, and the eyelids red and 
 swollen. The pulse is contracted and quickened, 
 more especially after meals, and towards night, ex- 
 cept in languid constitutions, in which it remains 
 slow. There is frequently a disposition to sleep 
 during the day, and at night the sleep is uncertain ; 
 the early part being often passed in watchfulness, 
 whilst in the morning there is a heavy slumber, fol- 
 lowed on awaking by languor and weariness, in place 
 of the refreshment which succeeds to natural sleep. 
 
DIGESTIVE ORGANS. 15 
 
 Headache is not an uncommon symptom ; the pain is 
 generally seated in the forehead, and the sensation is 
 that of tightness and oppression rather than acute 
 pain. It is most common in the evening and during 
 digestion ; and that more certainly after an exciting 
 meal. The patient is apt to be irritable, querulous, 
 and despondent ; and there is little inclination to 
 mental exertion, or power in concentrating the mind 
 on any subject. The influence of an irritated 
 state of the digestive organs over the mental as well 
 as bodily powers, I may remark in passing, is far 
 greater than is generally believed. In childhood, the 
 irritability of temper with which it is accompanied is 
 very remarkable ; when the disorder is protracted, 
 it is also a frequent cause of dulness in children, ren- 
 dering them incapable of mental application. At a 
 later period of life, the disposition is often so tho- 
 roughly changed, the mind rendered so incapable of 
 exertion, and the memory so much impaired by long- 
 continued irritation of the digestive organs, that the 
 sufferer becomes unable to apply himself steadily 
 to anything, and is incapacitated for his usual avo- 
 cations, or even the ordinary intercourse of social 
 life. 
 
 Atonic Dyspepsia.— In Atonic Dyspepsia the 
 symptoms indicate a loss of tone in the digestive 
 organs. There is little or no appetite, often a loath- 
 ing of food, and even sometimes nausea. After 
 
10 BISOEDEKS OF THE 
 
 eating there is a sense of distension or of oppression 
 in the stomach, accompanied by a feeling of general 
 uneasiness or listlessness, and a disposition to chilli- 
 ness ; some time after the meal there are eructations, 
 heartburn, and other symptoms of laborious digestion. 
 The tongue is pale and flaccid, not much furred, and 
 seldom or never dry. There is not much thirst 
 except during digestion. The urine is pale and 
 abundant, and the bowels constipated. The pulse is 
 weaker and sometimes slower than natural. The 
 surface and extremities easily become cold; the 
 countenance is pale and the expression dull and 
 heavy ; there are inaptitude and inability for bodily 
 exertion, and a corresponding languor of mind. 
 
 These symptoms vary in intensity at different 
 times. In bright, dry weather, or under circum- 
 stances of pleasurable mental emotion, the appetite 
 is better and the digestion is performed without the 
 usual feeling of distress. On the other hand, in 
 damp, cloudy weather, or under feelings of mental 
 depression, all the symptoms are greatly aggravated 
 and others superadded. Epigastric pain, great dis- 
 tension, fetid eructations, vomiting, headache, vertigo, 
 faintness, cold clammy perspirations, and cramps, are 
 liable to supervene, if much food, or food of an 
 indigestible quality, has been eaten. In such a state 
 of stomach, faintness and syncope may occur after 
 a heavy or indigestible meal, more especially after 
 long fasting. 
 
DIGESTIVE ORGANS. 17 
 
 This form of dyspepsia occurs most frequently in 
 languid leucophlegmatic temperaments, and in cold 
 humid weather and situations ; and is aggravated by 
 a confined, relaxing atmosphere. 
 
 Nervous Dyspepsia. — In Nervous or Irritable 
 Dyspepsia, the tongue deviates little from the natural 
 state ; it is pale, and often covered with a thin white 
 fur ; in some cases it is swollen, and exhibits the 
 impressions of the teeth along its margins, especially 
 in the morning ; it is rarely dry, and there is little 
 thirst. The appetite is unsteady, sometimes craving, 
 and at other times quite wanting, especially for 
 breakfast. Flatulency is a prominent symptom. The 
 urine is pale and often very copious; the bowels, 
 though constipated in some cases, are more frequently 
 in an opposite state, and this is especially the case 
 when the nervous system is naturally sensitive. 
 
 The sleep is uncertain, easily interrupted, and 
 often unrefreshing. The pulse is small and quick, 
 but less steady in its character than in gastritic or in 
 atonic dyspepsia. The skin is cool and often damp 
 and clammy. Headache is a prominent and often 
 very distressing symptom in this form of dyspepsia. 
 The morning is the most frequent period of its 
 attack, being felt on awaking ; and at all times it is 
 more liable to occur when the stomach is empty than 
 during the process of digestion : hence long fasting 
 proves a frequent exciting cause; over-fatigue. 
 
18 DISOEDEES OF THE 
 
 articles of food which irritate the stomach, such as 
 sweet subacid substances, pastry, dry fruits, and 
 imperfectly masticated food ; strong mental impres- 
 sions, and the air of crowded rooms, are also frequent 
 exciting causes. The headache, when occurring 
 during the day, is sometimes sudden, but in the 
 severer attacks is generally preceded by a sense of 
 coldness and creeping on the surface, which may 
 amount to shivering. In some cases the attack is 
 preceded by numbness in the extremities, by dimness 
 of sight, or ocular spectra; in others, a peculiar 
 uneasy sensation, originating in one of the extre- 
 mities, ascends gradually to the head, resembling the 
 aura epileptica. Nausea or vomiting occasionally 
 occurs at this stage, and the pulse is mostly slower 
 than natural. In the commencement, there is a 
 sensation of uneasiness rather than of actual pain ; 
 but as the feeling of coldness diminishes, the true 
 headache becomes developed. The pain is then 
 intense and throbbing, aifecting one side in general 
 more than the other ; and in the cases in which it 
 has been of the most agonizing kind has been con- 
 fined to a small spot over one eyebrow or temple. 
 The upper and back part of the head is often the seat 
 of pain, and the latter place is particularly apt to be 
 so when the headache is partly dependent on uterine 
 irritation or congestion. The pain, wherever seated, 
 is greatly aggravated by mental excitement or bodily 
 exertion. This class of headaches is common, in 
 
DIGESTIVE ORGANS. 19 
 
 delicate nervous persons, particularly females, when 
 its immediate dependence on dyspepsia is often over- 
 looked, but very generally the connexion is discovered 
 upon minute inquiry into the circumstances of the 
 case. The temper is apt to be fretful, and the mind 
 anxious and desponding, particularly regarding the 
 health. 
 
 Independently of the particular symptoms belong- 
 ing to each form of dyspepsia, there are circumstances 
 in their general character which distinguish them. 
 The symptoms which accompany gastritic dyspepsia 
 are more fixed and permanent : they may be present 
 in a greater or less degree, according to circumstances, 
 but they are scarcely ever absent. In nervous dys- 
 pepsia, on the contrary, the symptoms vary in a 
 remarkable manner. The patient feels, at times, 
 almost entirely free from them, and the functions of 
 the digestive organs are performed with scarcely any 
 indication of derangement ; at other times all the 
 symptoms are greatly augmented, the patient being 
 unable to assign any cause for their disappearance in 
 the one case, or their increase in the other. Atonic 
 dyspepsia resembles more in its characters the ner- 
 vous dyspepsia with which it is often complicated. 
 Both forms are greatly influenced by mental emotions, 
 changes of the weather, and other causes which par- 
 ticularly aifect the nervous system. The symptoms 
 which characterize the gastritic form of the disease. 
 
20 DISORDEKS OF THE 
 
 are increased by stimulants of every kind taken into 
 the stomach, whereas the same means often afford 
 temporary relief in the other two forms. 
 
 In mixed cases, these distinguishing characters may 
 be observed more or less as the one or other form of 
 dyspepsia prevails. When the gastritic and nervous 
 dyspepsia exist together, we have both inflammatory 
 excitement and extreme morbid sensibility, — the one 
 or other state predominating at different times. This 
 form of the disease occurs chiefly in persons of a ner- 
 vous temperament, to whom the causes of gastritic 
 dyspepsia have been applied. In like manner, ner- 
 vous is often associated with atonic dyspepsia; — a 
 morbidly sensitive state of the stomach with loss of 
 tone, a condition the converse of inflammation. Yet, 
 in all these mixed cases, the distinctive characters 
 of the prevailing affection may generally be re- 
 cognised. 
 
 But in protracted cases the disorder is seldom 
 confined to the stomach ; it is gradually propagated 
 to other portions of the digestive tube, and the 
 secreting organs in connexion with it; more espe-' 
 cially to the duodenum and liver. In many cases, 
 indeed, the disease is chiefly seated in the duodenum, 
 constituting what has been denominated Duodenal 
 Dyspepsia, a very important form of dyspeptic com- 
 plaint, to which I shall have occasion to recur, when 
 noticing the Diseases of Children, under the head of 
 Sthumous or Scrofulous Dyspepsia, or that form 
 
DIGESTIVE ORGANS. 21 
 
 wliicli is most frequently observed in children of a 
 scrofulous constitution. 
 
 We also find that the morbid state of the digestive 
 organs extends its influence to other systems ; giving 
 rise to various affections of the skin, of the joints, and 
 of the nervous system. Among the last may be 
 mentioned, in addition to headaches, convulsive affec- 
 tions, tic douloureux, paralysis, amaurosis, deafness, 
 loss of smell, loss of voice, spasmodic cough, asthma, 
 palpitation, &c. 
 
 The nature of the secondary affection frequently 
 depends upon peculiarities of constitution ; but often, 
 also, upon accidental causes, disposing to particular 
 diseases during the existence of dyspepsia. The new 
 disease being ingrafted on the old, becomes as it were 
 dependent on it, and the former cannot be cured till 
 the latter is removed. The secondary disease being 
 established, the primary affection is often obscured or 
 mitigated for a time. Indeed, so remarkably is this 
 the case, that the primary disease is frequently over- 
 looked, both by the patient and his medical attendant, 
 amid the more prominent symptoms of the secondary 
 affection. This I found frequently the case in pa- 
 tients sent abroad labouring under chronic bronchial 
 and tracheal irritation, symptomatic of gastritic and 
 duodenal dyspepsia. 
 
 Among the remedial measures for these various 
 morbid conditions of the digestive organs, and the 
 sympathetic diseases which originate in them, change 
 
22 DISORDERS OF THE 
 
 of climate is one of the most efficient. And when 
 the patient cannot avail himself of a more complete 
 change of climate, he may derive much benefit from 
 a temporary residence in some of the milder situations 
 in our own island. 
 
 In recommending such a change, however, to the 
 dyspeptic invalid, the peculiar disorder of the sto- 
 mach must be attended to. The different forms of 
 the disease, noticed above, are benefited by different 
 climates. The patient with gastritic dyspepsia should 
 not, for example, go to Nice, nor the South-east of 
 France. In such cases, the South-west of France or 
 Devonshire is preferable, and Home and Pisa are 
 the best places in Italy. On the other hand, in atonic 
 dyspepsia, in which languor and sluggishness of the 
 system, as well as of the digestive organs, prevail, 
 with lowness of spirits and hypochondriasis, Nice is | 
 to be preferred to all the other places mentioned; 
 and Naples will generally agree better than Rome or 
 Pisa ; while the South-west of France and Devonshire, 
 and all similar climates, will be injurious. In the 
 nervous form of dyspepsia, a climate of a medium 
 character is the best, and the choice should be regu- | 
 lated according as there is a disposition to the gastritic 
 or the atonic form. 
 
 In the more complicated and protracted cases, still 
 more discrimination is required in selecting a climate 
 and residence; as we must take into consideration 
 not merely the character of the primary disorder, and 
 
DIGESTIVE OKGANS. 23 
 
 the state of mind with which it is associated, but the 
 nature of the secondary aiFection which may ah-eady 
 exist, or to which the patient may be predisposed. 
 In such cases, repeated changes of climate may be 
 necessary, and will generally prove more beneficial 
 than a long residence in one place. 
 
 But to insure the full advantages to be derived 
 from the best- selected climate, urgent symptoms 
 should be removed or alleviated before the patient 
 commences his journey ; and he should, moreover, 
 have the nature of his disorder, and the principles 
 upon which he should regulate himself while travel- 
 ling, and during his residence abroad, fully explained 
 to him. Indeed, the want of attention to these 
 things is one of the chief reasons why so many dys- 
 peptic invalids derive little permanent advantage from 
 their summer tour, or even from a more prolonged 
 residence abroad. In order to secure success from 
 change of air or climate, it is necessary that the pa- 
 tient should understand the conditions on which the 
 promise of advantage is made, and how they are to 
 be best and most perfectly fulfilled. Above all, it 
 should be impressed on his mind, that he is not to 
 expect too much from climate ; that he must sedu- 
 lously avoid the causes which brought on the disease, 
 and adhere with steadiness to such a general regimen 
 as is necessary for its removal. Aided by this moral 
 and medical discipline, a winter spent in a favourable 
 
24 DISORDEES OF THE 
 
 climate rarely fails to prove highly beneficial to the 
 dyspeptic invalid. 
 
 The extent to which change of air or climate re- 
 quires to be carried, for the removal of stomach com- 
 plaints, will depend on the circumstances of the case. 
 In many instances a few months, even a few weeks, 
 judiciously employed, will do much for the restoration 
 of the health ; in others, a much longer period will 
 be required. In treating, therefore, of the influence 
 of change of climate and change of air in dyspeptic 
 disorders, it will be both convenient and useful to 
 divide them into two classes, — the more recent and 
 simple, and the more protracted and complicated 
 cases. 
 
 Of the more recets't and si^njple cases of Dys- 
 pepsia. — Under this class of dyspeptic patients is 
 comprehended that numerous body of our citizens, 
 and the inhabitants of large towns generally, whose 
 health, and digestive organs in particular, have suf- 
 fered by a sedentary life, close application to business, 
 errors in regimen, &c., and who require change of 
 air, to restore the tone of the system generally, and 
 especially that of the digestive organs. 
 
 The plans generally adopted with this view, are a 
 visit to some of our watering-places, or a tour through 
 the mountainous parts of our own island, or on the 
 Continent. The preference which one or the other 
 
DIGESTIVE ORGANS. 25 
 
 of these measures may deserve, will depend upon the 
 nature of the^case, the convenience of the patient, 
 and various other circumstances, which can be ap- 
 preciated only by the patient himself and his phy- 
 sician. 
 
 We shall suppose that a tour is the measure 
 adopted. Having had the more urgent symptoms 
 of his complaint removed or alleviated before he 
 sets out,* the next object of importance with the 
 dyspeptic traveller is diet. This must be regulated 
 according to the state of the digestive organs, regard 
 being had to the exciting eiSfects of travelling, which 
 render more especial attention to the diet necessary 
 during a journey. If much gastritic irritation exists, 
 and more especially if this is accompanied with any 
 disposition to fever, the diet should be very mild and 
 moderate in quantity. A small proportion of animal 
 food once a-day is all that should be allowed in such 
 cases. Tea, or arrowroot, or sago, forms the best 
 evening meal. The best general drink is toast- 
 water ; wine, and all kinds of fermented liquors and 
 spirits, should be avoided by the greater number of 
 dyspeptic patients during a journey. 
 
 Fruit should generally be abstained from, as it 
 will seldom be found to agree in any form of stomach 
 complaint. An exception is to be made in favour of 
 good ripe grapes, which are often useful in gastritic 
 
 See the introductory remarks to Part II 
 
26 DISOKDERS OF THE 
 
 dyspepsia. Ripe grapes, eaten in considerable quan- j 
 tity for several successive weeks, is a remedy {cure de \ 
 raisins) employed on the Continent in several com- 
 plaints. In the inflammatory form of dyspepsia, 
 more especially when there exists a similar state of 
 the mucous membrane of the intestines, with a dis- 
 position to diarrhoea, also in chronic cases of this 
 disease, and in hsemorrhoidal affections, ripe grapes h 
 are considered of great use. 
 
 If the dyspeptic invalid will observe the effects 
 which the different articles of food produce, and be 
 true to himself and candid in his observations, he 
 will soon discover that the more moderately he lives' 
 the better he will feel. When he has passed a rest- 
 less night, or has a dry or loaded tongue, or bitter 
 taste in the morning, he may feel assured that the 
 regimen of the preceding day was not suited to him ; 
 that he has erred either in the quantity or quality of 
 his food, and should regulate himself accordingly for 
 the future. 
 
 The next circumstance requiring the particular 
 attention of the dyspeptic traveller, is the state of 
 the bowels. Constipation is an evil from which 
 travellers generally, and more especially dyspeptics, 
 suffer ; and it is of great consequence that this state 
 should be obviated. The mild diet which has been 
 recommended will be a means of favouring the 
 action of the bowels, and of moderating the inju- 
 rious effects of their inaction when this occurs. 
 
DIGESTIVE OEGANS. 27 
 
 For the removal of constipation^ tlie milder laxatives 
 are much safer and more effectual than drastic pur- 
 gatives. The latter, in the smallest doses, are apt to 
 irritate the stomach and bowels, and, in this way, 
 are often productive of more evil than the state 
 they are given to obviate, which evil, moreover, their 
 frequent repetition tends to confirm. Castor oil, 
 or confection of senna, or manna, taken in such 
 doses only as are sufficient to obviate constipation, 
 are the best medicines. They may be taken at bed- 
 time, so as to act the following morning. When the 
 stomach cannot bear these medicines, a mild aperient 
 pill may be occasionally given. But what often 
 answers much better than any aperient medicine, is 
 the use of lavemens. To persons who have very 
 sensitive bowels, and who suffer from constipation, 
 this proves an invaluable remedy, more especially 
 during a journey ; and no one should travel without 
 being provided with the means of relieving the 
 bowels in this way. The relief obtained by the 
 judicious use of this remedy will not only add 
 greatly to the comfort of the patient, but favour the 
 return of the bowels to a more healthy and regular 
 performance of their functions ; while it will obviate 
 the necessity of having frequent recourse to purga- 
 tive medicines, a fruitful source of mischief, as I have 
 already remarked, to dyspeptic invalids. The lave- 
 mens should consist of water, barley-water, oatmeal- 
 water, or thin gruel, tepid ; or, what answers better 
 
 c2 
 
28 DISOEDEKS OF THE 
 
 in many cases, an infusion of chamomile flowers. 
 Cold water proves very beneficial in some cases ; but 
 soap and more irritating substances are generally objec- 
 tionable. The quantity injected need not be great ; 
 half a pint, or even less, will often bring on an action 
 of the bowels more readily than a larger quantity. 
 
 But lavemens should not be repeated too often ; 
 their frequent use tends to destroy the tone and 
 confirm the inactive state of the lower bowels. When 
 these cannot be brought to act without assistance, 
 mild aperients and cool lavemens may be so alter- 
 nated as to obviate in a great degree the injurious 
 effects of both. 
 
 Tepid or warm bathing should never be neglected 
 by the dyspeptic invalid while travelling. Independ- # 
 ently of its utility as a means of cleanliness and/ 
 comfort, it promotes the cutaneous exhalation, tends 
 to equalize the circulation, and cools and soothes the 
 whole system. 
 
 If the dyspeptic invalid will attend to these simple 
 directions, he may derive much and lasting benefit 
 from his tour. He should keep in mind that he has 
 an important object in view, the recovery of his 
 health, and that this is to be effected only by such a 
 mode of travelling as is compatible with his strength, 
 and by strict adherence to such a regimen as com- 
 ports with the deranged state of his digestive organs. 
 
 These observations, which are intended chiefly for 
 travellers on the Continent, are equally applicable to 
 
DIGESTIVE OEGANS. 29 
 
 those who confine themselves to excursions in our own 
 island, or pass the summer at the sea-side or inland 
 watering-places. Those who visit the sea-coast will 
 find the tepid or warm sea-water bath a most valua- 
 ble remedy. With a few, cold sea-bathing may agree, ; 
 but it does not suit the majority of dyspeptic pa- \ 
 tients. The cold and more frequently the tepid 
 shower-bath will be found more generally bene- 
 ficial. The warm or tepid bath is useful in almost/ 
 every case. The vapour-bath will prove serviceable 
 in certain cases, more especially where the skin 
 has been long in a dry state ; but its indiscriminate 
 use for the removal of this symptom is calculated 
 to do mischief. It should be impressed on the 
 patient's mind, that it is in vain to expect that any 
 kind of bath, or any remedy, will restore the natural 
 secretion of the skin while the irritation of the 
 digestive organs is kept up by improper diet. The 
 dry skin is consequent upon irritation of some inter- 
 nal organ ; and until this is removed the natural state 
 of the surface cannot be restored. 
 
 The great and common errors in dyspeptic cases 
 are, as I have already said, the condition in which 
 invalids are sent abroad, and the manner in which 
 they live while there. Much greater and more per- 
 manent benefit would be derived from such a mea- 
 sure, were its effects aided by a regimen suited to 
 the nature of each case. As these matters are gene- 
 rally managed, the invalid has not returned many 
 
so DISORDEES OF THE 
 
 weeks, before he finds himself almost in the same 
 state as when he left his home. The reason of this 
 is sufficiently obvious. Previously to the tour, 
 nothing effectual is done for the mitigation of the 
 disorder of the digestive organs, and no system of 
 regimen is adopted by which the beneficial effects of 
 change of air and travelling may be favoured and 
 rendered more permanent. All is trusted to air, 
 relaxation from business, and amusement ; and when 
 the influence of these is withdrawn, the dyspeptic 
 and nervous invalid lapses into his former state. 
 
 The more protracted and complicated cases 
 OF Dyspepsia. — Persons whose digestive organs 
 have been long deranged, and whose constitutions 
 have suffered in consequence, will require, in order 
 to obtain much or lasting benefit, a more prolonged 
 residence in a mild climate. The impressions pro- 
 duced by causes operating for a series of years on 
 the digestive organs, and, through them, on other 
 important organs, and on the system generally, are 
 not to be effaced by a residence of a few months in 
 the best climate, even when assisted by the most 
 judicious regimen, and the most exemplary conduct 
 on the part of the patient. 
 
 Generally speaking, such invalids will derive be- 
 nefit by changing our damp, chilly climate, for a 
 drier and milder one, during the winter. But it is 
 not a matter of indifference in what place they fix 
 
DIGESTIVE OKGANS. 31 
 
 their abode ; and, indeed, it was chiefly the consi- 
 deration of this circumstance which induced me to go 
 somewhat into detail, in endeavouring to describe 
 the distinguishing characters of the different dis- 
 orders of the digestive organs. 
 
 I have pointed out three forms of dyspeptic dis- 
 orders : — one, in which there is an inflammatory 
 state of the mucous surface of the stomach ; another, 
 in which an opposite condition prevails — a state of 
 atony; and a third, in which a morbidly sensitive 
 state of that organ exists. These are important dis- 
 tinctions, and must never be lost sight of in pre- 
 scribing for dyspeptic patients, whether it be medi- 
 cine, regimen, or climate. 
 
 It is true that these morbid states pass into each 
 other in every variety of shade, from the purely 
 inflammatory dyspepsia on the one hand to the purely 
 atonic dyspepsia on the other ; and the successful 
 management of each case will much depend upon 
 the degree of discrimination exercised in referring it 
 to its proper place in the scale. This applies as 
 much to change of climate as to any other remedy. 
 
 The selection of a residence even in the same 
 place is not a matter of indiflference to very sensitive 
 
 L invalids. One will feel himself better in an elevated 
 situation; another in a lower and more sheltered 
 one. The high and more confined situations of 
 Home and Naples afforded me many opportunities 
 of observing the different effects of locality on such 
 i 
 
32 DISOEDEPvS OF THE 
 
 persons, and satisfied me of the necessity of attend- 
 ing to this circumstance in selecting a residence for 
 them. But dyspeptic patients who pass the winter 
 in Italy need not in general be limited to one place. 
 Although the climate most suited to the particular 
 character of their complaint should be selected as 
 their head-quarters, they may visit, during the sea- 
 son, the principal cities in the South of Italy ; and if 
 this is done with judgment, the successive changes 
 will prove beneficial to their health. Generally 
 speaking, Rome is the best residence in Italy in 
 gastritic dyspepsia; Nice the best climate in the 
 purer cases of atonic dyspepsia. 
 
 To all these patients the spring proves the period 
 of the greatest excitement ; and they who are dis- 
 posed to the more acute kind of stomach affections 
 must be particularly on their guard against whatever 
 excites the digestive organs at this season. The 
 same degree of stimulus that is tolerated in the 
 winter will prove injurious to them in the spring. In 
 irritation of the mucous membranes, whether of the 
 digestive or pulmonary organs, I had every year 
 occasion to remark the increase of excitement that 
 occurred during the spring months in Italy. At this 
 season there are great and often rapid alternations of 
 temperature, which are extremely exciting to sensitive 
 invalids. A powerful sun, frequently accompanied 
 with a sharp wind during the day, alternates with 
 cold nights. This may be said to be the character 
 
DIGESTIVE OUGANS. 33 
 
 of the spring everywhere ; even within the tropics 
 it prevails in some degree ; but in the South of 
 Europe it is particularly so^ and this circumstance 
 renders the climate injurious in the more acute 
 degrees of gastritic dyspepsia. 
 
 It is not, however, as I have already observed, for 
 the acute forms of dyspepsia that I recommend a 
 change of climate — but for affections of some stand- 
 ing, in which the acute stage has passed over, and 
 with it the highly excitable state of the digestive 
 organs. For these, and for the essentially chronic 
 cases of dyspepsia, a residence for seme time in the 
 South of Europe, under the regulations already 
 pointed out with respect to season, residence, regi- 
 men, &c., will be of the greatest service. To the 
 hypochondriac of cultivated mind, from the variety 
 of interesting scenes and objects of art which present 
 themselves so abundantly in Italy, I know no mea- 
 sure more likely to prove beneficial. I class the 
 hypochondriac with the dyspeptic patients, because, 
 without venturing to affirm that hypochondriasis 
 always originates in dyspepsia, I think it may be 
 safely asserted that the former is very rarely met 
 with unaccompanied by more or less of the latter, 
 and in a large proportion of cases both acknowledge 
 the same origin and are cured by the same means. 
 
 Although patients of a hypochondriacal turn of 
 mind should not be encouraged to dwell on their 
 complaints, I consider it wrong to send them abroad 
 
 c3 
 
34 DISORDERS OF THE 
 
 with the assnrance that their complaints are purely 
 imaginary, — that nothing is required but change of 
 air, of scene, and amusement, to dispel their gloomy 
 thoughts and restore their health. That there may 
 be cases in which the physician can do little more 
 for his patient than commit him thus to the wide 
 world, I am not prepared to deny; but I believe 
 they are rare ; at least I did not meet with any such 
 during a residence of many years on the Continent, 
 where my intercourse with patients of this class was 
 pretty extensive. On the contrary, a single case did 
 not fall under my observation in which careful 
 examination did not detect a deranged state in the 
 functions, if not in the structure of some internal 
 organ; and in which judicious medical treatment 
 would not have promoted the beneficial influence of 
 climate. When we are better acquainted with the 
 morbid conditions of the digestive organs, and with 
 the extensive influence which they exert on the 
 mind, we shall have less frequent occasion to confess 
 our ignorance of the patient's complaints, by attribut- 
 ing them to nervousness, to low spirits, or other ima- 
 ginary states designated by the like unmeaning terms. 
 
 "With regard to the general management of these 
 cases while the patient is travelling, the same di- 
 rections are applicable as to the more recent cases of 
 dyspepsia which have just been detailed. 
 
 As on the journey, so during their residence 
 abroad, the diet is the most important circumstance 
 
Digestive organs. 3.5 
 
 requiring the attention of dyspeptic invalids. Seeing 
 that the stomach is the organ primarily and princi- 
 pally affected, it requires no argument to prove that, 
 unless the diet be such as is suited to its morbid 
 condition, climate or any other means will do little 
 good. It is impossible, however, in this place, to do 
 more than point out in a general way the kind of 
 diet which I found most generally suited to this class 
 of patients. I have already remarked, and it is a 
 circumstance deserving the particular attention of 
 invalids, that in removing to a warmer climate the 
 sensibility of the system is increased, and, conse- 
 quently, stimulants of every description more easily 
 excite. Hence, the diet which may be proper in 
 England will not agree in Italy or in the South of 
 France. This remark, applicable to invalids gene- 
 rally, is especially so to persons suffering from 
 stomach complaints. There is, no doubt, a difference 
 in dyspeptic patients in this respect ; but I invariably 
 found a mild and very moderate diet the most suitable 
 to them ; and for this plain reason, — that whatever 
 may be the nature of the disorder of the stomach, de- 
 bility, or, in other words, a diminution in the powers 
 of the organ for the performance of its functions, is an 
 almost constant accompaniment of the disease. 
 
 Wine, when it is permitted, should always be 
 taken in great moderation ; and it will be found that 
 the lighter kinds, if not acid, generally agree the 
 best. Of wines imported into Italy, those of Bor- 
 
36 DISORDERS OF THE 
 
 deaux are to be preferred. The spirituous wines of 
 Spain, Portugal, and Sicily, if used, should be largely- 
 diluted. Seltzer water will often prove a good sub- \ 
 stitute for wine. 
 
 It would be a wise rule for all dyspeptic patients 
 to abstain entirely from everything that is brought 
 to table in the form of dessert. This advice I feel 
 cannot be urged too strongly ; nor can the dyspeptic 
 patient have too forcibly impressed upon his mind 
 that temperance and abstemiousness are the best | 
 physic. The belief so generally entertained that 
 medicine can counteract the effects of habitual errors 
 in regimen, should be regarded as mere delusion. ^ 
 There is but one road to a permanent cure in these 
 cases, and he who shall steadily pursue it long 
 enough to feel its advantages, in the restoration of 
 mental and bodily energy, will not easily be induced 
 to deviate from it again. 
 
 Exercise in the open air is one of the greatest 
 advantages which a winter residence in the South 
 affords; and the dyspeptic invalid should take full 
 advantage of it. Walking. and riding on horseback ' 
 are the best kinds of exercise, but neither should be 
 carried so far as to produce over-fatigue. When the 
 irritation of the stomach is complicated with that of the 
 bronchial membrane, riding should be chiefly relied 
 on for exercise. Exercising the arms every morning is 
 very useful in dyspeptic complaints : for this purpose j 
 the clubs used in India are preferable to dumb-bells. 
 
DIGESTIVE ORGANS. 37 
 
 Friction of the whole surface of the body, night 
 and morning, is a valuable remedy, and the best sub- 
 stitute for exercise. For those whose occupation 
 compels them to a sedentary life, in our damp and 
 cold climate, there are few remedies more useful, 
 though none more neglected, than friction. The 
 diligent use of this, and sponging the surface with 
 cold or tepid water throughout the year, or the 
 shower-bath daily during summer, and the occasional 
 use of the warm bath at all seasons, form a powerful 
 combination of means for maintaining the health of 
 persons constrained by circumstances to forgo exercise 
 in the open air ; and the same measures are also singu- 
 larly efficacious in restoring the diminished energy of 
 the skin and digestive organs in cases of nervous and 
 atonic dyspepsia. They should not, however, be con- 
 sidered as superseding exercise in the open air when 
 at all practicable. For the want of exercise nothingi 
 can fully compensate ; but the means which I have 
 suggested, and especially active friction over the whole 
 surface night and morning,* will in some degree sup- 
 ply its place, and will always prove beneficial to the 
 class of invalids for w^hom I am now writing. f 
 
 * Various substances are recommended for this purpose, some 
 of them much too rough for delicate skins. The great object in 
 using friction is to excite the action of the skin, — to promote its 
 natural functions, not to bruise or irritate it. 
 
 t For the most judicious instructions on this subject, the 
 reader is referred to Dr. Combe's work on the * Principles ot 
 Physiology applied to the Preservation of Health, and to the 
 
38 DISORDERS OF THE 
 
 Cold and damp weather is particularly injurious j 
 in dyspepsia, more especially in the nervous and ' 
 atonic forms, in which coldness of the surface and 
 extremities is a prominent symptom. The use of 
 warm clothing, therefore, forms an essential part of 
 the treatment in such cases. Flannel should be worn 
 next the skin during the day ; and when any change 
 of dress is made in the summer, it should be effected 
 gradually and with great caution ; and the change of 
 weather in autumn should always be anticipated by a 
 return to warmer clothing. 
 
 All these measures tend to maintain an active 
 circulation through the extremities and surface, — an 
 object of the greatest importance in the treatment of| 
 dyspepsia. Indeed, it is chiefly in consequence of 
 the active circulation on the surface during the 
 warmth of summer, and being more in the pure open 
 air, that so many feeble, dyspeptic, and nervous inva- 
 lids find themselves better and get stouter during this 
 
 Improvement of Physical and Mental Education,' — a book which 
 no family should be without. The extensive sale of this work 
 shows how the public appreciate works containing sound infor- 
 mation. Of the 8vo edition 16,000 copies have been sold in this 
 country in less than twelve years ; and of the People's Edition, 
 published at 2s. 6c?., 8320 copies in two years. In the United 
 States of America 30,000 copies were sold in five years ; and 
 two other editions have been printed since, the sale of which is 
 not known. In Germany a translation has also sold well. The 
 very extensive diffusion of Dr. Combe's works has doubtless had 
 its influence in preparing the public mind for the present move- 
 ment on the subject of the public health. 
 
DIGESTIVE ORGANS. 39 
 
 season, and that the hypochondriac's mind is freed 
 from half the gloom which before oppressed it ; whilst, 
 on the contrary, it is from the diminished activity of 
 the circulation in the surface and extremities, and the 
 consequent congestion of the internal organs, and also 
 from breathing a comparatively impure air in the 
 house, that such patients languish and become thinner 
 during six months of the year in this country. On 
 this principle, much of the advantage derived from . 
 passing the winter in a mild climate may be ex- 
 plained. 
 
 If the measures which I have just recommended 
 be steadily adopted, little medicine will be required. 
 It will at aU times be necessary to attend to the state 
 of the bowels ; though the dyspeptic invalid should 
 endeavour to bring them to act regularly by proper 
 regimen and exercise rather than by medicine. That 
 this may generally be done, even in very obstinate 
 cases of constipation, I am satisfied from experience ; 
 and in young persons regularity of bowels may often 
 be induced in a much shorter period than would be 
 believed. In this respect a change of climate often 
 acts very beneficially. 
 
 I once more beg that it may be clearly understood • 
 that I do not recommend travelling, or a residence in 
 the South of Europe, to patients labouring under the 
 acute state of gastritic dyspepsia; much less do I 
 advise such a measure to those labouring under 
 organic disease, or chronic inflammation of the liver » 
 
40 DISOEDERS OF THE DIGESTIVE OEGANS. 
 
 or any of the abdominal viscera. When inflammation 
 is established in any organ of importance to life, a 
 long journey is more likely to increase than diminish 
 the evil. "Whenever inflammation exists in a degree 
 suflicient to excite the circulation, in whatever organ 
 or structure it may be situated, rest is an essential 
 part of the treatment. 
 
 The nature of a disease should be well ascertained 
 before the patient is urged to take active exercise, or 
 is permitted to undertake a long journey. If the 
 disease be of a purely nervous character, or depends 
 upon mere functional derangement, active exercise in 
 the open air forms a most effectual means of restoring 
 the health; whereas, if the symptoms depend on 
 chronic inflammation, the same measure will scarcely 
 fail to prove injurious, and may even convert a chronic 
 into an acute disease. The above distinction is 
 therefore very important, but it is one which I have 
 reason to know is not generally attended to in sending 
 patients abroad. 
 
 After a winter passed in a mild climate, a judicious 
 course of mineral waters will prove a very eflicient 
 remedy in cases of dyspeptic disease, dependent upon, 
 or complicated with, a congested state of the liver and 
 other abdominal organs, and a disordered state of all 
 the secretions. For my views on this subject I must 
 refer to the Appendix on Mineral Waters. 
 
( 41 ) 
 
 PULMONARY CONSUMPTION. 
 
 No subject connected with health possesses greater 
 claims to attention than that which relates to the class 
 of diseases of which Pulmonary Consumption is the 
 most frequent and fatal form ; and yet there is none 
 concerning which the public is less accurately in- 
 formed. 
 
 In the former editions of this work I entered fully 
 into the causes, nature, and progress of Pulmonary 
 Consumption ; but having published a separate 
 Treatise on that disease, I shall confine myself on 
 the present occasion to a description of the constitu- 
 tional disorder which precedes consumption, and the 
 indications by which a tuberculous state of the lungs 
 may be recognised. 
 
 TUBERCULOUS CACHEXY. 
 
 Tuberculous Cachexy was the term used in the 
 first edition of this work to designate that disordered 
 state of health which precedes and constitutes the es- 
 sential predisposing cause of pulmonary consumption. 
 The term has been generally adopted by the profession, 
 but the disorder itself has not yet received that degree 
 
42 PULMONARY CONSUMPTION. 
 
 of consideration which its importance demands. The 
 attention is still almost exclusively directed to the 
 pulmonary disease, and too little notice is taken of the 
 constitutional disorder; although on the successful 
 treatment of this alone can we rest our hopes of 
 diminishing in any essential degree the prevalence 
 of pulmonary consumption. It is of the utmost con- 
 sequence, therefore, that we should be able to dis- 
 tinguish, the leading features by which the con- 
 stitutional or curable period of the disorder may be 
 recognised. 
 
 The expression of countenance of a young person 
 labouring under tuberculous cachexy is generally 
 characteristic. It is pale, with a sallow cast, although 
 it is in this respect subject to considerable variations. 
 In persons of a florid complexion the changes are 
 often very remarkable : at one time general paleness, 
 with a faded expression of countenance ; at another, 
 an irregular mixture of white and red prevails; but 
 in place of the gradations by which these colours pass 
 into each other in health, they terminate abruptly, 
 giving the face a blotched or spotted appearance. 
 Sallow complexions assume a peculiarly dull, leaden 
 hue : there is paleness or lividity of the lips ; the 
 eyes have generally a dull pearly aspect; and the 
 whole countenance commonly appears sunk and lan- 
 guid, except when the person is under some degree of 
 excitement. These indications, as I have already 
 said, are very variable, and may pass for many 
 
TUBERCULOUS CACHEXY. 43 
 
 months unnoticed, except by tlie immediate relations 
 or the physician ; but as the constitutional disorder 
 increases they become evident to the most cursory 
 observer. 
 
 Upon close examination, the skin of such a patient 
 will be found in an unhealthy condition : either harsh 
 and dry, or moist, clammy, and relaxed ; and these 
 states often alternate. Its colour, too, is often sallow, 
 and in some cases assumes a dirty yellowish hue ; 
 and, except on the cheeks, there is always a deficiency 
 of red vessels. In some hereditary cases, particu- 
 larly in females of a fair and delicate complexion, the 
 skin has a semi-transparent appearance, resembling 
 waxwork, the veins being seen distinctly through it. 
 The temperature of the surface and extremities is for 
 the most part below the standard of health. 
 
 The digestive organs are very generally deranged, 
 though the degree and nature of the derangement 
 differ materially in different cases. The tongue is 
 more or less furred, the point and margin redder 
 than natural, and often studded with enlarged fungi- 
 form papillae of a still brighter hue. In another 
 class of cases, of rarer occurrence, the tongue is clean 
 and natural in its appearance, and the mucous mem- 
 brane of the internal fauces pale. I have remarked 
 this chiefly in females in whom the disease originated 
 in hereditary predisposition and was little complicated 
 with gastric disorder. The bowels are very gene- 
 rally constipated. 
 
44 PULMONARY CONSUMPTION. 
 
 The nervous system partakes of the general dis- 
 order. There is more nervous sensibility than is 
 natural to the patient. The sleep is not sound; 
 being disturbed or unnaturally heavy, and rarely 
 refreshing. In the purer and less complicated cases 
 of hereditary consumption, there is generally great 
 serenity of mind ; the spirits are of surprising buoy- 
 ancy, and the hope of recovery remains to the last. 
 But this state of mind is a less constant attendant on 
 consumption than is generally believed; especially 
 when it has been preceded by long-continued dis- 
 order of the digestive organs, which it very generally 
 is when the disease occurs in the more advanced pe- 
 riods of life. In such cases there is oftentimes great 
 impatience, irritability of temper, and despondency. 
 
 The state of the circulation is subject to great 
 variety. In hereditary cases the power of the heart 
 is commonly under the ordinary standard, whilst the 
 frequency of the pulse is generally above it, and pal- 
 pitation is a common symptom. The circulation is 
 in general feebly carried on through the extreme 
 vessels, as is shown by the condition of the skin 
 already noticed, and the tendency to coldness of the 
 extremities. This state of the surface and extremities 
 is a very constant attendant on abdominal conges- 
 tion, complicated with an irritated condition of the 
 gas tro -intestinal mucous surfaces; and hence it is 
 generally more evident according as the disorder of 
 the digestive organs is more considerable. 
 
TUBERCULOUS CACHEXY. 46 
 
 Although in the great majority of cases the indi- 
 cations of disease just enumerated are suificiently 
 apparent during a considerable period before the 
 occurrence of pulmonary disease, cases do occasion- 
 ally occur, and the subjects are chiefly delicate young 
 females, where tuberculous disease of the lungs is 
 indicated by such faint signs, and steals on so imper- 
 ceptibly, that the patient may be on the brink of the 
 grave before the friends are aware of the existence of 
 danger ; but this is rare, and will be still more so, 
 when the deranged state of health which precedes 
 the pulmonary disease is more generally known and 
 attended to. 
 
 Tuberculous cachexy is sometimes complicated 
 with chlorosis ; and in such cases the latter is often 
 considered the primary disease, the error not being 
 discovered till those means in general so successfully 
 employed to combat it are found to produce only a 
 very temporary benefit.* 
 
 Causes of Tuberculous Cachexy. — The disor- 
 dered state of health which I have just described 
 may be hereditary and manifest itself in the child 
 at birth, or it may be induced at any period of life 
 by the causes to be presently noticed ; although the 
 operation of these is much more rapid before the 
 
 * In Dr. Ashwell's ' Practical Treatise on the Diseases pecu- 
 liar to Women,' will be found some judicious remarks on this 
 state of disease. 
 
46 PULMONARY CONSUMPTION. 
 
 body has acquired its full maturity, than at a later 
 period of life. 
 
 Hereditary Origin. — It is certain that consump- 
 tion often originates in hereditary predisposition, 
 transmitted from one or both parents to the offspring. 
 But it is a grievous, although a very common error, 
 to suppose that this predisposition is derived from 
 consumptive and scrofulous parents only. The 
 children of persons labouring under a deranged state 
 of health are born with the same predisposition: 
 whether the disorder of the parent has originated in 
 long-continued derangement of the digestive organs, in 
 gout, in sedentary or other unhealthy occupations, or 
 in any causes which have induced a cachectic or debili- 
 tated state of constitution, the offspring is very gene- 
 rally born with a predisposition to consumption and 
 other tuberculous diseases. There are other circum- 
 stances in the condition of the parents, less clearly 
 understood, which also predispose their offspring to 
 the class of diseases under consideration ; there is, in 
 fact, no security against the transmission of hereditary 
 predisposition to disease but a state of sound health in 
 the parents. When these truths are generally recog- 
 nised and acted on, the frequency of consumptive 
 diseases will be greatly diminished. 
 
 From whatever causes the hereditary predisposition 
 may have originated, the earlier in life the means of 
 correcting it are adopted the more successful will 
 
TUBERCULOUS CACHEXY. 47 
 
 they be. Our efforts to improve the health should 
 commence with the birth of the infant, and be con- 
 tinued till it has reached maturity. Unfortunately 
 the errors committed in the nursery, and too often 
 continued during childhood and youth, rather tend to 
 confirm and augment the hereditary delicacy ; and 
 such will be the case till parents are taught to enter- 
 tain more correct views respecting the means of 
 promoting the health of their offspring.* 
 
 Exciting Causes. — We have just seen that a 
 deteriorated state of health in parents is a frequent 
 cause of tuberculous cachexy in their offspring. But 
 the same disorder may be speedily induced in children 
 of the healthiest parents, if they are exposed to the 
 causes which are known to induce it. Whatever 
 deteriorates the health, may lead to tuberculous 
 cachexy; residence in a low, damp, and chilly situa- 
 tion ; long confinement to close, ill- ventilated rooms, 
 whether nurseries, school-rooms, or manufactories ; 
 deficient exercise in the open air ; imperfect clothing ; 
 improper food, either deficient in quantity or of innu- 
 tritions quality ; or the habitual use of an overstimu- 
 lating diet, by inducing imperfect digestion and assi- 
 
 * Dr. Combe's admirable work on the ' Physiological and Moral 
 Management of Infancy,' will effect a vast improvement in nur- 
 sery management and in the health of children. It is the most 
 valuable work on the subject of health which has ever been pub- 
 lished, and no parent capable of reading his own language should 
 be without it. 
 
48 PULMONARY CONSUMPTION. 
 
 milation; may lead to tuberculous cachexy. The 
 offspring of the healthiest parents may thus become 
 tuberculous in early life, if exposed to the exciting 
 causes enumerated. The earlier in life these causes 
 are applied, the more rapidly in general will their 
 effects be manifested. 
 
 I shall now endeavour to state, with as much pre- 
 cision as the nature of the subject admits, what may 
 reasonably be expected from change of climate in 
 consumptive diseases. 
 
 For the removal of the deranged state of the 
 health which has been shown to precede consump- 
 tion, a change to a milder climate is a very power- 
 ful remedy, when aided by such other means as the 
 peculiar circumstances of the case require. Before 
 making such a change, however, the patient should 
 be carefully examined, and the functions more 
 evidently deranged restored as far as possible to a 
 healthy state. 
 
 In a large proportion of cases, the functions of the 
 digestive organs and skin, as I have already remarked, 
 are deranged, and until they are improved we shall 
 make little progress in remedying the constitutional 
 disorder, even under the influence of the best climate. 
 But the means employed for effecting this should be 
 directed with judgment and moderation. It must be 
 recollected that we have to deal with a constitution 
 either hereditarily weak, or which has been brought 
 
L 
 
 PULMONARY CONSUMPTION. 49 
 
 into its present condition by a long series of morbid 
 actions. Even when inflammation exists, we must 
 keep in mind that it is inflammation in a disordered 
 habit, and apply our remedies accordingly. If the 
 strength is now broken up, and the balance of the 
 circulation suddenly disturbed by debilitating reme- 
 dies, the system may lapse rapidly into tuberculous 
 cachexy. On the other hand, stimulating or irritating 
 remedies will be equally pernicious. In the cases 
 now under consideration, local congestion and irrita- 
 tion often exist with general debility ; and it requires 
 more judgment to manage this pathological state, 
 than almost any other with which I am acquainted. 
 The principal object in such cases is to promote a 
 regular distribution of the circulating fluids through 
 the parts in which they have been deficient, and to 
 relieve those organs which have been overloaded. 
 This will be best done by a mild, nutritious diet, 
 suited to the power of the digestive organs ; by exercise 
 in the open air, especially on horseback, proportioned 
 to the strength of the patient; by the use of the 
 warm bath ; and by sponging the surface daily with cold 
 or tepid water, followed by active friction. In short, 
 the whole system being deranged, we must not con- 
 tent ourselves by correcting one or two disordered 
 functions, but, by operating on aU, endeavour to raise 
 the standard of health generally ; and in doing this 
 we must depend more upon hygienic means than 
 upon medicines. 
 
 D 
 
50 PULMONAEY CONSUMPTION. 
 
 The removal of gastric and bronchial irritation, 
 when they exist, and the regulation of the bowels, 
 are the circumstances which chiefly require the em- 
 ployment of medicines. The proper application of 
 these, in each individual case, must depend on the 
 judgment of the medical attendant. 
 
 The deranged functions having been corrected, and 
 the general health improved as far as the circum- 
 stances of the case admit, the patient's prospects of 
 deriving permanent advantage from a change of 
 climate will be materially increased. 
 
 Unfortunately the period of constitutional disorder, 
 which we have just been considering, is too often per- 
 mitted to pass ; and it is not until symptoms of pul- 
 monary irritation, or congestion, such as cough, difR- 
 cult breathing, or spitting of blood, appear, that the 
 patient or relations are alarmed, and fears expressed 
 that the chest is "threatened." Such symptoms are 
 but too sure indications that tuberculous disease has 
 already commenced in the lungs. It may, indeed, 
 be difficult in some cases to ascertain the positive 
 existence of this, although by a careful examination 
 of the chest, and an attentive consideration of all 
 the circumstances of the case, we shall seldom err in 
 our diagnosis ; and it need not, at any rate, aflfect our 
 practice, as a strong suspicion of the presence of 
 tubercles should lead us to adopt the same precau- 
 tions as the certainty of their existence. 
 
PULMONABY CONSUMPTION. 61 
 
 When tuberculous matter is deposited in the 
 lungs, the condition of the patient is materially 
 changed. We have the same functional disorders 
 which existed in the former state ; and we have also 
 tuberculous deposits, predisposing to a new series of 
 morbid actions — to bronchial irritation, haemoptysis, 
 inflammation of the pleura and lungs, &c., which 
 call for important modifications in the plan of treat- 
 ment. Removal to a mild climate may still be use- 
 ful, on the same principle as in the former case; 
 namely, as a means of improving the general health, 
 of preventing inflammatory affections of the lungs, 
 and even perhaps arresting the progress of the 
 disease already existing in these organs. 
 
 When consumption is fully established — that is, 
 when there is extensive tuberculous disease in the 
 lungs — little benefit is to be expected from change of 
 climate ; and a long journey will almost certainly 
 increase the sufierings of the patient, and hurry on 
 the fatal termination. Under such circumstances, 
 therefore, the patient will act more judiciously by 
 contenting himself with the most favourable residence 
 which his own country aflbrds, or even by preferring 
 the comforts of home and the watchful care of 
 friends. And this will be the more advisable when 
 a disposition to sympathetic fever, to inflammation of 
 the lungs, or to hsemoptysis, has been strongly mani- 
 fested. 
 
 It is natural for relations to cling to that which 
 
 d2 
 
52 PULMONAKY CONSUMPTION. 
 
 seems to afford even a ray of hope ; but did they 
 know the discomforts, the fatigue, the exposure, and 
 irritation, necessarily attendant on a long journey in 
 the advanced period of consumption, they would 
 shrink from such a measure. The medical adviser, 
 also, when he reflects upon the accidents which 
 are likely to occur, should surely hesitate ere he con- 
 demns his patient to the additional evil of expatria- 
 tion ; and his motives for hesitation will be increased 
 when he considers how often the unfortunate patient 
 sinks under the disease before the place of destina- 
 tion is reached ; or, at best, arrives there in a worse 
 condition than when he left his own country, and 
 doomed shortly to add another name to the long and 
 melancholy list of his countrymen who have sought, 
 with pain and suffering, a distant country, only to 
 find in it a grave. When the patient is a female, 
 the objections to a journey apply with increased force. 
 In these advanced cases the patient's sufferings may 
 often be alleviated and life prolonged by confine- 
 ment to apartments kept at a regulated tempera- 
 ture. 
 
 There are, however, cases of chronic consumption, 
 in which, although the disease of the lungs may have 
 arrived at a very advanced stage, a mild climate may 
 be resorted to with advantage. The tuberculous 
 affection in such persons is generally limited to a 
 small portion of the lungs, and the system sympa- 
 thizes little with it. In instances of this kind, a 
 
PULMONARY CONSUMPIION. 53 
 
 residence for some time in a mild climate, especially 
 when aided by proper regimen, may be the means of 
 prolonging life. Likewise, in those fortunate cases 
 in which the disease in the lungs has ceased to ex- 
 tend, and a long period must elapse before the work 
 of reparation is completed, a mild climate will be of 
 considerable service, by improving the general health 
 and preserving the patient from the operation of 
 many causes likely to renew irritation in the lungs, 
 to which he would be exposed in this country. 
 
 In such cases, life may be prolonged many years 
 by residing in a mild climate, and at the same 
 time sedulously avoiding whatever is calculated to 
 induce congestion, or excite inflammatory disease in 
 the lungs. During my residence abroad, I met with 
 several invalids labouring under this chronic form of 
 disease, who passed their winters in Italy with infi- 
 nitely more comfort and enjoyment of life than in 
 England. 
 
 Choice of Climate. — When change of climate 
 is decided on, the next subject which naturally pre- 
 sents itself for consideration regards the selection of 
 that which is most suitable to the individual case 
 under consideration. The question is often put to 
 me — Which is the best climate ? The truth is, no 
 one climate or situation is the best in all cases. In 
 a subsequent part of this work will be found the 
 characters of the different climates usually resorted 
 
54 PULMONARY CONSUMPTIOX. 
 
 to, and a comparative estimate of their merits. With 
 regard to the climates of the South of France and of 
 Italy, I may here observe, that for consumptive 
 invalids, in whom there exists much sensibility to 
 keen winds, and more especially if immediate vici- 
 nity to the sea-coast is known to disagree, Rome and 
 Pisa are the best situations for a winter residence. 
 When, on the contrary, the patient labours under a 
 languid, feeble circulation, with a relaxed habit, and 
 a disposition to congestion or to hsemorrhage, rather 
 than to inflammation, and more especially when the 
 sea-air is known by experience to agree, Nice de- 
 serves the preference. In cases complicated with 
 gastritic dyspepsia, however, Nice is an improper 
 residence ; its climate being decidedly inimical to such 
 a state. In cases of chronic consumption, therefore, 
 which, according to my observation, are almost inva- 
 riably complicated with, and in a large proportion of 
 cases chiefly induced by, disorder of the digestive 
 organs, Nice will rarely agree. Besides, such pa- 
 tients have generally an irritated state of the bronchial 
 membrane, a dry skin, and a morbid degree of sensi- 
 bility of the nervous system — in all of which states 
 that place is unfavourable. Rome and Pisa wiU agree 
 better with this class of invalids. 
 
 But the climate which, of all others, I consider the 
 best suited to consumptive patients generally, is that 
 of Madeira. It will be seen by a reference to the 
 article on Madeira, and the Meteorological Tables in 
 
PULMONARY CONSUMPTION. 55 
 
 the Appendix, that the winter temperature of that 
 island is considerably higher and more equable, and. 
 the summer heat much more moderate, than at any of 
 these places. For such consumptive patients, there- 
 fore, as are likely to derive benefit from a mild, 
 equable climate, I consider that of Madeira the best. 
 And this opinion does not rest merely on a considera- 
 tion of the physical qualities of the climate, but is 
 warranted by the experience of its effects. Madeira 
 has also this advantage over all the places in the South 
 of Europe — that the patient may reside there during 
 the whole year, and thus avoid the inconveniences, 
 and even risks, attending a long journey, to w^hich 
 consumptive invalids who pass the winter in Italy 
 are exposed. The summer climate of the whole 
 shores and islands of the Mediterranean is unsuited 
 to consumptive invalids ; and, indeed, is known by 
 experience to be so injurious to them, that sailors and 
 soldiers attacked with the disease in the Mediterranean 
 fleet and garrisons of Malta, &c., are sent to England 
 on the approach of summer. 
 
 The two places which in the character of their 
 climate approach most nearly to Madeira, are Tene- 
 riffe and the Azores. During the winter, the tempe- 
 rature at Santa Cruz, on the southern coast of Tene- 
 riffe, is several degrees higher than at Funchal, and 
 in this respect would prove a superior winter climate 
 for some pulmonary invalids. 
 
 The climate of the Azores is remarkably mild and 
 
56 PULMONARY CONSUMPTION. 
 
 equable^ but suitable only to cases in which a soft 
 and rather humid atmosphere is indicated. 
 
 But various circumstances require to be taken into 
 consideration before we decide upon a particular 
 climate in any individual case. The age and consti- 
 tution of the patient ; the peculiarities and complica- 
 tions of the disease ; his ability to bear travelling, or 
 a sea- voyage ; the means at his command, and the 
 friends by whom he can be accompanied, are cir- 
 cumstances which should be taken into account, in 
 weighing the comparative advantages of different 
 places, and the inconveniences attending all of them, 
 when compared with the comforts and resources of 
 home. These collateral circumstances may render 
 it proper to recommend change of climate to one 
 patient when another, to whose case such a remedy 
 is equally applicable, will be better advised to remain 
 in his own country. 
 
 The winter climates in England most favourable 
 to consumptive patients are those of Torquay, Un- 
 dercliff, Penzance, Clifton, and Hastings; and to 
 these may be added Bournemouth. The choice 
 among these places will depend upon the nature 
 of the case, and especially upon the condition of the 
 digestive organs. For persons of an inflammatory 
 constitution, with a disposition to gastritic dyspepsia, 
 Torquay is the best residence, while it will as deci- 
 dedly disagree with persons of a very relaxed habit 
 and subject to copious secretions from the mucous 
 
PULMONARY CONSUMPTION. 5T 
 
 membranes, or to atonic dyspepsia. Such patients 
 will bear the climate of Torquay for a very short 
 time only. The same remark applies with equal 
 force to Penzance and the other parts of the Land's 
 End. Undercliff and Clifton are preferable resi- 
 dences for the latter class of patients. 
 
 In some cases the relation of the disease to the 
 climate is so nicely balanced, that it may be advan- 
 tageous to send the patient for a few months in the 
 early part of winter to one place, and the remaining 
 part of the season to another. In some cases, for 
 example, Torquay will suit remarkably well for two 
 or three months, after which it will be advantageous 
 to remove the patient to a less relaxing climate. The 
 winter at Torquay or Penzance and the spring at Clif- 
 ton, will suit some patients much better than continu- 
 ing the whole season at any one of these places. 
 
 During the summer great advantage will be 
 derived from frequent change of place in almost 
 all cases, as will be pointed out in the Article on 
 Summer Residences. 
 
 There is one circumstance connected with the 
 residence of consumptive patients concerning which 
 the profession are not quite agreed — I mean the 
 comparative advantages of a sea-side and of an inland 
 situation. We have, indeed, no very satisfactory 
 comparisons on this subject, in which the nature of 
 the climate, occupations, habits of life, &c., of the 
 inhabitants have been fairly and fully estimated, so 
 
 d3 
 
58 PULMONAHY CONSUMPTION. 
 
 as to enable us to judge how far tlie frequency of 
 consumption in any particular place may be con- 
 nected with the nature of the climate, and how much 
 may depend on the mode of living, &c. The question 
 is certainly a very difficult one, and involves a great 
 variety of circumstances not easily analysed ; hence 
 it is, that we have little more than opinions formed 
 from imperfect data on the subject. From all that I 
 have been enabled to learn and observe, consumption 
 is, I think, cceteris paribus, more frequent on the sea- 
 coast than in the interior ; * still the greater mildness 
 of many maritime places, as those on the South and 
 South-west coasts of England, may more than com- 
 pensate for this difference, especially when these 
 places are resorted to for a part of the year only. 
 
 In Italy, Rome is the only place frequented by 
 pulmonary invalids which is sufficiently remote from 
 the sea to be considered as an inland climate ; and 
 here the comparison is certainly in favour of the 
 inland situation. But my impression is, that there is 
 less difference between the sea-side and inland situ- 
 ations, in this range of latitude, than further north ; 
 owing perhaps to the greater dryness of the sea-side 
 in southern climates. Of two climates, the physical 
 characters of which were alike, the one on the sea- 
 shore, and the other inland, I should prefer the latter 
 
 * The comparisons in this respect which have been made be- 
 tween the sea-coast and the interior, as respects large continents, 
 I do not consider applicable to small islands. 
 
PULMONARY CONSUMPTION. 69 
 
 as a residence for a consumptive patient^ more espe- 
 cially if the disease were in an advanced stage ; but I 
 am ready to admit that this opinion is unsupported 
 by any very accurate or numerous data. In America 
 the opinions of medical men are greatly in favour of 
 the inland situation. For the opinion that the air of 
 a marshy country is beneficial in consumption, I be.- 
 lieve there are no grounds. Scrofula, and even con- 
 sumption, is more frequent in many aguish districts 
 than in others of a different character ; and an attack 
 of ague is much more likely to favour the occurrence 
 of consumption than to prevent it. 
 
 A sea-voyage is another measure regarding which 
 a difference of opinion prevails among professional 
 men. My own opinion is, that a voyage is generally 
 beneficial in the early stage of consumption. The 
 sickness and vomiting are highly useful in many 
 cases. It was chiefly to the unceasing motion of a 
 ship, by the constant exercise it produces, that the 
 celebrated Dr. Gregory attributed the benefit derived 
 from a voyage. Several striking instances of the 
 beneficial effects of a sea-voyage in consumption fell 
 under my notice while in Italy; and Dr. Peebles 
 met with many examples of the same kind. On 
 examining the notes of the cases with which Dr. 
 Peebles favoured me, I find that haemoptysis existed 
 in every one of them ; and this was also the case in 
 most of the examples which came under my own 
 observation. The circumstance of the patient being 
 
60 PULMOXAUY CONSUMPTION. 
 
 subject to haemoptysis, in the early stage more 
 especially, I should therefore consider as affording no 
 objection to a sea-voyage.* Dr. Davy's opinion is in 
 favour of this view : by observing its effects on him- 
 self, he thinks sailing acts by producing a sedative 
 effect more especially on the function of respiration.+ 
 In the consumptive cases, also, which are compli- 
 cated with palpitation, or increased action of the 
 heart, whether purely functional, or depending upon 
 organic disease, I consider a voyage useful, and much 
 preferable to a land journey. There are complica- 
 tions, on the other hand, which render a voyage un- 
 advisable. "When there is much nervous sensibility, 
 a strong disposition to headache, and an irritable state 
 of the stomach, a sea-voyage will generally disagree. 
 With these exceptions, I should say that a consump- 
 tive patient, in whose case a foreign climate is likely 
 to prove useful, had better go by sea than by land, 
 provided a vessel can be obtained with good accom- 
 modations. Much depends upon this last circum- 
 stance, and much also on the climate or season in 
 which the voyage is made. The motives for pre- 
 ferring a voyage to a journey will be still stronger 
 when the patient has not the means of travelling in 
 the most comfortable manner. Sailing or cruising 
 for some time would be still more preferable than a 
 
 * See Dr. Combe's ' Physiology/ already referred to, p. 107 
 for a remarkable example of the benefits of a sea-voyage, 
 t *Edin. New Philosophical Journal,' 1846. 
 
PULMONARY CONSUMPTION. 61 
 
 voyage ; and the Atlantic is more favourable for this 
 purpose than the Mediterranean. When a long voy- 
 age is objected to, shorter voyages, under favourable 
 circumstances, and repeated at short intervals, might 
 be of essential benefit. An objection to sea- voyages 
 is the length of time that the patient is necessarily 
 confined to the impure and deteriorating atmosphere 
 of the sleeping-places ;* but this is in a great degree 
 compensated for in fine weather by his being con- 
 stantly on deck during the day, and there breathing 
 the purest air. To take advantage of this with safety, 
 however, let the invalid be provided with an ample 
 store of warm clothing, and be wrapped up sufficiently 
 to be able to spend the whole time of daylight on 
 deck without being disagreeably chilled. 
 
 The measures which have been recommended as 
 necessary preparations for a long journey, are equally 
 requisite in the case of a voyage, — much of the 
 benefit of which will depend upon the condition in 
 which the patient is sent to sea, and the regimen he 
 adopts while there. 
 
 * This is a serious objection to a sea-voyage, which it is hoped 
 will soon be remedied in all ships conveying passengers, by the 
 adoption of a system of ventilation by which the sleeping-berths 
 shall be constantly supplied with the same pure air which the 
 patient breathes on deck during the day. This is more especi- 
 ally necessary in steam-vessels, and the example of thfe Peninsular 
 and the Oriental Steam Navigation Companies, who have given 
 directions for an efficient ventilation of their vessels, will no 
 doubt be followed by all other steam navigation companies. 
 
62 PULMONARY CONSUMPTION. 
 
 When it is deemed proper to send a consumptive 
 invalid abroad, his best residence will be found in 
 one or other of the places which have been noticed ; 
 and when it can be so arranged that he may change 
 his climate several times, it will generally be to his 
 advantage. When change of climate is wisely adopted 
 for the improvement of the general health, and before 
 local disease is established, a still wider range may 
 be permitted to the traveller. The whole South of 
 Europe is open to him, and if he manages his voyages 
 and travels judiciously, he may improve his health 
 more, by extending and varying them, than by 
 remaining the whole season in any one place. But 
 while great latitude may be allowed, over-exertion in 
 travelling, and exposure to harsh cold weather, should 
 be avoided, especially by the more delicate. The 
 total want of proper accommodation and means of 
 conveyance must also limit the extent of the invalid's 
 wanderings. General rules only can be laid down 
 in such cases. For the guidance of each individual, 
 an outline is all that can be traced by the physician ; 
 but the use of a little common sense and discretion 
 on the part of the traveller, will enable him to fill up 
 the detail so as to derive the maximum of benefit 
 with the minimum of those disadvantages which are 
 inseparable from all kinds of travelling. 
 
 With respect to the length of time which a con- 
 sumptive invalid may require to pass in a mild cli- 
 mate, in order to overcome the disposition to the 
 
PULMONAllY CONSUMPTION. 63 
 
 disease, no general rule can be given. When the 
 measure is had recourse to for the removal of the 
 disordered health which precedes tuberculous cachexy, 
 a single winter will be of great benefit, and possibly- 
 all that may be necessary. When tuberculous ca- 
 chexy is established, and still more, when there is 
 tuberculous disease in the lungs, several years may 
 be requisite, and in some cases it may be necessary 
 to reside permanently in a mild climate. 
 
 When by the influence of climate and other mea- 
 sures pulmonary disease has been warded off, or 
 when it has ceased to make progress, everything 
 calculated to excite irritation in the lungs should be 
 carefully avoided ; as a tendency to a return of the 
 constitutional and local disorder remains long after 
 the symptoms have disappeared. When the disease 
 has advanced a step further, and a cure has neverthe- 
 less been effected during a residence in a mild climate, 
 the patient should remain there for a considerable 
 time (some years perhaps) after every symptom of 
 the disease has disappeared. The same plan of treat- 
 ment, and the same climate which enabled the con- 
 stitution to effect a cure, should be continued, if 
 possible, till the respiratory organs and system have 
 accommodated themselves to the new condition of the 
 parts. This may, indeed, be such that the individual 
 shall not be able to live in any other climate. Under 
 whatever circumstances he may be placed, such a 
 
64 PULMONARY CONSUMPTION. 
 
 person must make up his mind to live with great 
 regularity and temperance during the remainder of 
 his life. He will bear neither full living nor much 
 bodily fatigue, — although regular and moderate exer- 
 cise in the open air, and, above all, riding on horse- 
 back, will be of the greatest service to him. Conges- 
 tion and excitement of the pulmonary organs are 
 what he has most to dread. Although the disease 
 has ceased to advance, the lungs cannot be restored 
 to their former integrity ; they remain diminished in 
 capacity in proportion to the extent of tuberculous 
 disease which existed. The chest can therefore 
 neither be so fully expanded nor the blood so freely 
 circulated through the lungs as before. Hence, as 
 the capacity of the respiratory organs is diminished 
 relatively to the bulk of the body, there will be a 
 constant tendency to a plethoric or congested state of 
 the pulmonary system ; and if the quantity and quality 
 of the food, and degree of bodily exertion, are not 
 adapted to the new condition of the lungs, a renewal 
 of the tuberculous deposits, or heemorrhagy or inflam- 
 mation of these organs, will be the consequence, and 
 may speedily terminate a life which, by prudence, 
 might have been prolonged many years. \ A mild and 
 moderate diet, with abstinence from everything 
 exciting, can alone preserve such persons. The state 
 of the digestive organs requires particular attention, 
 as congestion and irritation there will speedily lead to 
 a similar state of the lungs. When a plethoric con- 
 
PULMONARY CONSUMPTION. 65 
 
 dition of the abdominal and pulmonary circulation 
 exists in a considerable degree, either hsemorrhagy 
 from the bowels or lungs, or apoplexy, or inflamma- 
 tion of some important organ, can scarcely fail to be 
 the consequence. This, accordingly, is the manner 
 in which such patients are often suddenly carried off. 
 The slightest indication of pulmonary congestion or 
 inflammation should be immediately attended to. 
 
 Artificial Climate. — In place of sending con- 
 sumptive patients to pass the winter in a foreign 
 climate, it has been proposed to keep them in rooms 
 maintained at a regulated temperature. With the 
 advocates for this measure, the state of the lungs 
 appears to be the only consideration; but without 
 improving the general health, by exercise in the open 
 air, all remedies directed to the local disease will be 
 of little avail; the removal of the constitutional 
 disorder can alone afford the patient a hope of reco- 
 very. In tuberculous cachexy, therefore, and even 
 in incipient stages of consumption, particularly in 
 young persons, I consider such a measure generally 
 most inadvisable. But in the advanced stages of 
 consumption, when removal to a distant climate is 
 worse than useless, life may be prolonged, in many 
 cases, by keeping the invalids in apartments the 
 temperature of which is regulated and the air main- 
 tained in a pure state. Females will, cceteris paribus, 
 bear such a system of confinement better than males. 
 
66 PULMONARY CONSUMPTION. 
 
 from the circumstance of its being more congenial to 
 tlieir usual habits of life. 
 
 In cases of inflammation of the lungs occurring 
 during the winter in persons predisposed to con- 
 sumption, keeping the patient entirely to the house, 
 in a regulated temperature, till all symptoms of the 
 disease have ceased, or even until the return of mild 
 weather, will often be very judicious. But when a 
 person so circumstanced has the means, he should 
 pass the following winter in a climate where confine- 
 ment will be unnecessary, and where he can improve 
 his general health by exercise in the open air. 
 
 Comparing, then, the benefits to consumptive 
 patients, likely to be derived from a mild climate, 
 and confinement to rooms regulated to an agreeable 
 temperature, there can be no question of the decided 
 superiority of the former. But when circumstances 
 preclude the possibility of changing the climate, and 
 the patient is found quite unfit to bear exposure to 
 the external air in this country, then confinement to 
 apartments, properly warmed and ventilated, is the 
 best measure we can adopt to avoid the injurious 
 effects of our cold, damp, and variable atmosphere, 
 during the severe season. 
 
 Various plans have been tried for keeping up a 
 uniform temperature, but with very imperfect success, 
 till the invention of the self-regulating stove by Dr* 
 Arnott, which secures an equable temperature both 
 
PULMONARY CONSUMPTION. 67 
 
 night and day. The objection brought against it, in 
 common with all other close stoves, is, that the apart- 
 ments are not at the same time properly ventilated ; 
 but this objection may be obviated by the chimney- 
 ventilator, also the invention of Dr. Arnott.* 
 
 But it is scarcely possible to maintain a steady 
 temperature in one or two apartments, the doors of 
 which have to be frequently opened, unless the air of 
 the whole house is warmed on its first entrance. This 
 may be eflfected by having a self-regulating stove, or 
 hot-water apparatus, in the lobby or entrance-hall, 
 through which the principal supply of air passes. 
 By maintaining the air throughout the house at a 
 certain degree of warmth, the invalid is enabled to 
 leave his apartments without experiencing any mate- 
 rial change of temperature in the stairs or lobbies. 
 
 In addition to any particular arrangement for 
 keeping up a constant ventilation, it would be of 
 great advantage to have the windows completely 
 thrown open for a few minutes several times every 
 day, when the invalid leaves his room, in order that 
 the air throughout the whole apartment may be com- 
 pletely renewed. The walls being always warm, 
 the cold air admitted soon acquires the proper tem- 
 perature. 
 
 By thus maintaining purity as well as warmth of 
 the air, by night as well as by day, not only in the 
 
 See chapter on Ventilation. 
 
68 PULMONARY CONSUMPTION. 
 
 rooms occupied by tlie invalid, but tbrougbout the 
 whole building, the injurious effects produced on the 
 constitution by passing the winter within doors, may 
 be in a great measure obviated, and the utmost advan- 
 tages which can accrue from such a measure secured. 
 The invalid who has passed some months in an 
 artificial climate established within doors, should, 
 previously to his first going out in the open air, 
 habituate himself to alternations in the degree of 
 temperature in his apartments. Even during his 
 confinement a considerable range in the temperature 
 of his rooms is not only admissible, but will be bene- 
 ficial. Long residence in a very equable climate is 
 not congenial to health, even with all the advantages 
 of exercise in the open air. A moderate range of 
 temperature and of atmospheric changes seems neces- 
 sary to the maintenance of health ; and hence it is, 
 that many invalids who derive great benefit from a 
 temporary residence in a mild, sheltered situation, do 
 not bear a long residence in such an atmosphere 
 without injury. Dr. Combe, during his residence in 
 Madeira, remarked that the invalids were better when 
 the temperature was less steady, and the weather 
 more variable, than when the season was unusually 
 mild and equable. I have remarked the same effects 
 resulting from a long residence in some of the more 
 sheltered spots in our own island. Such situations 
 form excellent residences for a time, after which the 
 patient ceases to improve, and rather loses than gains 
 
PULMONARY CONSUMPTION. (59 
 
 strength. A long residence in very mild, sheltered 
 positions I regard as unsuitable to young persons dis- 
 posed to tubercular disease. 
 
 The Respirator will prove a valuable protection 
 to a patient who has been long confined, on first going 
 into the open air, and for some time afterwards, on 
 any sudden or considerable fall of temperature. 
 Indeed, the habitual use of this instrument may, in 
 some cases, be made a substitute for climate.* By 
 maintaining in their houses a comfortable degree of 
 warmth both night and day, and by the use of the 
 Respirator out of doors, many persons who labour 
 under chronic bronchial disease might escape the 
 great aggravation of it which never fails to distress 
 them every winter. Those who dislike the appear- 
 ance of the metallic Respirator may contrive one for 
 themselves, of a less formal appearance. 
 
 By keeping up the habit of going daily into the 
 open air, in almost all weathers, under the protection 
 of warm clothing, and with the addition of a Respi- 
 rator during the prevalence of cold winds, persons 
 with very delicate lungs may bring themselves to bear 
 this climate, and even strengthen their constitution to 
 an extent not generally believed. If in addition to 
 this daily exposure to the open air for a longer or 
 shorter period, according to the state of the weather. 
 
 * Mr. Jeffrey has brought his Respirator to a state of great 
 neatness 5 and has reduced the price to the lowest rate, in order 
 that the poor may avail themselves of it. 
 
70 VENTILATION AND 
 
 means were taken to secure a more uniform tempera- 
 ture and an efficient ventilation in our houses, we 
 should meet with much fewer examples of pulmonary 
 and other diseases, generally attributed to the vicissi- 
 tudes of our climate, but for which we are more 
 indebted to the alternations of temperature created 
 by ourselves, and the neglect of those precautions 
 and means of defence which are within our power.* 
 
 VENTILATION AND UNHEALTHY RESIDENCES. 
 
 Ventilation. — The subject of ventilation as a 
 means of preserving health may fairly claim a place 
 in a work the leading object of which is to urge the 
 adoption of precautionary measures for the preven- 
 tion of the most widely spread and fatal class of dis- 
 eases in this country. The necessity of a due supply 
 of pure air for respiration is still so little understood, 
 that any arrangement for securing the ventilation of 
 houses rarely enters into the plans of the architect; 
 and yet nutritious food is not more necessary to the 
 maintenance of health than is the respiration of pure 
 air. The attention of the public has been of late in 
 some degree directed to ventilation by Dr. Reid's 
 publication on the subject, and his plans for ventila- 
 ting the Houses of Parliament, &c., and by Dr. 
 
 * For some excellent advice on this subject I refer to Dr. 
 Combe's * Principles of Physiology applied to the Preservation 
 of Health,' &c., eighth edition, chapter vii. 
 
UNHEALTHY EESIDEXCES. 71 
 
 Arnott's method of ventilating rooms by means of 
 the chimney- ventilators. This consists in a valved 
 opening into the chimney near the roof of the room, 
 the valve being so nicely adjusted and balanced that 
 whilst it admits a free current of air from near the 
 ceiling — the region of the most impure air — into the 
 chimney, it prevents all return of smoke. By this 
 simple but truly philosophical contrivance, the au- of 
 our rooms may be kept in a state of great purity by 
 night as well as by day. To the class of invalids for 
 whom this work is written the chimney-ventilator is 
 a most important arrangement.* Nothing contributes^ 
 more effectually to strengthen the constitution, and 
 render it capable of bearing the vicissitudes of climate, 
 than the constant respiration of pure air. On the 
 I other hand, nothing tends more certainly to weaken 
 
 1 and relax the system, and render it susceptible of the 
 impression of a cold or humid atmosphere, than 
 
 :^ breathing impure air. 
 
 In the construction of a house, the dimensions of 
 
 J the bedrooms and the means of ventilating them, 
 ought to be one of the first considerations ; whereas 
 they are comparatively little thought of Nothing, 
 
 * Much as Dr. Arnott has done by his scientific inventions — 
 the Hydkostatic Bed, the Self-eegulating Stove, the Ven- 
 tilating Air-pump, &c. — the Chimney Vbntilator, as a means 
 of preserving health, may be regarded as the most important of 
 the whole ; and, simple as it appears, it is unquestionably one of 
 the most valuable gifts ever contributed by science to the preser- 
 vation of health. 
 
72 VENTILATION AND 
 
 indeed, can be constructed on a worse principle than 
 our bedrooms generally are. Their small size and 
 their lowness render them very insalubrious ; and the 
 case is rendered worse by close windows and thick 
 curtains and hangings with which the beds are often 
 so carefully surrounded as to prevent the possibi- 
 lity of the air being renewed. The consequence is, 
 that we are breathing vitiated air during the greater 
 part of the night, that is, during more than a third 
 part of our lives ;* and thus the period of repose, 
 which is necessary for the renovation of our mental 
 and bodily vigour, becomes a source of disease. Sleep 
 under such circumstances is very often disturbed, and 
 always much less refreshing than when enjoyed in a 
 well- ventilated apartment ; it often happens, indeed, 
 that such repose, instead of being followed by reno- 
 vated strength and activity, is succeeded by a degree 
 of heaviness and languor which is not overcome till 
 the person has been some time in a purer air. Nor 
 is this the only evil arising from sleeping in ill-venti- 
 lated apartments. When it is known that the blood 
 undergoes most important changes in its circulation 
 through the lungs, by means of the air which we 
 
 * The remarkable lowness of the bedrooms in numerous new 
 houses at this time building in and around London, affords 
 abundant proof of the truth of this remark. If a Board of 
 Health existed in this country, it would be part of their duty to 
 draw up and circulate instructions for the construction of build- 
 ings, and the preparations necessary for rendering them healthy 
 residences. 
 
UNHEALTHY KESIDENCES. 73 
 
 breathe, and that these vital changes can only be 
 effected by the respiration of pure air, it wiU be easily 
 understood how the healthy functions of the lungs 
 must be impeded by inhaling, for many successive 
 hours, the vitiated air of our bedrooms, and how the 
 health may be as effectually destroyed by respiring^! 
 impure air as by living on unwholesome or innutri- 
 tions food. In the case of children and young per- 
 sons predisposed to consumption, it is of still more 
 urgent consequence that they should breathe pure 
 air by night as well as by day, by securing a continuous 
 renewal of the air in their bedrooms, nurseries, 
 schools, &c. Let a mother who has been made 
 anxious by the sickly looks of her children, go from 
 pure air into their bedroom in the morning, before a 
 door or window has been opened, and remark the 
 state of the atmosphere, — the close, oppressive, and 
 often fetid odour of the room, — and she may cease to 
 wonder at the pale, sickly aspect of her children. 
 Let her pay a similar visit some time after means 
 have been taken, by the chimney-ventilator or 
 otherwise, to secure a full supply and continual re- 
 newal of the air in the bedrooms during the night, 
 and she will be able to account for the more healthy 
 appearance of her children, which is sure to be the 
 consequence of supplying them with pure air to 
 breathe. 
 
 The following instance shows the effects of venti- 
 lation on the health of children in a striking manner. 
 
 £ 
 
74 VENTILATION AND 
 
 In a school at Norwood, containing 600 boys, scrofula 
 prevailed extensively, and great mortality had oc- 
 curred, which was ascribed to bad and insufficient 
 food. Dr. Arnott, who was called to investigate the 
 cause of the disease and mortality, found the food 
 good and abundant, but the ventilation extremely^ 
 defective. Ventilation was properly applied, and the 
 scrofula speedily disappeared. Eleven hundred chil- 
 dren are now maintained in good health in the same 
 space where six hundred, before a regular system of 
 ventilation was adopted, were scrofulous and weakly. 
 Numerous examples of the same kind might be cited 
 to show the destructive effects of impure air on the 
 health of children. The atmosphere of many bed- 
 rooms is no better than that of the school at Norwood, 
 and children are even longer confined in it than they 
 are at school. Mr. Toynbee, in his evidence before 
 the " Health of Towns Commission," stated as the 
 result of his extended inquiries and observations on 
 the state of the poor in St. James's and St. George's 
 parishes, that the principal cause of scrofula was 4 
 defective ventilation. And he has recently informed 
 me that his further investigations on the subject — 
 and these have been both extensive and various — 
 afforded him many additional proofs of the correctness 
 of his opinion, that the respiration of impure air is the 
 principal cause of scrofula among both rich and poor.-^ 
 This is the opinion of M. Beaudelocque, an eminent 
 French physician, whom I cited in my work on 
 
UNHEALTHY RESIDENCES. *!5 
 
 Consumption. He considers the repeated respiration 
 jkOf impure air as the essential cause of scrofula ; that 
 if there be entirely pure air, there may be bad food, 
 deficient clothing, and want of personal cleanliness, 
 but that scrofulous diseases cannot exist.* 
 
 These remarks, in regard to the importance of free 
 ventilation in bedrooms, are equally applicable to 
 nurseries, school-rooms, and all places occupied by 
 the young ; as also to the workshops of that nume- 
 rous class of our population engaged in sedentary 
 occupations. 
 
 To secure efiicient ventilation, or a continuous 
 renewal of the air in all inhabited rooms, the pure 
 air should be admitted, so diffused as to avoid currents, 
 from below, and the deteriorated air allowed to 
 escape freely from above, — a circulation in accord- 
 ance with the natural motion produced in air by 
 increase of temperature, and prevented only by the 
 interference of art. To understand the proper me- 
 thod of ventilating, we have only to attend to the 
 currents which take place naturally in all inhabited 
 rooms. Air, as it increases in temperature, or becomes 
 loaded with watery vapour, has its weight diminished, i 
 and ascends. Now the air in an inhabited apartment 
 being both heated and generally combined with a 
 portion of watery vapour, from respiration, &c., 
 
 * ' Etudes sur les Causes, la Nature, et le Traitement de la 
 Maladie Scrofuleuse.' 
 
 E 2 
 
VENTILATION AND 
 
 becomes specifically lighter, at the same time that it 
 is vitiated, and rises to the roof. If it had the means 
 of escape, it would be gradually forced out by an 
 equal quantity of pure and more dense air entering 
 below, which, in its turn, becoming heated and dete- 
 riorated, would in like manner ascend and make its 
 escape ; thus would a continual renewal of the air go 
 on without any trouble on our part. Unless provi- 
 sion be made for the escape of the ascending current 
 ,of impure air, no admission of external air will secure 
 proper ventilation,* 
 
 Unhealthy Residences. — If it is requisite to 
 secure proper ventilation within our dwellings, it is 
 no less necessary that the air around them should be 
 pure and salubrious. The best internal arrange- 
 ments for ventilation cannot change the character of 
 the external air, nor prevent the injurious effects of a 
 ^ humid, relaxing atmosphere on the health of the in- 
 mates. 
 
 Persons living in low, damp, or confined situations, 
 rarely enjoy that degree of vigorous health of which 
 their constitution admits. Without suffering from 
 any formal disease, they are subject to various com- 
 
 * For more detailed explanations with respect to ventilation 
 and the means by which it may be carried into effect, the reader 
 is referred to Dr. Arnott's ' Treatise on Warming and Venti- 
 lating,' and Dr. Raid's ' Illustrations of the Theory and Practice 
 of Ventilation.' 
 
UNHEALTHY RESIDENCES. Y7 
 
 plaints which often imbitter their life, and render 
 them much less capable of bodily and mental exertion 
 than they would be if placed in a situation more 
 congenial to their constitution. They possess an in-. 
 ferior degree of vitality, and if attacked by disease, 
 they sink more rapidly under it than the inhabitants 
 of a healthy situation. 
 
 Dyspepsia, and its various concomitants — headaches, 
 general nervous irritability, and a variety of anoma- 
 lous nervous complaints, with languor and depression 
 of spirits — maybe enumerated among the more common 
 ills resulting from a residence in unhealthy situations. 
 All these ailments, in addition to others peculiar to 
 the sex, are more severely felt by females, because 
 they are more susceptible, and at the same time more ♦ 
 subjected to the influence of the locality in which 
 they reside. During infancy and childhood, the effects . 
 of a confined, humid atmosphere are most destructive ; 
 at this early age scrofula is almost the certain con- 
 sequence of residing in such a locality. 
 
 Under these circumstances, nothing affords so 
 effectual and speedy relief as a change of residence, 
 even for a short time, to a drier and more elevatedt 
 situation and a more bracing air. In very many 
 instances this is indeed the only means of restoring 
 the person to a better state of health. The increase 
 of strength and buoyancy of spirit, the mental energy, 
 as well as bodily vigour, which persons residing in a 
 close, humid atmosphere experience on changing to a 
 
<» VENTILATION AND 
 
 dry, open, and elevated part of the country, surprise 
 and delight them, and they hope that this state of 
 well-being may be permanent ; but a return to their 
 former residence soon convinces them that their feel- 
 ings of increased health were but temporary, and 
 t|:dependent entirely upon their change of residence. 
 
 Much might no doubt be done to improve the 
 condition of many unhealthy places by removing all 
 obstacles to a free circulation of air, and all sources of 
 humidity, especially stagnant waters, by draining, 
 &c. But until the public are fully acquainted with 
 the circumstances which require attention in the 
 selection and preparation of situations for building, 
 the complaints alluded to, and which may be fairly 
 styled malarious, will continue more or less.* 
 
 In a climate naturally humid, like that of Great 
 Britain, it is of the first importance in the selection 
 of a situation for building that it should admit of a 
 free circulation of air and thorough drainage. In 
 proportion as the soil is impermeable to, or retentive 
 of humidity, so ought the site of the building to be 
 high, in order to allow of sufficient fall for the water4 
 to drain off. 
 
 Trees and shrubberies close to houses are not 
 
 * When the public are better informed on the subject, many of 
 those places now inhabited around London will be abandoned 
 to what they are alone suited for, namely, the cultivation of fruit 
 and vegetables, and higher and drier situations will be selected 
 for human habitations. 
 
UNHEALTHY RESIDENCES. 79 
 
 only direct causes of humidity, but they act still more t_ 
 injuriously by impeding a free circulation of air and-j- 
 excluding the sun's rays. This is one of the 
 most frequent, and I may add most powerful, causes 4. 
 of insalubrity in country houses in England ; and the 
 case is frequently rendered worse by the addition of 
 stagnant water, in the form of ponds. Many country 
 houses, and indeed whole tracts of country, are 
 rendered unhealthy by the quantity of wood alone. J^ 
 The over-wooded state of the parks of many of the 
 nobility and gentry, especially in a flat country, is a 
 fertile source of ill-health, often of positive disease, 
 more especially in the autumn and spring. Fevers, 
 often of a dangerous character, bowel complaints, and 
 rheumatism, frequently originate in such situations,? 
 as do other afiections already noticed, which, although 
 not remarkable for their severity, are not less dis- 
 tressing from their permanency. Were trees, and 
 especially thick underwood, kept more distant from 
 houses, and rank grass, stagnant water, and other 
 obvious sources of impure humidity removed, and 
 more attention paid to drainage, a masrked improve- 
 ment would be effected in the health of the inhabitants 
 of such localities. The circulation of a purer and 
 drier air around their dwellings would be to them , 
 what the ventilation of the bedrooms would be to the 1 
 pale, sickly children who inhabit these. 
 
80 DISEASES OF THE LARYNX, 
 
 DISEASES OF THE LARYNX, TRACHEA, AND 
 BRONCHI. 
 
 In no class of complaints is tlie beneficial action of 
 change of air and climate more speedily manifested 
 than in irritations of the membrane lining the bronchi 
 or air-tubes of the lungs. In the slighter or more 
 superficial degrees of irritation, a change to a very 
 short distance only has a remarkable effect ; coughs 
 arising from this cause, and which had resisted me- 
 dical treatment for many weeks, often cease in the 
 course of a few days. But in protracted cases the 
 disease assumes a more fixed character, and may 
 require a thorough change of climate to produce 
 much effect upon it. 
 
 Some previous treatment will generally be neces- 
 sary to prepare the patient for deriving full advantage 
 from such a change ; and he should be made ac- 
 quainted with the various causes likely to increase 
 his disease while travelling. The long continuance 
 of the disease is no reason for disregarding these pre- 
 cautions, as chronic inflammation may be easily made 
 to assume during a journey a more acute character. 
 
 The next circumstance which requires attention in 
 bronchial diseases, is the state of the digestive organs. 
 Irritation of the lungs, more especially after the 
 middle period of life, is very often a sympathetic 
 affection, depending upon irritation of the stomach and 
 duodenum, and congestion of the liver. Accordingly, 
 
TRACHEA, AND BEOXCHI. 81 
 
 on tracing the progress of chronic bronchial diseases, 
 we shall generally find that they were preceded for 
 some time by a disorded state of the digestive organs. 
 In such cases, the cure depends more upon the 
 correction of the primary disorder, than upon the 
 direct influence of climate on the organs of respira- 
 tion. Indeed the chronic, and even the acute in- 
 flammations of the chest, are comparatively of easy 
 management when the digestive organs are in a state 
 of integrity, — when the abdominal circulation is 
 unembarrassed, and the various secretions connected 
 with digestion, free and natural.* 
 
 "When the patient is suffering from dyspeptic dis- 
 order, therefore, this should be remedied, as far as 
 possible, before he leaves his own country ; otherwise 
 the change, so far from proving beneficial, may be 
 injurious to him. 
 
 The skin will also require our particular attention, 
 as it is seldom in a healthy condition in persons who 
 have long laboured under bronchial irritation. 
 
 For the general management of such invalids 
 during the journey, I beg to refer to the Introduc- 
 tory Remarks to the Second Part of this work : and 
 for directions respecting regimen, to the article on 
 ' Disorders of the Digestive Organs' ; as they are 
 strictly applicable to the class of diseases now under 
 
 * For some very judicious remarks on this subject, I beg to 
 refer to the notes on the article * Pneumonia/ in Dr. Forbes's 
 translation of Laennec. 
 
 E 3 
 
82 DISEASES OF THE LARYNX, 
 
 consideration. One remedy, however, namely, warm 
 bathing, which is highly useful in dyspeptic com- 
 plaintSj requires to be employed with much caution 
 in bronchial, and still more in tracheal and laryngeal 
 irritations ; and, unless by medical advice, it had 
 better be omitted altogether in such cases during the 
 journey. 
 
 Besides these important points, which the physi- 
 cian alone can regulate, there are some minor cir- 
 cumstances which claim the patient's special atten- 
 tion ; and respecting which he can minister to him- 
 self. Persons labouring under irritation of the re- 
 spiratory organs should be particularly careful during 
 the journey, and, indeed, at all times and in all 
 climates, to avoid currents of air. Although it is 
 important that they should take daily exercise in the 
 open air, when the weather is favourable, it is far 
 better to remain for a few days within doors, than to 
 expose themselves to a cold and humid atmosphere, 
 or to cold winds. 
 
 To persons suffering from bronchial irritation, or 
 who are very liable to that complaint, the application 
 of cold water, or salt or vinegar and water, to the 
 chest and neck every morning, followed by active 
 friction, is very useful. When cold water is not 
 borne, tepid water may be used with benefit. This 
 practice might be generally adopted, with great ad- 
 vantage, at all seasons in this country. 
 
 By means of sponging with cold or tepid water 
 
TRACHEA, AND BKONCHI. 83 
 
 daily, or the cold or tepid shower-bath and friction, 
 and the occasional use of the warm bath, with a 
 steady perseverance in a mild regimen and regular 
 exercise, particularly on horseback, a surprising 
 change may often be effected in the health and feel- 
 ings of delicate persons, and their sensibility to cold 
 be greatly diminished.* 
 
 Warm clothing is particularly necessary ; and flan- 
 nel next the skin, during the day, I consider indis- 
 pensable. When the trachea is the seat of the affec- 
 tion, the neck and upper part of the chest should 
 be particularly well covered during the winter and 
 spring. The lower extremities should also be kept 
 warm ; and I wish it to be understood that these 
 precautions are as necessary in the South of Europe 
 as in this country : for, although the weather is alto- 
 gether considerably warmer and drier, and the winter 
 much shorter, in Italy than in England, the alterna- 
 tions of temperature are quite as great, and the 
 houses colder. The spring, too, in the South of 
 Europe, is very irritating ; and hence, during that 
 season, the greatest circumspection is required on 
 
 * ** In my own experience," says Dr. Forbes, " the effect of 
 sponging the chest with cold water and vinegar once or twice a- 
 day has proved of immense benefit to delicate subjects, and more 
 especially to those liable to catarrhal affections, and to persons de- 
 cidedly phthisical. In these cases, although no doubt the prac- 
 tice proves tonic to the system generally, I conceive its chief 
 operation is in lessening the sensibility of the lungs to the im- 
 pression of co\d."—2Vanslation of Laennec, 3rd edit. p. 98. 
 
84 DISEASES OF THE LABYNX. 
 
 the part of the class of invalids for whom I am now 
 writing. 
 
 "With respect to the best winter and spring resi- 
 dence, I found E-ome agree more decided^ with 
 such patients than any other place on the Continent ; 
 and I repeatedly had occasion to compare its influ- 
 ence with that of the other climates upon the same 
 patients. The climate of Rome is not, however, so 
 certainly beneficial when the disease is accompanied 
 with copious expectoration, and a relaxed state of 
 the system, as that of Nice ; but in dry tracheal 
 and bronchial afl^ections the climate of Rome, and 
 also that of Pisa, are preferable. Rome has several 
 obvious advantages over the other residences on the 
 Continent for patients labouring under bronchial 
 irritation. It is little liable to high winds, the air is 
 soft, and the surrounding country well adapted for 
 riding, — the best exercise for such patients. 
 
 But at Rome, the invalid labouring under bron- 
 chial disease will find reason for much self-denial. 
 He must be cautious in his visits to the cold galleries 
 and churches, and to such of the ancient ruins as are 
 damp, or subject to currents of air ; else he may sub- 
 ject himself to repeated relapses. During a strong 
 northerly wind he should not leave the house. I 
 have known a single ride, during the prevalence of 
 this wind, produce a renewal of the disease in a 
 patient who had been steadily improving for several 
 months. 
 
TRACHEA, AND BRONCHI. 85 
 
 "With the exception of cases in which there is a 
 copious expectoration and a relaxed state of the 
 system, Madeira is preferable to any part of the 
 Continent. In the dry bronchial irritations, Torquay 
 is the best climate in this country ; for those with 
 copious expectoration, a relaxed condition of the 
 system, or an atonic state of the digestive organs, the 
 climates of Undercliff and Clifton are preferable. 
 Invalids of this class may derive great benefit from a 
 tour during the summer, or from frequent changes 
 of place ; which proves to delicate invalids much 
 more beneficial than a continuous journey. Travel- j 
 ling rapidly seldom fails to derange the system in* 
 some degree. This will in a great measure be coun- 
 teracted by short journeys, and by resting occasion- ! 
 ally a week or ten days; at the same time, to be 
 effectual, the extent of the tour should be consider- 
 able, and all those precautions which have been sug- 
 gested as necessary on a journey ought to be at- 
 tended to. 
 
 It is scarcely necessary, after what has been said 
 on diseases of the mucous membrane of the digestive 
 and respiratory organs, to enter on the subject of 
 similar diseases of the mucous surfaces of other parts. 
 It may suflice to observe, that in chronic irritation . 
 of all these membranes, a mild climate will generally | 
 prove beneficial. 
 
88 ASTHMA. 
 
 ASTHMA. 
 
 Asthma is a term applied in common language to 
 various diseases in which difficulty of breathing is a 
 prominent symptom. In technical language it im- 
 plies a disease in which the difficulty of breathing 
 occurs in paroxysms. Asthma is very often sympa- 
 thetic of a morbid state of some other important 
 organ, as the heart, the digestive organs, the womb, 
 &c. Before recommending climate, or any other 
 remedy, to an asthmatic patient, therefore, the state 
 of these organs ought to be carefully inquired into. 
 In almost all cases of asthma, the digestive organs 
 are disordered. The skin is also very often dry, 
 harsh, and not unfrequently affected with eruptions. 
 The connexion between the morbid states of the 
 skin and this disease is rendered very evident, in some 
 cases, by the first attack of asthma succeeding to, and 
 apparently depending upon, the disappearance of 
 some cutaneous complaint, which had been injudi- 
 ciously removed by local applications, while the cause 
 of it was neglected : this I have known to occur at 
 the early age of five years, the asthma continuing 
 under various and great changes of climate. 
 
 In no disease, perhaps, is the efiect of change of air 
 more conspicuous than in asthma. Speaking generally, 
 it may be affirmed, that a removal to a warmer climate 
 is highly beneficial in this disease; but the degree 
 of relief will depend greatly upon the climate being 
 
ASTHMA. 87 
 
 suited to the particular case. We must not, therefore, 
 prescribe for a name, but take into account the 
 whole pathological condition of the patient, in order 
 that we may be enabled to fix upon the climate best 
 suited to his case. 
 
 The following forms of asthma require attention, 
 in prescribing change of air or climate. 
 
 Pure Nervous Asthma. — It is difficult to say 
 what place will agree best with this form of asthma. 
 The general constitution of the patient, and his past 
 experience in the particular quality of air which 
 suits him, will assist us in deciding. This form of 
 the disease is comparatively very rare, and I did not 
 see a sufficient number of cases while abroad to 
 enable me to state anything very positive respecting 
 the influence of particular climates on it. What 
 very often passes for simple spasmodic asthma will 
 be found, on closer examination, to be complicated 
 with that diseased state of the mucous membrane of 
 the lungs, termed dry catarrh, an affection which 
 frequently remains latent for a considerable time, and 
 is often overlooked altogether ; nevertheless it is a 
 very frequent cause of asthma. In this form of 
 disease, the climate of E-ome will generally be found 
 to agree well. That of Madeira I should also expect 
 to prove very beneficial. 
 
 Humid Asthma. — This variety is asthma compli- 
 
88 GOUT. 
 
 cated with chronic bronchitis, and is one of the most 
 common forms of the disease. It may be either idio- 
 pathic, or symptomatic of disordered digestive or- 
 gans ; in the former case, it is commonly much 
 benefited by the climate of Nice ; which is also often 
 useful in the latter variety, although the amount of 
 benefit will depend on the kind and degree of the 
 gastric afiection of which the asthma is symptomatic. 
 On this subject I need not repeat what has been 
 already said in the articles on Dyspepsia and Bron- 
 chial Diseases. Rome I found very beneficial in 
 some cases of this form of asthma. 
 
 Cardiac Asthma. — Asthma dependent upon, or 
 complicated with disease of the heart, may receive 
 temporary relief from a mild climate ; but the na- 
 ture of the primary disease demands the chief con- 
 sideration, as upon our power of abating it must 
 mainly depend our hopes of producing any perma- 
 nent effect upon the asthma. When change of 
 climate is adopted in this complication, a voyage is 
 preferable in general to a land-journey. 
 
 GOUT. 
 
 In the early stages of this disease, if the patient pos- 
 sesses sufficient resolution to adhere to a regimen 
 calculated to remove the gouty disposition entirely, a 
 residence for some time in a mild climate will greatly 
 favour his endeavours. 
 
CHROXIC BHEUMATISM. 89 
 
 In confirmed cases, when the joints are permanently 
 affected, and when serious inroads have been made 
 on the constitution, a mild climate very often improves 
 the state of the general health, and prolongs the 
 interval between the paroxysms. 
 
 The regimen of the gouty invalid, residing in the 
 South of Europe, while it requires to be regulated 
 according to the circumstances of the individual case, 
 should also be adapted to the climate. If the disease 
 is in an early stage, and a cure is expected, a very 
 mild regimen is necessary; and, as a part of this, 
 ji total abstinence from wine. When the disease has 
 been of long standing, and amelioration only is looked 
 for, the previous habits of the patient must be taken 
 into consideration in regulating his regimen. A 
 mild diet will, however, be more necessary in Italy 
 than in England. Sweet, acid wines should be 
 avoided; but the sound French wines, especially 
 those of Bordeaux, will soon be found to agree with 
 the generality of such invalids ; and, contrary to the 
 general belief, prove less " gouty," and less injurious 
 to the health, than the more spirituous wines of Spain, 
 Portugal, and Sicily : abstinence from all kinds of wine | 
 is still better, even in cases of gout of long standing. 
 
 CHRONIC RHEUMATISM. 
 A RESIDENCE for somc time in a mild climate proves | 
 of the greatest benefit in chronic rheumatism. Ac- 
 cording to my experience, Nice and Rome are the 
 
90 CHRONIC rheumatism; 
 
 best climates on the Continent for this disease. 
 Rheumatism is very often complicated with, and kept 
 up by, a disordered state of the digestive organs, 
 without the removal of which the affection of the 
 joints can scarcely be cured. In cases of this nature, 
 when gastritic irritation exists, Eome is the better 
 climate ; while in the pure chronic rheumatism Nice 
 deserves the preference, — as it does also in those 
 cases in which the disease is attended with an atonic 
 state of the digestive organs. In cachectic rheu- 
 matism, or that chronic affection of the joints de- 
 pendent upon a cachectic state of the system, Nice 
 has also appeared to agree well. 
 
 There are no doubt other diseases in the cure of 
 which climate may be made available. Some intract- 
 able cutaneous affections may be named as among the 
 number ; and Dr. Walshe, in his admirable work on 
 Cancer, just published,* has suggested the probability 
 of change of climate proving beneficial in checking 
 the course of that fatal disease in its very early stage. 
 Were such a measure adopted, " the two conditions," 
 Dr. Walshe observes, " of total change of climate, and 
 of removal to a land where the disease is almost un- 
 known, would be best fulfilled by sending sufferers 
 
 * ' The Nature and Treatment of Cancer,' by W. H. Walshe, 
 M.D., Professor of Pathological Anatomy in University College, 
 London, &c. &c. 8vo. London, 1845. 
 
DELICACY IN CHILDHOOD AND YOUTH. 91 
 
 / in this country to Egypt or Algeria.'' Certain it is, 
 as this author shows in another part of his treatise, 
 the inhabitants of the northern parts of Africa are 
 
 \ peculiarly exempt from cancerous complaiuts ; but 
 Dr. Walshe signifies, and I think justly, his doubts 
 whether this exemption can be fairly referred to the 
 special influence of climate, and not to some concomi- 
 tant conditions. " Wherever the disease is particu- 
 larly rare," he observes, " it may be remarked that a 
 low state of civilization prevails; wherever social 
 organization is of a highly perfect kind, there cancer 
 is common." 
 
 DELICACY IN CHILDHOOD AND YOUTH. 
 
 There are two periods in early life when a residence 
 for some time in the South of Europe is particularly 
 useful. 
 
 The first is during childhood, from about the 
 third or fourth to the tenth year. At this age 
 children often become delicate and subject to catarrh 
 on slight exposure to cold, to gastritic irritation, 
 constipated bowels, swellings of the lymphatic glands, 
 and other symptoms indicating a strumous disposi- 
 tion. In such cases a temporary residence in a warm 
 climate proves very beneficial. During my residence 
 in the South of Europe, I found the health of delicate 
 English children, whether of a strumous habit or 
 otherwise, very much improved by one or more 
 
92 DELICACY IN CHILDHOOD AND YOUTH. 
 
 winters in Italy. The mildness and dryness of the 
 Italian winter, and, still more, its shortness, compared 
 with that of this country, sufficiently account for the 
 beneficial eifects produced on the little invalids. 
 Their delicate frames are not chilled so much, nor for 
 so long a period of the year, as in our own climate, 
 while they are enabled to be much more in the open 
 air ; a circumstance of the greatest importance to deli- 
 cate children, and for the want of which nothing can 
 compensate. I must here, however, restrict my praise 
 to winter alone, as the summer in Italy has often an 
 injurious effect upon such children, especially if the 
 residence is prolonged beyond a single season.* 
 
 Rome and Nice are, according to my observation, 
 the best winter residences for children. The general 
 characters of their climates, and the opportunities 
 which the surrounding country affords for exercise, 
 give these places a superiority over other towns 
 resorted to by strangers in Italy. When the diges- 
 
 j tive organs are in an irritable 'state, Rome will be the 
 more suitable residence. On the other hand, if there 
 
 ^ is a torpid, languid state of the constitution, Nice 
 affords a preferable climate. "What answers well is 
 to spend the winter at Nice or Naples, and the 
 spring at Rome. 
 
 * The winter in Italy proves useful in difficult dentition, but 
 summer is in the same degree pernicious. Infants in Italy should 
 generally be suckled for a longer period than in England ; and it is 
 a rule never to wean them in the spring while teething. 
 
i 
 
 DELICACY IN CHILDHOOD AND YOUTH. 93 
 
 Children subject to chronic croup will derive 
 advantage from a winter passed in Italy ; for 
 although this disease is generally connected with a 
 disordered state of the digestive organs, it is often in- 
 duced, in children predisposed to it, by exposure to a 
 cold and damp atmosphere. Croup is scarcely known 
 in Southern Italy; and among the English children 
 at Eome, who had previously had the disease, no re- 
 lapses, I believe, occurred during my residence there. 
 
 "When there is a disposition to hydi'ocephalus (com- 
 paratively a rare disease, as far as I could learn, in 
 the South of Europe), and when there is not much 
 gastritic irritation, the same change of climate will be 
 useful. 
 
 But by far the most serious disease of child- 
 hood, and that which, when rightly understood, forms 
 the key to the treatment of almost all diseases 
 occurring at this early period of life, is a disordered 
 state of the digestive organs. This subject is in my 
 opinion so important and so intimately connected with 
 the design of the present work, that I deem no apology 
 necessary for entering into it at some length. 
 
 Dyspepsia in Children. — A deranged state of 
 the digestive organs is the source of most of the 
 chronic, while it aggravates and increases the danger 
 from all the acute diseases to which childhood is 
 liable, such as hooping-cough, measles, and scarlatina. 
 If neglected, it also leads to an unhealthy youth and 
 
94 DELICACY IN CHILDHOOD AND YOUTH. 
 
 imperfect development of the body ; but above all, it is 
 a principal cause of that morbid state of the system 
 which has been denominated tuberculous cachexy. 
 In the hygienic management of children, therefore, 
 it is of the utmost importance that correct views 
 should be entertained respecting the causes and na- 
 ture of disorders of the digestive organs. 
 
 Dyspepsia may assume the same characters in 
 childhood as in the more advanced periods of life ; 
 but by much the most frequent and destructive form 
 of the disease is that which has been termed Stru- 
 mous Dyspepsia, from its being intimately connected 
 with the strumous constitution.* 
 
 The symptoms in the early stages vary much in 
 degree in different children, and when not well 
 marked may exist a considerable time without at- 
 tracting much notice. The child is thirsty and fretful 
 during the day, feverish and restless in the early part 
 of the night, and soon after falling asleep or towards 
 morning often bathed in copious perspirations, f The 
 tongue is generally florid, and towards the point the 
 papillae are prominent and red. The appetite is vari- 
 
 * Strumous Dyspepsia has been admirably described by my 
 late lamented and talented friend Dr. Todd, in his able article 
 on Indigestion, in the * Cyclopaedia of Practical Medicine.' To 
 that article I beg to refer the medical reader for a full account of 
 dyspepsia in all its forms. 
 
 f In the more acute form, it assumes the characters of Infantile 
 Remittent Fever. 
 
I 
 
 DELICACY IN CHILDHOOD AND YOUTH. 95 
 
 able; the bowels costive, and the motions generally- 
 pale ; the urine is high-coloured or turbid. As the 
 disease advances, the tongue becomes more loaded, 
 the breath fetid, the countenance loses its natural 
 colour and animated expression ; the child looks pale 
 and pasty, and the flesh is soft; the appetite is at 
 times craving, and at other times there is no desire 
 for food. If the little patient be neglected, or impro- 
 perly treated, the skin becomes harsh and dry, the 
 abdomen tumid, the extremities waste, the eyelids 
 are swollen and inflamed, and puriform discharges 
 frequently take place from the ears ; the glands of the 
 neck become enlarged, and cutaneous eruptions are 
 not uncommon. The child is now on the verge of 
 tuberculous cachexy, into which he soon lapses unless 
 judiciously treated. Dr. Todd considers this form of 
 dyspepsia more characteristic of the strumous or 
 tuberculous disposition than any of the external 
 signs which have been usually trusted to as its indi- 
 cations. 
 
 A change to a mild climate, when the disorder has 
 become chronic, will be of the utmost advantage to 
 the child. During summer, frequent changes of air 
 will be productive of great benefit. In the early part 
 of the summer the interior, and towards the end 
 and during the autumn the sea-side, will best suit 
 such children. But no general measure of this kind 
 should be adopted until the morbid state of the diges- 
 tive organs is in some degree corrected ; and wherever 
 
96 DELICACY IN CHILDHOOD AND YOUTH. 
 
 the child goes, this should receive constant attention. 
 For although the general health may be much im- 
 proved by change of air, or climate, the improvement 
 will not be permanent unless the congestion and irri- 
 tation of the digestive organs, in which the disorder 
 had its origin, and on which its continuance depends, 
 are removed. With this view every means calculated 
 to correct this state should be adopted. The most 
 important thing is the regulation of the diet. This must 
 of course have reference to the age of the child, and 
 the degree of congestion and irritation which exists. 
 Generally speaking, the diet should be of the blandest 
 kind, more especially in the case of children of an 
 excitable constitution. When there is thirst, a red 
 tongue, and hot skin at night, milk and farinaceous 
 
 I food should constitute almost the sole nourishment. 
 As the irritation abates, a little mild animal food every 
 second day may be allowed. For children of a more 
 torpid character of constitution, who have little dispo- 
 sition to fever, when the tongue is loaded, and all the 
 functions languid, a more exciting diet may be per- 
 1 mitted. The warm bath and friction will be beneficial 
 in all cases, more especially in the languid constitu- 
 tions just alluded to. Sponging with tepid, or even 
 
 ^ cold water, will also be found useful, but the cold 
 bath will seldom agree until the irritation of the 
 digestive organs is greatly abated, or entirely removed. 
 The great objects in the treatment are, to regulate' 
 the diet, according to the sensibility and power of the 
 
DELICACY IN CHILDHOOD AND YOUTH. 97 
 
 digestive organs, to promote an active state of circula- 
 tion in the surface and extremities, with the view of 
 obviating the congestion and irritation of the internal 
 organs, and imparting tone to the system. Without 
 correcting the morbid state of the duodenum, and 
 abating the congestion of the liver and abdominal/ 
 organs generally, it will be in vain to expect an active* 
 circulation in the surface and extremities, a healthy 
 condition of the skin, or the power of resisting cold. ? 
 This irritation of the digestive organs influences every } 
 function of the body, and without its removal all reme- 
 dies directed to the improvement of the general health 
 will produce only a partial and evanescent effect. 
 
 Although it is not the object of this work to dis- 
 cuss the subject of medical treatment, I cannot resist 
 the present occasion of entering my protest against 
 the routine practice generally adopted in the stru- 
 mous diseases of children. Active mercurial purga- 
 tives, an exciting diet of animal food, repeated, not 
 unfrequently, several times a- day, with the addition 
 often of porter, or wine, or both, and this followed or 
 accompanied by steel and other tonics, constitute 
 generally, in this country, the treatment of scrofulous 
 children. Such a mode of practice is at total 
 variance with the gastro -duodenal irritation and 
 hepatic congestion, which are present in a greater or 
 less degree in all cases of scrofula. The total want 
 of success, also, which attends this stimulating 
 treatment, and the marked and steady improvement 
 
 F 
 
98 DELICACY IN CHILDHOOD AND YOUTH. 
 
 produced by an opposite practice, afford a striking 
 illustration of the nature of the disease, and the treat- 
 ment founded upon it. The whole range of medical 
 practice does not, I believe, afford a more striking 
 example of the injurious effects of following a routine 
 practice without regard to the nature of the disease. 
 Because a small proportion of cases of scrofula, in tor- 
 pid, leucophlegmatic children, where an almost ane- 
 mic state exists, the preparations of iron and a stimu- 
 lating diet prove beneficial, the same mode of treatment 
 is indiscriminately applied to all! I have entered 
 the more fully into this subject because I know no 
 greater or more common error in the treatment of 
 strumous or delicate children, than that which has 
 just been pointed out, and none which is fraught 
 with more injurious consequences to the patient. 
 
 When change to a distant climate cannot be accom- 
 plished, a residence in some of the milder situations 
 in our own island will be of great service in improving 
 the health of delicate children. The sea-coast is 
 considered the best residence for scrofulous children 
 and delicate young persons generally. This opinion, 
 however, is not always correct; and even when sea- 
 air is desirable, it is not a matter of indifference what 
 situation is chosen. There is a considerable difference 
 in the climate of the various places on the sea- coast 
 resorted to by invalids.* For some cases of scrofula, 
 
 * See Climates of England, in Part II. 
 
DELICACY IN CHILDHOOD AND YOUTH. 99 
 
 a dry, bracing air, such as that of Brighton, will be 
 the most suitable; for others, the more sheltered 
 situations of Undercliff or Hastings; and the mild 
 and soft climate of the South Coast of Devon will in 
 many cases prove a very favourable winter residence, 
 whilst during the summer months a dry elevated 
 part of the interior, such as that afforded by the 
 Malvern Hills or Tunbridge Wells, is superior to 
 any part of the sea-coast. 
 
 The second period of youth at which I consider 
 a mild climate more decidedly beneficial, is about 
 puberty. It frequently happens, at this age, that from 
 pursuing a course of study too assiduously, especially 
 during the debility consequent upon rapid growth, or 
 from various other causes, the health is materially 
 injured ; the whole system is debilitated, and the 
 changes which take place at this period of life, either 
 do not appear, or do so imperfectly, and the develop- 
 ment of the body is not fully accomplished. The 
 young person loses colour, plumpness, and strength ; 
 the face is pale, and the features fallen ; the skin is 
 dry and harsh, or relaxed and moist, or the former 
 state alternates with general or partial perspirations : 
 cutaneous eruptions are also common; the feet are 
 very liable to become cold ; the bowels are constipated ; 
 the tongue loaded, and the digestive organs disordered. 
 The nervous system is morbidly sensitive, and the 
 temper irritable ; or there may be great mental de- 
 pression, and the whole moral character is often 
 
 r2 
 
100 DELICACY IN CHILDHOOD AND YOUTH. 
 
 remarkably changed ; there is an indifference to the 
 objects and pursuits which previously interested the 
 mind, and a disinclination for either bodily or mental 
 exertion. The patient, under such circumstances, is 
 on the verge of tuberculous cachexy. 
 
 One of the most powerful means of preventing such 
 disorders when threatened, and of removing them 
 when they are present, is a temporary residence in a 
 warm climate : and when the person is known to pos- 
 sess an hereditary predisposition to consumption, this 
 measure is more urgently called for, as the deranged 
 condition of the system, if not soon corrected, may 
 terminate in the constitutional disorder which we 
 have seen to be the precursor and essential cause of 
 consumption. If a more complete change of climate 
 cannot be accomplished, the winter should be passed 
 in some of the milder parts of our own island, where 
 by exercise in the open air, warm sea-bathing, and 
 a well-regulated diet, much may be done to rescue 
 the youthful invalid from the impending danger. 
 
 A very beneficial effect is produced upon the health 
 of delicate young persons by a change of residence 
 several times during the cold season, — the autumn 
 being passed at one place, the winter at another, and 
 the spring at a third. Brighton is one of our best au- 
 tumnal climates, and will very generally be found to 
 suit the cases under consideration. The choice of the 
 winter and spring residences will depend greatly upon 
 the constitution and special condition of the invalid. 
 
CLIMACTERIC DISEASE. 101 
 
 Although I have particularly noted early childhood 
 and puberty as the periods of life at which a mild 
 climate proves signally beneficial, there is no period 
 of youth at which it may not be had recourse to with 
 advantage under the circumstances pointed out. 
 
 CLIMACTERIC DISEASE, 
 
 We have just seen that climate may be made avail- 
 able for the correction and removal of derangements 
 of health occurring in youth and impeding the de- 
 velopment of the body ; we also find, that as age 
 advances, and the system begins to feel the weight 
 of years or the effects of long-continued exertion, 
 climate may be made highly beneficial in arresting the 
 premature decay of the mental and physical powers. 
 
 At the age of from fifty to sixty, sometimes earlier, 
 a remarkable change often takes place in the health, 
 without any very obvious cause. The person's ap- 
 pearance is greatly altered ; his strength is diminished, 
 and he generally becomes thin, and looks aged. He 
 is unequal to the mental and bodily exertions to which 
 he has been habituated ; and the consciousness of 
 this frequently induces a depression of spirits and 
 fretfulness of temper ; or these may exist as the im- 
 mediate effects of the bodily disorder. With these 
 more general evidences of deteriorated health, some 
 organ or organs of importance to life, most frequently 
 the digestive organs, show symptoms of disorder. An 
 habitual morning cough, with more or less of expecto-^ 
 
102 CLIMACTERIC DISEASE. 
 
 ration, cutaneous eruptions, swellings^ and pains in the 
 joints, or nervous affections, chiefly of a painful kind, 
 amounting even to tic-douloureux, often precede and 
 accompany the condition described ; or the individual 
 may lapse into a state of general cachexy, without 
 much evident local disease. The whole system is, in 
 these cases, in a morbid condition ; and if such a 
 person is attacked with any acute disease, the con- 
 stitution sinks under it with great rapidity. 
 
 This state constitutes what is not unaptly termed 
 in common language " a breaking up of the consti- 
 tution" ; which, in truth, it generally proves to be, if 
 not judiciously treated.* 
 
 These symptons of premature decay originate often 
 in too much mental exertion, or too close attention to 
 business, and its consequent cares and anxieties ; fre- 
 quently they are the effects of a sedentary life and an 
 habitual system of full living ; more frequently still, 
 they are the result of the combined influence of several 
 of these causes. From whatever cause the disorder 
 proceeds, one or two winters passed in a warm climate, 
 with the adoption of such a regimen and the use of 
 such other remedial measures as the particular case 
 may require, will prove of essential service in arrest- 
 ing the progress of decay, and restoring the invalid 
 to a state of better health. 
 
 ♦ See an excellent paper on the ' Climacteric Disease,' by the 
 late Sir Henry Halford, Bart., President of the Royal College of 
 Physicians, in the ' Medical Transactions,' vol. iv. p. 316, &c. 
 
DISEASES OF WARM CLIMATES. 103 
 
 Dr. Warren, of Boston, U. S., informed me that 
 lie had frequently remarked the beneficial influence 
 which a visit to Europe had in renovating the health 
 of his countrymen about the middle period of life, 
 when the constitution had begun to flag, from apj^li- 
 cation to business and the cares and duties of life ; 
 and he himself experienced from the same measure a 
 marked and lasting improvement in his own health. 
 
 The change of climate in this case is no doubt a 
 very complete one, and is accompanied with all those 
 favourable circumstances which contribute so much to 
 aid climate in the restoration of health. Anything, 
 indeed, more likely to produce a favourable change in 
 the constitution, and call forth its latent energies, 
 than a visit to Europe by a citizen of the United 
 States, can scarcely be imagined. 
 
 When a change of climate cannot be accomplished, 
 great benefit may be obtained from a change of air 
 in our own country, from the use of warm or tepid 
 sea-bathing, and a course of such warm mineral waters 
 as are suited to the case. But to derive permanent 
 benefit from these measures, the invalid must eschew 
 those causes which first brought him into jeopardy, 
 and henceforth adopt a mode of life more consistent 
 with his age and constitution. 
 
 Persons just returned to England, and whose con- 
 stitutions have suffered by a long residence in a 
 tropical climate, will find great advantage in spending 
 
104 DISEASES OF WARM CLIMATES. 
 
 one or more winters in the South of Europe before 
 finally settling in this country.* The great object in 
 such cases is to maintain an active state of the circu- 
 lation in the surface and extremities, by warm 
 clothing, exercise, friction, and the use of the warm 
 bath. By these measures, any sudden change in the 
 relative state of the circulation and secretion of the 
 skin and internal organs, the consequence of a removal 
 from a hot to a cold climate, will be obviated, and 
 pulmonary and hepatic diseases prevented, f 
 
 Friction in particular may be made an efficient 
 means of promoting an active state of the cutaneous 
 circulation. The flesh-brush, horse-hair gloves, or 
 flannel, may be used, according to the sensibility of 
 the skin ; but the friction, to be effectual, should be 
 active, and applied over the whole surface, particularly 
 
 * For some very judicious advice to persons returning from a 
 warm climate, the reader is referred to Dr. James Johnson's 
 * Essay on Morbid Sensibility of the Stomach and Bowels as the 
 Cause of Indigestion, &c.' Tenth Edition, 1840. 
 
 f The great prevalence of pulmonary diseases among the natives 
 of tropical climates who come to this and other cold countries, is 
 doubtless chiefly owing to the influence of a cold and humid atmo- 
 sphere upon their system. It is in such persons, and in young 
 children, that tuberculous diseases are more speedily induced, and 
 where inflammation appears more intimately connected with the 
 production of tubercles. The rapid progress of the disease, in both 
 these classes of persons, is to be explained principally, I believe, 
 by the circumstance of their habit of body being that which is 
 most disposed to tuberculous affections, — the most nearly allied 
 to tuberculous cachexy. 
 
CONVALESCENCE. 105 
 
 the extremities. Sponging the chest and arms every 
 morning with cold or tepid water, will also aid in pro- 
 moting the same objects. When the skin is torpid or 
 relaxed, active friction may be advantageously em- 
 ployed, before the cold sponging as well as after it. 
 
 There are various other states of impaired health, 
 in which change of air and climate prove very bene*^ 
 ficial. Indeed it would be difficult to point out the 
 chronic complaint or the disordered state of health 
 which may not be ameliorated by the judicious adop- 
 tion of such a measure. 
 
 In the convalescence from fevers and other acute 
 diseases, no remedy is so effectual in restoring the 
 invalid to health as a well-timed change of air ; and 
 if the disease has had its origin in local causes, such 
 a change is almost essential to recovery. But the 
 amount of benefit to be derived from change of air 
 will depend greatly upon the judgment with which 
 it is prescribed, both as regards the condition of the 
 patient and the selection of the place. The convales- 
 cence from acute diseases should be fully established 
 before the removal is attempted, otherwise a relapse, 
 
 Lin place of improvement, is very likely to be the 
 consequence. 
 Ague affords an exception to this rule. In this 
 disease the first intermission should if possible be 
 taken advantage of to remove the patient from the 
 situation in which it has occurred, and a farther 
 residence in which will render the cure difficult. The 
 I ^3 
 
106 CONVALESCENCE. 
 
 remedies whicli produce little effect upon an inter- 
 mittent fever in the locality where it originated, will 
 often effect a speedy cure when the patient is removed 
 elsewhere. 
 
 The selection of the place will depend in some 
 measure on the nature of the complaint. It should 
 generally be of a different character from that in 
 which the patient resides, more especially in the mal- 
 arious class of diseases to which we have just alluded. 
 For a person who has had acute pulmonary disease, a 
 mild air and sheltered situation will be the most 
 favourable until the pulmonary irritation has sub- 
 sided ; after which another change to a more bracing 
 air may be attended with great advantage, especially 
 to persons of a languid and relaxed system. The 
 object desired by the first change is to soothe and 
 allay irritation in the affected organs ; by the second, 
 to give tone to the system generally. A succession of 
 changes will in almost all cases prove more beneficial 
 than a residence at any one place. 
 
 Children profit by change of air with surprising 
 rapidity ; and there are few cases of deranged health 
 at an early age in which it does not merit the first 
 rank in the list of remedies. Delicate females also 
 benefit greatly ; indeed, in proportion to the natural 
 susceptibility of the individual, is the beneficial in- 
 fluence of a judicious change of air evinced. It is to 
 the young and delicate the best and often the only 
 efficient tonic ; and we have daily occasion to regret 
 
CONVALESCENCE. 107 
 
 the straitened circumstances which keep many such pa- 
 tients vacillating in a feeble state, between health and 
 disease, in the confined air of the city, or in some un- 
 healthy residence in the country, when they might 
 be restored to health and vigour by a temporary change 
 to a purer air. 
 
 * A Convalescent Institution has been established for that class 
 of patients who cannot afford to change the air of London for that 
 of the country. This Institution does much good, and deserves 
 every encouragement and support. Many such institutions are 
 wanted. Every hospital should have one attached to it. 
 
PART IL 
 
 ON CLIMATES. 
 
 INTRODUCTORY REMARKS. 
 
 Directions for Invalids. — I shall now endea- 
 vour to make the invalid, about to change his climate, 
 acquainted with the circumstances which demand his 
 more particular attention, previously to setting out, 
 during his journey, and after he is fixed in his new 
 residence. This is a matter of the greatest conse- 
 quence ; and a want of due attention to it is one of 
 the principal causes why much less benefit is derived 
 from climate than would otherwise be the case. 
 
 Too much is generally expected from the simple 
 change of climate. It often happens that from the 
 moment the invalid has decided upon making such a 
 change, his hopes are fixed solely upon it ; while other 
 circumstances, not less essential to his recovery, are 
 considered of secondary importance, and sometimes 
 totally neglected. This is an error not always con- 
 fined to the patient ; his medical adviser frequently 
 participates in it : nor is this difiicult to be ac- 
 counted for. The cases hitherto sent abroad have 
 
110 INTKODUCTORY REMARKS. 
 
 been, for the most part, consumptive^ or otlier 
 diseases of long standing, in which the ordinary 
 resources of our art have failed; therefore, when 
 change of climate has at last been determined upon, 
 the physician, as well as the patient, is disposed to 
 look upon it as the sole remedy. 
 
 But as I have witnessed on a pretty extensive 
 scale the injury arising from this over-confidence in 
 the unaided efiects of climate, and the consequent 
 neglect of other matters of no less consequence, I 
 particularly request the attention of invalids to the 
 following remarks. 
 
 In the first place, I would strongly advise every 
 person who goes abroad for the recovery of his health, 
 whatever may be his disease or to what climate 
 soever he may go, to consider the change as placing 
 him merely in a more favourable situation for the 
 removal of his disease ; in fact, to bear constantly in 
 mind, that the beneficial influence of travelling, of 
 sailing, and of climate, requires to be aided by such 
 a dietetic regimen and general mode of living, and 
 by such remedial measures, as would have been 
 requisite in his case had he remained in his own 
 country. All the circumstances requiring attention 
 firom the invalid at home, should be equally attended 
 to abroad. If in some things greater latitude may be 
 permitted, others will demand even a more rigid 
 attention. It is, in truth, only by a due regard to all 
 these circumstances, that the powers of the constitu- 
 
DIRECTIONS FOR INVALIDS. Ill 
 
 tion can be enabled to throw off, or even materially 
 mitigate, in the best climate a disease of long stand- 
 ing. 
 
 It may appear strange to some of my readers that I 
 should think it requisite to insist so strongly on the 
 necessity of attention to these directions ; but I have 
 witnessed the injurious effects of a neglect of them 
 too often, not to deem such remarks called for in this 
 place. It was, indeed, matter of surprise to me, 
 during my residence abroad, to observe the manner 
 in which many invalids seemed to lose sight of the 
 object for which they left their own country, — the 
 recovery of their health. This appeared to arise 
 chiefly from too much being expected from climate. 
 
 The more common and more injurious deviations 
 from that system of living which an invalid ought to 
 adopt, consist in errors of diet ; exposure to cold ; 
 over-fatigue, and excitement in what is called " sight- 
 seeing"; frequenting crowded and over-heated rooms ; 
 keeping late hours, &c. Many cases fell under my 
 observation, in which climate promised the greatest 
 advantage, but where its beneficial influence was 
 counteracted by the injurious operation of these 
 causes. 
 
 In order that the patient may derive advantage 
 from his journey, or at least that his complaint may 
 not (as often happens) be increased by it, some pre- 
 paratory measures will generally be requisite before 
 he sets out. Travelling is exciting to most people ; 
 
112 INTRODUCTORY REMARKS. 
 
 and to those who have chronic inflammation of any 
 organ, however latent or obscure, it very often proves 
 injurious, particularly during hot and dry weather. 
 Almost every one in health is sensible of the excite- 
 ment arising from travelling. The appetite is gene- 
 rally increased, while the secretions and excretions 
 are much diminished. The consequence is a degree 
 of excitement of the system, not unaptly termed by 
 travellers, " a heated state." "What in health amounts 
 only to a slight degree of excitement, easily removed 
 by a few days' rest and the employment of some com- 
 mon cooling remedies, often proves of serious conse- 
 quence to the invalid who labours under, or is even 
 disposed to, any inflammatory aflfection. 
 
 When, therefore, the patient's disease is of an in- 
 flammatory nature, or threatens to assume such a 
 character, his condition should be well examined 
 before he comm^ences a journey or voyage. If any 
 undue vascular excitement exists, measures should 
 be taken to reduce it by proper regimen, by rest, 
 tepid bathing, &c. ; and local, or even general bleed- 
 ing may be requisite in some cases. Simple conges- 
 tion, or an overloaded state of the vascular system, 
 general or local, will also require to be diminished 
 ^ far as the nature of the case admits. 
 
 Having his system in a proper state when he sets 
 out, the invalid should endeavour to keep it so 
 during the journey, — by adhering to a light diet, « 
 taking care not to overload the stomach even with \ 
 
DIRECTIONS FOR INVALIDS. 113 
 
 the mildest food ; by abstaining from wine and spirits 
 of every kind ; and by maintaining the regular action 
 of the bowels. The latter object is best effected by 
 laxatives, such as castor oil, and electuary of senna, 
 or by the use of mild lavemens. Purgatives of the 
 more drastic kind, such as generally enter into the 
 composition of pills, are apt to irritate the bowels 
 and increase the disposition to constipation, and may 
 determine an attack of haemorrhoids, a frequent con- 
 sequence of neglected or irritated bowels while tra- 
 velling. When such medicines are used they should 
 be of the least irritating kind, and the dose so regu- 
 lated as to produce a laxative effect only.* To these 
 means of maintaining the system in a cool state I 
 may add the use of warm or tepid bathing, which 
 should not be omitted where it can be conveniently 
 procured, and when there are no objections to it from 
 the peculiar nature of the patient's disease. When 
 used with the necessary precautions it is free from 
 danger, and will generally prove very useful in 
 obviating the exciting effects of travelling. The 
 temperature may be from 94° to 97*^ of Fahrenheit's 
 thermometer, according to the feelings of the patient. 
 The forenoon, or rather, just before dinner, is the 
 best period for taking the bath, and from twenty 
 minutes to half an hour the proper time for remain- 
 
 * The watery extract of aloes, made into a pill with extract of 
 henbane and mastick, forms one of the mildest and best of these 
 combinations. 
 
114 INTRODUCTOEY REMARKS. 
 
 ing in it. By adopting tlie general regimen above 
 indicated, and travelling sucli distances only as the 
 strength can bear (resting for a day when it is found 
 necessary), the invalid will not only escape the inju- 
 rious effects frequently produced by travelling, but 
 arrive at his winter residence in a much better state 
 of health than when he left his own country. This, 
 I may observe, however, is a rare occurrence in the 
 usual mode of conducting a long journey ; for, even 
 when no positive increase of disease is the result, 
 the traveller has frequently sufficient cause to regret 
 his inattention to the precautions above mentioned. 
 There is often induced a degree of general excitement, 
 and a deranged state of the secreting organs in par- 
 ticular, the injurious effects of which may be felt 
 by a delicate constitution during a considerable part 
 of the winter. The invalid thus not only loses the 
 benefit which the journey might have produced, but 
 part of that also which he would have obtained from 
 his winter residence. If he is wise, he will keep 
 these things in mind. It is the duty of his medical 
 adviser to prepare him for his journey, by allaying 
 any excitement which may exist in his system, and 
 removing any other morbid affections with which the 
 principal disease may be complicated, and which often 
 form insurmountable obstacles to recovery.* 
 
 * It is culpable on the part of a physician to send an invalid 
 abroad without laying down strict rules for his regimen. The 
 errors in diet committed by invalids, arising chiefly from their not 
 
DIRECTIONS FOE INVALIDS. 115 
 
 His system being thus prepared for the change, the 
 invalid should endeavour, by a strict adherence to 
 the prescribed regimen, to maintain it in the same 
 state throughout his journey. If during his journey 
 his pulse should become frequent, his skin dry and hot, 
 or if he has thirst or a dry tongue in the morning, or if 
 his nights are restless, he may feel assured that all is 
 not right. He is over-excited, either by too full a diet, 
 by too rapid travelling, by exposure to a hot sun, or by 
 the bowels being overloaded. In the generality of such 
 cases, a few days' rest, and the use of some such cool- 
 ing remedies as have already been mentioned, will allay 
 the irritation ; and the invalid may then pursue his 
 journey, taking care to avoid whatever he has reason 
 to beUeve excited him before. 
 
 Arrived at his place of residence, some measures 
 of the same kind will probably be necessary ; as it 
 will rarely happen that one shall reach the end of 
 a long journey, even under the best management, 
 without some degree of temporary excitement or de- 
 rangement of the system. The invalid should, if 
 possible, be spared the examination and selection of 
 apartments, and particular care should be taken to 
 have these thoroughly dry and ventilated before he 
 enters them ; this, I may remark in passing, is not to 
 
 having been made aware of their consequences, during journeys 
 and voyages, which have come to my knowledge, lead me to press 
 this matter as essential to the success of the measure on which 
 invalids have so much at stake. 
 
116 INTRODUCTORY REMARKS. 
 
 t be done in any part of the continent of Europe 
 
 I without the use of fires. 
 
 There are some other circumstances more imme- 
 diately connected with the change of climate, which 
 require to be noticed here. As the traveller ad- 
 vances to the South, the sensibility of the system is 
 
 f increased ; and hence his mode of living should be 
 regulated accordingly. Persons, for example, bear a 
 diet in England which would prove too exciting for 
 them in Italy. Some articles of food, also, are more 
 apt to disagree in the South : of this kind are fish, 
 milk, and even vegetables, all of which should be 
 used in great moderation by persons in delicate 
 health. As soon, therefore, as a person changes his 
 climate, he ought to adapt his manner of living to 
 that which he has begun to inhabit. Besides the 
 diet, the clothing also requires particular attention. 
 This should be as warm during the winter in the 
 South of Europe as in England. The feelings are 
 altered in respect to temperature ; and houses being 
 
 I relatively colder in Italy, warmer clothing is neces- 
 sary within doors than in this country. It is advisable 
 also to keep the whole apartment at a moderate tem- 
 perature, and to avoid approaching too near the fire. 
 I To seek also too exclusively the sun's rays is a habit 
 
 I particularly injurious in the South of Europe, more 
 
 f especially during the spring. From these causes 
 arise headaches, catarrhs, inflammatory afiections of 
 the chest, and even fevers. 
 
DIRECTIONS FOR INVALIDS. 117 
 
 This seems to be the proper place in which to speak 
 of the best periods for travelling. With respect to 
 the routes to the different parts of the Continent, the 
 ordinary ' Guides ' and books of ' Directions ' for 
 travellers contain such full information as to render 
 it unnecessary that I should enter on that subject.* 
 
 There are two periods when the invalid who 
 means to pass the winter in Italy may best leave 
 England, namely, early in June and early in Sep- 
 tember. In setting out at the former period, he may 
 pass the summer in Germany or Switzerland, — a 
 plan which will suit the health of many. By leaving 
 this country in September, and conducting the journey 
 with judgment, the patient may enjoy a mild climate 
 to the place of his destination. But to ensure this, 
 nothing should be allowed to interfere with the 
 steady progress of the journey, except such periods 
 of repose as the invalid may require. The proper 
 time for entering Italy is the end of September or 
 early in October. 
 
 For Nice and the South of France, the period of 
 departure need not be quite so soon ; although an 
 invalid can scarcely have too much time for his 
 journey, inasmuch as, if conducted with judgment 
 and made at the proper season, it will be more bene- 
 ficial to his health the more time it occupies, within 
 reasonable limits. When the weather is chilly, the 
 
 Mr. Murray's Hand-books will be found the best guides. 
 
118 INTRODUCTOKY REMARKS. 
 
 invalid should not commence his journey too early 
 in the morning, nor until he has taken a light break- 
 fast ; and he should endeavour to arrive at his sleep- 
 ing-quarters before the chill of the evening. 
 
 One of the most exciting things to a sensitive inva- f 
 lid is exposure to a powerful sun ; this should there- * 
 fore be sedulously avoided, by resting during the mid- 
 dle of the day when the weather is oppressively hot. 
 
 When there is a disposition to coldness of the ex- 
 tremities, it is of essential consequence to the well- \ 
 being of the patient to guard against this. If the ' 
 surface and extremities are kept warm, a delicate 
 person will often bear travelling in a very cool atmo- 
 sphere, and even derive advantage from it. Persons 
 with the slightest disposition to inflammation of the 
 throat, trachea, or lungs, should avoid exposure to 
 cold, or to high winds or a powerful sun, and, still 
 more, alternations of these, which are very apt to 
 occur in valleys and in crossing mountains. They 
 should also avoid approaching too near a strong fire 
 in the evenings after a journey. 
 
 The foregoing observations apply more or less to 
 all invalids going abroad for the benefit of their 
 health. Particular instructions respecting the con- 
 duct of those affected with special diseases, and while 
 residing at different places, will be found in the 
 articles devoted to the consideration of such diseases 
 and places. 
 
CLIMATE OF LONDON. UQ 
 
 CLIMATES OF ENGLAND. 
 
 The Mild Region of England admits of being 
 divided into four districts, or groups of Climate ; 
 tliat of the South Coast, comprehending the tract 
 of coast between Hastings and Portland Island ; the 
 South-West Coast, from the latter point to Corn- 
 wall ; the district of the Land's End ; and the West- 
 ern Group, comprehending the district along the bor- 
 ders of the Bristol Channel and aestuary of the Severn. 
 We shall find that each of these regions has some 
 peculiar features in its climate which characterize it 
 and distinguish it from the others, as regards both 
 its physical qualities and its influence on disease. 
 
 LONDON. 
 As a point of comparison, and for other reasons, it 
 will be useful to begin with a brief notice of the cli- 
 mate of the Metropolis. London is indebted for the 
 peculiarities of its climate chiefly to artificial circum- 
 stances. The crowded assemblage of so many living 
 beings ; the multifarious processes ministering to their 
 wants ; the countless operations of art ; the influence of 
 buildings, &c., in retaining, augmenting, and diffusing 
 warmth, by reflection, by radiation, and in other 
 ways, all tend, some in a greater, others in a less 
 
120 CLIMATES OF ENGLAND. 
 
 degree, to the creation of a peculiar climate in London. 
 The more indirect influence also of draining and 
 paving, in contributing to maintain a dry state of the 
 soil and atmosphere, must be taken into account. As 
 regards temperature, we have the influence of all 
 these circumstances very accurately demonstrated; 
 but the subject becomes more difficult when we would 
 discover the other elements which constitute the com- 
 plex problem of climate. 
 
 The mean annual temperature of London is 50° 
 39', being one and a half degree above that of the 
 environs.* 
 
 This difference of temperature between the metro- 
 polis and surrounding country is very unequally dis- 
 tributed throughout the year and throughout the day. 
 The excess of the City temperature is greater in 
 winter than in summer. It is at its maximum in 
 January, at which time it exceeds that of the environs 
 by 3°. In the spring months, the temperature of the 
 environs becomes nearly equal to, and in the month 
 of May rather exceeds, that of London. That accurate 
 observer, Howard, further shows^that this excess of 
 temperature of the City belongs in strictness to the 
 nights, which on an average are three degrees and 
 seven tenths warmer than in the country ; while the heat 
 of the day, owing, without doubt, to the interception 
 
 * The temperature of the environs is calculated from Howard's 
 observations made at Plaistow, Stratford, and Tottenham- Green, 
 
I 
 
 I 
 
 LONDON. 121 
 
 of a portion of the solar rays by a constant veil of 
 smoke, falls, on a mean of years, about a third of a 
 degree short of that on the open plain."* As was 
 also to be expected, the temperature of London does 
 not show so extensive a range between its extremes, 
 during either the year, the month, or the day, as the 
 temperature of its environs ; and the amount of vari- 
 ation between the successive days, which shows the 
 steadiness of temperature, is also considerably less in 
 the former than in the latter. Howard's observations 
 also prove, that although London is warmer than the 
 country, it acquires and loses its heat more slowly. 
 It will be the duty of the physician to decide how far 
 this gain in warmth (more particularly in the night), 
 in steadiness of temperature, and in a greater degree 
 of dryness and stillness, is counterbalanced by a dimi- 
 nution of the purity of the atmosphere, and of other 
 qualities of climate. The benefit so often experienced 
 by delicate invalids on coming from the country to 
 London, in the winter and spring, is no doubt owing 
 to the qualities of the climate above enumerated. It 
 is during the night that the climate possesses the 
 greatest advantages for the sensitive invalid. In ad- 
 dition to its warmth and dryness, the atmosphere is 
 then in its purest state, being free from the smoke and 
 
 * ' The Climate of London, deduced from Meteorological 
 Observations made in the Metropolis, and at various Places around 
 it.' By Luke Howard, Gent. Second edition, vol. i., p. 237. 
 London, 1833. 
 
122 CLIMATES OF ENGLAND. 
 
 dust with which it is loaded and obscured during the 
 day, the product of the numerous fires and the un- 
 ceasing traffic of carriages, &c. 
 
 I shall not at present enter more fully upon the 
 consideration of the Climate of London. Its peculi- 
 arities will be made more apparent in the sequel, by 
 the comparisons which we shall have occasion to make 
 between it and the other climates described ; and in 
 the mean time I can confidently refer those who are 
 desirous of further information on the subject to the 
 excellent work of Mr. Howard, just quoted, and also 
 to the memoir of the late Professor Daniell in his 
 ingenious ' Meteorological Essays.' 
 
 SOUTH COAST. 
 
 HASTINGS, BRIGHTON, CHICHESTER, GOSPORT, SOUTH- 
 AMPTON, UNDERCLIFF (iSLE OF WIGHT), BOURNE- 
 MOUTH. 
 
 Were we to rest contented with the result of the 
 mean annual temperature, we should find that there 
 was very little diiference between that of the South 
 Coast and that of London. But when we descend 
 to particulars, we observe that there does exist a 
 considerable difference in their temperature, arising 
 chiefly from the mode of its distribution. It is be- 
 cause the higher degree of the temperature of London 
 and the interior of the island in summer, compensates 
 for the lower degree in the winter, that the climate 
 
SOUTH COAST. 123 
 
 of these places appears to equal that of the South 
 Coast. The mean temperature of the latter, how- 
 ever, during the winter months,* is from one to 
 two degrees above that of London. The supe- 
 riority is greatest in those months in the follow- 
 ing order : — January, February, December. It 
 diminishes in March; and in April and May the 
 temperature of the coast is nearly the same as that of 
 London and its vicinity. In June, July, and August, 
 the temperature of the coast is about one degree less 
 than that of the interior. In September and Octo- 
 ber, the mean temperature of the coast and of the 
 interior is nearly equal, but in November that of 
 the coast begins to rise above the other. 
 
 It is important to remark, that the difference of 
 temperature in favour of the coast during the winter 
 occurs principally between the loioer extremes ; so 
 that the temperature of the day is nearly the same at 
 both places, whilst that of the night is considerably 
 warmer on the coast. For instance, the difference 
 between the minima of Gosport and London during 
 the winter is to the difference of their maxima as 7 
 to 3. The minimum temperature observed on the 
 
 * It may be proper here to state that in this work I adopt the 
 more common division of the seasons ; including under Winter, 
 the months of December, January, and February ; under Spring, 
 those of March, April, and May ; under Summer, June, July, 
 and August; and under Autumn, September, October, and 
 November. 
 
 g2 
 
124 CLIMATES OF ENGLAND. 
 
 South Coast generally, is from three to four degrees 
 above the minimum temperature observed at London. 
 The temperature of the South Coast, moreover, is not 
 subject to the same extent of range as that of London 
 and the interior. Thus, the diiFerence of the mean 
 temperature of the warmest and coldest months in 
 London is 26'', while at Gosport it is only 24"; and 
 the mean of the monthly ranges at London is 34^, and 
 at Gosport only 31^. In steadiness of climate, as de- 
 duced from the variation of temperature between 
 successive days, the South Coast does not appear to 
 possess any very remarkable superiority over London 
 itself. Of the places on this tract of coast which have 
 been particularly examined, Southampton is the most 
 variable in its temperature, equalling in this respect 
 the environs of London. 
 
 More rain falls on the South Coast than at London, 
 the ratio being, as nearly as could be ascertained, as 
 30 to 25 : but the quantity varies considerably at dif- 
 ferent parts. (See Appendix.) Of the places on this 
 coast, frequented by invalids, Hastings, Brighton, and 
 Undercliff, may be considered as having, respectively, 
 peculiar climates. 
 
 HASTINGS. 
 
 This place has long enjoyed the reputation of being 
 one of the mildest and most sheltered winter resi- 
 dences on the South Coast. Owing to its low situation. 
 
HASTINGS. 125 
 
 and the height of the neighbouring cliffs, it is pro- 
 tected in a considerable degree from all northerly- 
 winds. To those of the south it is fully exposed ; 
 and although the gales from that quarter are less 
 violent on this coast than on that of Cornwall and 
 Devonshire, still, during the winter season, south- 
 westerly winds often prevail many days successively. 
 In regard to the degree of protection from northerly 
 and north-easterly winds, there is a considerable dif- 
 ference in different parts of Hastings.* The lower 
 situations facing the beach are particularly well 
 sheltered by a perpendicular cliff which rises imme- 
 diately behind them. Other parts of the town are 
 more or less exposed, according to their elevation and 
 aspect. In another point of great importance in the 
 chaiacter of a winter residence for invalids, namely, 
 sheltered exercising ground, Hastings is not very 
 favourably circumstanced. It is true, the Parade 
 affords a sheltered walk of small extent, close upon 
 the beach ; and there is a ride along the shore 
 through St. Leonards, which is protected by a range 
 of cliffs from northerly winds ; but it is almost the 
 only sheltered ride of any extent in the neighbour- 
 hood. 
 
 * On this subject see the two following small works : viz., 
 * On the Adaptation of the Different Parts of Hastings to 
 Different Diseases,* by the late Dr. Harwood ; and ' Hastings 
 considered as a Resort for Invalids, &c.,' by James Mackness, 
 M.D. 
 
126 CLIMATES OF ENGLAND. 
 
 With respect to the comparative merits of this 
 climate^ it may be observed, that its superiority in 
 winter appears to be confined chiefly to the months 
 of January and December. During these two months, 
 and in the spring also, it has the advantage of being 
 more effectually sheltered from north and north-east 
 winds than the other places frequented by invalids 
 on the coast of Sussex. 
 
 As might be expected from the low and sheltered 
 situation of Hastings, it affords a favourable residence 
 generally to invalids labouring under diseases of the 
 chest : hence delicate persons, who require to avoid 
 exposure to the north-east winds, may pass the cold 
 season here with advantage. But in recommending 
 Hastings as a residence in such cases, it will be 
 necessary to take into consideration the full influence 
 of sea air ; for, owing to the close manner in which 
 this place is hemmed in on the sea by steep and high 
 cliffs, it has an atmosphere more completely marine 
 than almost any other part of this coast, with the 
 exception of St. Leonards. 
 
 Judging from my own experience, I should say 
 that the climate of Hastings is unfavourable in nervous 
 complaints, more especially in nervous headaches 
 connected with, or entirely dependent upon, an irri- 
 tated condition of the digestive organs, and also in 
 cases where a disposition to apoplexy or epilepsy has 
 been manifested. But it will be understood from 
 what has been already stated respecting the topogra- 
 
ST. LEONARDS. 12t 
 
 pHcal relations of Hastings, that this effect of its 
 climate is chiefly experienced in the lower and more 
 confined parts : nor is such an effect peculiar to this 
 place ; it is common, I believe, to all places similarly- 
 situated. The class of persons alluded to, if induced 
 to reside for any length of time at Hastings, should 
 avoid the more confined situations below the cliff, 
 and rather seek such quarters as are more open and 
 elevated, yet in some degree protected from north 
 and north-east winds. 
 
 These remarks on the climate of Hastings apply to 
 it as a winter residence ; as a summer residence, the 
 more open and exposed situations should be sought, 
 and for many persons the high grounds behind 
 Hastings would be preferable to the lower situations 
 close to the shore. 
 
 ST. LEONARDS. 
 
 This place is about a mile to the westward of 
 Hastings, and, like it, possesses a dry and absorbent 
 soil. St. Leonards is separated from the sea-beach 
 merely by a carriage-road and broad esplanade, and 
 lies along the base of a range of cliffs which afford 
 considerable protection from northerly winds. The 
 circulation of the sea atmosphere is more free and 
 uninterrupted here than at Hastings, and, the cliffs 
 being lower, cold draughts and counter-currents of 
 wind from above are less experienced. The breadth 
 and extent of its esplanade also, and the protection 
 
128 CLIMATES OF ENGLAND. 
 
 afforded by the colonnades for walking exercise, are 
 circumstances of considerable importance to the 
 invalid. 
 
 In other respects, the climate of St. Leonards 
 may be considered as almost identical with that of 
 Hastings. 
 
 In the extent and quality of accommodations, St. 
 Leonards much surpasses Hastings. 
 
 Dr. Harwood thinks Hastings and St. Leonards 
 most favourable for invalids from November to the 
 end of February.* 
 
 Ague is not unfrequent in the neighbouring dis- 
 tricts ; but Dr. Harwood never knew an instance of 
 a visitant being attacked with the complaint. 
 
 The Yale of Ginseng, between Hastings and St. 
 Leonards, and in which Warrior Square is projected, 
 affords for residences a site superior perhaps to any 
 other part of this neighbourhood. Although open to 
 the sea, it has the advantage of being somewhat 
 retired from the beach, and is protected in a consi- 
 derable degree from the south-west gales, as well as 
 from the north-easterly winds, by the rising grounds 
 on each side. 
 
 * ' On the Climate of the Hastings Coast; Viewed in 
 Reference to its Effects in Diseases of the Throat and Chest. 
 By John Harwood, M.D., F.R.S. 
 
BRIGHTON. 129 
 
 BRIGHTON. 
 
 Brighton has a climate in many respects the reverse 
 of that of Hastings, the air being dry, elastic, and 
 bracing ; yet even within the limits of Brighton a 
 considerable diversity of climate is to be found. The 
 true character of the Brighton climate belongs, in 
 strictness, to the part of the town east of the Steyne ; 
 here the air is eminently dry and bracing. That to 
 the westward is somewhat damp, but milder. Delicate, 
 nervous invalids are very sensible of this diiference, 
 and generally feel better in the western part. Those, 
 on the other hand, who suffer from a relaxed state of 
 the system, enjoy their health more fully in the 
 eastern district. The Steyne forms an intermediate 
 climate, being sheltered in some degree from the cold 
 north-easterly winds on the one hand, and the bois- 
 terous south-westerly winds on the other. 
 
 Compared with the other parts of this coast, the 
 climate of Brighton appears to the greatest advantage 
 in the autumn and the early part of winter, when 
 it is somewhat milder and more steady than that of 
 Hastings. Accordingly, in all cases in which a dry 
 and mild air proves beneficial, Brighton, during this 
 period of the year, deserves a preference over every 
 other part of the South Coast. In the spring, on the 
 other hand, owing to its exposure to the north- 
 easterly winds, the climate is cold, harsh, and irritating 
 to delicate constitutions. At this season, therefore, 
 
 g3 
 
130 CLIMATES OF ENGLAND. 
 
 sensitive invalids generally, and more especially per- 
 sons with delicate chests, should avoid Brighton. 
 
 During the autumn and winter the climate is 
 singularly well suited to young persons, particularly 
 females suffering from a deficiency of red blood, and 
 the debility and deranged functions consequent upon, 
 or connected with, such a state of the system. All 
 derangements of the constitution indicating the use 
 of iron will be benefited in a marked manner ; and 
 in convalescence from acute diseases, and the debility 
 consequent upon long confinement, no sea-side climate 
 with which I am acquainted is to be compared with 
 that of Brighton. 
 
 For convalescents, therefore, and all persons who 
 require bracing, and in whose cases sea-air is suit- 
 able, Brighton presents one of the most favourable 
 climates which can be selected. For children and 
 young persons generally it forms an excellent resi- 
 dence. 
 
 Relaxed nervous invalids, whom it does not irritate, 
 feel more vigour and energy here than at almost any 
 place with which I am acquainted; on the other 
 hand, persons of an irritable nervous system, or those 
 subject to gastritic dyspepsia, or a dry irritable state 
 of skin, will not derive advantage from the climate of 
 Brighton ; on the contrary, their complaints will 
 generally be aggravated by it. From the disposition 
 to gastric irritation experienced at Brighton, invalids, 
 and dyspeptic invalids in particular, should adhere 
 
ISLE OF WIGHT. 131 
 
 to a very mild diet, more especially on their first 
 arrival. 
 
 A large proportion of invalids also, who require to 
 pass the winter and spring in the warmer parts of 
 our island, may remain with great advantage at 
 Brighton during the autumn. The weather is then 
 generally mild, and favourable for exercise on horse- 
 back or otherwise, as, from the nature of the soil, the 
 surface dries with great rapidity. 
 
 Having passed the autumn and part of the winter 
 at Brighton, the delicate invalid may remove to the 
 more sheltered situations of Undercliff, Hastings, 
 Bournemouth, or Torquay, — a plan which will prove 
 more advantageous to many invalids than passing the 
 whole season at any one of these places. 
 
 ISLE OF WIGHT. 
 
 The Isle of Wight, from the variety which it pre- 
 sents in point of elevation, soil, and aspect, and the 
 configuration of its hills and shores, possesses several 
 peculiarities of climate and situation which render it 
 a very favourable residence for invalids throughout 
 the year. 
 
 The most favourable part of the island as a winter 
 residence is the Undercliff, a tract of country ex- 
 tending from Dunnose to St. Catherine's Hill on the 
 south-east coast, about six miles in length and from 
 a quarter to half a mile in breadth. This singular 
 
132 CLIMATES OF ENGLAND. 
 
 district consists of a series of terraces, formed by the 
 upper strata, composed of chalk and green sand, 
 which have slipped down from the cliffs and hills 
 above, and been deposited in irregular masses upon a 
 substratum of blue marl. The whole of the Under- 
 cliff, which presents in many places scenery of the 
 greatest beauty, is dry and free from moist or impure 
 exhalations, and is protected from the north, north- 
 east, north-west, and west winds, by a range of lofty 
 downs, or hills of chalk and sandstone, which rise 
 boldly from the upper termination of these terraces, 
 in elevations varying from four hundred to six and 
 seven hundred feet ; leaving Undercliff open only in 
 a direct line to the south and south-east, and obliquely 
 to the east and south-west winds.* 
 
 The physical structure of the UndercliiF has been 
 carefully investigated and described by the geologist,t 
 and the beauties of its scenery have been often dwelt 
 
 * The height of the range is greatest at its two extremities ; 
 St. Catherine's Hill is nearly nine hundred and St. Boniface Down 
 eight hundred feet above the level of the sea. The intermediate 
 parts of the range vary from six hundred and fifty to seven hun- 
 dred feet. 
 
 t See the splendid work of Sir Henry C. Englefield, * A De- 
 scription of the Principal Picturesque Beauties, Antiquities, 
 and Geological Phenomena of the Isle of Wight.' I would also 
 recommend to the attention of the naturalist a beautiful and instruc- 
 tive model of the Isle of Wight, exhibiting its geological structure, 
 which has just been constructed by Mr. Wilde (of Cursitor- 
 street), under the direction of Dr. Mantell. Dr. Mantell has 
 
ISLE OF WIGHT. 133 
 
 upon by the tourist ; but its far more important advan- 
 tages as a winter residence for the delicate invalid, 
 have attracted attention of late years only. 
 
 The continuous range of high hills which separates 
 this district from the rest of the island, protects it 
 most effectually from all northerly winds ; while nu- 
 merous short ridges, projecting from the main range 
 towards the sea, break, in a considerable measure, the 
 violence of the south-west winds. The protection 
 afforded by the northern barrier is greatly increased 
 by the very singular and striking abruptness with 
 which it terminates on its southern aspect. This in 
 many places consists of the bare perpendicular rock 
 of sandstone ; in others, of chalk, assuming its charac- 
 teristic rounded form, covered with fine turf and 
 underwood; but so steep as to justify the appella- 
 tion conferred on the beautiful tract which extends 
 from its base to the sea-shore. The defence afforded 
 by this natural bulwark against northerly winds is. 
 
 also announced, for immediate publication, * A Geological 
 Ramble round the Isle of Wight, Illustrative of the most Inter- 
 esting Localities and Organic Remains.' This work will con- 
 tain a map, sections, and sketches of the most remarkable 
 geological scenery, and numerous figures of the fossils with 
 which many of the strata abound. It will form a guide or 
 hand-book for the intelligent visitor who may be desirous of 
 adding to the charms of picturesque scenery the gratification of 
 exploring and interpreting the natural records of some of the 
 most marvellous events in the earth's physical history, ex- 
 hibited in this small island. 
 
134 CLIMATES OF ENGLAND. 
 
 indeed, more perfect than anytliing of tlie kind with 
 which I am acquainted in England ; and the transi- 
 tion of climate experienced on descending from the 
 exposure of the open and elevated down to the shelter 
 of the Undercliff, will remind the Italian traveller of 
 his sensations on entering the valley of Domodossola, 
 after quitting the chilly defiles of the Simplon, in an 
 autumn evening. You feel at once that you have 
 entered a new climate ; and the luxuriance of the 
 vegetable tribes, which you find around you, proves 
 that the impression made on the senses has not been 
 deceitful. 
 
 The whole of the Undercliiff, however, is not pro- 
 tected in an equal degree. The eastern part, com- 
 prehending the country from Bonchurch to the village 
 of St. Lawrence, a distance of nearly three miles, has 
 in this respect the advantage over the western por- 
 tion, which is more open to the south-westerly winds ; 
 but even here several very sheltered spots are to be 
 found ; and the temperature does not differ materially 
 from that of the eastern division. The whole extent 
 of Undercliff' is, indeed, singularly protected from 
 winds ; and I apprehend it will be difficult to find 
 in any northern country a tract of equal extent and 
 variety of surface, and I may add (as by no means a 
 matter of indiflference to the invalid), of equal beauty 
 in point of scenery, so completely screened from the 
 cutting north-east winds of the spring on the one 
 hand, and from the boisterous southerly gales of the 
 
ISLE OF WIGHT. 135 
 
 autumn and winter on the other. The Undercliff 
 terminates towards the sea-shore in a range of per- 
 pendicular cliffs, of from forty to sixty or seventy 
 feet in height. It may therefore be represented as 
 a lofty natural terrace, backed by a mountainous wall 
 on the north, and open on the south to the full in- 
 fluence of the sun from his rising to his going down, 
 during that season at least when his influence is most 
 wanted in a northern climate. 
 
 Owing to its elevation above the level of the sea, 
 the Undercliff differs from most of the situations on 
 our coast in being less exposed to the direct and im- 
 mediate influence of the sea air ; a circumstance which 
 in a medical point of view deserves attention. Sea- 
 fogs are rare, except towards the end of May and 
 during June, when they are more or less prevalent. 
 Observation has proved that less rain falls at Under- 
 cliff than on the South Coast generally, and even 
 than at other parts of the Isle of Wight ; a cir- 
 cumstance which might have been inferred from a 
 consideration of the topographical relations of the 
 place. 
 
 The following Tables, showing the fall of rain, the 
 number of days in which rain falls, and the temper- 
 ature, at Ventnor and Newport respectively, exhibit 
 in a striking manner the remarkable difference which 
 may exist in the most important elements of climate 
 between places separated only by a few miles from 
 each other. Newport is in the interior of the island. 
 
136 
 
 CLIMATES OF ENGLAND. 
 
 to the north of the principal chain of hills, and on the 
 border of the small river Medina. 
 
 Comparative Quantity of Rain which fell at Ventnor and at New- 
 port, for a period of five years, viz. 1841-1845 (inclusive). 
 
 
 Mean 
 Annual 
 Quantity. 
 
 Mean for Seasons. 
 
 Ventnor . . . 
 Newport . . . 
 
 Inches. 
 
 Winter. 
 
 Spring. 
 
 Summer. 
 
 Autumn. 
 
 23-48 
 33'60 
 
 4-65 
 
 7-87 
 
 4-06 
 6-45 
 
 4-29 
 6-48 
 
 9-48 
 12-90 
 
 Comparative Number of Days on which any Moisture (Rain or Snow), 
 however small the quantity, fell at Ventnor and at Newport, for 
 a period of six years, viz., 1840-1845 (inclusive). 
 
 
 Number 
 of Days. 
 
 Winter. 
 
 Spring. 
 
 Summer. 
 
 Autumn. 
 
 Ventnor . . . 
 Newport . . . 
 
 151 
 190 
 
 39 
 49 
 
 32 
 45 
 
 33 
 44 
 
 42 
 
 50 
 
 Comparative Temperature of Ventnor and Newport.* 
 
 
 Mean An- 
 nual Tem- 
 perature. 
 
 Mean for Seasons. 
 
 Ventnor . . . 
 Newport . . . 
 
 o 
 51 'SS 
 
 49*73 
 
 Winter. 
 
 Spring. 
 
 Summer. 
 
 Autumn. 
 
 41-89 
 38-51 
 
 49-66 
 48-19 
 
 60-63 
 61-17 
 
 53-58 
 50-63 
 
 * The temperature of Ventnor is the mean of nine years, that of 
 Newport six years. 
 
ISLE OF WIGHT. 
 
 13Y 
 
 Temperature of Springs at Bonchurch and St. Lawrence (Under- 
 cliflF), and of the deep Well at Carisbrook Castle ; taken during 
 every season of the year, by Dr. William Arnold Bromfield.* 
 
 Carisbrookf 
 St.Lawrencet 
 Bonchurch $ 
 
 Highest 
 Temper- 
 ature ob- 
 served. 
 
 52-25 
 52*75 
 52-50 
 
 Lowest 
 Temper- 
 ature ob- 
 served. 
 
 50*50 
 
 51'00 
 
 50 '75 
 
 Mean. Number of Observations, 
 
 51*37 24, from September 1842 
 j to February 1846, 
 
 51 '87 18, from March 1843 to 
 I February 1846. 
 
 51 • 62 , 15, from January 1843 
 to February 1846. 
 
 Mean of 
 the whole 
 
 Number 
 of Obser- 
 vations re- 
 spectively. 
 
 51*83 
 51*92 
 51*65 
 
 This Table is very interesting, on account both of 
 the accuracy with which the observations were made, 
 and the accordance of the temperature of the springs 
 with that of the mean annual temperature of the 
 atmosphere. 
 
 The soil of the Undercliff, consisting chiefly of the 
 detritus of the sandstone and chalk from the incum- 
 
 * The temperature in every instance was taken with a thermometer 
 of extreme delicacy, made expressly for the purpose by Newman of 
 Regent Street. 
 
 t Total depth of Carisbrook well 290 feet, containing ordinarily 90 
 feet of water. 
 
 X Taken from a spring gushing from a bank opposite the Earl of 
 Yarborough's marine villa at St. Lawrence. 
 
 § Taken from a spring near the church at Bonchurch,— an excel- 
 lent and copious source, flowing briskly through a cylindrical basin 
 about two feet and a half deep. 
 
138 CLIMATES OF ENGLAND. 
 
 bent cliff, is naturally dry, and speedily regains its 
 dryness after rain. The nature of the rock, and the 
 general shelving form of the surface, likewise con- 
 tribute to render Under cliff a dry situation. 
 
 The climate is remarkably equable as well as mild 
 and dry, and there are not many days during the 
 winter on which the invalid cannot take some exercise 
 in the open air. The mildness and dryness of the 
 climate, during the winter months, may be in some 
 degree estimated by the circumstance of myrtles, 
 geraniums, sweet-scented verbena, and various tender 
 and greenhouse plants, usually withstanding the 
 winter in the open flower-borders. The honey-bee 
 likewise continues working, in ordinary seasons, until 
 after Christmas. The absorption of heat by the 
 almost perpendicular cliffs which back the Undercliff, 
 exposed as they are to the rays of the sun during the 
 whole day, must be considerable, even in winter; 
 and the radiation of this heat during the night no 
 doubt tends to equalize the temperature. 
 
 To the invalid who has cultivated natural history, 
 this sheltered district and neighbourhood possesses 
 an additional advantage. It is rich in varied and 
 interesting plants ; indeed the specimens' of natural 
 history with which it abounds offer abundant induce- 
 ment to exercise and mental occupation to the culti- 
 vators of this delightful science. 
 
 When we consider the numerous local advantages 
 of the Undercliff, already detailed, and the result of 
 
ISLE OF WIGHT. 139 
 
 the meteorological observations appended, and also 
 take into account the still more conclusive evidence 
 furnished by the condition of the exotic plants which 
 grow there, we must acknowledge it to be one of our 
 warmest winter climates and most eligible residences 
 for a large class of delicate invalids. With respect 
 to the most decisive evidence of all, in a medical 
 point of view, namely, the effects of the climate 
 on pulmonary disease, my experience is favour- 
 able. 
 
 I have certainly seen nothing along the South Coast 
 that will bear a comparison with the more sheltered 
 parts of Undercliff; and on the South-west Coast the 
 only place that will do so is, I apprehend, Torquay. 
 But much more extended observations than we at 
 present possess for either of these places are required 
 to determine their comparative merits. With a tem- 
 perature nearly the same, the climate of Torquay is 
 soft, but rather humid and relaxing ; while that of 
 Undercliff is dry, somewhat sharp, and bracing. The 
 winter temperature at these two places differs very 
 little. Although at Torquay the temperature some- 
 times rises higher, it likewise sinks lower than at 
 Undercliff, giving the latter the advantage in point 
 of equability of temperature. These qualities, pecu- 
 liar to the two places respectively, render each of them 
 suitable in different diseases, in different forms and 
 complications of the same disease, and in constitutions 
 of a different character. For pulmonary invalids. 
 
140 CLIMATES OF ENGLAND. 
 
 the best season at Undercliff is from November to 
 May.* 
 
 "We have now to consider the advantages of the 
 Isle of Wight as a summer residence for invalids. 
 The Undercliff itself affords a mild summer resi- 
 dence; but for many invalids the summer months 
 may be better passed in the cooler situations in other 
 parts of the island. Up to the middle of August, the 
 climate of the Undercliff is pleasant ; the sea breeze, 
 which in fine weather usually sets in about seven 
 o'clock in the morning, is very refreshing, and pre- 
 vents the solar heat from becoming oppressive. The 
 open and undulating character of the surface also, 
 which favours a free circulation and continual renewal 
 of the air, may account for that feeling of lightness 
 and buoyancy in the atmosphere which is a frequent 
 subject of remark by visitors at the Undercliff. From 
 the middle of August to the middle of October, the 
 Undercliff is not a desirable residence. The air is 
 
 * Since the last edition of this work was published, Ventnor, 
 the chief residence of invalids on the Undercliff, and then only a 
 small village, has sprung up into a town ; and although in planning 
 it little regard has been paid to the natural advantages which the 
 place affords, much may still be done to improve it. There are 
 some good houses in the town, and many in the neighbourhood 
 around it, including Bonchurch, which is part of the same 
 district. A promenade has also been formed on the beach, 
 affording a sheltered and pleasant walk for invalids. If the 
 contemplated extension of this walk be carried out, it will form 
 one of the prettiest sheltered spots for exercise that a marine 
 place can possess. 
 
ISLE OF WIGHT. 141 
 
 then relaxing, and has a depressing effect on the 
 animal economy, and invalids who have remained 
 there during the summer should leave the place at 
 this time. From the end of October to the middle 
 or end of May is the proper season for the residence 
 of invalids at the Undercliff. 
 
 Niton, on the western extremity, but without the 
 limits of Undercliff, affords a pleasant summer resi- 
 dence ; and the accommodation for visitors, which has 
 been hitherto very limited, is becoming enlarged by 
 the erection of some pretty houses and baths. 
 
 CowES, as a summer residence, is conveniently 
 situated for exercise on the water. 
 
 The little village of Sandovtn, on the eastern shore, 
 is also a retired and pleasant summer residence, and 
 well suited for sea-bathing. It has much increased 
 during the past few years, and a handsome church, 
 which is in progress of building, will supply a want 
 hitherto much felt. 
 
 Shanklin, in the same neighbourhood, is a favour- 
 ite summer retreat, and one of the prettiest places in 
 the island. But of all the situations in the island, 
 Ryde appears to me to deserve a preference as a sum- 
 mer residence. It stands on the slope of a dry, gravelly 
 hill, facing the north, immediately opposite Ports- 
 mouth ; and from the open manner in which part of 
 it is built, many of the houses having gardens 
 attached to them, it possesses most of the advantages 
 of a country residence, together with those of a sea 
 
142 CLIMATES OF ENGLAND. 
 
 bathing-place. The neighbourhood is also very- 
 beautiful and favourable for exercise. 
 
 The Isle of Wight thus presents a considerable 
 variety of healthy and beautiful sites, suited to the 
 wants of a large proportion of valetudinarians. Its 
 short distance from the Metropolis, and the rapid 
 and easy communication established by the South- 
 western Railway, add greatly to its conveniences as 
 a residence for invalids. 
 
 BOURNEMOUTH. 
 
 Bournemouth is situated at the bottom of a fine 
 bay on the coast of Hampshire, nearly opposite 
 to, and only about ten miles distant from, the 
 western extremity of the Isle of Wight. It is built 
 in a small basin formed by a series of hills clothed 
 with plantations of pine. These pine-woods, which 
 cover all the rising grounds around Bournemouth, 
 give a peculiar character to the place, and at the 
 same time answer a very useful purpose by increasing 
 the shelter from northerly winds afforded by the hills, 
 which are of small elevation. The extent of these 
 plantations, with intervening tracts of heath, give the 
 place more the appearance of a district in the High- 
 lands of Scotland than in the South of England. 
 
 Bournemouth, although close to, is not immediately 
 upon the shore, a range of undulating cliffs inter- 
 vening between it and the sea. These cliffs, varying 
 in height from fifty to a hundred and fifty feet, 
 
BOURNEMOUTH. 148 
 
 consist chiefly of sand in different degrees of ag- 
 gregation, from the fine drift-sand on the surface 
 to the consistence of stone, resting on a bed of 
 clay. The beach is well protected by these cliffs 
 from north and partially from east winds, and affords 
 good ground for walking and for riding on horseback, 
 and even for light carriages. From the pecu- 
 liarity of the tides on this part of the coast, the 
 space left for exercise is at all times narrow, the sea 
 rarely receding above fifty yards from the high- water 
 mark. Bournemouth is well protected from north 
 and north-east winds ; on the north-west and south- 
 west it has but little protection, and consequently is 
 exposed to the full influence of the south-westerly 
 gales. The soil is composed chiefly of sand ; the 
 roads are good, and the country favourable for car- 
 riage drives and exercise on horseback, but the extent 
 of sheltered ground is not great. The accommo- 
 dation for strangers is at present very limited, but 
 there are excellent sites for building detached houses, 
 which if judiciously placed would afford very favour- 
 able winter residences for invalids. But the whole 
 ground around Bournemouth requires to be well 
 drained before any new buildings are erected. This 
 is absolutely necessary to render the place healthy. 
 
 There are no meteorological observations for 
 Bournemouth to enable us to judge of the actual 
 climate of the place, and compare it with that of the 
 other mild climates on the south and south-west coasts 
 
144 CLIMATES OF ENGLAND. 
 
 of our island.* But from an attentive consideration 
 of its position, its soil, and the configuration and 
 character of the surrounding country, there can be 
 no doubt that Bournemouth deserves a place among 
 our best climates, and for a certain class of invalids 
 capable of taking exercise in the open air, affords a 
 very favourable winter residence. If the winter 
 temperature is lower, and the daily range greater 
 than at Undercliff and Torquay, and if Bournemouth 
 is less protected from cold winds than these two 
 places, it has the advantage over the former in the 
 excellence of its roads and the extent of open coun- 
 try around it for exercise, — and it has an atmosphere 
 of a less relaxing and depressing character than that 
 of Torquay. As a summer residence Bournemouth 
 must, from its position and the nature of its soil, be 
 hot, and the clouds of fine sand which rise in high 
 winds at this season are said to be very disagreeable. 
 The sea-bathing is moderately good. 
 
 Branksome, about two miles to the west of 
 Bournemouth, is described as a still more sheltered 
 position than the latter place. It consists of an 
 irregular undulating basin or valley, opening on the 
 bay at its south-eastern extremity. The sites for 
 
 * This deficiency is likely to be supplied in the course of a few 
 years by Dr. Mainwaring, the resident physician at Bournemouth, 
 who has procured a set of good meteorological instruments, and 
 commenced a series of observations, which he promises to continue. 
 
SOUTH-WEST COAST. 145 
 
 building detached villas are more extensive and 
 varied, and the protection from winds more perfect, 
 than at Bournemouth. The soil is similar to that of 
 the latter place, and the rising grounds are covered 
 in a similar manner with pine-plantations. The 
 description which has been given me of Branksome 
 Vale has induced me to notice it as affording a very- 
 favourable site for establishing winter residences for 
 invalids.* 
 
 SOUTH-WEST COAST. 
 
 The South Coast of Devon has a winter temperature 
 nearly two degrees higher than that of the coast of 
 Sussex and Hampshire, and from three to four de- 
 grees higher than that of London.t The difference 
 
 * For this information I am chiefly indebted to my friend 
 Dr. Gumming (author of * Notes of a Wanderer in Search 
 of Health through Italy, Egypt, Greece, Turkey,' &c., 
 1840), who being somewhat of an invalid himself, and well 
 acquainted, from personal observation, with all the noted climates 
 in the South of Europe and with Egypt, is well qualified to form 
 an opinion on the subject. Dr. Cumming's estimate of the 
 climate of Bournemouth, from his experience of the present 
 season, is very favourable. 
 
 t Notwithstanding that public attention has been so long 
 directed towards the climate of Devonshire, the materials which 
 can be collected with a reference to the subject are still very 
 defective. It is to be hoped that this may not long con- 
 tinue to afford a ground of complaint. We should think it an 
 object well worth the attention of the scientific Institutions of 
 Exeter, Plymouth, Bath, Bristol, &c., to establish a series of 
 
 H 
 
146 CLIMATES OF ENGLAND. 
 
 is most remarkable during the months of November, 
 December, and January; amounting, on an average, 
 in the sheltered places, to five degrees above London. 
 In February the difference falls to three degrees, 
 and in March and April the excess of the mean 
 temperature over that of London does not amount 
 to one degree. It ought also to be remarked, that 
 this difference takes place principally in the night ; 
 as the difference between the lower extremes of 
 London and the South-west Coast is to the difference 
 of the higher extremes as 4 to 3, — a less disproportion, 
 however, than occurs between the South Coast and 
 London. Hence, when compared with the latter, 
 the days are proportionally warmer on the South- 
 western than on the Southern Coast, whilst the 
 nights on both coasts are nearly equal. The range 
 of daily temperature is about the same on the South- 
 
 simultaneous observations in different parts of the country. If this 
 were kept up for a few years only, the character of the climate of the 
 South-western part of England might be accurately ascertained. 
 Since the last edition of this work appeared, Dr. Shapter's excellent 
 work on ' The Climate of the South of Devon,* &c., has greatly 
 increased our knowledge of the climate of South Devon 
 generally. But what we want is a series of accurate observations, 
 conducted exactly upon the same method, at the different places 
 frequented by invalids. It is not till one attempts to construct 
 a series of tables, such as are to be found in the Appendix to this 
 work, that the imperfect manner in which almost all our meteoro- 
 logical registers are kept is discerned, or that the great diffi- 
 culty of making an accurate comparison between the climates 
 of different places is perceived. 
 
SOUTH-WEST COAST. 147 
 
 west and South Coasts, although, as has been re- 
 marked, less than at London. As regards the 
 continuance of the same temperature, the South- 
 western has a remarkable superiority over the 
 Southern Coast, amounting nearly to three fourths 
 of a degree ; which is a very considerable difference, 
 when we reflect that the whole amount of variation 
 of successive days scarcely exceeds three degrees. 
 
 Diflferent places on the South-western Coast possess 
 these general qualities in a more eminent degree, 
 according as they are more or less sheltered from 
 northerly and easterly winds. Of these, taking them 
 in succession from west to east, Salcombe, Torquay, 
 Dawlish, Exmouth, Salterton, and Sidmouth, deserve 
 to be particularly noticed. But many other shel- 
 tered spots may be found along this coast, as, for 
 instance, in the neighbourhood of Plymouth, at 
 Kingswear, near Dartmouth, and other places. But 
 the great fault of most of these situations is, that 
 their climate is too circumscribed to be of much 
 utility to the class of invalids who are in a condition 
 to derive the greatest advantage from a mild climate, 
 — I mean those who are capable of taking exercise in 
 the open air. At a very little distance from the 
 coast, several situations may be met with still more 
 completely protected from north-easterly winds than 
 most of the places situated immediately on the sea- 
 shore. Among these may be mentioned the village 
 of Lympstone, about two miles from Exmouth, and 
 
 h2 
 
148 CLIMATES OF ENGLAND. 
 
 Bishopsteignton, about the same distance from Teign- 
 mouth. To this class of situations the village of 
 Upton also belongs. All these places, while they 
 are sufficiently near the coast to partake of the mild- 
 ness of its climate, are beyond the more immediate 
 influence of the sea- air, and are more protected from 
 the southerly gales to which the whole coast is ex- 
 posed. These circumstances deserve the consider- 
 ation of the physician while weighing the comparative 
 merits of the two classes of places as residences for 
 difl^erent invalids. 
 
 There are also sheltered spots in the immediate 
 vicinity of Exeter which would afford mild winter 
 residences for invalids. But it will be found that as 
 we recede from the coast the cold, especially during 
 the night, is more intense and the range of tempera- 
 ture greater. And, independently of this circum- 
 stance, the want of accommodations at these places 
 prevents them from being resorted to at present by 
 invalids, except in a very limited degree. 
 
 SALCOMBE. 
 
 This small place (the Montpellier of Huxham) 
 deserves notice here for its remarkable mildness. 
 Yet, although it is perhaps the warmest spot on the 
 South-west Coast, its climate is limited to too small 
 a space to admit of Salcombe ever becoming the 
 resort of invalids to any extent. 
 
 There is unfortunately here a want of sheltered 
 
TORQUAY. 149 
 
 ground for exercise; and this I hold to be one of 
 the greatest defects in a winter residence for a large 
 proportion of invalids. It is indeed chiefly for the 
 advantage of exercise in the open air that they leave 
 the comforts of their own homes. In the immediate 
 vicinity of Salcombe there are two beautifully si- 
 tuated villas, Woodville and Moult. At the former, 
 under the shelter of a wooded hill, the American 
 aloe has twice flowered in the open air, and with a 
 degree of luxuriance almost equalling that which it 
 displays in a tropical climate. The orange and lemon 
 tree also thrive here, and ripen their fruit in the 
 open air; the only protection they require during 
 the winter being that afforded by a covering of straw 
 mat. These trees exhibit a degree of luxuriance and 
 vigour which I have seen in no other part of England 
 under the same circumstances. The olive tree has 
 also occasionally produced fruit in this place. 
 
 TORQUAY. 
 
 The general character of the climate of the South- 
 west Coast is soft and humid. Torquay is certainly 
 drier than the other places, and almost entirely free 
 from fogs. This drier state of the atmosphere pro- 
 bably arises in part from the limestone rocks, which 
 are confined to this neighbourhood, and partly from 
 its position between two streams, the Dart and the 
 Teign, by which the rain appears to be in some 
 degree attracted. Torquay is w^ell sheltered from 
 
150 CLIMATES OF ENGLAND. 
 
 the north-west, and is in a great measure protected 
 from north east winds, the great evil of our spring 
 climate. This protection from winds extends also 
 over a very considerable tract of country, abounding 
 in every variety of landscape, in which the invalid 
 may find at all times a sheltered spot for exercise 
 either on foot or on horseback. The beauty of the 
 country around Torquay, and the manner in which it 
 is sheltered from all winds — combining also as it does 
 in the highest degree all the favourable qualities of the 
 South-western climate — are advantages of great im- 
 portance to the invalid, and which Torquay possesses to 
 a greater extent than any other place on this coast.* 
 
 The accommodations for strangers at Torquay have 
 been greatly increased of late ; and the judicious plan 
 of building detached houses in favourable situations, 
 surrounded by a considerable space of open ground, 
 is of great advantage to the invalid. New roads and 
 other improvements are also making. The extent of 
 sheltered country around Torquay has this additional 
 advantage, that it enables the invalid, by extending 
 his rides into the higher parts of the district, to change 
 his climate, in some degree, frequently ; a matter of 
 consequence to those especially who remain the whole 
 season at Torquay. 
 
 * For a full and interesting account of the country, the reader 
 is referred to the ' Panorama of Torquay,' &c., by Octavian 
 Blewitt, Esq. See also the * Guide to Torquay,' more recently 
 published. 
 
DAWLISH. 151 
 
 The village of Tor, situated immediately behind, 
 and on the high ground above Torquay, has been 
 mentioned as a favourable residence for invalids. 
 It is, however, considerably colder, and less protected 
 from northerly winds than the latter place, and is 
 also said to be damper. Just beyond Tor is the 
 little vale of Upton, which affords one of the most 
 eligible situations on this coast for establishing a 
 Madeira village; being protected from southerly 
 as well as northerly winds. Were houses built along 
 the base of the hills which bound this little vale, 
 and the intervening space thoroughly drained and 
 laid out in open pleasure-grounds for exercise, Upton 
 would, I believe, form one of the best winter resi- 
 dences in Devonshii-e for invalids. 
 
 DAWLISH. 
 
 Of the places on this coast frequented by invalids 
 during the winter, Dawlish appears to me to deserve 
 the preference after Torquay. Although less dry 
 than the latter place, it is perhaps drier than the 
 other parts of the coast. Dawlish is well protected 
 from northerly winds, and also from the violence of 
 the south-westerly gales. It is less protected from 
 east winds ; and this is more especially the case with 
 the part of the town situated near the beach, which 
 is much exposed to easterly winds, and consequently 
 unsuited as a spring residence for pulmonary inva- 
 lids. The part more distant from the sea is better 
 
152 CLIMATES OF ENGLAND. 
 
 protected ; and there are also some well- sheltered 
 walks in this quarter. But Dawlish is altogether 
 upon a small scale ; and its confined situation must 
 render the air, in calm, mild weather, close and 
 somewhat oppressive to many invalids. 
 
 EXMOUTH.— SALTERTON. 
 
 Part of Exmouth stands high, and is exposed to 
 almost every wind, more especially to the south- 
 westerly gales. The lower parts of the town are 
 protected from these, and in a considerable degree 
 also from northerly winds. The situation of this part 
 of the town with respect to the river, however, 
 exposes it to occasional damp, as it did formerly to 
 inundations from the sea during severe storms with 
 high tides. This latter inconvenience has been lately 
 obviated by means of an embankment which excludes 
 the sea, and has thus allowed about sixty acres of 
 what were formerly banks of mud to be converted 
 into green meadows. There is here also a want of 
 sheltered ground for exercise, and the place altogether 
 does not appear to possess great advantages as a win- 
 ter residence for delicate invalids, more especially 
 for those labouring under pulmonary affections. 
 Exmouth is, however, a healthy place ; and I may 
 remark here, that, notwithstanding the whole of this 
 coast is rather humid, agues, so far as I could learn, 
 are almost unknown. A little way in the interior 
 they ai*e not uncommon. 
 
SIDMOUTH. 153 
 
 Although Exmouth is not well suited for persons 
 with delicate chests, other invalids often experience 
 great benefit from a residence there, more particularly 
 on the Beacon Hill, the most elevated and finest 
 situation in the place ; and which, as some compen- 
 sation for the buffetings of the south-west gales, com- 
 mands one of the most magnificent views in Devon- 
 shire. Along the southern base of this hill there is 
 also a road of considerable extent, protected from 
 north and north-east winds, and well suited for exer- 
 cise during the prevalence of these. 
 
 The village of Salterton, about four miles to the 
 eastward of Exmouth, presents advantages in point 
 of situation which render it preferable to the latter 
 place as a winter abode for the invalid. It stands in 
 a small open valley on the sea-shore, well protected 
 from winds, particularly northerly winds. Its great 
 defect to the invalid is the want of sheltered ground 
 for exercise. 
 
 SIDMOUTH. 
 
 This place is situated on the sea -beach, at the 
 mouth of an open valley, through which the little 
 river Sid runs; and would be fully exposed to 
 northerly winds from the mountains, whence this 
 stream takes its rise, but for the profusion of lofty 
 and luxuriant elms and other trees, which shel- 
 ter it partially in that quarter. Some of the houses 
 at a little distance firom the sea-beach are tolerably 
 
 h3 
 
154 CLIMATES or ENGLAND. 
 
 well protected from northerly winds ; whilst Peak 
 Hill and Salcombe Hill give protection in a consider- 
 able degree from westerly and easterly winds. Sid- 
 mouth seems well calculated for a summer and 
 autumn bathing-place ; and in the more sheltered 
 situations mentioned the invalid may find a suitable 
 abode during the winter. 
 
 INFLUENCE OF THE SOUTH-WEST CLIMATE ON DISEASE. 
 
 The influence of the South-western Climate on 
 disease may be anticipated, in a great degree, from a 
 consideration of its physical characters, which we have 
 shown to be mild but rather humid, consequently 
 soothing but rather relaxing. In one class of com- 
 plaints it is therefore calculated to prove decidedly 
 beneficial, — in another, of an opposite character, 
 equally injurious. 
 
 Pulmonary diseases are those in which the climate 
 has been considered especially beneficial. But as 
 there is considerable variety in the character of the 
 diseases to which the lungs are liable, and still more 
 in that of the constitutions in which they occur, so 
 will the benefit to be derived from this climate de- 
 pend upon its being applied to the proper cases. In 
 chronic inflammatory affections of the throat, trachea 
 and bronchi, attended with a dry cough, or with little 
 expectoration, decided benefit may be expected. But 
 
SOUTH COAST OF DEVON. 165 
 
 when there exists in such cases a congested state 
 of the mucous surfaces with copious expectoration, 
 especially when occurring in a languid and relaxed 
 constitution, the disease is more likely to be aggra- 
 vated than diminished by a residence on this coast. 
 From this statement will be understood the character 
 of the diseases of the chest which are likely to be 
 relieved by the Devonshire air. 
 
 In gastritic dyspepsia the climate is serviceable ; 
 likewise in dysmenorrhcea, and the various nervous 
 symptoms consequent upon it. On the other hand, 
 it certainly exerts an unfavourable influence on all 
 nervous complaints arising from relaxation or want 
 of tone of the nervous system ; on persons subject to 
 nervous headaches ; and in the purer forms of atonic 
 dyspepsia. Indeed, this form of dyspepsia is one of 
 the most common complaints among the inhabitants 
 of the coast ; and it frequently happens that persons 
 in good health, who have come from a colder and 
 more bracing part of the country to reside here, suflfer 
 much from this disease. 
 
 This climate will also be found no less unfavourable 
 to persons subject to menorrhagia and leucorrhcea, 
 and in all diseases of the mucous membranes attended 
 with copious secretion and a relaxed state of the sys- 
 tem. In recommending a residence on this coast to 
 invalids, it is absolutely necessary to attend to these 
 distinctions respecting the nature of their diseases 
 and the character of their constitutions, other- 
 
156 CLIMATES OF ENGLAND. 
 
 wise frequent disappointments must be the conse- 
 quence. 
 
 Even in cases in which this climate proves bene- 
 ficial for a time, a prolonged residence has often an 
 injurious effect. When the soothing and relaxing 
 effects of the climate have been obtained, the patient 
 begins to flag, and must quit it for a drier and more 
 bracing air. The nice point is to determine when 
 the change should be made. Some persons, to obtain 
 the full benefit of the climate, require to reside at 
 Torquay during the whole winter and spring seasons ; 
 others derive in two or three months, or even a 
 shorter period, all the benefits which the climate 
 affords. Others cannot remain above a few weeks 
 without suffering ; and yet the diseases of these pa- 
 tients shall all pass under the same name, and are 
 essentially the same diseases. The constitution of 
 the patient is the chief guide in selecting a suitable 
 climate. 
 
 What may be the real estimation in which the 
 climate of Devonshire ought to be held in consump- 
 tive complaints, and what may be its absolute effect 
 upon these, I have much difficulty in saying : but 
 this much I may venture to advance, that as the 
 invalid will be exposed to less rigorous cold, and for 
 a shorter season, — will have more hours of fine wea- 
 ther, and, consequently, more exercise in the open 
 air, — he gives himself a better chance by passing the 
 winter here than in the more northern parts of the 
 
SOUTH COAST OF DEVON. 157 
 
 island. To compare it also in this respect with the 
 milder climates of the South of Europe, is no easy 
 task. In the South, the invalid has finer days, a 
 drier air, and more constant weather; but the tran- 
 sitions of temperature, though less frequent, are 
 more considerable. In the nights I believe invalids 
 are often exposed to severer cold than here ; and 
 this arises partly from the great range of temper- 
 ature, and partly from the imperfect manner in which 
 they are protected from the cold of night by the bad 
 arrangement of the houses, chimneys, &c. To afibrd 
 an opportunity of judging of the proper value of 
 this last circumstance, I subjoin a comparison of the 
 temperature in-doors and out-of-doors, from observa- 
 tions made by the same invalid (a correct and careful 
 observer) at Nice and Torquay.* 
 
 From the soft nature of the climate of this coast, 
 and the relaxing and enervating effects which a long 
 residence on it is liable to produce on many consti- 
 tutions, invalids who intend to reside here during 
 several winters should leave it in the summer, and 
 seek a drier and more bracing air. Such as are 
 unwilling or unable to undertake a long journey 
 should retire to some of the drier and more elevated 
 spots at a little distance from the coast. Among 
 these, Chudleigh deserves to be particularly noticed. 
 
 See Appendix. 
 
158 CLIMATES OF ENGLAND. 
 
 It is finely situated on a ridge of limestone rock, 
 beyond the range of th.e Haldon hills, and about five 
 miles from the coast, and is esteemed one of the driest 
 and most healthy sites in this part of the country. 
 A more inland situation, and, from its vicinity to 
 Dartmoor, one which possesses a still more bracing 
 air than Chudleigh, is Moreton Hampstead ; and this 
 place, if suitable accommodations were to be found, 
 would be a good summer quarter for invalids under 
 the circumstances alluded to. Ilfracombe and Linton, 
 on the northern coast of Devon, and other places in 
 that beautiful and romantic region, aiFord excellent 
 summer residences for some invalids. One objection 
 to such a migration, which formerly existed in the 
 badness of the roads, is now remedied by the forma- 
 tion of a new level line of road from Exeter to Barn- 
 staple and Ilfracombe ; and this will no doubt soon 
 be supplanted by a railroad. 
 
 There is as marked a difierence between the sum- 
 mer climate of North and that of South Devon as 
 there is between the cast of the scenery of those 
 districts ; the air of the former being keen and bra- 
 cing, and its features romantic and picturesque, while 
 in the latter the rich softness of the landscape har- 
 monizes vdth the soft and soothing qualities of the 
 climate. 
 
PENZANCE. 159 
 
 CORNWALL. 
 
 The climate of the South Coast of Cornwall, in its 
 general characters, as also in its influence on disease, 
 resembles closely that of the South Coast of Devon and 
 has also long been resorted to by pulmonary invalids. 
 
 PENZANCE. 
 Penzance, as the chief residence of invalids in 
 Cornwall during the winter, claims a particular 
 notice ; it is situated on the shore of a beautiful bay 
 (Mounts-Bay,) about ten miles from the extreme 
 western point of England, termed the Land's End. 
 Although situated on the shore of a bay surrounded 
 by high land, Penzance can hardly be said to be 
 sheltered from any wind ; it therefore exhibits, in its 
 meteorological results, the common features of the 
 district in which it lies. Dr. Forbes was the first to 
 point out the character of this climate ; and it would 
 have spared me much trouble and time had I had 
 the facility afforded me, in inquiring into other cli- 
 mates for which we are indebted to Dr. Forbes in 
 regard to this. A few more such analyses as his 
 ' Observations ' present would soon render the solution 
 of the problem of the climate of this country, as re- 
 gards all useful purposes, no longer a desideratum.* 
 
 * * Observations on the Climate of Penzance and the District 
 of the Land's End.' By John Forbes, M.D. 
 
160 CLIMATES OF ENGLAND. 
 
 The mean annual temperature of Penzance is 
 51°' 80, being only P-41 above that of London. But 
 the temperature is very differently distributed over 
 the year at the two places. Although Penzance is 
 only a degree and a half warmer than London for the 
 whole year, it is nearly 5° warmer in winter; 2° 
 colder in summer; scarcely r"" warmer in the spring ; 
 and only about 2° warmer in the autumn. 
 
 As regards the temperature of the different months, 
 relatively with London, the greatest difference occurs 
 in the following order, — December, January, Novem- 
 ber and February. In April the difference is reduced 
 to half a degree ; in May, Penzance is 1° and in July 
 2 J° colder than London ; and the temperature does 
 not again rise above that of London until the month 
 of October. So that were one to give a graphical 
 term of expression for the progression of the mean 
 temperature of the two places through the year, that 
 of London would more resemble an ellipsis, and that 
 of Penzance the more equal figure of a circle. This 
 wiU be aptly illustrated by observing that the differ- 
 ence between the mean temperature of the warmest 
 and coldest months in London is 26°, while at Pen- 
 zance it is only 18° ; and that whilst in London the 
 mean difference of the temperature of successive 
 months is 4°*36, it is only 3^ at Penzance. On ex- 
 amining the progression of temperature for the 
 twenty-four hours at these two places, we find that 
 in winter it is during the night that the greater part 
 
PENZANCE. 161 
 
 of this difference of temperature occurs; Penzance 
 being nearly on an average six degrees and a half 
 warmer than London during the night, and only 
 little more than three degrees warmer during the day. 
 But this equable distribution of heat throughout the 
 year at Penzance, which we have compared so advan- 
 tageously with that of London, is still more striking 
 when compared with that of the South of Europe. 
 Madeira and the Azores are the only climates we have 
 examined that are superior to Penzance in this quality. 
 The same remarkable equality in the distribution 
 of temperature during the year at Penzance holds 
 equally true for the day ;* and indeed I may ob- 
 serve generally, that the progression of temperature 
 for the year and for the day are faithful types of 
 each other. I find, on comparing the months for a 
 series of years, that the daily range at Penzance is 
 little more than half that of the South of Europe ; 
 but in this quality it also falls short of Madeira. 
 And here is a proper opportunity of remarking, that 
 although in mean temperature for the whole twenty- 
 four hours, Penzance is considerably lower than that 
 of the South of Europe, yet that during the night, 
 through the winter, its extreme minimum temperature 
 seldom is so low. It is during the day only that the 
 
 * Thus in the winter of 1827-28, the mean daily range at 
 Penzance was 7° '50; at London, at Gosport, Torquay, and 
 Nice, it was 12°, lO*', IT, and IV respectively. 
 
162 CLIMATES OF ENGLAND. 
 
 South of Europe, as far as regards temperature 
 simply, possesses a superiority. Thus, in winter, 
 at seven o'clock in the morning, there is little differ- 
 ence between Rome and Penzance, but at two o'clock 
 in the afternoon there is the difference of nearly 7°. 
 Indeed the whole advantage of Penzance, as com- 
 pared with the South of Europe, appears to occur in 
 the winter and during the night. 
 
 In the duration of the same temperature, as shown 
 by the mean variation of successive days, the climate 
 of Penzance excels all the northern climates, and 
 nearly equals Home and Nice in this respect. 
 
 In the spring, Penzance loses its superiority of 
 climate. In April and May it is decidedly inferior 
 to the more sheltered spots on the South Coast of 
 Devon, and to Undercliff, and very much so to the 
 South-west of Prance. For instance, at Pau, the 
 mean temperature of winter is nearly 3° below that 
 of Penzance, while that of spring is 4.^ above it. 
 
 In the other elements of climate this district has 
 less peculiar advantages. There falls at Penzance 
 about twice as much rain as at London. The num- 
 ber of days on which rain falls does not, however, 
 seem in proportion to the quantity of fluid precipi- 
 tated. Mr. Giddy makes the average number of wet 
 days, during seven years, 177*3, and he particularly 
 states that under this head he comprehends " rainy, 
 showery, and misty days, — in short, all days on 
 which there is any fall whatever, even a slight 
 
PENZANCE. 163 
 
 shower." The average number of wet days at Lon- 
 don is 178, being almost precisely the same as that 
 recorded by Mr. Giddy for Penzance. Of the much 
 greater humidity of the atmosphere in Cornwall, 
 however, there can be no doubt. The testimony of 
 Dr. Forbes, who had ample means of forming a cor- 
 rect judgment, is very strong on this point. Another 
 of the disadvantages of the climate of the south- 
 western extremity of our island is its liability to 
 violent and frequent gales of wind ; and of this dis- 
 advantage Penzance appears to partake largely. 
 
 The effect of the southerly winds is to raise the 
 temperature greatly, especially during the night. 
 " During the prevalence of the south or south-west 
 gales," says Dr. Forbes, " there is very little differ- 
 ence of temperature between the day and night, as 
 proved by the register thermometer. Sometimes 
 there is no difference whatever ; and very commonly 
 the minimum of the night is not more than 3^ or 4"^ 
 below the maximum of the day. This shows how 
 very completely the influence of the sun is excluded 
 by the dense vapour with which the air is loaded ; 
 and during these our moist siroccos, we may say, 
 without any metaphor, that we are breathing the 
 breezes of a climate milder than our own. When 
 these south and south-west winds, so prevalent in 
 winter, are very gentle, the sky is often clear for 
 many days together. On these occasions, the warmth 
 and softness of the air are truly delightful ; and when 
 
164 CLIMATES OF ENGLAND. 
 
 taken in conjunction with the beautiful scenery around 
 Penzance, — the calm blue bay, — the gay green mea- 
 dows, — the myrtles and other exotic plants common in 
 our shrubberies, — one is almost tempted to forget that 
 it is a winter landscape that he is contemplating."* 
 
 It is principally in consequence of its exposure 
 to the north-east in the spring months, that Pen- 
 zance is absolutely colder than the coast of Devon- 
 shire, or even the neighbourhood of Bristol, during 
 this season. This circumstance of exposure to, or 
 shelter from cold winds, constitutes the principal 
 cause of the difference of different places in the same 
 line of climate in point of warmth as experienced by 
 man ; for the influence of temperature on the living 
 body is indicated much more accurately by our sen- 
 sations than by the thermometer. Unless, therefore, 
 the indications of the thermometer are corrected by 
 observing the winds, we shall form very erroneous 
 ideas of the climate of many places. 
 
 The disadvantages which attach to the climate of 
 the Land's End generally, in point of humidity and 
 exposure to winds, are such as in a great measure to 
 neutralize the superiority which it possesses over the 
 other climates of England in mildness and equability 
 of temperature. In its general characters, this climate 
 resembles so closely that of the South Coast of Devon, 
 that the remarks already made on the influence of the 
 
 Op.citat. (ante,^. 159). 
 
THE LAND'S END. J 65 
 
 latter on disease are equally applicable here. The 
 climate of the South-west of Cornwall is still more 
 relaxing than that of the South of Devon. Disorders 
 commonly termed nervous and stomach complaints, 
 are unusually frequent among the lower classes. Dis- 
 eases of the osseous system — of the spine and large 
 joints (mostly of a scrofulous character) — are also 
 common. Although not a strong race of people, the 
 inhabitants of this district are, however, long lived. 
 
 Regarding the influence of this climate on con- 
 sumption, we have the testimony of Dr. Forbes, 
 founded on ample experience, that little is to be ex- 
 pected from it; but we ought to admit, at the same 
 time, that in the advanced stages of that disease it 
 in this respect but shares the opprobrium with every 
 other climate. " In a good many cases, however, of 
 chronic bronchitis simulating phthisis, the health was 
 greatly improved, and in some it was completely re- 
 stored from a state of great debility and seeming 
 danger. In a few cases, also, of young persons who 
 accompanied their diseased relatives, and in whom the 
 hereditary predisposition was strongly marked, if 
 there was not already evidence of nascent tubercles, — 
 a great and striking improvement in the general health 
 and strength followed within a short period after their 
 arrival, and seemed fairly attributable to the combined 
 influence of change of air, scene, and habits."* 
 
 * Dr. Forbes's Translation of ' Laennec's Treatise on Diseases 
 of the Chest.' Note by translator, 3rd Edit. p. 73. 
 
166 CLIMATES OF ENGLAND. 
 
 The consumptive cases in which the soft humid 
 atmosphere of this place is likely to prove beneficial, 
 are those in which the disease is accompanied with an 
 irritated state of the mucous membrane of the lungs, 
 with a dry cough, or one with little expectoration. 
 
 In idiopathic tracheal and bronchial diseases of 
 the same character, whether complicated with 
 asthma, or otherwise, and also in certain pure cases 
 of the latter disease, it is likely to be very benefit 
 cial. When, on the contrary, there exists a relaxed 
 state of the system, or a disposition to copious secre- 
 tion from the bronchial membrane, whether idiopathic 
 or symptomatic of a tuberculous state of the lungs, or 
 where haemoptysis has occurred, I believe the climate 
 of the Land's End will generally prove inj urious. 
 
 As a summer residence for invalids, and also as a 
 residence during the whole year, the district of 
 the Land's End is perhaps equal to the Coast of 
 Devonshire. In the winter, however, and still more 
 in the spring, the latter in most cases deserves a 
 preference. If Penzance is somewhat warmer and 
 more equable in its temperature, it is more humid and 
 more exposed to storms during the winter, while it is 
 rather colder and less protected from the north-east 
 winds during the spring. Aged invalids, with whom 
 in general a soft climate agrees, and to whom 
 a moderate degree of humidity even is not objec- 
 tionable, might more particularly derive benefit by 
 residing during the whole year at Penzance. The 
 
WEST OF ENGLAND. jgy 
 
 great mildness of the winter would enable them, to be 
 much in the open air, and they would have less to 
 dread from the coldness of the nights than in any- 
 other part of England. 
 
 The country around Penzance is healthy, and 
 affords a great variety of excellent rides and drives ; 
 and being a sea-port, the place also affords conve- 
 nience for water exercise during the summer. The 
 accommodations for invalids are numerous. Those 
 who have passed the winter at Penzance, and whose 
 complaints are likely to be aggravated by the spring 
 winds, may remove to Clifton with advantage.* 
 
 WEST OF ENGLAND. 
 
 The mean temperature of the Western Group of 
 climates during the winter is rather lower than that 
 of the South Coast, but in the spring rises a little 
 higher. Bristol during the month of November is 
 about 3°'64, and in December 0°-97 warmer than 
 London. In January Bath is above 4°, and in Feb- 
 ruary and March about 2° warmer. In March 
 Cheltenham is 3J° warmer than London. 
 
 * For much interesting information respecting the natural 
 history and antiquities of this district, I refer the reader to Dr. 
 Forbes's ' Observations ' already referred to, and to his more recent 
 and admirable essay on the ' Medical Topography of the Land's 
 End' in the Provincial Medical Transactions, vol. ii. ; also to 
 an amusing little work entitled, ' A Guide to Penzance and the 
 Land's End,' written, it is said, by an eminent physician now 
 resident in London. 
 
IgS CLIMATES OF ENGLAND. 
 
 On comparing Penzance with this tract, we find 
 hardly half a degree of difference in the mean annual 
 temperature. In winter, however, Penzance is nearly 
 4° warmer; but in the spring the temperature is 
 nearly equal, and in summer somewhat colder. The 
 distribution of heat throughout the year is more un- 
 equal in this district than in the others ; the diifer- 
 ence of the warmest and coldest months being 28°, 
 while it is only 26*' at London, 24° at Gosport, 20° at 
 Torquay, and 18° at Penzance. We find, also, that 
 the range of temperature for the day and the month 
 is considerably more than on the South and South- 
 west Coasts and the Land's End ; the minimum term 
 of temperature being from 3° to 5°, and even 6° lower 
 than at some of these places. In steadiness of tem- 
 perature from day to day, it nearly corresponds with 
 the South Coast, but is inferior to that of South Devon, 
 and considerably so to Penzance. 
 
 CLIFTON. 
 
 In this tract of country the Yale of Bristol ap- 
 pears to be the mildest and most sheltered spot. 
 The climate, during the winter, is mitigated by the 
 vicinity of the great western ocean, while its land- 
 locked situation protects it from the winds of that 
 quarter. To those from the south-east it is fully 
 open. The fall of rain in this district is less than 
 from its western position might have been expected. 
 The mountain ranges which flank the country border- 
 
CLIFTON. 169 
 
 ing the Bristol Channel — namely, those of Wales on 
 the north, and those of Cornwall and Devonshire on 
 the south — appear to modify the course of the clouds i 
 from the Atlantic, and thus diminish the fall of rain T 
 in the intervening space. There is reason to believe 
 also that the average fall at Bristol is less than that 
 of the surrounding district ; a circumstance which 
 may be accounted for, partly by its being protected 
 from westerly winds, and partly from its position with 
 respect to the course of the Severn and its extensive 
 estuary, from the nearest part of which Bristol is 
 distant about five miles, and is, at the same time, com- 
 pletely shut out from it by the intervening high land. 
 But however the circumstance may be explained, the 
 fall of rain is absolutely less here than in Devonshire 
 and Cornwall, and much the same as on the South Coast. 
 The result of ten years' observation at the Bristol Phi- 
 Julosophical Institution is 32 inches for the year. 
 
 Clifton is built on the southern declivity of a hill, 
 the greater part of which consists of carboniferous ^ 
 limestone and hard sandstone. These circumstances, 
 with a scanty covering of soil, explain the short 
 detention of moisture on the surface after rain, and i 
 'the dryness of the air. Clifton affords considerable 
 variety in point of shelter and elevation. At the ' 
 bottom of the hill is the Bristol Hot- wells, where, 
 and in that vicinity, are to be found the most sheltered 
 and warmest situations : and, accordingly, consump- 
 tive and other delicate invalids should seek the more 
 
 I 
 
170 CLIMATES OF ENGLAND. 
 
 protected spots in this quarter during the winter ; 
 while those requiring less shelter may reside on the 
 higher parts of Clifton. The crescentic form of the 
 buildings in this place is singularly well adapted to 
 the situation, as it affords protection to so many 
 terraces well suited for exercise during the prevalence 
 of northerly winds. In the lower grounds there are 
 also some sheltered walks, and towards the park 
 several rides and footpaths which are tolerably 
 defended from northerly winds. But in this respect 
 Clifton during the cold season does not afford great 
 variety. When, however, the weather is sufficiently 
 mild to admit of the invalid going to some little 
 distance from home, few places present more beauty 
 or variety. The whole parish of Clifton is indeed 
 well described by the late Dr. Chisholm as " a beau- 
 tiful and romantic assemblage of woods, rock, water, 
 pasture, and down. It seems indeed singularly well 
 adapted to the maintenance of health ; the soil resting 
 on immense beds of limestone rock, exposed to the 
 southerly and westerly winds for nearly three fourths 
 of the year, with an atmosphere elastic, vivifying — 
 I not humid."* The surrounding country is healthy. 
 
 * See an excellent paper, by that amiable and enlightened 
 physician, on the Statistical Pathology of Bristol and of Clifton, 
 in the Edin. Med. and Surg. Journal, vol. xiii. 1817. See also 
 an Essay on the Medical Topography of Bristol, by Dr. Carriek 
 and Dr. Symonds, in the Transactions of the Provincial Medical 
 and Surgical Association, vol. ii. 
 
CLIFTON. 1^1 
 
 being free from everything like marsh. Dr. C. informs 
 us that in the list of diseases admitted during four 
 years into the Clifton dispensary, only one case of 
 intermittent fever appeared, and that one was from 
 the fenny district near Congresbury, about twelve 
 miles to the westward of Clifton. 
 
 As far, then, as we may judge respecting this cli- 
 mate, from the obvious local advantages which it pos- 
 sesses in point of aspect and shelter, and from the evi- 
 dence afforded by meteorological registers, the vicinity 
 of Bristol and Clifton is the mildest and driest climate ^ 
 in the West of England, and consequently the best win- 
 ter residence for invalids in that part of the country. . 
 
 Compared with the South and South-west Coasts, 
 the spring is the period of the year during which ♦ 
 this climate appears to the greatest advantage. That 
 season, as we have already seen, is warmer here than 
 on the South Coast (with the exception of Under- 
 cliff ), whilst it is equal to that of the warmer parts of 
 the South-west Coast. Compared more closely with 
 that of Devonshire, the climate of Clifton may be 
 characterized as drier and more bracing than the 
 former, and as less soothing to most consumptive 
 patients, and to those labouring under irritable affec- 
 tions of the bronchial membrane. For such cases, 
 the softer and more humid air of Devon will be found 
 more soothing ; while for invalids, whose constitutions 
 have suffered from long-continued derangement of 
 the digestive organs, or a congested state of the 
 
 I 2 
 
172 CLIMATES OF ENGLAND. 
 
 1 mucous membranes with copious secretion, and also 
 for young scrofulous persons, and those of relaxed 
 habits of body generally, Clifton will prove a preferable^ 
 
 I climate. And this gives me an opportunity of repeating, 
 that in comparing climates together, as regards their 
 influence on diseases, the constitution of the patient 
 and the particular nature and complications of the dis- 
 ease must be taken fully into consideration in deciding 
 on their respective merits in each individual case. 
 
 But the advantages of Clifton, as a residence for 
 the invalid, are not limited to the winter ; it aflfords 
 
 I also a very favourable summer climate. Indeed, the 
 higher situations on Clifton Hill are as eligible 
 during the latter season as the lower and more 
 sheltered parts are during the former. A more 
 complete change of air than this, however, will in 
 general be advisable, when there are not material 
 objections to travelling. The interior parts of the 
 same district, as about Cheltenham, and, still better, 
 the hills of Malvern, one of the coolest and most^ 
 healthy summer residences in England, will suit 
 many invalids. For young persons of a scrofulous 
 constitution, the summer climate of Malvern is 
 admirably suited. Others may pass the summer with 
 more benefit among the mountains of "Wales ; and in 
 cases in which a course of goat's whey promises 
 advantage, this will be the preferable plan. Aber- 
 gavenny is, I believe, the most esteemed station for 
 this purpose. Several healthy and convenient places 
 
BRISTOL HOT-WELL. 173 
 
 present themselves on the south coast of Wales, as at 
 Aberystwith, Tenby, Barmouth, &c., which form good 
 residences during the latter part of summer and the 
 autumn, more especially when sea-air or sea-bathing is 
 indicated. These places, from the accommodation of 
 steam- vessels, may be reached from Clifton in a few 
 hours ; a circumstance of material consequence to the 
 invalid unable to bear the fatigue of a journey by land. 
 In its geographical position and local advantages, 
 therefore, Clifton affords peculiar advantages as a 
 residence for a large class of invalids. V/ithin its r- 
 own limits it affords a sheltered winter and spring, \ ( * 
 and an open airy summer and autumn residence; ^ 
 whilst it is surrounded by numerous places of con- 
 venient and agreeable resort in the fine season, suited 
 to the various classes of persons who may seek its 
 shelter during the winter. It is also very conveniently 
 situated for making short sea-voyages. 
 
 Bristol Hot- well. — I must not quit Clifton with- 
 out some notice of the once celebrated spring which 
 formerly, indeed, was the chief object of attraction for 
 invalids at this place. The qualities of this spring 
 were then as much overrated as they appear now to 
 be neglected. Yet I believe many of the valetudina- 
 rians who frequent Clifton on account of its climate 
 might derive benefit from the use of this water. 
 
 According to Dr. Carrick's analysis, made in 1797, 
 this water appears to be very pure, having at its 
 
174 CLIMATES OF ENGLAND. 
 
 natural temperature of 74° a specific gravity of only 
 1 -00077. It contains a very small proportion of 
 lime, soda, and magnesia, in combination with the 
 carbonic, sulphuric, and muriatic acids, but a con- 
 siderable proportion of free carbonic acid and a 
 little atmospheric air. The presence of the fixed 
 air, together with its temperature, renders this water 
 grateful to the stomachs of most persons. Dr. 
 Saunders has well characterized it as a pure, warm, 
 slightly acidulated water ; and even as such it will, 
 I have no doubt, be found useful in many cases of 
 dyspepsia. Like some other natural warm waters, 
 it is said to be very efficacious in allaying the thirst 
 which accompanies the paroxysms of symptomatic 
 fever ; and Dr. Riley, of Clifton, informs me that he 
 has found it of essential service in several cases of 
 diabetes. But it is chiefly in a deranged state of the [ 
 digestive organs that its use is indicated. In the 
 nervous forms of dyspepsia, when the stomach is in ^ 
 a languid state, and does not tolerate cold fluids, it 
 will prove useful. During the spring, several tumblers 
 of this water drunk before breakfast, with exercise 
 on foot or on horseback, according to circumstances, 
 will in many cases greatly favour the effects of the 
 climate in restoring the energy of the digestive 
 organs, and thereby improving the general health. 
 It may be advantageously used also as a common 
 drink at meals. But I venture these opinions rather 
 on the experience of others than on my own. 
 
ISLAND OF BUTE. 175 
 
 ISLAND OF BUTE. 
 
 This island lies in the Frith of Clyde, about eighteen 
 miles below Greenock, and is almost surrounded by 
 the lofty hills of the opposite coast. It is eighteen 
 miles in length from east to west, and from four to 
 six miles in breadth. The highest parts of it are not 
 more than 140 feet above the level of the sea. 
 
 The temperature of Bute never falls low during 
 winter, nor rises high in summer, so that its yearly 
 range is comparatively limited, being under 40"", which 
 is at least 15^ less than that of Glasgow. The tempe- 
 rature will more frequently rise above 75^ at Glasgow, 
 than above 70^ at Rothsay in Bute ; and oftener sink 
 below 20^ at Glasgow, than below SO" at Rothsay. 
 
 Snow, when it does chance to fall, seldom liesV 
 longer than a few hours. During severe and long- 
 continued frost on the mainland, and when the 
 surrounding hills are for many weeks covered with 
 snow, a little may be seen on the higher parts of 
 Bute ; but even then the temperature on the lower 
 grounds is rarely under 28° during the night, and^ 
 34^ during the day. In the whole course of twelve 
 years of accurate hourly observations, the thermo- 
 meter never fell lower in Bute than 20^, and on three ^ 
 occasions only was it nearly so low. On one of these 
 
176 ISLAND OF BUTE. 
 
 the thermometer in the Botanic Gardens at Glasgow 
 s/: indicated 5^ below zero. This was indeed the greatest 
 difference observed during the twelve years ; but in 
 very severe frost the difference between the two 
 I places was often from 10 to 15 degrees. In ordinary 
 weather there is no marked difference ; but in very 
 hot weather the thermometer in Bute does not rise 
 so high by several degrees as on the mainland. 
 
 Every part of Bute is not equally mild during 
 winter. The Eastern is much milder than the 
 Northern coast, owing to its being in some measure 
 X^rotected from the influence of the north wind. 
 
 The climate of this island may be characterized as 
 mild and equable, but rather humid. It resembles 
 in character that of the South-west of England and 
 France, and of the Channel Islands, though it is 
 considerably less warm than any of these. As a 
 winter residence for invalids, it holds out considerable 
 advantages to that class only for whom a soft, equable, 
 but rather humid atmosphere is indicated. 
 
 The observations which have been made on the 
 character of the diseases benefited by the climates 
 above alluded to apply to the climate of Bute.* 
 
 ♦ We are indebted to Mr. Thorn for a very complete account 
 of the climate of Bute. In the Appendix will be found a meteo- 
 rological table, the results of twelve years' hourly observations, 
 which Mr. Thorn had the kindness to draw up at my request. 
 
co\t:. 177 
 
 COVE. 
 
 Cork Harbour, on the Southern shore of Ireland, 
 is an ovoid basin, above seven miles by five, sur- 
 rounded by the mainland. Within, and on the 
 Northern side of this harbour, lies the island of 
 Cove ; the extreme length of which from east to west 
 is seven miles, and its greatest breadth three and a 
 half The island consists of two hills, from two to 
 three hundred feet high, running from east to west ; 
 the northern ridge forming the chief body of the 
 island. The town of Cove, containing about eight 
 thousand inhabitants, is built on the southern acclivity 
 of the southern hill. It consists of terraces rising 
 from within a few feet above water-mark to a con- 
 siderable height, and in a crescentic form, facing 
 the south. From its position and configuration, the 
 town is sheltered from northerly winds on the one 
 hand, and on the other is open to the full influence 
 of the sun. 
 
 The accommodations for invalids are good, and the 
 walks and drives well sheltered. The facilities of 
 intercourse between Cove and other places are fre- 
 quent and daily increasing. 
 
 The following observations by Dr. Scott relate to 
 the lower part of the town. 
 
 The mean annual temperature of Cove, deduced 
 
 I 3 
 
178 COVE. 
 
 from tlie mean observations of seven years from Sep- 
 tember 1834 to August 1841, amounts to 5r-93. 
 The mean dew-point 46^ The fall of rain 33-25 
 inches. 
 
 Fall of rain in winter 10'54 inches, and number of 
 rainy days 37. In spring the fall is 4*05, and the 
 number of rainy days 29. 
 
 The number of days of frost and snow, in winter 
 and spring, is very inconsiderable. Snow seldom lies 
 longer than a few hours. 
 
 The duration of each wind, during three years, 
 was : — from the south, 96 days ; south-west, 222 ; 
 west, 159; north-west, 213; north, 132; north-east, 
 84; east, 78 ; and south-east. 111.* 
 
 From these observations, and the comparisons 
 given in the Tables on English climates. Cove appears 
 to be one of the mildest climates in Great Britain ; 
 being inferior in point of temperature to Penzance 
 only during the winter months, and to the same 
 place and Torquay only during the spring. In point 
 
 * Dr. Scott, On the Medical Topography of Cove. — Dublin 
 Journal of Medical Science, vol. xiii. To this elaborate and 
 excellent paper I am indebted for the information contained in 
 the above article on Cove ; also a full account of the climate 
 of Cove by the same author, in a work on the ' Irish Watering- 
 Places, their Climate, Scenery, and Accommodations,' &c., 
 by Alexander Knox, M.D., Dublin, 1845. Dr. Scott also 
 kindly permitted me to avail myself of his extensive manuscript 
 tables. 
 
COMPAEATIVE TEMPEKATURE OF PLACES. 
 
 179 
 
 of dryness, Cove does not stand so high in the table 
 of comparison. The winter is, comparatively with 
 the other places, the season during which the greatest 
 quantity of rain falls. 
 
 In its general characters of climate, and the in- 
 fluence of this on disease. Cove corresponds with the 
 South-west of England, and other similar climates. 
 
 The subjoined Tables exhibit the temperature, the 
 fall of rain, and the number of rainy days during the 
 winter and spring, at the principal places in Britain 
 resorted to by invalids. 
 
 COMPARATIVE TEMPERATURE. (BY REGISTER-THERMOMETERS.) 
 
 
 MeanT 
 Winter. 
 
 emp. of 
 Spring. 
 
 Mean of 
 the two 
 Seasons. 
 
 Number of Years' Observation from 
 which the Means are taken. 
 
 London . 
 
 39'12 
 
 48-76 
 
 43-94 
 
 Nineteen years. 
 
 Hastings 
 
 39-06 
 
 47*46 
 
 43-26 
 
 Tliree years, 1843-44^45. 
 
 Underclifif 
 
 41 '82 
 
 49-43 
 
 45-62 
 
 For winter nine years, for spring 
 seven years. 
 
 Torquay . 
 
 44-05 
 
 60-08 
 
 47-06 
 
 Four years, 1842-43-44-45. 
 
 Penzance 
 
 44-03 
 
 49-63 
 
 46-83 
 
 Ten years. 
 
 Cove . . 
 
 44-21 
 
 50-17 
 
 47-19 
 
 Seven years. 
 
 Bute . . 
 
 39-62 
 
 46-66 
 
 43-13 
 
 Nineteen years. 
 
180 
 
 CLIMATES OF ENGLAND. 
 
 COMPARATIVE QUANTITY OF RAIN.— CALCULATED IN INCHES. 
 
 
 Mean quantity for 
 Winter. | Spring. 
 
 No.ofra 
 Winter. 
 
 ny Days. 
 Spring. 
 
 Number of Years' Obser- 
 vation from which the 
 Means are taken. 
 
 London . 
 
 5-85 
 
 4-80 
 
 48-0 
 
 43-0 
 
 Twenty years. 
 
 Hastings. 
 
 7-12 
 
 4-95 
 
 39-0 
 
 29-0 
 
 Eight years, 1838-45, 
 
 UndercliflF 
 
 5-27 
 
 3-97 
 
 39-0 
 
 32-0 
 
 Eight years, 1838-45. 
 
 Torquay. 
 
 6-82 
 
 5-61 
 
 35-5 
 
 30-2 
 
 Four years, 1842-45. 
 
 Cove . . 
 
 10-54 
 
 4-05 
 
 37-3 
 
 29-7 
 
 Rain, three years ; rainy 
 days, nine years. 
 
 Penzance 
 
 12-64 
 
 9-35 
 
 50-7 
 
 40-6 
 
 Twelve years. 
 
 Bute . . 
 
 10-17 
 
 7-21 
 
 44-7 
 
 32-5 
 
 Nineteen years. 
 
 In bringing to a conclusion this brief account of 
 the warmer situations in our own country, it may be 
 expected that I should apply the preceding observa- 
 tions on the physical characters of their climates to 
 the object of our researches, and say what are the 
 advantages which these situations hold out generally 
 to invalids, and what are the diseases in which they 
 are respectively beneficial. 
 
 The whole of these places, as we have seen, are 
 considerably warmer during the winter and spring 
 than England generally, and very much warmer than 
 the colder parts of it. Indeed, as I have shown, and 
 as a reference to the Tables in the Appendix will 
 
CLIMATES OF ENGLAND. 181 
 
 further prove, there exists as much difference in 
 regard to temperature between the northern and 
 southern parts of England, as between the latter and 
 the South of Europe. Now, as the influence of tem- 
 perature on the living body is in a great degree 
 relative, an inhabitant of one of the coldest parts of 
 this country would, it is reasonable to believe, feel 
 the influence of the climate of the South of England 
 (as far, at least, as regards temperature) as much as 
 an inhabitant of the latter would that of the South 
 of Europe.* An invalid, therefore, from Scotland 
 or the North of England will find in the places 
 above mentioned a climate sufficiently mild to pro- 
 duce a beneficial influence on his health. Besides 
 this, opportunities of taking exercise in the open air 
 will be much more frequent ; and being exposed to a 
 
 * The influence of relative temperature on organic life might 
 be aptly illustrated by a reference to its very remarkable effects 
 on plants ; and the influence of warmth, whether natural or arti- 
 ficial, in exciting or accelerating the vegetation of these, affords 
 matter of reflection to the physician in estimating the effects of 
 climate on man. It is, I believe, a general practice with 
 gardeners in respect to plants which they wish to force rapidly 
 in the hot-house, to keep them previously in as cold a tempera- :|^ 
 ture as they will bear. And it has often been proved that a 
 vine accustomed to the temperature of the open air will vegetate i 
 in winter if transferred to the hot-house, while a plant from the^ 
 same stock, accustomed to the stove, will remain without any 
 sign of budding. See Mr. Knight's ' Observations on the 
 Method of Producing New and Early Fruit.' — Trans, of the 
 Horticultural Society of Lotidon, vol. i. 
 
182 CLIMATES OF ENGLAND. 
 
 degree of cold less severe and of shorter continuance, 
 the invalid will avoid a constantly recurring cause of 
 relapse. 
 
 But it must be kept in mind, as has been before 
 observed, that there are other circumstances con- 
 nected with the adaptation of climate to disease which 
 require attention as well as temperature. The par- 
 ticular nature of the disease and of the patient's 
 constitution, and the character of the climate most 
 suitable for these, will naturally be the first objects of 
 the physician's consideration : the nature of the cli- 
 mate in which the invalid has lived ought also to be 
 taken into account. This last circumstance — namely, 
 the comparative influence of any particular climate 
 on different individuals, depending on the nature of 
 that which they previously inhabited — has not, I 
 believe, been sufiiciently attended to : it deserves, 
 however, the especial consideration of physicians 
 when selecting a climate for their patients. 
 
 With respect to the merits of the milder parts of 
 England in their influence on disease, I have already 
 made a few remarks while treating of particular 
 places. As regards consumptive invalids, for whom 
 climate has been looked to as the great resource, I beg 
 to refer the reader to the article on Consumption. 
 
 There is no one of the English climates, as far at 
 least as our present knowledge of them extends, so 
 much superior to the others as to give it a claim to 
 
CLIMATES OF ENGLAND. 183 
 
 a decided preference in consumptive diseases. The 
 selection must therefore depend upon the nature of 
 the individual's constitution, and the character and 
 complications of disease. In cases in which a soft 
 and rather humid air is known to agree, the South 
 Coast of Devon, Penzance, and Cove, deserve a 
 preference. For invalids labouring under a relaxed 
 state of the bronchial membrane, or of the system 
 generally, or where a strong disposition to haemo- 
 ptysis has shown itself, the drier and more bracing 
 I air of Clifton will agree better ; and Undercliff will 
 prove a still more favourable residence. The climate 
 of Hastings may be considered as somewhat inter- 
 mediate between that of Devonshire and Clifton: 
 less warm, but also less relaxing than the former, it 
 is of about the same temperature as the latter, but4 
 less dry and bracing, and it is inferior to it as a spring 
 climate. The air of Hastings, as has been already 
 remarked, is also more essentially a sea-air than that 
 of any of these places ; a circumstance which will 
 have its due weight with the physician when deciding 
 upon a climate for his patient.* 
 
 On the other diseases of the chest, climate exerts a 
 very beneficial influence. In the chronic inflamma- 
 tory afiections of the throat, trachea, and bronchi, of 
 the dry irritable kind, or accompanied with little 
 secretion or expectoration, likewise in dysmenorrhoea, 
 and in dry irritable cutaneous diseases, the coast 
 
 * See article on Consumption. 
 
184 CLIMATES OF ENGLAND. 
 
 of Devonshire affords a very favourable climate. 
 In diseases of the bronchial membrane, on the other 
 hand, which are attended with copious expectoration, 
 or when there is a greatly relaxed state of the mucous 
 membrane of the chest; in atonic dyspepsia; also 
 in uterine disorders attended with copious discharges ; 
 in menorrhagia, and in all diseases accompanied with 
 a relaxed state of the system generally^ this climate 
 will not agree. It is difficult to find any place in our 
 island well suited, during the whole of the cold sea- 
 son, to that numerous class of bronchial diseases 
 where there is a greatly relaxed state of the mucous 
 membranes, and yet a constant disposition to a more 
 active degree of inflammatory disease. Undercliff 
 will be found one of the best climates for such patients, 
 and that of Clifton also is good. Brighton is a very 
 favourable residence during the autumn and part of 
 the winter, but after February it is equally unfavour- 
 able. Persons labouring under bronchial disease in 
 its less severe forms, might pass the autumn and winter 
 at Brighton, and the spring at Undercliff or Clifton; 
 or should this be inconvenient, Chelsea, Brompton, 
 and Kensington, afford sheltered spring situations. 
 
 In the disordered state of the digestive organs, 
 more especially in broken-down constitutions, the 
 genial influence of a mild climate is one of the most 
 ' powerful remedies which we possess. In dyspeptic 
 cases accompanied with irritation of the mucous mem- 
 brane of the chest and habitual cough, aggravated 
 
CLIMATES OF ENGLAND. • 185 
 
 during the winter and spring, such a change is pecu- 
 liarly beneficial. No class of invalids is, indeed, 
 more susceptible of, or suffers more from cold, than 
 
 j dyspeptics, more especially nervous dyspeptics. But 
 
 ' a low degree of temperature is not the only condition 
 of the atmosphere which disagrees with persons suf- 
 fering from stomach complaints : there are other 
 circumstances in the nature of a climate, cognizable 
 rather by their effects than by the appreciable physi- 
 cal qualities of the air, which exert a powerful influx/ 
 ence on sensitive constitutions. Different forms of 
 dyspepsia also derive benefit from climates of a dif- 
 ferent character. With persons labouring under 
 
 ^ gastritic dyspepsia, the climate of Devonshii*e will 
 agree, while it will decidedly disagree with those 
 
 4. suffering from the atonic form of the disease.* In 
 proportion, therefore, as the one or other of these 
 conditions predominates, will this climate prove bene- 
 ficial or the reverse ; but I should scarcely consider 
 
 , a long residence in it advisable in any form of 
 dyspepsia. Persons who have lived in a drier and 
 more bracing air become, after a short residence on 
 this coast, very sensible of the enervating and debili- 
 tating influence of the climate on their digestive 
 organs. They feel a sense of distention or oppres- 
 sion in the region of the stomach, with a torpor of the 
 whole system after meals, indicative of laborious 
 
 * See article on Disorders of the Digestive Organs. 
 
186 CLIMATES OF ENGLAND. 
 
 digestion. In the atonic forms of dyspepsia Clifton f 
 will prove a much more favourable residence than 
 any part of Devonshire. Brighton, during the autumn 
 and greater part of the winter, agrees admirably with 
 this form of the disease in general. 
 
 Other situations are, no doubt, to be found in our 
 island, besides those which I have noticed, capable of 
 affording a favourable retreat to the invalid during 
 our inclement season. Among these Bournemouth, 
 of which a brief notice has been already given, de- 
 serves mention. But I have thought it necessary to 
 notice those places only with the climates of which 
 we are best acquainted. 
 
 It is probable that some may find my distinctions 
 of climate too minute and particular, and my direc- 
 tions not sufficiently positive and absolute. To such 
 I beg to observe, that I have drawn no distinctions 
 ffoY which I have not data ; and that one of the prin- 
 cipal objects of this work is to call the attention of 
 the profession to these distinctions, the importance of 
 which in a remedial point of view is far greater than 
 is generally believed. Where my experience has 
 allowed, I have pointed out the application of these 
 distinctions ; but when this has not been the case, I 
 have preferred to leave the application of them to 
 future and more extensive observation ; lest, by going 
 beyond what my premises justify, I might, by a false 
 conclusion, destroy the value and importance of what 
 ^ I know to be true. 
 
CLIMATES OF ENGLAND. 187 
 
 Summer Residences. — After this survey of the 
 best winter climates in England, it may be expected 
 that I should take some notice of our more salu- 
 brious summer residences. On this subject, how- 
 ever, it is not necessary to go into detail, as there 
 is no lack of healthy situations to which our invalids 
 may repair with advantage during this season. In 
 the selection of a summer, as of a winter residence, 
 the same circumstances require attention, both as 
 regards the character of the climate and the nature of 
 the invalid's disease. Even during this season, the 
 milder and more sheltered situations must be chosen 
 for delicate and very sensitive invalids ; while for the 
 relaxed and enervated, and those possessing less sen- 
 sibility, the bracing air of the higher and drier dis- 
 tricts will prove more suitable. To a large class of 
 invalids our sea- side watering-places offer a variety of 
 excellent situations; and for those cases in which 
 sea-bathing is proper, they deserve a preference over 
 the interior, especially during the latter part of the 
 summer and in the autumn. Several of our inland 
 watering-places, independently of the advantages to 
 be obtained in many cases from the use of their 
 mineral waters, afford good summer climates ; and 
 indeed some of them, more on this account than any 
 other, have become places of fashionable resort. 
 Among these we may mention Malvern, Cheltenham, 
 Leamington, Tunbridge Wells, Matlock, &c. In 
 general it will be advantageous to invalids who have 
 
188 THE CHANNEL ISLANDS. 
 
 resided during the summer at any of those places, to 
 pass the autumn by the sea-side, as at some of the 
 driest places on the south, or south-east coast. In 
 the great number of cases in which travelling is borne 
 without inconvenience, several changes, or a succes- 
 sion of short journeys, will be more beneficial to most 
 invalids than a residence during the whole season in 
 any one place. It is remarkable how such repeated 
 changes, with frequent gentle exercise, especially on 
 horseback, renovate the constitution enfeebled by dis- 
 ease, enable it to overcome many chronic affections, 
 and contribute to the restoration of permanent health. 
 But we shall have occasion to recur to this subject. 
 
 THE CHANNEL ISLANDS. 
 
 These islands are occasionally resorted to by inva- 
 lids from England, and, when the cases are properly 
 selected, often with considerable advantage. 
 
 Jersey is the largest of the Channel Islands, and 
 that most frequented by invalids. It stretches from 
 east to west, and averages nine miles in length by 
 five in breadth. From the north coast, which is 
 steep and craggy, the island slopes to the south. It 
 consists almost entirely of hill and dale, and abounds 
 in wood and verdure. The general character of the 
 soil of Jersey is a deep sandy loam, with a subsoil of 
 
JERSEY. 
 
 189 
 
 red loam or clay, based on granite rock, or schistose 
 formations. Generally speaking, the water of the 
 higher situations is soft ; of the lower, hard. 
 
 The following table, from Dr. Hooper's work,* 
 shows the distribution of temperature throughout the 
 year. 
 
 MEAN TEMPERATURE OF THE MONTHS, SEASONS, AND WHOLE 
 YEAR AT JERSEY; AVERAGED ON THE YEARS 1831-32-33-34-35. 
 
 March .... 45*75 \ 
 
 April 5009 > Spring . . 50*97 " 
 
 May 57*08 J 
 
 June 61*31 ] 
 
 July 63 50 \ Summer. . 62*84 
 
 August .... 63*72 J 
 
 September . . . 59*82 \ 
 
 October .... 55*65 \ Autumn. . 54*63 
 
 November . . . 48*42 J 
 
 December . . . 45*27 ] 
 
 January . . . . 41*58 I Winter . . 43*82 , 
 
 February . . . . 44*62 ) 
 
 5> 53*06 
 
 From its small size and its situation in the current 
 of the English Channel, Jersey is exposed to all winds. 
 High winds are very prevalent. A perfectly calm 
 
 * ' Observations on the Topography, Climate, and Prevalent 
 Diseases of the Island of Jersey.* By George S. Hooper, M.D., 
 London, 1837. 
 
190 ^HE CHANNEL ISLANDS. 
 
 day, even in summer, is rare ; and, generally speak- 
 ing, says Dr. Scliolefield, even the finest weather 
 may be called " blowy." The western breezes, 
 according to Dr. Hooper, occupy two thirds of the 
 year. The north-east wind often reigns continuously 
 for a considerable time, particularly in the spring 
 months, and then it is severely felt by the delicate 
 invalid. 
 
 The actual fall of rain in Jersey does not appear to 
 have been measured. Dr. Hooper states that the 
 number of rainy days falls short of that of the 
 South and South-west Coasts of England ; but he is 
 inclined to think that if the quantity of rain was 
 estimated by a rain-gauge, it would be found greater 
 at Jersey, as the showers there are generally copious 
 and of long duration. In addition to the quantity of 
 rain which falls, the thickly wooded state of the 
 island, and the imperfect drainage, contribute to the 
 ^xtreme humidity of Jersey. 
 
 " It maybe said," observes Dr. Hooper, "that the 
 island of Jersey enjoys an early spring and a pro- 
 tracted autumn ; vegetation being usually active and 
 forward in March, and the landscape of the country 
 far from naked so late as the end of December. The 
 dreary aspect of winter, therefore, is short-lived. 
 With rare exceptions, the latter season passes off in 
 
 * *Inglis's Account of the Channel Islands.' Appendix, 
 by Dr. Scholefield. 
 
JERSEY. 191 
 
 soft or windy weather, with intervals of astonishingly- 
 mild days, and with scarcely any frost or snow. The 
 prevailing winds of this season are the west and south- 
 west, and the actual temperature, its variations and 
 ranges, are all in favour of this island compared with 
 other places in neighbouring latitudes. The season 
 of spring is of course marked by the same unsteadiness 
 of temperature and harsh variations of weather as in 
 most places under a similar latitude ; and this disad- 
 vantage is particularly felt in May, which often fails 
 to bring with it the expected enjoyments. The 
 month of March, on the contrary, is comparatively 
 mild, and so is October." Dr. Hooper farther 
 remarks (p. 71), that the general qualities of the 
 climate of Jersey may be made available to the 
 invalid, to whose case they are applicable, during a 
 period of six months in the year. 
 
 St. Helier's, the capital of Jersey, Dr. Scholefield 
 says, is not favourably situated for exercise, and is 
 peculiarly subject to rain and fogs. The most healthy 
 situations in Jersey, according to Mr. Murray, are 
 on the south-west side of St. Helier's parish. The 
 eastern side is also healthy ; and St. Aubin's, about 
 three miles to the west of St. Helier's, is considered 
 one of the best situations for invalids. 
 
 The most prevalent disease in the Channel Islands 
 is chronic rheumatism, which among the people of 
 the rural districts is universal after the age of thirty ; 
 dyspepsia, diseases of the liver, and dropsy are also 
 
192 THE CHANNEL ISLANDS. 
 
 prevalent. Scrofula is common. Intermittent fevers 
 are said to be rare ; remittent fevers common. 
 Phthisis is said not to be frequent, but no accurate 
 statistical account is given. Calculous diseases are 
 rare ; inflammatory diseases are not of acute charac- 
 ter, and the natives do not bear bleeding well. 
 
 The climate of the Channel Islands has a close 
 resemblance to that of the South - west Coast of 
 England, and especially to Penzance. There are 
 the same equable temperature, the same soft humid 
 atmosphere, and the same liability to high winds 
 during the winter, and cold north-east winds in the 
 spring, which characterize the latter place. So close 
 is the affinity of their climates, and so similar their 
 influence on disease, that the remarks which have 
 been made on the South-west of Devonshire and the 
 Land's End, as residences for invalids, are perfectly 
 applicable to the Channel Islands.* 
 
 * For fuller and more particular information regarding Jersey, 
 Dr. Hooper's work already referred to may be advantageously 
 consulted. 
 
( 193 ) 
 
 CLIMATES OF FRANCE. 
 
 The South of France, as regards climate, may be 
 properly classed under two divisions, namely, the 
 South-eastern and the South-western provinces ; 
 differing essentially from each other in the physical 
 characters of their climate, and the influence of this 
 on disease. 
 
 SOUTH-WEST OF FHANCE. 
 
 The climate of the South-western provinces of 
 France resembles in its general qualities that of the 
 South-west of England ; the mean annual tempera- 
 ture being about 4° higher. The climate may be 
 characterized as soft, relaxing, and rather humid ;-; 
 and, generally speaking, beneficial in chronic inflam- 
 matory affections of the mucous membranes accom- 
 panied with little secretion, as in chronic bronchitis 
 not attended by much expectoration or difliculty of 
 breathing, and in similar morbid states of the larynx 
 and trachea. It will be equally proper in dry scaly 
 eruptions of the skin ; in dysmenorrhcea ; in certain 
 kinds of headache, especially those induced or ex- 
 asperated by sharp north-east winds ; and in high 
 morbid sensibility in general, when accompanied with 
 that habit of body which the ancients called strictum. 
 
 K 
 
194 CLIMATES OF FRANCE. 
 
 On the other hand, the same diseases occurring in 
 relaxed habits, in which there is a disposition to copi- 
 ous secretion, will be aggravated by this climate. 
 
 PAU. 
 
 Pau, the capital of the Department of the Lower 
 Pyrenees, and the only place in this district of which 
 I consider it necessary to give a particular account, 
 is finely situated upon a ridge of gravelly hills, over- 
 looking an extensive valley to the north. The 
 Pyrenees rise gradually behind it, their higher range 
 being nearly forty miles distant. Pau is about 1 50 
 miles from Bordeaux, and fifty from Bayonne. 
 Having made but a short visit to this place myself, 
 I am indebted for the following account of it princi- 
 pally to the kindness of Dr. Playfair, who resided 
 there for several years. 
 
 Although the character of the climate of Pau cor- 
 responds with that of the South-west of France 
 generally, it possesses some peculiarities which it 
 owes to its topographical situation. Notwithstanding 
 its distance from the coast, it is very much under the 
 influence of the Atlantic. All the changes to which 
 this gives rise extend as far as Pau, though modified 
 in some degree by distance, and still more by the 
 position of the place with respect to the neighbour- 
 ing mountains. Calmness, for example, is a striking 
 character of the climate, high winds being of rare 
 occurrence and of short duration. 
 
PAU. 196 
 
 The mean annual temperature of Pau is 5|° higher 
 than that of London, and about 4i^ higher than that 
 of Penzance ; it is about 3J^ lower than that of Mar- 
 seilles, Nice, and Pome, and 8|° lower than that of 
 Madeira. In winter, it is 2|^ warmer than London, 
 2i° colder than Penzance, 6° colder than Nice, 
 nearly 5° colder than Pome, and i8J^ colder than 
 Madeira. But in the spring, Pau, is 5\° warmer than 
 London, and 4 J" warmer than Penzance ; only 3 4° 
 colder than Marseilles and Pome, and 8^'' colder 
 than Madeira. The range of temperature between 
 the warmest and coldest months at Pau is 32° ; this 
 at London, and likewise at Pome, is 26 ; at Pen- 
 zance it is only 18°, and at Madeira 14°. The daily 
 range of temperature at Pau is 7i° ; at Penzance it 
 is 6J° ; at Nice, 8i°; at Rome, 11°.* 
 
 The quantity of rain which falls annually at Pau is 
 stated by Dr. Taylor to be about 42 inches, and the 
 number of days on which rain falls 1 1 9, about 70 less 
 than at London. The west wind blowing directly 
 from the Atlantic, is accompanied with rain ; the 
 wind from the north-west, and from this point to the 
 
 * The account of the temperature of Pau is taken from the 
 tables in Dr. Taylor's work on the Climate of that place ; but the 
 results have been corrected, as on calculating the tables it was 
 found that there had been some error either in the original 
 calculations or in the printing.—' On the Curative Influence of 
 the Climate of Pau, and the Mineral Waters of the Pyrenees on 
 Disease,' &c., by Alexander Taylor, M.D. London, 1845. 
 
 k:2 
 
196 CLIMATES OF FRANCE. 
 
 north-east, brings dry cold weather ; while that from 
 the north-east to the south is usually attended by 
 clear mild weather. The south and south-west 
 winds are warm and oppressive. The westerly or 
 Atlantic winds are the most prevalent; the north 
 wind blows feebly, and is not frequent ; the oppres- 
 sive southerly winds are of rare occurrence, and 
 seldom continue beyond twenty-four hours. Indeed, 
 Pau appears to be almost exempt from the oppressive 
 southerly winds on the one hand, and the cold north- 
 west winds on the other, both of which prevail over 
 this part of France generally. The east winds are 
 next in frequency to the west, with which they usually 
 alternate ; and it is observed that, according as the 
 one or other wind prevails, the weather is rainy, or 
 dry and pleasant. 
 
 Though from the more frequent occurrence of west 
 winds this climate may be said to be rainy, still it is 
 not subject to some of the evils which commonly 
 attend humid climates ; or, at least, it suffers from 
 them in a less degree than these generally do. Rain 
 seldom continues above two days at a time, and is 
 usually followed in a few hours by warm sunshine ; 
 while the ground, from the absorbing nature of the 
 soil, dries rapidly. The atmosphere, generally speak- 
 ing, is also remarkably free from moisture, as indi- 
 cated by the hygrometer. In October, some snow 
 generally falls on the centre chain of the Pyrenees ; 
 and at Pau this fall is marked by a sudden change of 
 
PAU. 197 
 
 temperature, the weather becoming rainy and chilly. 
 In November, the weather clears up and becomes 
 milder. December and January are cold and dry ; 
 frost and slight snow-showers then occur, but the 
 snow does not lie on the ground. The sun is bright 
 and warm; and from twelve till three o'clock, an 
 invalid may generally take exercise. February is 
 milder; but towards the end of this month the 
 spring rains fall, and the weather is then chilly and 
 disagreeable. March is mild, but variable ; though 
 there are no cutting winds. In spring, westerly 
 winds, which are soft and mild, accompanied with 
 rain, alternate with dry easterly winds, also of a mild 
 character. Hence it is, that the vernal exacerbation 
 of inflammatory affections of the stomach and lungs, 
 so commonly observed in other climates, is little felt 
 by invalids at Pau. Vegetation bursts forth in the 
 first week of April, which is a warm month. May 
 resembles April, but is warmer. In June the wea- 
 ther is hot and fine. July, August, and September, 
 are very hot months, the thermometer sometimes 
 rising as high as 94° in the shade ; with a very pow- 
 erful sun, preventing exercise from eight in the 
 morning till seven in the evening. 
 
 According to Dr. Playfair, the gpod qualities of 
 the winter climate of Pau may be summed up as 
 follows:— Calmness, moderate cold, bright sunshine 
 of considerable power, a dry state of atmosphere 
 and of the soil, and rains of short duration. Against 
 
198 CLIxMATES OF FEANCE. 
 
 these must be placed — changeableness, the fine 
 weather bemg as short-lived as the bad ; rapid vari- 
 ations of temperature, within moderate limits. In 
 autumn and spring there are heavy rains. 
 
 There are several circumstances in the climate of 
 Pan which render it a favourable residence for a 
 certain class of invalids. The atmosphere, when it 
 does not rain, is dry, and the weather fine, and there 
 are neither fogs nor cold piercing winds. The cha- 
 racteristic quality of the climate, however, is the 
 mildness of its spring, and exemption from cold 
 winds. While the winter is rather more than 2^ 
 colder than the warmest parts of England, and about 
 &^ colder than Rome, the spring is nearly 4^° warmer 
 than the former, and only 2^-° colder than the latter. 
 The mildness of the spring, and its little liability to 
 winds, render this place favourable in diseases of the 
 larynx, trachea, and bronchi. Dr. Playfair has found 
 it beneficial in gastritic dyspepsia and some cases 
 of asthma ; also in irritation of the trachea and bron- 
 chi ; but, he adds, it is relaxing, and tone is never | 
 acquired there. Hence the change from Pau should 
 be to a bracing climate. With delicate children, 
 also, he fpund the climate agree well, especially 
 when they removed to the mountains during the 
 summer. 
 
 In bronchial diseases, when accompanied with 
 relaxation of the system, and with copious expecto- 
 ration and dyspnoea, this climate does not in general 
 
PAU. 199 
 
 prove beneficial ; and Dr. Playfair considers it too 
 changeable in consumption. 
 
 Dr. Foville, who passed two years at Pau for the 
 benefit of his own health, considers the above account 
 of its climate correct in the main, but in some re- 
 spects too favourable. Its greatest advantage is the 
 constant calmness of the air. He thinks the climate 
 uncongenial to persons with delicate chests. The 
 inhabitants, he says, are generally healthy, and the 
 mortality less than in most cities of France. 
 
 According to Dr. Taylor, the primary effects of the 
 climate are to diminish nervous energy and arterial i 
 action, and induce venous congestion. Languor, 
 disinclination for exertion, and a sense of fulness 
 in the head and chest, are the primary efifects experi- 
 enced by healthy strangers.* Hence in all diseases ' 
 of an atonic character, — in a depressed and relaxed I 
 state of the nervous and muscular systems, and in 1 
 congestive diseases, the climate of Pau is injurious, j 
 Dr. Taylor contrasts the climate of Pau with that of 
 Nice in their physical characters and influence on 
 diseases, and they may be fairly regarded as the 
 extremes of the Continental climates frequented by 
 
 * The invalid will find full information in Dr. Taylor's work 
 respecting the Climate of Pau, and the Mineral Waters, &c., of the 
 Pyrenees. I am indebted to it for several corrections, but it was 
 very satisfactory to me to find that in all essential points Dr. 
 Taylor's experience of the climate and its influence on disease 
 accorded with that given in the former editions of this work. 
 
200 CLIMATES OF FRANCE. 
 
 English invalids. The brilliant skies and exhilarating 
 but often irritating climate of Nice afford a striking 
 contrast to the more clouded, depressing, and too | 
 \ soothing climate of Pau. Keeping these characters 
 of the two climates in mind, the physician will be at 
 no loss to distinguish the class of patients to whom 
 each is suited. 
 
 In fixing the period for leaving Pau, the destina- 
 tion of the person must be taken into account. If 
 his object is to return to England, he may leave it in 
 May ; if he means to spend the summer among the 
 Pyrenees, he should not leave it before June, as the 
 best season for using the mineral waters of the Py- 
 renees commences about the first of July. 
 
 In the same class of diseases in which the climate 
 of Pau is useful, the mineral waters of the Pyrenees 
 are also very beneficial ; and it may be convenient 
 and advisable for the invalid who has derived bene- 
 fit from a course of these waters, to pass the winter at 
 Pau, with a view of returning to them in the following 
 season. 
 
 SOUTH-EAST OF FRANCE. 
 
 Various places in the South-east of France have 
 been at different times recommended as affording a 
 good winter climate for consumptive patients ; but 
 the experience of later years is in complete opposition 
 to such advice, and the general and leading charac- 
 ters of the climate show that there never was the 
 
SOUTH-EAST OF FRANCE. 20'1 
 
 least reason to sanction it. How the practice origi- 
 nated, it is not of importance to inquire ; but that it is 
 founded on error, I shall be able to prove by a refer- 
 ence to the physical characters of the climate as well 
 as to the want of success which has attended it. 
 
 The mean annual temperature of Provence gene- 
 rally is .58° ; that is, about 7° warmer than the South- 
 west of England, 3° warmer than the South-west of 
 France, and about a degree below Italy, including 
 the climate of the lower Apennines. Its winter 
 temperature is 43<* ; being only 1 \° above the South- 
 west of England, and P above the South-west of 
 France, while it is 3° below Italy. The spring tem- 
 perature is b^"" ; namely, 6° above the South-west of 
 England, 1** above the South-west of France, and 
 2° below Italy. The temperature is distributed very 
 unequally through the year ; the difference of the 
 mean of the warmest and the coldest months being 
 35°; this in the South-west of England is 22°, in 
 the South-west of France 30°, in Italy 32°, and in 
 Madeira only 14°. 
 
 Dryness is one of the most remarkable characters 
 of the climate of Provence. At Marseilles and Tou- 
 lon, about nineteen inches of rain fall annually. This 
 is less by six inches than the fall at London, and is 
 not half so much as in the South-western extremity 
 of Cornwall. The annual number of days on which 
 rain falls in Provence is only sixty-seven, while at 
 London it is 178. Again, in Provence (at Toulon) 
 
 K 3 
 
202 CLIMATES OF FRANCE. 
 
 the quantity of water evaporated annually, is forty 
 inches, while at Paris it is thirty- two inches, at Gos- 
 port twenty- five, and at London only twenty -four. 
 When these circumstances are taken into consider- 
 ation, together with the high mean temperature, the 
 climate of Provence appears the driest in Europe. 
 Indeed, the dry nature of the soil, and the bare 
 parched aspect of the country bespeak this. 
 
 The general character of the climate of the South- 
 east of France is dry, hot, and irritating. Its 
 temperature throughout the year and the day is dis- 
 tributed with great irregularity, and the range is 
 much ^dder than in our own climate ; being as three 
 to one for the year, and as two to one for the day. 
 The temperature, no doubt, remains more steady 
 from day to day than our own; but its changes, 
 though less frequent, are more sudden and extensive. 
 Sometimes the winter is very rigorous. The orange 
 trees are occasionally killed by the cold in the most 
 sheltered parts of Provence. In 1709 the ports of 
 Marseilles and Toulon were frozen over. The whole 
 of this tract of country is subject also to keen, cold, 
 northerly winds, especially the mistral, which pre- 
 vails during the winter and spring, and is most 
 injurious in pulmonary diseases. 
 
 Although decidedly improper for consumptive 
 patients, and for those labouring under irritation of 
 the mucous membranes of the lungs, stomach, and 
 other organs, this climate may prove useful to invalids 
 
MONTPELIER. 203 
 
 of a different class. On persons of a torpid, or re- 
 laxed habit of body, and of a gloomy, desponding, 
 cast of mind, with whom a moist relaxing atmosphere 
 disagrees, the keen, bracing, dry air of Provence, 
 and its brilliant skies, will often produce a beneficial 
 effect. In some cases of chronic intermittent fevers, 
 also, it proves very favourable. 
 
 The distinctive characters of the climate prevail 
 more or less in the different places resorted to by 
 invalids, but none can be considered as exempt from 
 them. The remarks which I have to make on these 
 places individually, are derived partly from native 
 practitioners, and partly from my o^ti observation ; 
 and it will be found, I think, that the particular facts 
 confirm the general character given of the whole 
 South-east of France, from Montpelier to Nice. 
 
 MONTPELIER. 
 The celebrity of the medical school of Montpelier 
 had probably a considerable share in giving rise to 
 the character which this place obtained for the 
 benignity of its climate. It will be easy to show, 
 however, that Montpelier little deserved the repu- 
 tation which it long enjoyed as a residence for the 
 consumptive. I prefer the evidence afforded on this 
 subject by native authors. M. Murat, in his ' Medical 
 Topography of Montpelier,' published in 1810, states, 
 on the authority of M. Fournier, the following pro- 
 portion of deaths from consumption at the Hotel 
 
204 CLLMATES OF FRANCE. 
 
 Dieu of tliat city in the year 1763. The total 
 number of patients that passed through this Hospital 
 in the course of the year was 2756. The total 
 number of deaths was 154; and of this number 55 
 died of pulmonary consumption ; that is, more than 
 a third of the whole. After alluding to M. Fouquier's 
 opinion, that phthisis was still more frequent at a 
 former period, he adds, '^ Mais la phthisie pulmonaire 
 n*est que trop repandue dans ce pays : elle y enleve 
 meme des families entieres ; et la position de la ville, 
 et la constitution seche et variable des saisons phy- 
 siques, sont des causes locales qui la developeront 
 to uj ours." * M. Fournier, the author from whom 
 the above numbers are taken, observes, when noticing 
 the prevalence of northerly winds at Montpelier 
 during the winter and spring, "II faut avoir la 
 poitrine bien bonne et bien constituee pour resister 
 a ses impressions." f Other circumstances in the 
 topography and nature of the climate of Montpelier 
 might be stated to show its unfitness as a residence 
 for consumptive patients, but surely it is unnecessary 
 to adduce further evidence on the subject. Con- 
 sumptive patients are frequently sent from this place 
 to the village of Gauche, at the foot of Cevennes, 
 about two leagues distant. 
 
 * * Topographic Medicale de la Ville de Montpelier,' p, 149. 
 t ' Recueil d' Observations de Medeeine des Hopitaux Mili- 
 taires,' par M. Richard de Hautsierck, torn. ii. p. 5. 
 
MAESEILLES. 205 
 
 MARSEILLES. 
 
 Marseilles is but little entitled to claim any exemption 
 from the general character of the climate of Provence. 
 It is open to the full influence of the cold winds of 
 this country, and especially to the mistral. There 
 is, moreover, no part of the neighbourhood of 
 Marseilles where invalids can take exercise with 
 advantage, when the weather does permit them to go 
 out ; one of the principal objects for which they left 
 their own climate. The country around the city is 
 divided into small properties, inclosed by high walls, 
 between which the roads in every direction lead for 
 miles. The dry arid nature of the soil renders these 
 roads in general very dusty, and their narrow wind- 
 ing form subjects them to gusts of wind; both of which 
 circumstances make them most improper exercising 
 ground for invalids labouring under pulmonary irri- 
 tation. Indeed, it may be almost said that there is 
 no country about Marseilles, at least for the stranger 
 residing there. But the character of the climate is 
 still more objectionable. It is dry, variable, and 
 subject to cold irritating winds, which are particularly 
 injurious to consumptive patients. Marseilles is, 
 indeed, one of the towns in France in which pulmonary 
 consumption is most prevalent. A large proportion 
 of the youth of both sexes is carried off by it. Females, 
 from fourteen to eighteen years of age are said to be 
 its most frequent victims. To use the words of a 
 
206 CLIMATES OF FRANCE. 
 
 native author : " II fait des ravages inouies en mois- 
 sonnant la plus belle jeunesse." * Scrofula attacking 
 the external parts of the body is rather a rare occur- 
 rence at Marseilles. Pleurisy and catarrh are frequent ; 
 as ai'e cancer and cutaneous eruptions. Diseases of 
 the uterine system are also common. 
 
 HYERES. 
 
 The little town of Hyeres, agreeably situated on the 
 southern declivity of a hill, about two miles from the 
 shores of the Mediterranean, and twelve from Toulon, 
 is the least exceptionable residence in Provence for the 
 pulmonary invalid. It is in some degree protected 
 from northerly winds, and has the advantage of being 
 situated in a beautiful open country. Immediately 
 under the town, the orange -tree is cultivated in 
 abundance. It is the hardiest species, and thrives 
 very well in general, being little injured by the 
 winter. It has nevertheless happened several times, 
 although at intervals of many years, that the cold 
 has been sufficiently intense to destroy the whole of 
 
 ithe orange -trees at Hyeres in one night. This oc- 
 curred last in the winter of 1820, on which occasion 
 not a single orange-tree escaped ; and many of the 
 
 1 olive-trees, in the most exposed situations, were also 
 partially killed. 
 
 * ' Expose des Travaux de la Societe de Medecine de Mar- 
 seilles,' 1816, par M. Sigaud, p. 14. 
 
HY^RES. 207 
 
 The lower grounds are occupied with vines and 
 corn, and about the bases of the hills the olive is 
 extensively cultivated, and attains a considerable 
 size. The hills immediately surrounding Hyeres 
 are finely covered with evergreen shrubs, affording 
 a striking contrast to the bare unseemly aspect 
 which the hills of Provence generally present. The 
 thyme, rosemary, lavender, and many other aromatic 
 plants grow here in abundance ; and several of these 
 we find blooming in December. With all these 
 indications of mildness, Hyeres is by no means 
 sufficiently protected from the mistral, to render it a 
 desirable residence for consumptive invalids (setting 
 aside objections from the general character of the 
 climate), although it has been strongly recommended 
 as such. It is true that about the base of the hills 
 there are some spots sheltered from the niistral, 
 where the invalid might enjoy several hours in the 
 open air almost every day; but these are almost 
 unattainable when they would be most useful. The 
 keen blast sweeping round every exposed corner, 
 forbids the valetudinarian to venture there, except in 
 a close carriage, while the roads leading to these 
 places do not admit wheeled vehicles. When the 
 weather does permit, the invalid residing at Hyeres 
 may enjoy the advantage of a variety of rides through 
 a fine open country. But when the mistral blows 
 with any degree of force, he should confine himself 
 to the house, if his chest be delicate ; and he must 
 
208 NICE. 
 
 even be cautious at all times of exposing himself to 
 this wind, which, independently of its low tempera- 
 ture, is very irritating. "With all these objections, 
 the climate of Hyeres is the mildest in Provence ; 
 and the invahd may feel assured, that whatever 
 inconveniences he is subjected to from the cold 
 winds at this place, he would have experienced in 
 a greater degree in any other part of Provence. 
 
 KICE. 
 
 The climate of Nice approximates more nearly in 
 its general character to that of Provence, which has 
 just been described, than to any other. Its mean 
 annual temperature is 59°, being 9° warmer than 
 London, 7° warmer than Penzance, 1** colder than 
 Kome, and 5° colder than Madeira. The mean tem- 
 perature of itnnter is 48° ; that is, nearly 9° warmer 
 than London, 4° warmer than Penzance, 1° colder 
 than Pome, and 12° colder than Madeira. The mean 
 temperature of spring is 56° ; being 7° warmer than 
 London, 6° warmer than Penzance, 1° colder than 
 Rome, and 6° colder than Madeira, The temperature 
 throughout the year is more equally distributed at 
 Nice than at any other place in the South of Europe, 
 except Rome and Cadiz; the difference of the 
 warmest and coldest months being only 28°, and the 
 mean difference of successive months only 4°'74. 
 
NICE. 20d 
 
 The range of temperature for the day is also less 
 at Nice than at any other part of the South of 
 Europe; and in steadiness of temperature it ranks :js 
 next to Madeira. 
 
 The mild and equable character of the climate of 
 Nice depends in a great measure on the position of 
 the place with respect to the neighbouring moun- 
 tains and the sea. The maritime Alps form a lofty 
 barrier, which shelters it in some degree from 
 northerly winds during winter; and the cool sea- 
 breeze, which prevails every day with a regularity 
 almost equal to that of a tropical climate, moderates 
 the summer heat. *' Get alize Mediterraneen,*' says 
 M. Eisso, " toujours doux, frais et tranquille, s'eleve 
 periodiquement vers neuf a dix heures du matin, 
 cesse souvent vers les quatre heures apres midi, et 
 s'etend dans Tinterieur de nos Alpes rarement au 
 dela de huit myriametres." * These circumstances 
 explain the small annual range of temperature at this 
 place, already noticed, and which a reference to the 
 table in the Appendix will show to be much less than 
 in most parts of Italy. 
 
 Notwithstanding the extent, however, to which 
 Nice and its environs are encircled by mountains 
 
 * ' Histoire Naturelle de Princi pales Productions de TEurope 
 Meridionale, ct particulierement de cellesdes Environs de Nice.' 
 1826. par A. Risso. Vol. i. p. 219. To this excellent work I 
 beg leave to refer those of my readers who may be desirous of in- 
 formation respecting the natural historj- of the South of Europe. 
 
210 NTCE. 
 
 (and it is so in a great measure from W. S. W. to 
 E. S. E.), it is by no means exempt from cold winds 
 during the winter, and still less so during the spring. 
 The easterly winds are the most prevalent during 
 the latter season. They range from east to north- 
 east, frequently blow with considerable force, and 
 are often accompanied with a hazy state of atmosphere. 
 Sometimes this wind commences in the forenoon, at 
 other times not until the afternoon. When the early 
 part of the day is fine, it never should be lost for 
 exercise, as a cold windy afternoon not unfrequently 
 succeeds a calm mild morning. 
 y From the north-west or mistral, which is the 
 scourge of Provence, Nice is pretty well sheltered. 
 The force of this wind seems to be broken, and 
 directed to the southward by the Estrelles, a chain 
 of mountains between Frejus and Cannes. But 
 although the mistral is not experienced in its full 
 force at Nice, or only towards its termination, when 
 it takes a more westerly direction {la queue de la 
 mistral), the keen, dry quality of the air is very 
 sensibly felt whilst it prevails. It sets in generally 
 about two or three o'clock in the afternoon, and is 
 not of long duration. The wind seldom blows strong 
 directly from the north, though the air is very sharp 
 when it is in that quarter. The northerly gales, 
 descending from the summits of the high range of 
 mountains which encircle the valley of Nice on the 
 north, are little felt; they appear to pass in an ob- 
 
NICE. 211 
 
 lique direction over the town.* The sirocco is of 
 rare occurrence, and when it does pay a visit in the 
 \vdnter, it is gentle, and not unpleasant to the feelings 
 of invalids in general. 
 
 The weather at Nice during the winter is com- 
 paratively settled and fine, the atmosphere being 
 generally clear, and the sky remarkable for its bril- 
 liancy. The temperature seldom sinks to the freez- 
 ing point, and when it does, it is only during the 
 night; so that vegetation is never altogether sus- 
 pended. Indeed, at Nice, winter is a season of 
 flowers, the dryness of the air rendering the same I 
 degree of cold less injurious to them than it would 
 be in a more humid atmosphere. Spring is the most 
 unfavourable season; the sharp, chilling, easterly 
 winds are the greatest enemy with which the invalid 
 has to contend ; and the prevalence of these during the 
 months of March and April forms the greatest objec- 
 tion to this climate, especially in pulmonary diseases. 
 
 It must not be supposed, however, that these sharp 
 spring winds are peculiar to Nice. They prevail 
 
 * ''On eprouve fort rarement," says M. Risso, "toute sa 
 force dans les couches inferieures de I'air qui environnent le 
 plateau de Nice, h, cause du triple rang de montagnes qui I'entou- 
 rent ; il occupe presque toujours les couches superieurs, et descend 
 en pente comme un grand torrent aerien sur la raer ; car on 
 aper^oit h un kilometre du rivage qu'il commence k en friser la 
 surface pour former un peu plus loin des vagues qui, s'elevant les 
 unes sur les autres, vont porter les tempetes sur les cotes boreales 
 d'AMquer—Hist. Nat. vol. i. p. 216. 
 
212 NICE. 
 
 more or less over the whole South of Europe. They 
 are equally bad at Naples ; somewhat softened at 
 Pisa ; and still more so, perhaps, at Rome. 
 
 The climate of Nice is altogether a very dry one*^ 
 Rain falls chiefly during particular seasons. From 
 the middle of October to the middle of November it 
 generally rains a good deal; also about the winter 
 solstice there is commonly some rain, and again after 
 the vernal equinox. The quantity of rain that falls 
 during the year has not been accurately estimated. 
 
 Upon the whole, in the physical qualities of its 
 climate, Nice possesses considerable advantages over 
 the South-east of France, more especially in being 
 protected from the mistral. 
 
 Nice is upon the whole a healthy place. Catarrhal 
 affections and inflammation of the lungs rank among 
 the most frequent diseases of the inhabitants. They 
 are especially common and violent in the spring, and 
 are generally complicated with irritation of the diges- 
 tive organs. Pulmonary consumption is much less 
 j&requent than in England and France. Gastric fever 
 and chronic gastritis are very common diseases. In- 
 deed, gastric irritation appears to be very prevalent - 
 and almost all other diseases are complicated with it.r 
 Intermittent fevers are not unfrequent among the 
 peasantry living or labouring in unhealthy situations 
 in the country. The flat ground on the banks of the 
 Var is the most fruitful source of these fevers. The 
 guards stationed on the bridge which crosses this 
 
NICE. 21S 
 
 boundary stream are frequently attacked with ague 
 during the unhealthy season, although they are 
 stationed there only a few days at a time. This is a 
 disease, however, from which the winter resident at 
 Nice has nothing to fear. Dr. Skirving, during a 
 long residence there, met with one case only of 
 ague amongst the strangers. Diseases of the eyes 
 are very prevalent, particularly amaurosis and cata- 
 ract : cutaneous diseases are also very common. 
 
 In describing the eflfects of the climate of Nice on 
 disease, I am much indebted to Dr. Skirving for the 
 results of his extensive experience.* 
 
 In Consumption, the disease with which the cli- 
 mate of Nice has been chiefly associated in the minds 
 of medical men in this country, little benefit is to bel^ 
 expected from the climate. When this disease is 
 complicated with an irritable state of the mucous 
 membranes of the larynx, trachea, or bronchi, or of the 
 stomach, the climate is decidedly unfavourable ; and, 
 without extreme care on the part of the patient, and 
 a very strict regimen, the complaint will in all proba- 
 bility be aggravated by a residence at Nice. Indeed, 
 the cases of consumption which ought to be sent to 
 this place are of rare occurrence. If there are any 
 
 * Dr. Skirving practised at Nice with great reputation for 
 many years ; but for the last ten years he was mostly confined to 
 his house by a paralytic affection, which carried him off last 
 autumn. 
 
214 NICE. 
 
 such, it is when the disease exists in torpid constitu- 
 tions, and is free from the complications which have 
 been just mentioned. Even the propriety of select- 
 ing Nice as a residence for persons merely threatened 
 with consumption, will depend much upon the con- 
 stitution of the individual. Dr. Skirving met with 
 cases which left no doubt on his mind that a resi- 
 dence for one or two winters often proves of advan- 
 tage, as a preventive measure, in young persons 
 predisposed to this disease ; and even in some in- 
 stances in which there was every reason to believe 
 that tubercles already existed in the lungs, the climate 
 has appeared to be useful. But in the advanced 
 stage of consumption, his opinion, founded on eight 
 years' experience, accords with what has been already 
 stated ; and this is still further supported by the 
 testimony of Professor Fodere, of Strasbourg, who 
 resided six years at Nice.* Indeed, sending pa- 
 tients labouring under confirmed consumption to 
 Nice, will in a great majority of cases prove more 
 injurious than beneficial. 
 
 In Chronic Bronchitis, which often simulates 
 phthisis, very salutary effects are produced by a 
 residence at this place. Such patients generally 
 pass the winter with comparatively little suffering 
 
 * See ' Voyage aux Alpes Maritimes, ou Histoire Naturelle, 
 Agraire, Civile et Medicale du Pays de Nice,' &c. Strasbourg, 
 1823. 
 
NICE. 216 
 
 from their complaint, and with benefit to their general 
 health. They are here able to be much in the open 
 air, whereas if they had remained in England they 
 would in all probability have been confined during 
 the greater part of the winter to the house. The 
 particular kind of bronchial disease most benefited 
 by a residence at Nice is that which is accompanied 
 with copious expectoration, whether complicated with 
 asthma or otherwise ; and in the chronic catarrh of 
 aged people it is particularly beneficial. This variety 
 of bronchial disease is directly the reverse of that 
 which is mitigated by the South-west of France and 
 of England : and I think it important here to remark, 
 that unless the distinctions which I have pointed out 
 in bronchial diseases, and their complications, are 
 attended to, great errors must be committed in 
 selecting a residence for such patients. For fuller 
 information on this subject, the reader is referred to 
 the article on * Bronchial Diseases.' 
 
 The invahd subject to Chronic Gout may, in most 
 cases, escape his usual winter attack, and provided 
 he lives with prudence his general health may be 
 improved, by a winter's residence at Nice. 
 
 In Chronic Eheumatism the climate is generally 
 very beneficial ; and its advantages are also remark- 
 able in Scrofulous Complaints. On children the 
 climate generally exerts a very favourable influence, 
 if attention be paid to their diet. 
 
 In the numerous train of hypochondriacal and 
 
216 NICE. 
 
 nervous symptoms which often originate in dyspeptic 
 complaints, Nice is beneficial ; but here again it is 
 necessary to distinguish the particular character of 
 the affection. The cases of dyspepsia most benefited 
 are those accompanied with a torpid, relaxed state of 
 the system, with little epigastric sensibility, and none 
 of those symptoms which denote an inflamed or very 
 irritable state of the mucous membrane of the stomach. 
 "Where the latter state prevails, Nice will decidedly 
 disagree. But I must refer to the article on * Dis- 
 orders of the Digestive Organs ' for more precise 
 directions regarding the best winter residence for 
 persons suffering from such complaints. 
 
 In all cases where there is great relaxation and 
 torpor of the constitution, the climate of -Nice is 
 extremely useful. In young females labouring under 
 such a state of system, connected with irregularities 
 of the uterine functions, either when these have not 
 been established at the usual period, or when they 
 have afterwards been suppressed, marked benefit may 
 generally be expected. In indicating the class of 
 cases alluded to as likely to derive advantage from 
 the climate of Nice, I would designate them to the 
 practical physician as those that are usually relieved 
 by chalybeates. 
 
 In a numerous class of patients, whose constitu- 
 tions have been injured by a long residence in tropical 
 countries, by mercury, &c., and in which a dry and 
 rather exciting climate is indicated, Nice will prove 
 
NICE. 217 
 
 favourable. Some cases of clironic paralysis not 
 connected with cerebral disease have also been found 
 to derive considerable benefit from a residence at this 
 place. 
 
 In stating its general influence on the animal 
 economy, I would say that the climate of Nice is 
 warm, exhilarating, and exciting, but to highly sen- 
 sitive constitutions somewhat irritating, more espe- 
 cially during the spring. It is extremely favourable 
 to the productions of the vegetable kingdom, some of 
 which flourish here in a degree of luxuriance that 
 is scarcely to be equalled in other parts of the South 
 of Europe.* 
 
 Invalids who pass the winter at Nice scarcely ever 
 reside in the town. Some good houses, tolerably 
 well situated, and overlooking the terrace, are, how- 
 ever, now to be had; but in the suburb called the 
 Croix de Marhre, and along the sea- beach, from 
 
 I 
 
 * *'Peu de contrees meridionales de I'Europe offrent un 
 tableau aussi varie en vegetaux indigenes et exotiques que les 
 environs de Nice. Dans le fond, c'est une masse d'oliviers qui 
 s'etend sur toutes les collines, et dispairait insensiblement k 
 m^sure qu'elle s'eloigne du rivage de la mer. Sur le devant, 
 ce sont des orangers, des bigaradiers, des limoniers, disposes en 
 jardins qui offrent toute la luxe des Hesperides. Pour relever 
 la sombre verdure des uns et la monotonie des autres, des carou- 
 biers, des figuiers, des jujubiers, des raquettiers, des dattiers, des 
 grenadiers, et toutes sortes d'arbres fruitiers distribues sans ordre, 
 en etalant toute leur vigueur, achevent d'orner et d'embellir ce 
 bel ensemble." — Risso, Op. citat. 
 
218 VILLA FRANCA. 
 
 the town to the ridge of mountains where the plain 
 terminates on the west, the largest a>nd best houses 
 are to be found ; and here strangers generally reside. 
 At the foot of the hill on which stood Cimiez there 
 are also good houses ; and this is a situation preferable 
 to the lower part of the plain for patients very sus- 
 ceptible of injury from damp ; it is also more protected 
 from the cold northerly winds, and altogether perhaps 
 the best situation at Nice for invalids. 
 
 Invalids should endeavour to arrive at Nice about 
 the middle of October, or sooner, and should not 
 leave it before the beginning of May. The inconve- 
 niences experienced from the spring winds here are 
 felt in a much greater degree in the South of France ; 
 and, accordingly, invalids often suffer severely from 
 the winds of Provence when they leave Nice too 
 early. The invalid may move in the direction of Nice 
 and Genoa at a much earlier period than it would be 
 advisable for him to return over the Estrelles to 
 Provence; and when the climate of Nice is found 
 to disagree, a change in the spring in the direction of 
 Genoa may in some cases be advisable. 
 
 Villa Franca. — This little town, situated on the 
 southern base, or rather declivity, of a steep and 
 lofty range of mountains, and having a beautiful bay 
 extended out before it, lies immediately to the east- 
 ward of Montalbano, which separates the bay of Villa 
 Franca from that of Nice. From the north and 
 
I 
 
 MENTON. 219 
 
 north-west winds this place is more eiFectually pro- 
 tected than Nice ; it is also sheltered from the north- 
 east, but is open to all other easterly winds. In its 
 general characters the climate corresponds closely 
 with that of Nice ; it is said to be still drier and 
 somewhat warmer, and it is certain that the vegetable 
 productions are considerably earlier than at Nice. 
 There are a few good houses at Villa Franca, but the 
 accommodations are not numerous. Within the last 
 few years a carriage road has been cut between this 
 place and Nice ; so that the accommodations will 
 most likely be increased, as in this secluded little 
 vale sites for building may be found more effectually 
 protected from cold winds than any part of the more 
 open and extended plain of Nice. 
 
 Menton, about fourteen miles from Nice, on the 
 road to Genoa, is also a very sheltered spot ; and San 
 \,Remo, still further, is even more protected from east- 
 erly winds. The great mildness of both these places 
 is indicated by the flourishing state of their lemon 
 plantations. And at Bordighera, in the neighbour- 
 hood of the latter, the palm-tree is cultivated on a 
 large scale for the sake of its etiolated leaves, of 
 which it has long afforded a supply for the cere- 
 monials of the Church of Eome. But the want of 
 accommodation at these places at present prevents 
 the invalid, to whom a change from Nice might be 
 advantageous, from availing himself of it. The 
 
 l2 
 
220 NICE. 
 
 increased number of travellers, however, who now 
 pass by this road from Nice to Genoa, will afford the 
 means of improving the accommodation along this 
 beautiful coast. 
 
 The invalid who has passed the winter at Nice, 
 when he begins to feel the irritating effects of the 
 spring winds, should leave it and proceed by the sea 
 coast to Genoa. This road runs between the sea-shore 
 and the base of the mountains, and is well protected 
 from northerly winds. From Genoa he may continue 
 his journey by land to Pisa or Kome ; or by the steam- 
 boat, which touches at Genoa every week, he may pro- 
 ceed at once to Civita Vecchia, about forty miles from 
 Rome. By adopting this last plan the invalid will 
 be spared the fatigue and inconveniences incident to 
 a long journey, and E-ome at this season will afford 
 a very favourable change to the pulmonary invalid 
 who has been at Nice during the winter 
 
( 221 ) 
 
 CLIMATES OF ITALY. 
 
 Italy possesses great diversity of climate, but my 
 observations are limited to the part situated between 
 the Apennines and the shores of the Mediterranean. 
 The climate which prevails over the whole of this 
 region, while it exhibits a great similarity of cha- 
 racter, differs in several respects from any of the 
 climates already noticed. It is considerably warmer 
 and less humid, but subject to a greater range of 
 temperature than that of the South-west, — softer, less 
 dry, and less harsh and irritating than that of 
 the South-east of France ; suffering more from the 
 heavy oppressive winds of the south, and less from 
 the dry searching winds of the north. 
 
 The principal circumstance which appears to mo- 
 dify the general character of this climate at different 
 places, is the relative position of the latter with re- 
 spect to the sea-shore and the Apennines. In this 
 there is considerable variety ; Genoa and Naples are 
 in the vicinity of both, as the mountains at these places 
 approach closely to the Mediterranean ; Pisa is only 
 a few miles distant from the latter, and close to the 
 Tuscan hills, a branch of the lower Apennines ; Rome 
 is about twelve miles from the coast, and nearly twice 
 that distance from the mountains ; Florence is quite 
 
222 CLIMATES OF ITALY, 
 
 embosomed in the Apennines^ and the character of 
 its climate is thereby affected to such a degree as 
 scarcely to admit of its being classed with the other 
 Italian climates. 
 
 GENOA. 
 
 The situation of Genoa, hemmed in between a 
 range of steep mountains and the sea, with little or 
 no surrounding country well adapted for exercise, 
 renders it an unsuitable residence for invalids gene- 
 rally. Nor is there much in the character of the 
 climate to recommend it. The summer is hotter and 
 the winter colder than at Nice ; the difference in the 
 mean temperature of the warmest and the coldest 
 months at Genoa being 35°, while at Nice it is only 
 28^ The distribution of heat throughout the year is 
 also very unequal, and the temperature by no means 
 steady from day to day. The air is sharp and ex- 
 citing, but with less of the irritating quality than 
 that of the South-east of France. The climate is, on 
 the whole, dry and healthy, but not suitable to 
 delicate, sensitive invalids. It is more congenial to 
 relaxed, phlegmatic habits. Dyspeptic complaints 
 and gout are said to prevail less at Genoa than in 
 most parts of Italy. For pulmonary invalids, Genoa 
 is decidedly an improper residence. It is subject to 
 frequent and rapid changes of temperature, and to 
 dry, cold winds from the north, alternating with 
 warm, humid winds from the south-east, — the two 
 
GENOA. FLORENCE. 223 
 
 prevailing winds of the place. To these rapid 
 changes are attributed the inflammatory affections 
 of the respiratory organs, which, with tubercular 
 consumption, cause a great part of the mortality of 
 Genoa. In some places in the neighbourhood, more 
 sheltered from these winds, inflammatory affections 
 of the lungs are said to be much less common than 
 in the city and its immediate vicinity. Hheumatism 
 is frequent, while gout and calculous diseases are 
 comparatively rare. Scrofula is common. Intermit- 
 tent fevers are rare, and of mild character. 
 
 FLORENCE. 
 
 Though Florence is one of the most agreeable re- 
 sidences in Italy, it is far from being a favourable 
 climate for an invalid and least of all for an invalid 
 disposed to consumption. 
 
 Its situation among the lower Apennines, by 
 which it is almost encircled, and the higher summits 
 of which are covered with snow during the winter, 
 together with its full exposure to the current of the 
 valley of the Arno, render Florence subject to sud- 
 den transitions of temperature, and to cold piercing 
 winds during the winter and spring. Fogs, too, are 
 more common here than in most parts of Southern 
 Italy. The winter temperature is upon the whole 
 low, while that of the summer is high. The mean 
 annual temperature is only IJ** below that of Rome; 
 
224 CLIMATES OF ITALY. 
 
 but this is owing to the great heat of summer at 
 Florence ; for the winter is only 5° warmer than that 
 of London, and is nearly of the same temperature 
 as the winter at Penzance. The difference in the 
 mean temperature of the warmest and the coldest 
 months is SG**, which is one degree more than that 
 of Provence. Nevertheless, although the daily, 
 monthly, and annual ranges of temperature are very 
 great, the climate is not more variable or unsteady 
 from day to day than that of Kome, and is less so than 
 that of Naples. The annual range of atmospheric 
 pressure is greater than that of the neighbouring 
 places. The annual fall of rain at Florence is 31 '6 
 inches, but the number of days on which rain falls 
 is only 103, being fewer than at Rome. In the 
 winter the air is rather chilly and loaded with 
 moisture. 
 
 Dr. Playfair describes the months of December 
 and January as intensely cold, especially during the 
 nights ; February and March cold and humid, the 
 east winds of the latter month being extremely keen 
 and often checking the progress of vegetation. In 
 April and May the weather is fine, the temperature 
 gradually rising in the latter month to 74°. During 
 July and August everything is parched up ; the tem- 
 perature rises to 80° and even 90°, and the nights 
 are oppressively hot. In September the weather be- 
 comes cool, and during this and the two following 
 months is generally fine, although in October fogs are 
 
FLORENCE. 225 
 
 common. From this account of the climate, it will 
 be understood what diseases are likely to be benefited 
 or aggravated by a residence at Florence. In con- 
 sumption and all inflammatory diseases of the chest 
 it is injurious ; Dr. Playfair never allowed a patient 
 of this class to remain at Florence after October : 
 indeed, acute inflammation of the lungs is one of the 
 most prevalent and fatal diseases among the inhabi- 
 tants in the winter and spring. On the other hand, 
 the dry bracing character of the climate renders it 
 useful in diseases accompanied with relaxation. Dr. 
 Playfair describes it as very beneficial in humid asth- 
 ma, and even in the purer spasmodic form of that 
 disease ; also in atonic dyspepsia, but injurious in the 
 inflammatory form. Gout is much relieved, and scro- 
 fulous swellings of the glands disappear during a re- 
 sidence at Florence.* Every person who can should 
 leave Florence during the months of July and August. 
 With children the summer disagrees extremely, and 
 an attempt to wean a child at this season is attended 
 with extreme danger. The Baths of Lucca aflford a 
 convenient and cool retreat during the hot months. 
 
 * * Dr. Playfair practised many years as a physician at Florence, 
 and had ample opportunities of forming an accurate judgment on 
 the nature of the climate, and its effects on disease. 
 
 l3 
 
226 CLIMATES OF ITALY. 
 
 PISA. 
 
 Pisa has long had the reputation of being one of 
 the most favourable climates in Italy for consumptive 
 patients. It has accordingly been frequented, and 
 continues to be so, by invalids from England. It is 
 even resorted to, during the winter, by invalids from 
 the rest of Tuscany, from the neighbouring states of 
 Lucca, and occasionally also from Lombardy. 
 
 The town is built on the banks of the Arno, about 
 five miles from the sea-shore. The surrounding 
 country is flat, except towards the north, where a 
 range of hills shelters Pisa in some measure from 
 the winds of that quarter. It is also protected, in a 
 considerable degree, from easterly winds by the 
 lower Tuscan hills. The Arno, in flowing through 
 Pisa, makes a semicircular sweep to the north, so 
 that the buildings on the northern bank of the river 
 {Lung' Arno) assume the form of a crescent facing 
 the south, and shelter the greater part of the broad 
 space between them and the river from northerly 
 winds. This is the best residence for delicate in- 
 valids. 
 
 Pisa is not so warm as Rome in winter, and is 
 hotter in summer. In winter it is 7° warmer than 
 London, and 2<* warmer than Penzance. In spring 
 it is 8° warmer than London, and about 7° warmer 
 than Penzance. The range of temperature betweeu 
 day and night is very considerable. According to 
 
PISA. 227 
 
 Professor Piazzini, the fall of rain annually is very f 
 great, being 45*66 inclies, which is nearly as much 
 as falls in Cornwall. The climate of Pisa is genial, 
 but rather oppressive and damp. It is softer than 
 that of Nice, but not so warm ; less soft, but less / 
 oppressive, than that of Rome. For invalids who are 
 almost confined to the house, or whose power of 
 taking exercise is much limited, Pisa offers advan- 
 tages over either Rome or Nice. The Lung' Arno 
 affords a warm site for their residence, as well as a 
 sheltered terrace for their walks ; but they must be 
 careful to confine themselves to it. 
 
 The most common acute diseases at Pisa are 
 peripneumony, dysentery, and gastric fevers. Oph- 
 thalmia and cataract are frequent; but this is the 
 case over the whole southern parts of Italy. Con- 
 sumption is not a common disease, but chronic 
 bronchial affections are frequent ; and croup is 
 occasionally met with. Calculous diseases are so 
 rare, that Vacca, the celebrated surgeon, during 
 thirty-two years that he had been operating on 
 such patients from all parts of Italy, had not had 
 occasion to operate on one Pisan. 
 
 Pisa is less frequented by invalids than formerly, 
 in consequence of the easy communication by steam- 
 boats between Leghorn and Rome and Naples. Tra- 
 vellers who remain at Pisa more than one season usu- 
 ally pass the summer at the Baths of Lucca. 
 
28 CLIMATES OF ITALY. 
 
 ROME. 
 
 The climate of Eome is mild and soft, but rather 
 relaxing and oppressive. The mean annual tempera- 
 ture at Rome is 10® higher than at London, 8" higher 
 than at Penzance, 3 J® higher than at Pau, about 1** 
 higher than at Marseilles, Toulon, and Nice ; it is 1** 
 lower than at Naples, and 4* lower than at Madeira. 
 The mean temperature of unnter at Rome still re- 
 mains 10° higher than at London, but it is only 5° 
 higher than at Penzance ; it is 7** higher than at Pau, 
 P higher than at Nice, and somewhat higher than at 
 Naples ; it is 4** colder than at Cadiz, and 1 1° colder 
 than at Madeira. In spririg, the mean temperature of 
 Rome is 9^ above that of London, 8** above that of 
 Penzance, 3J° above that of Pau, and 1° above that of 
 Nice and Provence ; it is \° colder than Naples, and 
 only a little more than 4** colder than Madeira. 
 
 In range of temperature (the extent of which is the 
 leading fault of the climate of the South of Europe) 
 Rome has the advantage of Naples, Pisa, and Pro- 
 vence, but not of Nice. Its diurnal range is nearly 
 double that of London, Gosport, Penzance, and 
 Madeira. In steadiness of temperature from day to 
 day, in which our own country, with the exception of 
 the South-west of Cornwall, is so remarkably defi- 
 cient, Rome comes after Madeira, Nice, Pisa, and 
 Penzance, but precedes Naples and Pau. 
 
 Rome, although a soft, cannot be considered a damp 
 
EOME. 229 
 
 climate. Upon comparing it with the dry, parching 
 climate of Provence, and with that of Nice, we find 
 that about one third more rain falls, and on a greater 
 number of days. It is, however, drier than Pisa, and 
 much drier than the South-west of France. 
 
 At Penzance there falls about one third more rain 
 than at Rome, and the number of rainy days is also 
 about one third greater. This circumstance, together 
 with the greater evaporation at Rome, owing to its 
 higher temperature, must make a considerable dif- 
 ference in the hygrometrical state of the atmosphere 
 at the two places. Rome is not so dry as Madeira ; 
 as there falls one sixth more rain, and the proportion 
 of wet days is as 11 7 to 73. 
 
 From these comparisons it would appear that the 
 climate of Rome, in regard to its physical qualities, is 
 one of the best in Italy for pulmonary invalids. One 
 peculiarity of it deserving notice is the stillness of its 
 atmosphere ; high winds being comparatively of rare 
 occurrence. Calmness is, for pulmonary diseases and / 
 for invalids generally, a valuable quality in a winter 
 climate, as it admits of their taking exercise in the i 
 open air at a much lower temperature than they could 
 otherwise do. To patients labouring under bronchial | 
 irritation, wind is peculiarly hurtful. When wind 
 does occur at Rome during the winter and spring, it 
 is generally from the north, and is very moderate, at 
 least when it continues for any considerable time. 
 From this quarter there are occasionally high cold 
 
230 CLIMATES OF ITALY. 
 
 winds {Tramontane); but these are of sliort dura- 
 tion, being limited with surprising regularity to | 
 three days. The Tramontana is a dry, keen, and 
 irritating wind, resembling in its effects the cold 
 sharp winds of Provence ; and is equally to be 
 guarded against by invalids, who should not leave 
 the house while it blows with much force. The 
 southerly winds during the winter and spring are 
 not productive of inconvenience to invalids at Eome. 
 Even the relaxing and enervating effects oit)ie sirocco 
 are only felt by the more sensitive and plethoric 
 among the healthy, and by them only after it has 
 continued to blow for a few days. Invalids, on the 
 other hand, who suffer from great irritability, and a 
 degree of morbid sensibility of body, commonly feel 
 the winter sirocco pleasant. In its effects on the 
 body this wind is directly opposed to the Tramontana. 
 In the months of March and April, wind is more 
 frequent at Rome ; it sets in generally in the forenoon, 
 and continues till sunset, when it subsides, leaving 
 the nights calm and serene. The effects of the keen 
 spring wind, combined with the influence of a pow- 
 erful sun, are severely felt by the sensitive invalid; 
 though, as far as I could observe or learn from the 
 testimony of others, in a less degree than at Naples 
 and Nice, and perhaps even, than at Pisa. 
 
 Diseases.— Among the more prevalent diseases of 
 Rome, malaria fevers are the most remarkable, and 
 
EOME. -231 
 
 claim our first notice. In the few remarks I am 
 about to make on the subject, I shall confine myself 
 chiefly to a notice of those points respecting malaria 
 which it is important for travellers to know, with the 
 view of enabling them to avoid its effects. 
 
 In the first place, I may observe that the malaria 
 fevers of Rome are exactly of the same nature^ both 
 in their origin and general characters^ as the fevers 
 which still occur in the fens of Lincolnshire and 
 Essex in our own country; in Holland; and in cer- 
 tain districts over the greater part of the globe. The 
 form and aspect under which these fevers appear 
 may differ according to the concentration of the 
 cause, or may arise from some peculiarity in the 
 climate or the season in which they occur ; but it is 
 the same disease from the fens of Lincolnshire and 
 the swamps of Walcheren to the pestilential shores of 
 Africa ; only increasing in severity, cceteris paribus, 
 as the temperature of the climate increases. In Eng- 
 land and in Holland these fevers generally appear 
 in the simple intermittent form ; more rarely in the 
 remittent form ; and they are, for the most part, easy 
 of cure. In France, - especially towards the south, 
 the same fevers often assume a more formidable cha- 
 racter. Those which from their unusual severity 
 and the peculiar character of their symptoms have 
 received the name of pernicious, are by no means 
 uncommon in the South-west of France ; and in the 
 rice districts of Lombardy they are met with in all 
 
232 CLIMATES OF ITALY. 
 
 tlieir varieties, and with a degree of severity perhaps 
 equal to the more aggravated forms of the malaria 
 fevers of Rome. Even in this country intermittent 
 fevers occasionally assume the pernicious form, and 
 unless medical practitioners in our malaria districts 
 keep this in mind, patients may be lost before the 
 real nature of the disease is discovered. 
 
 Malaria fevers seldom appear at Rome before July, 
 and they cease about October ; a period during which 
 few strangers reside there. The fevers of this kind 
 which occur at other seasons are generally relapses, 
 or complicated with other diseases. One of the most 
 frequent exciting causes of this fever is exposure to 
 currents of cold air, or chills in damp places, imme- 
 diately after the body has been heated by exercise, 
 and is still perspiring. This is a more frequent 
 source of other diseases also, among strangers in 
 Italy, than is generally believed by those who are 
 unacquainted with the nature of the climate. Expo- 
 sure to the direct influence of the sun, especially in 
 the spring, may also be an exciting cause : it has 
 certainly appeared to me to produce relapses. 
 Another cause of this disease is improper diet. An 
 idea prevails, that full living and a liberal allowance 
 of wine are necessary to preserve health in situations 
 subject to malaria. This is an erroneous opinion; 
 and I have known many persons suflfer in Italy from 
 acting on it. A deranged condition of the digestive 
 organs is generally the consequence of this impro- 
 
ROME. 233 
 
 per regimen, and this renders the individual much 
 more liable to disease of every kind. Irregularities 
 in diet are among the most frequent predisposing 
 causes of malaria fever among the peasantry about 
 Rome, who are the principal sufferers from it. A 
 plain and moderate diet, as it is the most conducive 
 to health generally, so it must, in the present case, 
 best aid the constitution in resisting the cause of this 
 fever. If there is any one circumstance in the state 
 of the constitution which more than another enables 
 it to combat and to pass through disease, it is, ac- 
 cording to my observation, a healthy condition of the / 
 digestive organs. In every situation of life, at all 
 ages, and in every climate, this holds true. 
 
 In regulating the diet of persons living in a malaria 
 country, regard should be had to the nature of the 
 climate. The same stimulating regimen which may 
 be borne, and even prove useful, in the damp chilly 
 atmosphere of Holland, is not suited to the exciting 
 climate of Italy. The peasantry in some parts of Italy 
 are very sensible of this. Sleeping with open win- 
 dows, during either the day or the night, more espe- 
 cially in places subject to these fevers, is very dan- 
 gerous ; and I have known repeated instances of fever 
 produced in this way. Towns are safer than villages, 
 and the latter than country houses ; and the central 
 parts of a town, again, are safer than the suburbs. 
 
 Much has been said about the healthy and un- 
 healthy quarters of Rome ; and in this respect there 
 
234 CLIMATES OF ITALY. 
 
 certainly is a material difference in the summer ; but 
 in the season during which strangers reside there, the 
 choice of situation demands much less consideration. 
 More is to be feared from currents of cold air in the 
 winter, than from a confined humid atmosphere, 
 which last is the evil to be avoided during summer. 
 It is of consequence to attend to the causes of disease 
 occurring at different seasons, inasmuch as a resi- 
 dence which is very proper during the winter may 
 not be so in summer. 
 
 It may be stated, as a general rule, that houses in 
 confined, shaded situations, with damp courts or 
 gardens, or standing water close to them, are unhealthy 
 in every climate and season, but especially in a 
 country subject to intermittent fevers, and during 
 summer and autumn. The exemption of the central 
 parts of a large town from these fevers is explained 
 by the dryness of the atmosphere and by the compa- 
 rative equality of temperature which prevails there. 
 Humid, confined situations, subject to great alternation 
 of temperature between day and night, are the most 
 dangerous. Dryness, a free circulation of air, and a 
 full exposure to the sun, are the material conditions 
 to be attended to in choosing a residence. Of all the 
 physical qualities of the air, humidity is the most 
 injurious to human life ; and therefore, in selecting 
 a residence or situations for building, in all climates 
 particular regard should be had to the circumstances 
 which are calculated to obviate humidity in the soil 
 
HOME. 235 
 
 and atmosphere. A person may, I believe, sleep with 
 perfect safety in the centre of the Pontine Marshes, 
 if he have his room kept well heated by a fire during 
 the night. 
 
 Persons attacked by this fever should be strictly 
 confined to the house until the disease has been 
 completely checked; after which, the sooner they 
 change the air, the more likely will they be to avoid 
 relapses, and to prevent a disposition to a return of 
 the disease from being fixed on the constitution — an 
 object of great consequence to the future health of 
 the individual. During the autumn or winter, such 
 persons may go to Naples ; but if the spring is far 
 advanced, Florence will be the better place. 
 
 The next circumstance connected with the diseases 
 of Pome, which deserves notice, is the peculiar 
 sensibility of the nervous system of its inhabitants. 
 This is evinced, in a very particular manner, by the 
 disposition to convulsive affections, and the singular 
 sensitiveness of the Pomans, especially the females, 
 to perfumes. This peculiar susceptibility of the 
 nervous system, appears to be of recent origin. 
 "We learn from ancient authors that the Poman 
 matrons were fond of perfumes ; and as the present 
 susceptibility is not mentioned by the Poman medical 
 authors who have more recently written on the cli- 
 mate and diseases of Rome — for instance, Petronio, 
 Baglivi, Marsilio Cagnato, and Lancisi — there can be 
 little doubt that it did not exist in their time. It is 
 
236 CLIMATES OF ITALY. 
 
 to be remarked, that it is not disagreeable odours 
 which produce such effects on the nervous system, 
 but the more delicate and to northern nations agree- 
 able odours of flowers and other perfumes. Head- 
 aches, and numerous other nervous affections, are 
 produced by such odours. 
 
 The Roman physicians, who agree in the recent 
 growth of this morbidly sensitive state of the nerv- 
 ous system among the inhabitants of Rome, can- 
 not fix upon any other cause to which it can be 
 fairly attributed, than the indolent manner of life 
 of the Romans, which favours, especially in such a 
 climate, the relaxation and sensibility of the system. 
 Thus Dr. De Matthaeis, after remarking that power- 
 ful odours have at all times produced sensible effects 
 on the system, observes, that " there is nothing 
 wonderful in this, if we consider the daily increasing 
 mobility of the nervous system, produced by the 
 luxurious and inactive life of our Romans.'* * Such 
 most likely was the source of this idiosyncrasy, and 
 no doubt still tends to maintain it ; while the morbid 
 sensibility of the nervous system, once acquired, is 
 doubtless transmitted from parent to child. But 
 though much may depend on the effeminate and 
 indolent manner of living at Rome, the climate, I 
 believe, has a specific effect in inducing this state 
 of the nervous system. The. habits of the Romans 
 
 ♦ De Matthaeis, ' Ratio Instituti Clinici Romani.' 
 
EOME. 237 
 
 differ little from those of the inhabitants of the other 
 large towns in Italy, for instance, Naples, Florence, 
 Genoa, &c. ; and yet this morbidly sensitive state of 
 the nervous system does not exist by any means in 
 the same degree in these places. Even a temporary 
 residence of some duration in Rome produces a 
 degree of the same morbid sensibility, and that in 
 cases where the Roman mode of living cannot be 
 adduced as the cause. 
 
 Inflammatory affections of the chest are frequent 
 during winter and spring. Acute inflammation of 
 the lungs appeared to me more violent and more 
 rapid in its course than in England. This remark 
 does not apply to Rome only, but I believe to the 
 whole of Italy, and to warm climates generally. 
 When at Dresden, the late celebrated German phy- 
 sician. Dr. Kreysig, remarked to me that he had 
 never witnessed such violent cases of pneumonic 
 inflammation in Germany as he saw during his stay 
 at Pavia. In Rome, the obstinacy and mortality of 
 pulmonary diseases are greatly increased by their 
 frequent complication with enlarged and otherwise 
 diseased abdominal viscera, the consequence of mal- 
 aria fever. 
 
 Pure tubercular consumption is not of very frequent 
 occurrence at Rome, the greater number of chronic 
 affections of the lungs being the effect of inflammation. 
 These occur chiefly among the lower classes, who 
 are badly clothed during the winter, and many of 
 
238 CLIMATES OF ITALY. 
 
 whom are predisposed to such affections from having 
 abeady suffered from repeated attacks of intermittent 
 fever, which have left behind them obstructions of 
 the abdominal viscera. 
 
 Headaches are common at Kome, and among 
 strangers I found them of very frequent occurrence. 
 
 Among the diseases benefited by a residence at 
 Rome, I may rank Consumption. In the early stages 
 of this affection the climate will generally be found 
 favourable. I have frequently known patients who 
 had left England labouring under symptons that gave 
 much and just alarm, and which continued during 
 the whole journey, get entirely rid of them after a 
 short residence in Eome. The same persons have 
 remained comparatively free from all bad symptoms 
 during the whole season ; and this, when from the 
 ultimate result of the case there could be no doubt 
 of the existence of tuberculous disease at the time.* 
 In the advanced stages of consumption, the climate 
 produced no benefit, the disease generally proceeding 
 in the usual course, and during the spring months 
 often more rapidly than in England. 
 
 In BiioNCHiAL Affections the climate is very 
 generally beneficial, especially in cases where there 
 
 * Dr. Carlyle, who resided six winters at Rome, was struck 
 with the remarkable influence of the climate in preventing the 
 development and checking the progress of tubercular disease in 
 young persons of a strumous constitution. 
 
ROME. 239' 
 
 prevails great irritability of the bronchial membrane. 
 I have known many such patients express themselves 
 as feeling much better at Rome than at Nice, or any 
 other place where they had resided. Nothing was 
 more common than to meet with bronchial diseases, 
 which, after having been benefited by a short resi- 
 dence at Rome, were aggravated by a visit to Naples, 
 and again relieved by the return to Rome. In Chronic 
 Bronchitis, indeed, more especially when the disease 
 was of the dry irritable kind, or was complicated with 
 irritation of the digestive organs, a residence at Rome 
 produced the best effects ; and in cases of this kind I 
 consider it the most favourable residence in Italy. 
 
 Chronic Rheumatism is generally much relieved ; 
 but as this disease is very frequently connected with a 
 disordered state of the digestive organs, it is necessary 
 to take into account the particular form of dyspepsia 
 before sending a rheumatic patient to Rome.* 
 
 With persons disposed to Apoplexy, or who have 
 already suffered from paralytic affections, and valetu- 
 dinarians of a nervous, melancholic temperament, or 
 subject to mental despondency, the climate of Rome 
 does not agree : in many such cases, indeed, a resi- 
 dence at Rome is fraught with danger ; nor is it suitable 
 for persons disposed to haemorrhagic diseases, or for 
 those who have suffered from intermittent fevers. 
 
 No city in the South of Europe frequented by in- 
 
 * See Article on Rheumatism, ante, p. 89. 
 
240 CLIMATES OF ITALY. 
 
 valids, affords greater facilities for exercise in tlie 
 country than Rome. In the variety and extent of 
 its rides it surpasses every other large city I have 
 visited on the Continent. This advantage, and the 
 immediate vicinity of the public walks to that part 
 chiefly occupied by strangers, render Rome a far less 
 objectionable abode for invalids than the generality 
 of large towns. The Piazza di Spagna, and streets 
 in that vicinity, afford the best residences. The 
 streets that run in an easterly and westerly direction 
 are to be preferred to those running north and south, 
 as they are less exposed to currents of cold air during 
 the prevalence of northerly winds, and the houses 
 have a better exposure. Both the sitting-rooms and 
 the bed- rooms of delicate invalids should, if possible, 
 have a southern aspect. Nervous persons should live 
 in the more open and elevated situations. 
 
 Besides care in the selection of apartments, there 
 are various other points which require peculiar at- 
 tention from the invalid residing at Rome. There is 
 no place where so many temptations exist to allure 
 him from the kind of life which he ought to lead. 
 The cold churches and still colder museums of the 
 Vatican and the Capitol, the ancient baths, &c., are 
 full of danger to the delicate invalid ; and if his visits 
 to these be long, or frequently repeated, he had 
 better have remained in his own country. When an 
 invalid does venture into them, his visit should be 
 short, and he should choose for it a mild warm day. 
 
EOME. 241 
 
 It is a grievous mistake to imagine that having once 
 entered such a place the mischief is already done, 
 and that no additional harm will accrue from remain- 
 ing. A short visit to these places is much less dan- 
 gerous than a long one. The body is capable of 
 maintaining its temperature, and of resisting with 
 comparative impunity the injurious effects of a cold 
 damp atmosphere, for a certain length of time. But if 
 the invalid remain till he becomes chilled, and till the 
 blood forsakes the surface and extremities, and is 
 forced upon the internal organs, he need not be sur- 
 prised if an increase of his disease, whether of the 
 lungs or of the digestive organs, be the consequence 
 of such exposure. The invalid, unwilling to admit 
 the real cause in such cases, is too apt to impute to 
 the climate that which in truth arises from his own 
 imprudence and indiscretion, in exposing himself to 
 causes which are not necessarily connected with the 
 climate. Excursions into the country, when the warm 
 weather of spring commences, particularly when made 
 on horseback, are frequent causes of mischief to deli- 
 cate invalids. 
 
 The invahd should arrive at Rome in October, and 
 if the chest be the part affected, and he is still very 
 sensible to the spring winds, the beginning or even 
 middle of May will be sufficiently early for him to 
 leave it. After" this time he should move northwards, 
 being guided by the weather as to the period of 
 crossing the Alps; though this should scarcely be 
 
 M 
 
242 CLIMATES OF ITALY. 
 
 done before the middle or end of June. About the 
 Lago Maggiore, or Lago di Como, the invalid may 
 pass a week or two, if the weather is such as to 
 render it prudent for him to delay crossing the 
 mountains. 
 
 NAPLES. 
 
 In its general characters the climate of Naples re- 
 sembles that of Nice more than any other. As at 
 Nice, the autumn and winter are generally mild, and 
 the spring is subject to cold, sharp, irritating winds, 
 rendered more trying and hurtful to invalids by the 
 heat of a powerful sun. The climate of Naples is 
 much more changeable than that of Nice; and if 
 somewhat softer in the winter, it is more humid. The 
 sirocco, which is little known at Nice, is severely felt 
 at Naples. The mean annual temperature is higher 
 than that of Rome, Pisa, or Nice ; but the annual 
 range of mean temperature is very considerable, 
 being 30^ whilst that of Nice is but 28% and that 
 of Rome only 26°. The distribution of temperature 
 in the different months is more unequal than at Nice 
 or Rome. The daily range of temperature is also 
 very great, being 2° more than at Rome. The tem- 
 perature likewise varies very much from day to day, 
 as will appear from the following statement : — The 
 mean variation of successive days at Naples is 3° * 26 ; 
 at Rome it is 2'»-80; at Nice 2° -33. The annual 
 range of atmospheric pressure is very small, being 
 
I 
 
 NAPLES. 24^ 
 
 somewhat less than at Eome, and very considerably- 
 less than in the South-east of France. E-ain falls 
 less frequently at Naples than at Kome. 
 
 Of the diseases of the inhabitants of Naples, catar- 
 rhal affections are the most common. Consumption 
 is said not to be very frequent, nor in general rapid 
 in its course ; and autumn the most fatal season to the 
 consumptive. Rheumatism is very frequent. Nervous 
 aifections are also common, as are cutaneous erup- 
 tions, and diseases of the uterine system. Inflamma- 
 tion of the eyes is very prevalent. Naples is not 
 subject to any endemic disease, although intermittent 
 fever is not unfrequent in some places in the outskirts 
 of the city. 
 
 Of Naples as a residence for invalids it is unneces- 
 sary to say much ; for consumptive patients it should 
 certainly not be selected. The qualities which have 
 been pointed out in its climate sufficiently mark 
 it as a very unsuitable residence for this class of in- 
 valids ; and to the list of its defects must be added 
 that of its topographical position, which affords no 
 proper places for exercise, without such exposure as 
 would prove highly injurious to delicate invalids. In 
 chronic rheumatism the climate is certainly inferior 
 to that of Nice and Rome. Naples is, however, well 
 suited as a winter residence for those who are labour- 
 ing under general debility and deranged health, 
 without any marked local disease. The beauty of 
 its situation, the brilliancy of its skies, and the interest 
 
 m2 
 
244 CLIMATES OF ITALY. 
 
 excited by the surrounding scenery, render it a very 
 desirable and very delightful winter residence for 
 those who require mental amusement and recreation 
 for the restoration of their general health, rather than 
 a mild, equable climate for the removal of any par- 
 ticular disease. 
 
 Of the situations frequented by strangers, the Borgo 
 di Chiaja and Chiatamone afford altogether the best 
 residences for invalids. These situations are fully 
 exposed to the south, and pretty well sheltered from 
 the north; while their immediate vicinity to the pub- 
 lic gardens (Villa Keale) is convenient for walking 
 exercise. 
 
( 245 ) 
 
 SUMMER RESIDENCE ON THE CONTINENT. 
 
 For invalids who for the re-establishment of their 
 health may require to pass more than one winter on 
 the Continent, it becomes a matter of importance to 
 select a place where they may spend the summer with 
 the greatest benefit. To those who have passed the 
 winter in Italy, two plans present themselves — either 
 to recross the Alps, or to select the most favourable 
 situation in that country. By the first, the invalid 
 will escape the oppressive heat of an Italian sum- 
 mer ; by the latter, he will avoid the inconveniences 
 of a long journey. In deciding between these plans, 
 in individual cases, various circumstances will require 
 to be considered, which admit of being noticed here 
 only in a very general manner. 
 
 Consumptive invalids should leave Italy before the 
 summer sets in ; and I may observe that I compre- 
 hend in this class, not only those actually labouring 
 under phthisis, but all such as are threatened by it. 
 The summer heat of Italy will disagree with both 
 classes of patients — in proportion to the advanced 
 period of the disease in the former, and to the de- 
 ranged state of the general health in the latter. In 
 both cases we generally find a weak and relaxed state 
 
246 SUMMER RESIDENCE ON THE CONTINENT. 
 
 of the system, accompanied, very often, with a morbid 
 sensibility of the nervous system, in which great heat 
 is always injurious. And when symptomatic fever, 
 or morning perspirations are present, these afford still 
 stronger reasons against a summer residence south 
 of the Alps. 
 
 Among those who are only threatened with con- 
 sumption, some exceptions to this rule may be found. 
 Torpid constitutions, in which there is little nervous 
 sensibility, and little disposition to febrile excitement, 
 with a defective state of the cutaneous secretions, and 
 a rigid rather than a relaxed state of fibre, may even 
 derive advantage from a summer passed in one of the 
 more healthy situations in Italy. 
 
 But the greater number of invalids who have de- 
 rived benefit from the Italian climate during the 
 winter, will do well to quit it in the summer. This 
 remark will apply more especially to those who labour 
 under a morbidly sensitive state of the nervous system, 
 depending upon, or connected with, cerebral conges- 
 tion ; indeed, very few of this class of invalids should 
 venture to pass even the winter in Italy, without care- 
 fully adapting their regimen to the nature of the 
 climate. Likewise, in cases of irritation of the mu- 
 cous membrane of the digestive organs, and in con- 
 gestions of the abdominal viscera, with a deranged 
 state of the functions of the liver, or a disposition to 
 dysentery, the whole South of Europe will disagree 
 during the summer. 
 
VOMERO, CAPO DI MONTE, ETC. 247 
 
 The places principally resorted to by invalids who 
 pass the summer in Italy, are Naples, and its vicinity; 
 Sienna, and the Baths of Lucca. These are the most 
 eligible summer residences south of the Apennines : 
 and I am not aware that any place superior to them 
 in point of climate, and possessing the necessary ac- 
 commodations for invalids, is to be found in the North 
 of Italy. 
 
 The VoMERO and the Capo di Monte, in the im- 
 mediate vicinity of Naples^ are recommended as good 
 summer residences. Of the more distant places. So- 
 RENTO, Castelamare, and the island of Ischia are 
 the best. Sorento appears to be the coolest of these ; 
 which is owing chiefly to its peninsular form, being a 
 long narrow strip of land, having the bay of Naples 
 on one side, and the gulf of Salerno on the other. 
 
 Castelamare partakes more of the climate of the 
 Apennines, and affords also their usual shelter of 
 chestnut trees. The air is less dry than at Sorento. 
 From its north-western aspect, and the mountains 
 which rise immediately behind it, this place enjoys a 
 long morning shade ; but its full exposure to the set- 
 ting sun renders the evenings often oppressively hot. 
 
 The accommodations for strangers at Sorento and 
 Castelamare have been greatly increased of late years. 
 Walks and drives have been formed, and bathing- 
 machines constructed. 
 
 The island of Ischia is also resorted to as a 
 summer residence, and it may deserve a preference 
 
248 SUMMER EESIDENCE ON THE CONTINENT. 
 
 by some invalids on account of its mineral waters. 
 These are very abundant ; indeed, almost all the 
 water of the island is more or less thermal, and 
 mineralized. Dr. Adair Crawford, who resided during 
 a summer in Ischia, found that the heat was mode- 
 rated by regular sea breezes during the day, and that 
 the nights were very pleasant. 
 
 Sienna affords a healthy summer residence for 
 persons who are not very liable to suffer from rapid 
 changes of temperature, for such often occur here 
 during the summer, owing to the high and exposed 
 situation of the place. Sienna is considerably cooler 
 in the summer, and much colder in the winter, than 
 Naples, Rome, or Pisa. The mean annual tempera- 
 ture is 55° -60 ; being 6^ less than Naples, and only 
 about 5° more than London ; but this arises from the 
 coldness of its winter, which is only \°'3S warmer 
 than that of London. Its summer temperature is 
 about the same as that of Capo di Monte at Naples, 
 but 3° warmer than that of the Baths of Lucca. Its 
 daily range of temperature is very great. It is a dry 
 and healthy climate, and a good summer residence, 
 particularly for relaxed people. For persons disposed 
 to or labouring under pulmonary disease, however. 
 Sienna is an unfavourable climate at all seasons. 
 
 Baths of Lucca. — This little watering-place, 
 situated among the Apennines near Lucca, is much 
 
BATHS OF LUCCA. 249 
 
 frequented during the summer, partly on account of 
 its mineral waters, but more on account of the cool- 
 ness of the situation. This last quality is its chief 
 attraction to the English. The mean temperature of 
 the summer here is only about 6<* higher than the 
 summer of London. In the middle of the day, how- 
 ever, the heat is often oppressive ; but the evenings 
 and nights are cool and pleasant, and there are no 
 mosquitoes. June, July, and August constitute the 
 proper season at this place. Earlier than June, and 
 after August, the air is damp and unsuitable to 
 delicate persons, especially in wet seasons. The 
 Bagni Caldi, on the brow of a high hill ; the Bagni 
 ALLA Villa, partly on the decKvity of a hill and 
 partly in a plain ; and the Pont' a Seraglio in a 
 valley on the banks of the little river Lima, aflford 
 some variety in point of situation. The Bagni Caldi 
 is the driest situation, and, where protected from the 
 sun, also the coolest. The Bagni alia Villa is warmer, 
 but quieter and more retired. The accommodations, 
 which have been greatly extended of late years at all 
 these places, are pretty good. 
 
 For those who require carriage exercise, there are 
 one or two drives only, but the rides on horseback 
 among the mountains are beautiful and varied. 
 
 The preference to be given to any one of the summer 
 residences mentioned will depend upon the particular 
 circumstances of the case. When sea-air is known 
 to agree well, and when passive exercise on the water, 
 
 m3 
 
250 SUMMER EESIDENCE ON THE CONTINENT. 
 
 or sea-bathing is advisable, some of the cooler situa- 
 tions in the neighbourhood of Naples afford the most 
 convenient residences. On the other hand, persons 
 of much nervous sensibility, and who are likely to suf- 
 fer from great heat or from the effects of the sirocco, 
 ought to avoid Naples and its vicinity. The Baths 
 of Lucca and Sienna should be preferred by such 
 invalids, particularly the former, which is a very de- 
 lightful summer residence. 
 
 Switzerland. — Although I have not hesitated in 
 advising invalids generally, and consumptive patients 
 in particular, to quit Italy during the summer, I do 
 not feel the same confidence in pointing out an unex- 
 ceptionable residence elsewhere, more especially for 
 the latter, during that season. Switzerland in point 
 of convenience is very eligible ; but much caution 
 and prudence are required on the part of invalids 
 labouring under pulmonary affections who pass the 
 summer there. The alternations of temperature are 
 often rapid and very considerable. The difference 
 between the day and the night is great, and there is 
 often a sharpness in the air which proves irritating to 
 sensitive persons. 
 
 But invalids may pass the summer in Switzerland 
 with safety, provided they use prudence, and are 
 careful to avoid unnecessary exposure to the vicissi- 
 tudes of the weather. They should also content 
 themselves with such excursions only as they can 
 
SWITZERLAND. 251 
 
 accomplish without being overfatigued, or heated at 
 one moment, and exposed, while in a state of perspi- 
 ration, perhaps, to a cold breeze the next ; an occur- 
 rence to which one is constantly liable during mountain 
 excursions in Switzerland. In a word, they should not 
 for a moment lose sight of the great object for which 
 they are there, namely, the improvement of their 
 health. Severe attacks of fever, and other acute dis- 
 eases, are not uncommon consequences of imprudence 
 of the kind alluded to, even among the more robust. 
 
 It will not, I hope, be supposed from anything 
 now stated, that I wish to throw obstacles in the 
 way of young persons, threatened with consumption, 
 taking exercise. This is so far from being my inten- 
 tion, that I think such persons can scarcely be too 
 much in the open air. All I desire to inculcate is, 
 that they should be careful not to convert the best 
 means of improving their health into a source of evil. 
 For this class of invalids, riding on horseback is of 
 all kinds of exercise the most favourable. Frequent 
 and gentle motion in a mild atmosphere on horse- 
 back or in an open carriage, is one of the most 
 soothing and invigorating measures which we possess 
 for allaying an irritated and congested state of the 
 mucous membranes of the lungs, for giving tone to the 
 nervous system, and improving the general health. 
 
 The borders of the Lake of Geneva afford the best 
 situations for a summer residence in Switzerland; 
 and the neighbourhood of Geneva is altogether the 
 
252 SUMMER RESIDENCE ON THE CONTINENT. 
 
 part least exceptionable. Vevey is very hot during 
 July and August; and the higher situations about 
 Lausanne are exposed to the north winds, especially 
 the cutting Bise, which frequently blows in the 
 evenings and nights after the hottest days of summer, 
 accompanied with a great and often sudden change 
 of temperature. The low grounds between Lausanne 
 and the lake are close and hot. 
 
 In some parts of the Tyrol and the South of Ger- 
 many good summer residences may be found. 
 
 I cannot close these few remarks on the choice of 
 a summer residence without recalling the attention 
 of the reader to the cautions I have already given on 
 the subject of travelling.* Unless a journey in hot 
 weather is conducted with great circumspection, the 
 irritation and excitement arising from it in susceptible 
 systems, especially where any important organ is in a 
 state of chronic disease, however slight in degree, 
 it will do more mischief than the advantage to be 
 derived from a succession of short residences in the 
 best climates. It will be more advisable for such an 
 invalid to remain quietly in a situation even though 
 not the most suitable to him (but the inconveniences 
 of which may, in a great measure, be obviated by pru 
 dence), than expose himself to the danger of having 
 his disease increased by an exciting journey. 
 
 * See Introductory Chapter to Part II. 
 
( 253 ) 
 
 CLIMATE OF MALTA. 
 
 Malta is in the 36th degree of north latititude, and 
 at a greater distance from the mainland than any 
 other island in the Mediterranean. Its circumference 
 is from sixty to seventy miles, its greatest length 
 eighteen and its greatest breadth twelve miles. Most 
 of the southern coast is formed of high perpendicular 
 rocks ; the other parts are low and have a very barren 
 appearance. The highest ground is, according to 
 Dr. Sankey, somewhat more than 600 feet above the 
 level of the sea.* 
 
 The whole island consists of calcareous formations. 
 Limestone, calcareous freestone, marl and calcareous 
 shell, are the prevailing rocks and deposits. Lime- 
 stone commonly occupies the higher situations, marl 
 the lowest, and freestone the intermediate.f Not- 
 withstanding the scanty mould with which the 
 surface is covered, the culture which is bestowed 
 upon it renders the soil very fertile. There is no 
 
 * * Malta considered with reference to its Eligibility as a 
 Place of Residence for Invalids.' 
 
 t From the softest and finest-grained varieties of the freestone 
 are formed those beautiful Maltese vases which are so much 
 admired. The finest models of antiquity are selected for imi- 
 tation by the Maltese sculptors, and their copies possess much of 
 the beauty of the originals. 
 
254 
 
 MALTA. 
 
 intermission of vegetation throughout the year ; but 
 in March and April it is most luxuriant. During the 
 summer months it is very much burnt up. 
 
 The surface of the island is diversified by hills of 
 slight elevation, and vales. There is neither river 
 nor lake, but numerous springs exist throughout the 
 island. 
 
 The range of the thermometer during the months 
 of October, November, December, and January, on 
 the average of twenty-one years, from 1820 to 1840 
 inclusive, was as under :* 
 
 Maximum 
 
 October. 
 
 November. 
 
 December. 
 
 January. 
 
 81 
 
 73 
 
 65 
 
 63 
 
 Miuimum 
 
 63 
 
 57 
 
 52 
 
 46t 
 
 Medium 
 
 72 
 
 65 
 
 58i 
 
 54^ 
 
 Rain is of very rare occurrence in Malta during 
 the summer ; but it falls in spring and autumn with 
 tropical violence. The autumnal rains usually last 
 from the middle of September to the middle of Octo- 
 ber. Rain falls most heavily during the night. Very 
 rarely does the rain continue for several days in suc- 
 cession. There is occasionally hail, but never snow. 
 
 * * Sulla Temperatura dell' Isola di Malta,' Memoria del Dr. 
 S. Schembri. 
 
 t Dr. Davy, during a residence of eight years in Malta, never 
 saw the thermometer below 41°. 
 
MALTA. 25S 
 
 Heavy falls of dew occur sometimes during the 
 summer. Fogs are rare at all seasons. 
 
 The wind which has procured a bad name for 
 Malta with strangers is the south-east, commonly 
 called sirocco. It is a hot, humid, and disagreeable 
 wind ; but in winter it is not frequent, and never 
 oppressive. It is most prevalent in the beginning of 
 September. Strangers in general are affected during 
 the prevalence of the sirocco with great lassitude and 
 debility. Persons with diseased lungs suffer more 
 or less from it; but, says Dr. Liddell,"I am not 
 aware of any mischief that it produces in the healthy 
 constitution beyond the temporary discomfort that it 
 occasions." 
 
 The climate of Malta may be considered pretty 
 equable, the range of temperature during the twenty- 
 four hours seldom exceeding 6^. The air is almost 
 always dry and clear. Gales of wind are not fre- 
 quent, though Malta may be said to be a windy place, 
 particularly in spring. Thunder storms are common 
 during the rainy season. The fall of rain is supposed 
 to be about 15 inches in the year. 
 
 Dr. Liddell's account of the winter climate of 
 Malta is very favourable. From the middle of Oc- 
 tober to the middle of January he thinks it can 
 scarcely be surpassed. The weather is delightful, 
 with the exception of an occasional gregale, or north- 
 east wind, which is so chilling, that during its 
 existence, invalids should either stay at home or, 
 
256 MALTA. 
 
 if they do go out, should seek the most sheltered 
 walks or drives. During the period mentioned, the 
 atmosphere is generally clear, and the weather mode- 
 rate ; and the island is usually fanned by the agree- 
 able north-west wind, that sweeps along the channel 
 of Malta over a sea at the temperature of 72°.* 
 
 Towards the middle of January the weather be- 
 comes unsettled; February and March are usually 
 boisterous and rainy; April, as elsewhere, is pro- 
 verbially variable ; and before June, phthisical pa- 
 tients should leave the island to avoid the sultry sum- 
 mer heat. 
 
 The diseases in which Dr. Liddell has observed 
 the climate of Malta serviceable, in conjunction with 
 the important preliminary sea-voyage to it, have 
 been asthma connected with chronic bronchitis, — 
 scrofulous swellings and eruptions, — dyspepsia and 
 hypochondriasis, — and that atrophy and disordered 
 state of health which are induced by over-active 
 therapeutics. He considers the climate to be pecu- 
 liarly conducive also to the health of the aged. Dr. 
 Sankey has found it beneficial in chronic rheuma- 
 tism. The mortality amongst Maltese children is 
 enormous, arising apparently from scanty and im- 
 proper food ; but the Maltese women, when well fed. 
 
 * 
 
 The temperature of the sea, at the depth of 10 or 12 fathoms, 
 was ascertained by Capt. Smyth to be from 73° to 76° during 
 the whole year. 
 
MALTA. 257 
 
 make excellent wet nurses, and the English children 
 thrive remarkably well in Malta. The diseases of 
 children, such as measles, scarlet fever, and hooping- 
 cough, are comparatively mild. 
 
 When phthisis pulmonalis occurs among the Eng- 
 lish at Malta, Dr. Liddell thinks it is more rapid in 
 its course than in England. In regard to its fre- 
 quency among the Maltese, the late Dr. Hennen, 
 according to Dr. Liddell, fell into an error which 
 has been perpetuated in the Army Medical Reports. 
 It is the confounding of pulmonary consumption 
 with Maltese consumption, a disease which has no 
 necessary reference to the lungs. Instead therefore 
 of six per cent., cases of phthisis pulmonalis, ac- 
 cording to Dr. Liddeir s tables, do not exceed three 
 per cent.* 
 
 The immunity of Malta from any endemic disease, 
 the ordinary good health enjoyed by the natives and 
 by the English, as well as by persons from other 
 countries resident there, and the actual state of the 
 weather throughout the year, have given a character 
 for salubrity to the climate. But from the statistical 
 tables of Major Tulloch it appears that even as re- 
 gards the indigenous inhabitants Malta is by no means 
 
 * The investigations at present making by my talented friend 
 Dr. Galland, Professor of Anatomy and Clinical Surgery in the 
 University of Malta, will soon set this question at rest. As 
 far as they have been carried they support the opinion of Dr. 
 Liddell. 
 
258 MALTA. 
 
 SO healthy as Britain. It seems to enjoy only the aver- 
 age salubrity of the states of the South of Europe. 
 
 Strangers reside chiefly in Valetta, the capital of 
 Malta, which is built on a declivity sloping from 
 south to north-east, and is one of the finest towns of 
 Europe. The principal streets run north and south, 
 and are swept by the cold northerly winds. The 
 houses are excellent, and the rooms large and lofty. 
 
 In Valetta, the inns are numerous and good ; and 
 there is no longer any difiiculty in finding commo- 
 dious lodgings, with Turkey carpets on the stone 
 flooring, fires, and other English comforts. Country- 
 houses, with gardens and orange-groves, may be 
 readily obtained at short distances from the city. 
 The markets are plentifully supplied, and at moderate 
 prices. Valetta is abundantly provided with excel- 
 lent water, brought from a spring six miles off by an 
 aqueduct. The other places in the island are mainly 
 supplied by rain-water collected from the flat roofs 
 of the houses, and kept in cisterns excavated from 
 the solid rock. The principal streets, which are kept 
 very clean, are either paved or macadamized, and 
 readily dry after rain. The roads leading from Va- 
 letta to the country, and round the harboursj are 
 kept in good condition, but they are of no great 
 extent or variety. Saddle-horses and close or open 
 carriages can always be obtained at moderate prices ; 
 and there are few entire days in the winter without 
 some hours of sunshine, in which delicate invalids, 
 
MALTA. 
 
 suitably clothed, may not take exercise with advan- 
 tage in the open air, on foot, on horseback, or in a 
 carriage. The Maltese boats are clean, commodious, 
 and safe, and will be found during the numerous 
 calm and mild days of winter to be the most agree- 
 able vehicles for conveying delicate invalids round 
 the harbours and fortifications, in which the great 
 interest of Malta consists. The most desirable places 
 in Valetta for winter residence, are those with a 
 southern and eastern aspect, near the Barraccas, 
 looking towards Floriana, or into the great harbour 
 in Strada Levante. 
 
 Casal Lia, about three miles from Valetta, is, 
 in Dr. Liddell's opinion, unexceptionable as a resi- 
 dence for phthisical invalids. It is well sheltered, 
 and is contiguous to the public garden of Saint An- 
 tonio. This extensive garden has a south-eastern 
 aspect, and is surrounded by a wall, and the walks, 
 which are paved with stone, speedily dry after rain. 
 But with all these advantages. Dr. Liddell fears that 
 suitable accommodation with good English comforts 
 for invalids, could not be obtained in Casal Lia, al- 
 though the houses are generally large and good. 
 
 "No place," Dr. Liddell sums up, "that I have 
 seen in the South of Europe, can, I think, compete 
 with Malta for a mild, dry, bracing air, in Novem- 
 ber, December, and part of January; and during 
 the other winter and spring months, I think it is 
 equal to any of them. I have been at them all in 
 
260 MALTA. 
 
 winter, except Nice." Dr. Davy observes: "Of 
 its spring and winter climate I think favourably, 
 especially for those who are in delicate health, who 
 are likely to be benefited by a mild atmosphere, 
 and are in easy circumstances, so as to be able to 
 command good accommodations and to use horse 
 
 or carriage exercise The best time to proceed 
 
 there is the latter end of October or beginning of 
 November; it is good for the voyage, and the climate 
 of the Mediterranean then is generally delicious." * 
 
 The best season of the year at Malta for pulmonary 
 invalids is from October to January. In the course 
 of January the weather generally becomes unsettled, 
 and such invalids will find it advantageous to leave 
 Malta about this time. They may go to Naples for 
 the remainder of the winter, and to Eome during the 
 spring. By adopting this plan the invalid will have 
 the advantage of three changes, and be at each place 
 at the most favourable season. But invalids may, and 
 many do, remain at Malta till the end of May, and 
 then return to England by sea. 
 
 There are doubtless on the shores and among the 
 islands of the Mediterranean, situations possessing 
 climates equal to those of the places which have 
 been noticed ; but we are not suiRciently acquainted 
 with them, and they are mostly deficient in those 
 other requisites which are as essential to an invalid as 
 
 * Op, cit.j\o\. ii. p. 318. 
 
lAfi MEDITEREANEAN. 261 
 
 climate. In giving an account of the best climates 
 of the Mediterranean, we have had in view the wants 
 of the more delicate class of invalids. To those who 
 are sent abroad for the prevention of disease, and 
 the improvement of their health, the whole shores 
 and islands of the Mediterranean are open. They 
 may visit the south coasts of Spain, Sicily, the Ionian 
 Islands, Greece, Syria, and Egypt ; and, if their 
 tour is conducted with judgment and discretion, 
 their health may be more improved than by residing 
 at any one of the places mentioned. But the more 
 delicate invalid must rest satisfied with such limited 
 changes as have been pointed out in the preceding 
 pages.* 
 
 * In drawing up the preceding account of Malta, I have availed 
 myself of some valuable communications from Dr. Liddell, v^^ho 
 was physician to the Royal Naval Hospital in that island for 
 twelve years, and whose statements and opinions are deserving 
 of the utmost confidence. I would here also acknowledge my 
 obligations to the sensible pamphlet by Dr. Sankey, already 
 referred to. For a more detailed account of the climate of the 
 Mediterranean and its influence on disease, and more especially 
 the climates of Malta and the Ionian Islands, I beg to refer to 
 the interesting work of Dr. Davy already noticed. 
 
( 262 ) 
 
 CLIMATE OF EGYPT. 
 
 The ease and regularity with which Egypt may be 
 reached, and the facilities for travelling in that coun- 
 try, are now such that our invalids may avail them- 
 selves of its advantages, whatever they may be, 
 almost as easily as of those of the South of Italy. To 
 invalids requiring a dry, warm climate this is a great 
 advantage, as I believe there is to be found in no 
 part of Europe a climate possessing these qualities in 
 so eminent a degree during the winter as that of 
 Upper Egypt. At this season, indeed, the Egyptian 
 climate, in point of warmth, dryness, and steadiness 
 of temperature, is superior to any noticed in the pre- 
 ceding pages ; and in regard to the two first-named 
 qualities it surpasses every other climate, not within 
 the tropics, mentioned in this work. 
 
 I have not succeeded in meeting with a series of 
 meteorological observations sufficiently extensive and 
 minute, or extending over a sufficient length of time, 
 to enable me to form a positive opinion as to the pre- 
 cise qualities of this climate, and to compare it with 
 others of a similar character : but I have collected so 
 much and such various information from my patients, 
 as well as from other sources, as to justify me in 
 speaking with some confidence on the general charac- 
 ter of the climate, and its influence on disease. 
 
EGYPT. 263 
 
 The season during which invalids should visit 
 Egypt extends from November to March. In No- 
 vember the weather at Cairo is fine ; and in this 
 month the northerly winds commence. The invalid 
 should take advantage of these to ascend the Nile, 
 so as to reach Thebes by the end of that month or the 
 beginning of December. During this and the two 
 following months the cKmate of Upper Egypt is 
 described as exceedingly fine. The air is dry and 
 elastic, and the sky cloudless ; rain rarely falls, and 
 dew is seldom seen. The wind is sometimes un- 
 pleasantly high, and the midday sun oppressively hot ; 
 the temperature during the night also often falls con- 
 siderably, producing a feeling of cold greater than 
 might be expected from the actual fall of temperature, 
 more particularly just before sunrise. But the heat 
 is tempered by the north wind, which blows here with 
 all the steadiness of the Atlantic trade-winds, and the 
 cold of the night may be guarded against by proper 
 covering. This great diflference between the temper- 
 ature of the night and that of the day forms a remark- 
 able feature, and at the same time the greatest de- 
 fect, in the climate of Upper Egypt. The greatest 
 care on the part of the invalid is necessary to guard 
 against its chilling effects ; as by neglecting to do so 
 he may lose a great part of the benefit to be derived 
 from the climate. Exposure to the night cold is, I 
 believe, a frequent cause of dysentery and ophthalmia, 
 the prevailing diseases of the country. 
 
264 EGYPT. 
 
 Clot Bey, a French physician, and Director-general 
 of the Medical Department of the Egyptian army, 
 whose opportunities of observation have been exten- 
 sive, states, in his late work on Egypt,* that diseases of 
 the chest — inflammation of the lungs, pleurisy, and 
 pulmonary consumption — are very rare. During a 
 practice of fifteen years he met with very few cases 
 among the natives which presented symptoms of 
 consumption, and even these cases were doubtful. 
 Strangers from more northern countries, — from Tur- 
 key, Greece, France, Germany, and from England, 
 &c., are also exempt from the disease. Clot Bey at 
 least never met a case of consumption among them ; 
 and of those who arrived labouring under the disease 
 he has seen many cured, and others materially 
 relieved. He therefore advises the consumptive, and 
 those strongly predisposed to the disease, to come to 
 Egypt, where they will have a much better chance of 
 being cured than in any other country. On the other 
 hand, he observes that the natives of Nubia, Senaar, 
 
 •i-and Abyssinia, countries in which consumption is 
 still more rarely observed than in Egypt, when they 
 come into the latter country frequently fall victims to 
 the disease ; as happens with the natives of all hot 
 
 4: countries on removing into a colder climate. Although 
 inflammation of the lungs and consumption are rare, 
 
 4 bronchial diseases and asthma are frequent, but 
 
 'Aper^u Gdndral sur I'Egypte.' 1840. 
 
EGYPT. 265 
 
 never lead to phthisis. Nervous affections, including ^ 
 insanity, are very rare.* Rheumatism is also uncom- 
 
 :^mon, and Gout absolutely unknown. For this im- 
 munity the Egyptians are indebted, he says, to the 
 
 1 small quantity of animal food which they use, and their 
 
 ^abstinence from stimulating drinks ; but the climate, 
 it may be presumed, has some share in this exemp- 
 tion. Tetanus very seldom occurs. During the fif- 
 teen years that he has been living among hospitals. 
 Clot Bey only saw two cases of Traumatic Tetanus, 
 and not one idiopathic case of the disease. Hydro- 
 
 i phobia is wholly unknown in Egypt. Cancerous 
 diseases are rare, as are uterine diseases of all kinds. 
 Scrofulous diseases are not common. Two of the 
 most frequent diseases of Egypt are Dysentery and 
 Ophthalmia, but they are less frequent in Upper than 
 in Lower Egypt. 
 
 Dr. Cumming, who passed a winter in Upper 
 Egypt, describes the climate at that season as delight- 
 ful. The Doctor being himself an invalid, and well 
 acquainted with the best European climates, his 
 opinion is the more valuable. "It is impossible," he 
 says, " to imagine anything more divine than the cli- 
 mate of Egypt ; the sky is bright and cloudless, and 
 
 "^ the atmosphere pure and transparent as crystal : here 
 are no soul-subduing fogs nor vapour-giving rains, no 
 
 ^P * In Cairo, which contains about tliree hundred thousand in- 
 habitants, there are only from thirty to forty insane. This does 
 not include the idiots allowed to live in the streets. 
 
 N 
 
266 EGYPT. 
 
 grim frosts nor ghastly snows. The sun rules su- 
 preme, yet without despotic sway ; hitherto I have 
 braved with impunity even his direct rays. I feel 
 convinced that the climate of Egypt has only to be 
 known in order to be appreciated and resorted to by 
 the pectoral invalid. In what part of Europe will he 
 find such a winter ? I boldly assert in none. That 
 there are many disadvantages and drawbacks cannot 
 be denied ; nor is Egypt at all adapted to the invalid 
 whose malady is far advanced.*' But Dr. C. advises 
 all persons disposed to consumption, who are liable 
 to catch cold on slight exposure to damp, to resort to 
 the Nile during the winter. He adds^ "The invalid 
 who comes here for the winter should not be later 
 in arriving at Alexandria than the middle or end of 
 October; he should lose no time in pushing for Cairo, 
 nor remain there beyond the end of November. The 
 further he proceeds the drier and milder the climate 
 becomes."* 
 
 But notwithstanding the excellence of the climate 
 and its comparative exemption from Consumption and 
 some other diseases, there are many inconveniences 
 attending a winter's residence in Egypt. 
 
 For delicate or sensitive invalids who cannot bear 
 such exposure and inconveniences as are inseparable 
 from the mode of travelling and living in boats (the 
 
 * * Notes of a Wanderer in search of Health through Italy, 
 Egypt, Greece, &c.' vol. ii. 
 
EGYPT. 267 
 
 only habitations to be found after passing Cairo), 
 this country is not suited; and for females it is par- 
 ticularly unfitted. Of the evils to which travellers 
 in Egypt are subjected, the quantity of vermin by 
 which they are assailed, by night as well as by day, 
 is not the smallest, and it is one from which they 
 can the least protect themselves. Another evil is 
 the impalpable dust of the dried Nile mud, which is 
 often driven in clouds across the river, covering 
 everything in the boat. 
 
 Provisions are described as better than might be 
 expected in a country so devoid of the conveniences 
 of life ; but the dyspeptic invalid who means to pass 
 the winter on the Nile would do well to carry with 
 him some preserved meat, which is now prepared in 
 this country to keep for almost any length of time and 
 in any climate. 
 
 From the description which has been given of the 
 climate, may be inferred the character of the diseases 
 and deranged states of health which will derive 
 benefit from a winter passed in Egypt. Invalids 
 requiring a dry, warm, exhilarating climate will find 
 it here. Certain forms of dyspeptic disorder of long 
 standing, with their consequences, chronic afifections 
 of the mucous membranes of the respiratory and 
 lother organs of an atonic and congestive kind, and 
 chronic rheumatism, may be numbered as among the 
 diseases likely to be benefited ; and there is a large class 
 of persons suffering from a state of deranged health 
 
 n2 
 
 I^B of pei 
 
268 EGYPT. 
 
 which scarcely admits of definition, and yet is well 
 known as one of the many consequences of sedentary 
 habits, prolonged and anxious mental exertions, irre- 
 gularity of living, &c., who will derive great advan- 
 tage from a winter spent on the Nile. But the 
 patients whom I have had chiefly in view in giving 
 this brief notice of the climate of Egypt are young 
 men whose health has become deranged from the 
 causes already mentioned, or from others of an 
 analogous kind, and to such a degree as to excite 
 apprehension lest the disordered condition of their 
 system might end in consumption. For this class 
 of invalids, suffering from disordered health rather 
 than actual disease, and not so delicate as to be in- 
 jured by the inconveniences and mode of life to 
 which they would be subjected during a winter 
 in Upper Egypt, the climate seems to me peculiarly 
 well adapted. In the case of invalids also returning 
 from India for the recovery of their health, and to 
 whom it is important to avoid arriving in England 
 at an unfavourable season, it may be very advanta- 
 geous to remain in Egypt till the most favourable 
 period of the year arrives for their return home. 
 
 The proper time for arriving in Egypt and ascend- 
 ing the Nile, has already been stated. The end of 
 March or beginning of April is the proper season for 
 leaving it. This is also a favourable time for visiting 
 Syria ; but it is too early for the greater number of 
 invalids to return to England. To employ the next 
 
EGYPT. 269 
 
 two months to the best advantage for his health, the 
 invalid may visit Greece, and from thence go on to 
 Constantinople, where the climate during the month of 
 May is pleasant and healthy. From Constantinople 
 the voyage to England by the steam-packets occupies 
 about four weeks, a period which will bring the in- 
 valid home about the middle of June, before which 
 lime invalids who have passed the winter in a warm 
 climate should not ai'rive in England. 
 
 To secure the full advantage which such a 
 lengthened tour promises, the invalid must of course 
 attend to all those rules which have been already 
 laid down for his guidance.* Dyspeptic patients 
 in particular should adhere as strictly as circum- 
 stances wiU admit to the regimen suited to their case. 
 All invalids should avoid unnecessary exposure to 
 the rays of a powerful sun, and they should provide 
 themselves with sufficient coverings to protect them 
 from the cold of the nights. 
 
 These are the chief points which demand attention. 
 By neglecting them, the invalid may not only lose 
 the benefit which may be fairly expected from the 
 climate, but will run the risk of suffering from the dis- 
 eases incident to it, such as dysentery and ophthalmia, 
 the two most prevalent diseases of Egypt. 
 
 The invalid for whose case the climate of Egypt is 
 suited, if he can give up nine or ten months for the 
 recovery of his health, may enjoy the advantage 
 * See Introduction to Part II. 
 
270 EGYPT. 
 
 of successive changes of the finest climates during 
 the whole period of his absence. Supposing him to 
 leave England early in October by the Peninsular 
 steam-packet, he may so arrange his voj^^age as to visit 
 the most interesting places on the south coasts of 
 Spain and Portugal, and Gibraltar. From this place 
 the voyage to Malta occupies only a few days, and the 
 same from Malta to Alexandria, where he should 
 arrive by the middle of November, and thus be 
 enabled to reach Upper Egypt at the proper season. 
 In March he should return to Cairo, so as to com- 
 mence his voyage to Greece and Constantinople in 
 the beginning of April. From the latter place, if he 
 commences his voyage homewards at the end of May, 
 he will arrive in England about the end of June. 
 
 It would be difficult to imagine any measures more 
 calculated to restore the drooping health or invigorate 
 the enfeebled constitution of the class of persons re- 
 ferred to, than such an extended and varied tour in a 
 succession of such brilliant climates, and through coun- 
 tries and amid scenes of such surpassing interest.* 
 
 * The chief obstacle to the easy accomplishment of such a 
 tour is the vexatious nature of the quarantine regulations. But 
 the time is near at hand when these regulations must be greatly 
 modified. 
 
( 271 ) 
 
 ATLANTIC CLIMATES. 
 
 Various islands in the Atlantic have been recom- 
 mended as affording favourable winter retreats for 
 invalids ; Madeira, the Canaries, and the Azores in 
 the Eastern, and the Bahamas and Bermudas in the 
 Western Atlantic. 
 
 It is to be remarked, that the climate of North 
 America differs materially in its physical characters 
 from that of Europe and Africa.* The range of tem- 
 
 * The climate of North America is of that class which Buffon 
 has designated Excessive Climates ; that is, having exceedingly 
 hot summers and intensely cold winters, consequently an exten- 
 sive annual range of temperature. The following comparison of 
 a few places having nearly the same mean annual temperature in 
 the Eastern and Western hemispheres, will sufl&ce to show this : — 
 
 PLACES. 
 
 Mean 
 Annual 
 Temp. 
 
 Temp. 
 
 of 
 
 Summer 
 
 Temp. 
 
 of 
 Winter. 
 
 Diff. of 
 
 Winter 
 
 and 
 
 Summer. 
 
 Paris . . . 
 Cambridge, U. 
 
 s.' ! 
 
 
 
 O ' 
 
 51'4 
 50-4 
 
 o 
 66-0 
 70-5 
 
 o 
 ,38-0 
 34" '0 
 
 o 
 28*0 
 36-0 
 
 St. Maloes . 
 Cincinnati 
 
 
 
 
 
 54-5 
 53-7 
 
 66*0 
 72-9 
 
 42-0 
 .32-9 
 
 24-0 
 40-0 
 
 Nantes 
 New York. 
 
 
 
 
 
 55-6 
 53'8 
 
 70-7 
 79-2 
 
 42-2 
 
 29-8 
 
 28-4 
 40*0 
 
 Bordeaux . 
 Philadelphia 
 
 
 
 
 
 56-5 
 54-9 
 
 70-7 
 73-9; 
 
 42 •! 
 32 "2 
 
 28-6 
 41'7 
 
272 EASTERN ATLANTIC. 
 
 perature is mucli greater, and the changes more rapid 
 and extensive; the summer heat is much higher, 
 and the winter cold much more intense, under the 
 same parallels of latitude, on the American shores 
 than on those of Europe. The Western is also 
 more subject to storms than the Eastern Atlantic. 
 We shall find a corresponding difference in the 
 climate of the islands under consideration, according 
 as they approach the American or African Conti- 
 nents. 
 
 EASTERN ATLANTIC. 
 
 The islands of the Eastern Atlantic, while they differ 
 considerably in the physical qualities of their climate, 
 Sifier still more remarkably in their structure and 
 external configuration, from those of the Western 
 Atlantic. The latter are low, arid, and mostly barren 
 rocks, almost destitute of springs ; the former, on the 
 contrary, are lofty volcanic islands, abundantly sup- 
 plied with water, and covered with luxuriant vegeta- 
 tion; circumstances, which independently of their 
 geographical position, modify the climate in a very 
 material degree. 
 
 MADEIRA. 
 
 I shall commence my survey of thie Atlantic Islands 
 with Madeira. It is the most important of them and 
 the most frequented by invalids ; and the character of 
 
MADEIRA. 273 
 
 its climate being the most fully determined, it will 
 serve as a standard by which to estimate the climates 
 of the other islands. 
 
 Madeira has been long held in high estimation for 
 the mildness and equability of its climate ; and we 
 shall find, on comparing this with the climates of the 
 most favoured situations on the Continent of Europe, 
 that the character is well founded. 
 
 The mean annual temperature of Funchal, the 
 capital of the island, is 64% being about 6'^ only above 
 that of the Italian and Provenqal climates. This 
 very moderate mean temperature, relatively to its low 
 latitude, arises, however, from the circumstance of 
 the summer at Madeira being proportionally cool. 
 For, whilst the winter is 20° warmer than at London, 
 the summer is only 7° warmer ; and whilst the winter 
 is 12** warmer than in Italy and Provence, the summer 
 is nearly 5p cooler. The mean annual range of tem- 
 perature is only 14°, being less than half the range 
 of Rome, Pisa, Naples, and Nice. The heat is also 
 distributed throughout the year with surprising 
 equality, so that the mean difference of the tempera- 
 ture of successive months is only 2°-21 ; this at Eome 
 is 4°-39, at Nice 4°-74, at Pisa 5°75, and at Naples 
 50O8. 
 
 Whilst there is much equality in the distribution 
 of temperature throughout the year, there is not less 
 in the progression of temperature for the day, the 
 mean range for the twenty-four hours being 9^^* by 
 
274 EASTERN ATLANTIC. 
 
 the register thermometer, while at Rome it is 10*^, at 
 Naples IS**, at Nice 9% by the common thermometer, 
 which gives the extremes observed during the day 
 only. 
 
 The steadiness of temperature from day to day 
 
 ^' also exceeds that of all the other climates. In this 
 
 ' respect, it is not half so variable as Rome, Nice, or 
 Pisa, and is only about one third as variable as 
 Naples. The degree of variableness from day to day 
 at Madeira is l°'ll; at ;Rome it is2<''80; at Nice 
 2^-33 ; and at London 4°-01. 
 
 The annual range of atmospheric pressure is also 
 
 4very small, being about the same as that of Rome 
 and Naples. 
 
 Two inches less of rain falls annually at Madeira 
 than at Rome and Florence, and at Madeira there 
 
 4 are only 70 days on which any rain falls, while at 
 Rome there are 117. At Madeira, also, the rain falls 
 at particular seasons, chiefly in the autumn, leaving 
 the atmosphere in general dry and clear during the 
 remainder of the year. But the air, although dry, 
 
 ^ is nearly at the point of saturation, and hence the 
 small diflference between the temperature of a ther- 
 mometer with a wet and one with a dry bulb, and 
 the immediate precipitation of moisture which occurs 
 on the fall of a very few degrees of temperature. To 
 this state of the atmosphere is owing the soothing 
 quality of the climate, which fits it for diseases of 
 irritation and inflammatory action. 
 
 k 
 
MADETEA. 275 
 
 From this comparative view of the climate of 
 Madeira, it must be readily perceived how great the 
 advantages are which this island presents to certain 
 invalids over the best climates on the continent of 
 Europe. It is warmer during the winter, and cooler 
 during the summer ; there is less difference between 
 the temperature of the day and that of the night, 
 between one season and another, and between suc- 
 cessive days : it is almost exempt from keen, cold 
 winds, and enjoys a general steadiness of weather to 
 which the Continental climates are strangers. During 
 the summer, the almost constant prevalence of north- 
 easterly winds, especially on the north, and the regular 
 sea and land breezes on the south side of the island, 
 maintain the atmosphere in a temperate state. The 
 sirocco, which occurs two or three times, at most^ 
 during the season, and then continues only for a few 
 days (seldom more than three), sometimes raises the 
 thermometer in the shade to 90**.* With this excep- 
 tion, the summer temperature is remarkably uniform, 
 the thermometer rarely rising above 80°. In conse- 
 quence of the regular sea-breezes, the heat is not so 
 oppressive as that of the summer in England often 
 is. Close, sultry days are little known in Madeira, 
 and there is neither smoke nor dust to impair the 
 
 * The late Dr. Heineken never knew the sirocco raise the ther- 
 mometer in the shade above 85°; but Dr. Ren ton has seen it on 
 one occasion at 93° in the open air two hours after sunset. 
 
276 EASTERN ATLANTIC. 
 
 purity of the atmosphere. Such, indeed, is the 
 \ mildness of the summer at Madeira, that a physician, 
 himself an invalid, who resided for some time on the 
 island on account of his health, doubted whether this 
 season was not more favourable to pulmonary invalids 
 than the winter.* 
 
 Autumn is the rainy season ; and towards the end 
 of September, or the beginning of October, the rains 
 commence, accompanied with westerly or south- 
 westerly winds. In November the weather clears 
 up, and generally continues fine and mild till the 
 end of December. About this time some snow 
 usually falls on the mountains, and rain at Funchal, 
 attended by north-west winds, and the weather 
 continues more or less damp through January and 
 February ; but fog is never seen, and even during 
 this, the winter, the thermometer at sunrise is rarely 
 ever found below 50°. The sensation of cold, how- 
 Jever, is then greater than with an equal temperature 
 m England ; and this is the case also in Italy. In 
 clothing, invalids must not trust too exclusively to 
 the thermometer ; their sensations are a better guide 
 in this respect. Dr. Combe remarked, during a resi- 
 dence in Madeira, that the majority of the cases of 
 catarrh and of diarrhoea, which occurred during the 
 
 * See an excellent paper by the late Dr. Heineken, in the 
 Medical Repository, vol. xxii. 1384. -* 
 
MADEIRA. 277 
 
 winter, were produced by insufficient clothing in this 
 change of temperature, and by continuing the use 
 J of fruit and slops with the same freedom as during 
 warm weather. Party excursions into the country 
 are another and frequent cause of relapse, and 
 ought to be avoided by all invalids. 
 
 The spring at Madeira, as at every other place, is 
 the most trying season for the invalid, and will 
 require even there a corresponding degree of caution 
 on his part. In March, winds are frequent; and April 
 and May are showery. 
 
 The mild character of the climate appears to be 
 accompanied with a corresponding degree of health 
 ^in the inhabitants of Madeira. The peasantry, 
 though hard worked and badly fed, are a fine, 
 healthy, and robust race. This island is almost 
 exempt from the diseases peculiar to warm climates, 
 and little subject to many of those which are common 
 in more northerly countries. Intermittent and re- 
 mittent fevers are said never to occur, and continued 
 fevers are rare i croup seems to be unknown ; cal- 
 culous disorders are very unfrequent. The more pre- 
 valent diseases are cutaneous affections. Apoplexy 
 I is also a very frequent disease. Bowel complaints 
 r are very common, and often fatal ; and dysentery is 
 said to be frequently epidemic ; indeed this disease 
 may be said to be almost endemic among the labour- 
 ing classes ; nor need this excite our surprise when 
 
278 EASTERN ATLANTIC. 
 
 we consider their mode of living, which will be 
 presently noticed. 
 
 With respect to the prevalence of Consumption 
 among the natives of Madeira, there is a difference 
 of opinion among those who have had the best oppor- 
 tunities of observing. " Though so highly beneficial 
 
 I in this disease with the natives of other countries," 
 says Dr. Gourlay, " it is not to be concealed that no 
 
 J malady is more prevalent here than phthisis, with 
 
 J the natives of the island."* Dr. Heineken's obser- 
 vation leads him to a contrary conclusion. " It has 
 been asserted," says this gentleman, " that no malady 
 is more prevalent than phthisis with the natives of 
 Madeira; but, as far as my own personal experience 
 and the result of my inquiries go, I incline to a con- 
 
 ]^ trary conclusion."! 
 
 Since the first edition of this work was published, 
 I have made particular inquiries respecting the 
 frequency of consumption in Madeira, and I am 
 satisfied, from the information which I have received, 
 that tubercular consumption (with which alone we 
 have to do here) is a rare disease, compared with 
 
 ^ what it is in more northern climates. *^With re- 
 spect," says Dr. Renton, "to the question relative 
 to the frequency of consumption among the natives, 
 
 * ' Observations on the Natural History, Climate, and Diseases 
 of Madeira.' By William Gourlay, M.D. 1811. 
 f Op. citat. 
 
MADEIRA. 279 
 
 Dr. Gourlay (if he alluded to tubercular disease) has 
 greatly over-rated it. Tubercular phthisis occurs 
 more frequently, perhaps, than might, a priori, have 
 been expected in such a climate ; and I have even 
 known it, in a few instances, sweep off nearly wholej- 
 families. But it is only necessary to take a cursory^ 
 view of the habits and circumstances of the natives, 
 to see that they enjoy a singular degree of exemption 
 from a disease, to the ordinary causes of which a 
 :t large proportion of them is constantly exposed." 
 
 The lower classes in Madeira are hard-worked 
 and miserably nourished. Their food consists chiefly 
 ^of crude vegetables and hard- salted fish. They are 
 badly clothed, and worse lodged; their habitations 
 are low miserable huts, and their beds consist of 
 pallets of straw, raised a foot or two only from the 
 ground, damp during nine months of the year. 
 That diseases of the lungs should be frequent under 
 such circumstances is not surprising; and as these 
 are generally neglected, or badly treated, they often 
 prove fatal in a chronic form simulating phthisis. 
 But even if tubercular consumption were a frequent 
 occurrence under the circumstances which we have 
 stated, it would afford no reasonable ground of 
 objection to the climate of Madeira for persons 
 exempted from such palpable causes of disease. 
 Many of the children, especially in the country, are 
 miserable objects, and a large proportion die with a 
 tumid abdomen, emaciated extremities, rickety or 
 
280 EASTERN ATLANTIC. 
 
 scrofulous. The more robust alone, in all probability, 
 attain a healthy maturity, and form the fine-looking 
 athletic race of labourers that are seen in Funchal ; 
 and from which a judgment is usually formed of the 
 state of the peasantry in the island generally. 
 
 In my inquiries respecting the influence of the 
 climate of Madeira on disease, I shall confine myself 
 to Consumption, which is indeed almost the only 
 disease on account of which Madeira has been resorted 
 to. As I never resided at this island, I must rely on 
 the information and opinions which I have derived 
 from other sources. On this subject, however, I have 
 obtained so much assistance from Dr. Renton, who 
 has long resided in the island, and from the late Dr. 
 Heineken, who spent the last nine years of his life 
 there, on account of a pulmonary disease, that the 
 utmost reliance may be placed on the following 
 observations. Both these gentlemen have published 
 valuable papers on the climate of Madeira, and its 
 influence on consumptive patients. Their opinions 
 regarding the propriety of sending such patients, in 
 the advanced stage of the disease, to this island, are 
 in perfect accordance with those I published on the 
 subject, with reference to the Continent, upwards of 
 twenty years ago.* And the results of their experi- 
 ence, given below, confirm in the most conclusive 
 
 * Notes on the Climates of France and Italy,' &c. 1 820. 
 
MADEIRA. 281 
 
 manner the principles which are inculcated in this 
 work respecting the proper period of sending con- 
 sumptive invalids abroad. They show the necessity of 
 adopting change of climate as a means of preventing 
 rather than of curing consumption. Dr. Ronton, in 
 a sensible paper published in the Edinburgh Medical 
 and Surgical Journal,* makes some judicious remarks 
 on the '^ inutility, not to say cruelty," of sending pa- 
 tients in the advanced stages of consumption to Ma- 
 deira. 
 
 I give the following interesting and instructive 
 table from Dr. Renton's paper. It is drawn up from 
 the cases of which he had kept notes during the pre- 
 ceding eight years. 
 
 Cases of Confirmed Phthisis ... 47 
 
 Of these died within six months after their 
 
 arrival at Madeira ..... 32 
 
 Went home in summer, returned, and died . 6 
 
 Left the Island, of whose death we have heard 6 
 
 Not since heard of, probably dead ... 3 
 
 47 
 
 Cases of Incipient Phthisis . . 35 
 
 Of these there left the Island much improved, 
 
 and of whom we have had good accounts . 26 
 Also improved, but not since heard of , . 6 
 
 Have since died ...,.• 4 
 
 35 
 
 " In the cases marked Confirmed Phthisis, there 
 
 * Vol. xxvii. 1817. 
 
EASTERN ATLANTIC. 
 
 were copious purulent expectoration, diarrhoea, &c., 
 and almost all of them terminated fatally. 
 
 " Some of those marked Incipient Phthisis were 
 probably not fully entitled to an appellation so 
 ominous. The subjects were generally young people 
 who were said to have ' overgrown themselves/ and 
 who had been liable in England to inflammatory 
 attacks, having cough, &c. Others had suffered from 
 neglected or mistreated inflammation, and in many 
 there was a strong family predisposition to pulmonary 
 disease. Most of them, I have little doubt, would 
 now have been in their graves, but for the precau- 
 tionary measure which was adopted." 
 
 With respect to the consumptive cases which are 
 likely to derive advantage from a residence at Ma- 
 deria. Dr. Renton further remarks, " When it (con- 
 sumption) has proceeded to any considerable extent, 
 I should consider it the duty of a medical attendant 
 not only not to advise the adoption of such a measure, 
 but most earnestly to dissuade from it those who, 
 from hearsay evidence of the recovery of persons in 
 circumstances similar to their own, may feel disposed 
 to fly to it as a last resource. 
 
 " That great and lasting benefit is to be derived 
 even from a temporary residence in this climate, which 
 is probably inferior to no other in cases where pul- 
 monary disease is merely threatened, or where strong 
 family predisposition to it exists, many living examples 
 sufficiently prove. But even under such compara- 
 
MADEIRA. 283 
 
 tively favourable circumstances, it ought to be strongly- 
 impressed on the mind of the invalid that half 
 measures are worse than useless, and that no advan- 
 tage is to be derived from climate, however fine, 
 unless it be seconded by the utmost caution and 
 prudence on his part." 
 
 The result of Dr. Heineken's observations is quite 
 in accordance with that of Dr. Renton's. 
 
 Of the thirty-five cases reported by Dr. Heineken, 
 several died before they reached the island, three 
 within a month of their landing, and five or six in 
 about six months. Of forty-seven cases of the same 
 class of invalids in Dr. Renton's report, more than 
 two thirds died within six months of their arrival in 
 the island. This is a melancholy picture of the 
 progress of consumption under all the advantages of 
 the mildest climate ; it shows in a striking point of 
 view the necessity of discrimination in sending pa- 
 tients to Madeira, and ought to impress medical men 
 with a deep feeling of the heavy responsibility which 
 they take upon themselves in deciding on a question 
 of such importance. By far the greater number of 
 the patients above referred to ought never to have 
 left their own country ; the advanced period of their 
 disease could leave no reasonable prospect of benefit 
 from such a measure. 
 
 The result of the cases sent to Madeira at the 
 proper period is very difierent. Of thirty-five cases 
 of incipient or threatened phthisis, twenty-six were 
 
284 EASTERN ATLANTIC. 
 
 much improved, and probably a large proportion of 
 tbem were ultimately saved. 
 
 While, therefore, the result of sending patients in 
 an advanced stage of consumption to Madeira shows 
 the inutility of such a measure, to say the least of it, 
 the efiects of the climate in incipient cases, and on 
 those threatened with the disease, are highly encoura- 
 ging, and should lead medical men to recommend such 
 a measure at the time only when it promises benefit. 
 
 The following table, for which I am also indebted 
 to Dr. Renton, while it shows the same result as 
 regards confirmed cases of consumption sent to Ma- 
 deira, exhibits the good effects of sending proper 
 cases. It is also satisfactory to see that much the 
 larger proportion of cases now sent are of the latter 
 description. 
 
 Number of Consumptive Invalids who arrived at Madeira 
 between 1st January 1838 and 31st May 1840 . 182 
 
 With Tuberculous Lungs ... 56 
 
 Died here 30 
 
 Left the Island 22 
 
 Still here 4 
 
 66 
 
 Threatened with Pulmonary Disease . 108 
 
 Remained free from symptoms ... 93 
 
 Fell off . . " 13 
 
 Lost sight of 2 
 
 108 
 
 For some time after the publication of the first 
 edition of this work. Dr. Renton remarked that the 
 
MADEERA. 285 
 
 proportion of invalids whose cases admitted of benefit 
 from the climate was greatly augmented ; but I have 
 reason to fear that the successful issue of such cases 
 has encouraged many to go to Maderia who would 
 have found it better to remain at home. 
 
 When we take into consideration the mildness of 
 the winter, and the coolness of the summer, together 
 with the remarkable equality of the temperature 
 during the day and night, as well as throughout the 
 year, we may safely conclude that the climate of 
 Madeira is the finest in the northern hemisphere. 
 
 The salubrity of this favoured island also, — its 
 almost total exemption from endemic diseases, and 
 the general mildness of the ordinary complaints from 
 which no climate or situation is exempt, contribute 
 to render Madeira a very desirable residence for all 
 invalids who are in a condition to be benefited by a 
 mild and equable climate. 
 
 On the whole continent of Europe there is no place 
 with which I am acquainted where the pulmonary 
 invalid could reside with so much advantage during 
 the entire year as in Madeira. ^' As a permanent 
 abode," says Dr. Heineken in a written communica- 
 tion to me, " I believe Madeira surpasses every other 
 place, because it contains within itself the means of 
 equalizing the annual temperature more completely 
 than any other spot with which we are acquainted. 
 The lowest to which a thermometer exposed all night 
 
286 EASTERN ATLANTIC. 
 
 in a nortli aspect has ever fallen in Funchal during 
 five years, is 50°, and the highest to which it will ever 
 rise, at such a distance up the mountains as would in 
 every respect suit an invalid, need never exceed 74?. 
 The sirocco visits us so seldom, and its heat may so 
 readily be avoided by closing the doors and windows, 
 that it need not be taken into account. The mean 
 annual diurnal range is from 8^ to 10°; but an invalid 
 may with ordinary precaution, and without the aid of 
 fires, live in a temperature never varying within doors 
 more than perhaps 6° throughout the twenty-four 
 hours. In a few words, I would say — there is no 
 occasion for a person, throughout the winter in Fun- 
 chal to breathe, night or day, within doors, an atmo- 
 sphere below the temperature of 64** ; or in the country 
 and at such a height as to ensure dryness, above that 
 of 74:° ; that he may during the summer take abun- 
 dance of exercise by choosing his hours without ever 
 exposing himself to oppressive heats ; and that in the 
 winter he need not be confined to the house the whole 
 day either by wet or cold more perhaps than a score 
 of times." Dr. Heineken found that he rather retro- 
 graded during the winter, but always gained ground 
 during the summer. "Could I enjoy for a few 
 years," he observes, " a perpetual Madeira summer, 
 I should confidently anticipate the most beneficial 
 effects." So high, indeed, is his opinion of the sum- 
 mer climate of Madeira, that he suggests the pro- 
 priety of pulmonary invalids, who can conveniently 
 
MADEIRA. 287 
 
 accomplish such a plan, passing the winter in the 
 West Indies, and the summer at Madeira. Of the 
 effects of such a plan, however. Dr. Heineken does 
 not appear to have had any experience. 
 
 The coolness of the summer at Madeira is a very- 
 fortunate circumstance for those invalids who require 
 to pass several winters abroad (which is the case with 
 by far the greater number of consumptive patients), 
 and for whom it is very difficult to find a good situa- 
 tion during the summer on the Continent, even after 
 a long and often tiresome journey. When it becomes 
 requisite for a whole family to remove to a mild 
 climate, this is a consideration of much weight, more 
 especially when the members of such a family are 
 chiefly females. In Madeira, the invalid has only to 
 change his quarters from Funchal to a more elevated 
 situation in the neighbourhood ; or go to the north 
 side of the island. This will be found a still more 
 favourable summer residence, from its being under 
 the influence of the north-east trade wind, which blows 
 constantly there during the summer months, and 
 affords a degree of coolness and freshness to which 
 the residents on the south side of the island are 
 strangers. There is now, in the parish of St. Ann's, 
 an excellent house established for the accommodation 
 of strangers, and other houses are to be had. Dr. 
 E-enton says, " that from his personal knowledge of 
 the place, as well as from the accounts of those who 
 have lived there during the three warm months of 
 
288 EASTERN ATLANTIC. 
 
 summer, he has no hesitation in saying, that many 
 whom he formerly recommended to leave the island 
 on the approach of warm weather, and who would in 
 all probability be obliged to return, or go elsewhere 
 the following winter, might have found a comfortable 
 residence there, and by returning to Funchal, or its 
 neighbourhood, at the proper season, secured the 
 enjoyment of a wonderfully equal temperature during 
 the whole year." The invalid may thus be saved a 
 voyage or journey ; and if he is prudent, he will often 
 find that he has gained more in health during the 
 summer than he did in the winter. 
 
 The foregoing evidence is quite sufficient, I think, 
 to show that where climate is likely to be useful in 
 consumption, that of Madeira is preferable to any 
 in the South of Europe ; and Madeira has this im- 
 portant advantage over all other places frequented 
 by invalids, as I have just remarked, that they 
 may remain there during the whole year without 
 sujSering from oppressive heat, or being subjected to 
 the inconvenience of a long journey. When such 
 consumptive patients only are sent abroad, therefore, 
 as ought to be sent, a proportion of them may pass 
 the summer safely, and often even with advantage, in 
 Madeira, particularly on the northern side of the 
 island. But a much larger proportion would suffer 
 from the summer heat even of Madeira, or at least 
 would derive benefit from a cooler and more bracing 
 air. The latter will generally be found among 
 
MADEIEA. 289 
 
 young growing persons, and more frequently females 
 of relaxed constitutions. To the more firm and rigid 
 frame of the adult, in whom the internal organs are 
 habitually congested, and the skin inactive, the sum- 
 mer at Madeira will often prove more beneficial than 
 the winter. But I quite agree with Dr. Combe 
 in the opinion that in the majority of cases it is 
 better to leave the island during the summer, and 
 seek a cooler and more bracing climate. The effect 
 of the summer climate of Madeira is to diminish the 
 power of the digestive organs, and the tone of the 
 system generally. If this tendency of the climate is 
 kept in view, and attention is paid to the constitution 
 of the patient, it will not be difficult to decide upon 
 the cases likely to be benefited, and those likely to 
 be injured, by remaining during the summer in 
 Madeira. 
 
 There are several situations in the island at which 
 invalids who have passed the winter in Funchal or 
 its immediate vicinity, may pass the summer months 
 at a degree of temperature which, with a little care 
 to avoid exposure in the hot period of the day, will 
 not be oppressive or even disagreeable. 
 
 The north side of the island affords the best situa- 
 tions for a summer residence, as in the parish of St. 
 Ann, which is fully exposed to the north-east trade- 
 winds, which blow during the day, and during the 
 night has the advantage of a cool breeze from the 
 mountains. The country about St. Ann's is tolerably 
 
 o 
 
290 EASTERN ATLANTIC CLIMATE, 
 
 level, and there are shaded roads and walks for 
 exercise.* Dr. Renton says, that from his personal 
 knowledge of the place, as well as from the accounts 
 of those who have lived there during the three warm 
 months of summer, he has no hesitation in saying, 
 that many whom he formerly recommended to leave 
 the island on the approach of warm weather, and 
 who would in all probability be obliged to return or 
 go elsewhere the following winter, might have found 
 a comfortable residence there, and by returning to 
 Funchal, or its neighbourhood, at the proper season, 
 have secured the enjoyment of a wonderfully equal 
 
 * Dr. Macaulay (' Notes on the Physical Geography, Geology, 
 and Climate of the Island of Madeira,' in the Edinburgh New- 
 Philosophical Journal for October 1840,) describes this district 
 as one of great beauty, and rich in plantations, gardens, and vine- 
 yards. Between Funchal and St. Ann's there is some of the finest 
 scenery of the island. " Many artists," says Dr. Macaulay, " have 
 endeavoured to delineate the scenery of Madeira ; but by far the 
 most successful attempt has been made by Mr. Picken, a young 
 artist of great genius, who has resided for several winters on the 
 island on account of his health. He has made some admirable 
 paintings of the principal scenes, including the city of Funchal. 
 To the geologist these will give a very good idea of the appear- 
 ances and physical geography of the island, and will be generally 
 interesting as representations of the most remarkable natural 
 scenery in the world." This talented young artist lately fell a 
 victim to consumption, the progress of which was checked appa- 
 rently for several years by a residence in Madeira. 
 
 Mr. Picken's work is entitled, * Madeira Illustrated',- and is 
 published by Day and Haghe, Gate Street, Lincoln's-Inn-Fields, 
 London. 
 
MADEIRA. 291 
 
 temperature during the whole year. The invalid may 
 thus be saved a voyage or journey; and if he is 
 prudent, he will often find that he has gained more 
 in health during the summer than he did in the 
 winter. 
 
 On the south side of the island, at a moderate eleva- 
 tion, there are also some cool situations ; but it does 
 not answer to go too high into the mountains, as 
 there the alternations of temperature between night 
 and day are great, the air is humid, and rain much 
 more frequent than on the low grounds. The period 
 during which the invalid should reside on the north 
 coast of the island is from the end of June till the 
 beginning of October. 
 
 But how proper soever it may be for an invalid 
 who has passed the winter at Madeira to remain there 
 during the summer, with a view of spending another 
 winter, — a case will rarely occur in which it would 
 be advisable to send a consumptive patient from 
 this country to pass the summer in that island. An 
 invalid, however, who has passed the winter in the 
 West Indies, probably could not select a better 
 situation for his summer residence than Madeira. 
 
 The only part of Madeira where invalids reside 
 during the winter is Funchal and its immediate 
 vicinity, which is the warmest part of the island. 
 This advantage it owes to its being open only to- 
 wards the south, while it is in a great measure 
 screened from the north by the central mass of moun- 
 
 o 2 
 
292 EASTERN ATLANTIC CLIMATE. 
 
 tains which, rise immediately behind it in the form 
 of an amphitheatre. Invalids peculiarly sensitive to 
 humidity should live within the limits of the town, 
 on account of its greater dryness. The steepness of 
 the island renders wheel-carriages useless ; invalids 
 must therefore ride, or be carried in palanquins or 
 hammocks. There is abundance of horses, sure- 
 footed and accustomed to the roads. There are some 
 level spots near the town where invalids may take 
 exercise. 
 
 The soil of Madeira is dry, consisting mostly of 
 the debris of volcanic rocks. Provisions of every kind 
 are good and abundant, and the water is pure and of 
 excellent quality. 
 
 Invalids who intend to pass the winter in Madeira 
 should leave this country in October. The beginning 
 of June is sufficiently early to leave the island to 
 return home, as before the middle or end of that 
 month the weather in England is seldom sufficiently 
 warm, or at least steadily so, for a consumptive patient 
 who has passed the winter in a mild climate. 
 
 Opportunities of going from this country to Madeira 
 are very frequent. Independently of the regular 
 traders to the island, many West India vessels, and 
 the monthly packets to the Brazils, touch there on 
 the outward voyage. The "West India steam-packets 
 also touch at ^Madeira twice a month on their outward 
 passage, the voyage being generally accomplished in 
 six days. About ten days may be considered the 
 
MADEIEA. 293 
 
 average time of making the passage by sailing vessels ; 
 it is frequently less, and rarely exceeds fifteen days. 
 The opportunities of returning from Madeira are, 
 however, by no means so frequent ; as comparatively 
 few vessels touch there on their voyage to England. 
 Yet I believe that in this respect much inconvenience 
 is not experienced.* 
 
 * The reader who is desirous of obtaining information on the 
 natural history, &c. of Madeira, is referred to a small work entitled 
 ' Rambles in Madeira and Portugal,' which contains much useful 
 information, especially in the Appendix, on the Climate, &c. of 
 Madeira, written by the late Dr. Heineken. There has been 
 recently published a small work, * The Invalid's Guide to Ma- 
 deira,' by Mr. Cooper, which may be consulted with advantage ; 
 and in Mr. Maelaren's ' Visit to Madeira and Teneriffe,' in the 
 7th volume of Chambers's Miscellany of Useful and Entertaining 
 Tracts, will be found much useful information. Mr. Picken's 
 beautiful work, already referred to, also contains valuable infor- 
 mation respecting Madeira, the conveyances to and from it, &c. 
 
294 EASTERN ATLANTIC CLIMATE. 
 
 CANARIES. 
 
 The Canaries group is nearer the African coast, and 
 a few degrees further south than Madeira, from 
 which they are about 200 miles distant. 
 
 TenerifFe is the principal island and the only one 
 of the group possessing accommodations for invalids. 
 Santa Cruz, the capital, is situated on the south- 
 eastern shore of the island, and is a clean, well- 
 built town. The country around is dry and barren. 
 Above the range of cultivation, which is chiefly 
 confined to the coast, the island is covered with 
 laurels, arbutuses and pines, whilst the uppermost 
 parts are bare and sterile. 
 
 The mean annual temperature of Santa Cruz is 
 70°*9 ; while that of Funchal, the capital of Madeira, 
 is 64°- 5. This excess of temperature at Santa Cruz, 
 is not equally distributed over the year ; the differ- 
 ence between the summers at the two places being 
 greater than between their winters. While Santa 
 Cruz is 7° warmer than Funchal in summer, it is only 
 5° warmer in winter. The temperature is more 
 equable throughout the year at Madeira ; the differ- 
 ence between the mean temperature of the summer 
 and winter being 9° 8, and at Santa Cruz, 12<*-3. 
 
CANAEIES. 295 
 
 The heat during the summer is considerably higher 
 in the Canaries than at Madeira ; although it would 
 appear that in this respect the summer temperature 
 of Orotava, in the northern parts of the island, differs 
 little from that of Funchal and its vicinity. 
 
 The climate of Santa Cruz possesses some advan- 
 tages during winter, in point of temperature and 
 dryness, over that of Funchal, but there are no ac- 
 commodations for invalids. There are a few places 
 fit for carriage or horse exercise, particularly the 
 terrace leading from Santa Cruz to the Lazaret, 
 which is about a mile long, and broad enough for a 
 couple of carriages to drive abreast. Mosquitoes are 
 found at Santa Cruz during the whole year. 
 
 Orotava is a town on the north western side of 
 the island, twenty-five miles from Santa Cruz, stand- 
 ing at the foot of the mountain, on ground gently 
 sloping towards the sea-shore. It is surrounded by 
 vineyards and corn-fields. The country immediately 
 behind is described as very beautiful, and the roads, 
 though steep, are not so precipitous as those of 
 Madeira. Orotava -is cooler than Santa Cruz, but not 
 so dry. The climate at an elevation of several 
 hundred feet above Orotava is described as very 
 equable during the whole year. As a residence for 
 invalids, Orotava possesses many advantages over 
 Santa Cruz, in point of accommodations, roads, and 
 beauty of country. The invalid residing at Orotava 
 might, by changing his residence to a more elevated 
 
296 
 
 EASTERN ATLANTIC CLIMATE. 
 
 site, remain throughout the summer, without sufier- 
 ing much inconvenience from the heat, and he might 
 pass the winter months in the warmer and drier 
 climate of Santa Cruz. 
 
 Laguna, the former capital, which is situated at 
 some elevation above Santa Cruz, is cooler, and might 
 form a good summer residence. 
 
 Were the accommodations for strangers at Tene- 
 riffe, and the means of communication between it and 
 Madeira more frequent, many invalids might benefit 
 greatly by passing the winter partly at Funchal and 
 partly at Santa Cruz. 
 
 The following table of the temperature at Orotava, 
 although for one year only (1834), is deserving of a 
 place here, in the absence of more extensive data. 
 The observations were made with a register thermo- 
 meter, by Mr. Charles Smith, who has resided seve- 
 ral years on the island. 
 
 Months. 
 
 Mean 
 Mini- 
 mum. 
 
 Mean 
 Maxi- 
 mum. 
 
 Mean 
 Tera- 
 perat. 
 
 Mean 
 Varia- 
 tion. 
 
 Months. 
 
 Mean 
 Mini- 
 mum, 
 
 Mean 
 Maxi- 
 mum. 
 
 Mean 
 Tem- 
 perat. 
 
 Mean 
 Varia- 
 tion. 
 
 Jan. 
 
 Feb. 
 
 Mar. 
 
 April. 
 
 May. 
 
 June. 
 
 July. 
 
 Aug. 
 
 55 
 56 
 59 
 CO 
 63 
 65 
 66 
 67 
 
 68 
 65 
 69 
 71 
 75 
 
 Vs 
 
 78 
 
 60^ 
 
 64 
 
 65i 
 
 69 
 
 71 
 
 72 
 
 72i 
 
 13 
 9 
 10 
 11 
 12 
 12 
 12 
 11 
 
 Sept. 
 Oct. 
 Nov. 
 Dec. 
 
 66 
 65 
 62 
 60 
 
 77 
 77 
 74 
 71 
 
 71i 
 71 
 68 
 65^ 
 
 11 
 12 
 12 
 11 
 
 Means") 
 for the > 
 Year. J 
 
 62 
 
 73] 
 
 67 
 
 11^ 
 
AZORES. 
 
 AZORES. 
 
 297 
 
 The Azores, or Western Islands, lie in the midst 
 of the Atlantic Ocean, about five degrees further 
 north, and considerably more to the westward, than 
 Madeira. Of volcanic origin, they rise abruptly 
 out of the water, and present numerous mountains 
 covered to the very top with perpetual verdure. 
 The conical mountain, which gives name to the 
 island of Pico, and which is about 8000 feet high, 
 has its summit often covered with snow during the 
 winter and spring. 
 
 St. Michael's is the largest of the Azores, and, with 
 the exception of the little island of St. Mary's, the 
 southernmost of the group. It is of an irregular 
 oblong form, and extends from west to east rather 
 more than forty-eight miles ; its greatest breadth is 
 eleven and its least six miles. The extremities of 
 St. Michael's are mountainous ; the eastern end the 
 most so ; the highest points rise 3 or 4000 feet 
 above the level of the sea ; the intermediate part is 
 hilly. The soil consists of pumice, volcanic clay, and 
 other decomposed volcanic products, lying upon hori- 
 zontal strata of basaltic lava. 
 
 The chief town of the island is Ponta Delgada, 
 containing upwards of 12,000 inhabitants. The sur- 
 rounding country is for many miles tolerably level, 
 and the roads fit for carriages. Asses, for riding and 
 
 o3 
 
296 EASTERN ATLANTIC CLIMATE. 
 
 carrying burdens, may be hired for a small sum. 
 Horses and carriages are kept by private individuals. 
 
 Consuls for Britain and America, and many Eng- 
 lish and American merchants reside at Delgada, 
 and there is a Protestant episcopal chapel and chap- 
 lain. Furnished lodgings are not to be had, but 
 houses may be rented at a moderate sum : there are 
 two boarding-houses. 
 
 Villa Franca, another town on the southern coast 
 of St. Michael's, twelve or fifteen miles to the east- 
 ward of Delgada, is more pleasantly situated, being 
 protected behind from the north-east winds by a 
 range of mountains. It has a sandy beach, and its 
 neighbourhood is not so much obstructed by the 
 high walls of orange gardens as that of Delgada. It 
 contains about 4000 inhabitants, but there are no 
 English residents. The soil is a light porous pumice, 
 of from ten to fifty feet in depth, covering the hori- 
 zontal strata of lava. The heaviest rains are speedily 
 absorbed, so that the roads are left dry. The water 
 which filters through this pumice soil is very pure 
 and abundant. 
 
 There are no accommodations expressly for invalids, 
 but houses may occasionally be hired. 
 
 The mean in-door temperature of a room without 
 fire, carpet, or curtains, in Villa Franca, during the 
 period from December 1838 to April 1839, was 
 60**-9, with a mean range of 3°-6. The mean out- 
 door temperature, during the same time, was 60°* 1 0, 
 
AZORES. 
 
 299 
 
 and the mean daily range 7^'Q. The highest point 
 to which the thermometer rose in the shade, between 
 eight o'clock in the morning and ten at night, was 
 76°, and the lowest point to which it sank was 51°. 
 Thus, the mean temperature during the winter is 
 about 2° colder than Madeira. It is to be remarked 
 that the averages out-of-doors were not taken with 
 the register thermometer ; they, however, approxi- 
 mate the truth, and prove, what is evident to the feel- 
 ings of the visitor, that the temperature is remark- 
 ably steady, ranging little from day to day, and varying 
 little between day and night. Dr. Bullar remarked 
 that to his feelings it was always warmer out of 
 doors. 
 
 The following Table affords a pretty accurate idea 
 of the Temperature : 
 
 
 Register Thermo- 
 meter within doors. 
 
 Thermometer in the open 
 air at four hours of the day. 
 
 a. 
 1^ 
 
 Hi a 
 
 P 
 
 4. 
 
 11 
 
 Max 
 
 Min 
 
 Med 
 
 Ran 
 
 A.M. 
 
 8 
 
 P.M. 
 
 1 
 
 P.M. 
 
 6 
 
 P.M. 
 
 10 
 
 Med 
 
 
 December 
 
 60 
 
 57 
 
 58-5 
 
 4 
 
 55 
 
 63 
 
 52 
 
 58 
 
 57 
 
 5 
 
 17 
 
 12i 
 
 10 
 
 N.E. 
 
 January 
 
 63 
 
 60 
 
 61-5 
 
 3 
 
 60 
 
 64 
 
 58 
 
 68 
 
 60 
 
 9 
 
 13 
 
 17i 
 
 lOi 
 
 S.E. 
 
 February 
 
 63 
 
 60 
 
 61-5 
 
 3 
 
 63 
 
 66 
 
 60 
 
 58 
 
 61-25 
 
 8 
 
 10 
 
 25* 
 
 U 
 
 s.w. 
 
 March . 
 
 64 
 
 60 
 
 62 
 
 4 
 
 61 
 
 66 
 
 61 
 
 60 
 
 62 
 
 6 
 
 14 
 
 21+ 
 
 2 
 
 s.w. 
 
 April . 
 
 63 
 
 59 61 
 
 4 
 
 62 
 
 66 
 
 59 
 
 56 
 
 60 '25 
 
 10 
 
 •• 
 
 •• 
 
 •• 
 
 S.E. 
 
 Mean . 
 
 62-6 
 
 59*2 60-9 
 
 3-6 
 
 60-2, 65 
 
 58 
 
 58 
 
 60*18 
 
 7*6 
 
 10-8 
 
 19-25 
 
 
 
 The monthly average of days on which rain fell 
 in Villa Franca, during the period above specified, 
 was ten. This estimate, however, affords little direct 
 
300 
 
 EASTERN ATLANTIC CLIMATE. 
 
 information as to the humidity of the climate. The 
 rain on some days was nothing more than a mountain 
 scud, of a few minutes' duration ; and at other times 
 it fell for several hours ; but during the whole five 
 months there was not a day in which many hours 
 were not available for exercise in the open air. At 
 the same time, the humidity of the atmosphere is so 
 great, that boots grow mouldy in a few days, kid 
 gloves become spotted, books feel damp, and clothes 
 not constantly worn have a musty smell. To pre- 
 vent these inconveniences, the inhabitants frequently 
 expose their clothes to the sunshine. Salt-fish soon 
 spoils, so that no quantity is ever kept ; and no salt 
 is made on the island. 
 
 The prevalent winds were, in December north- 
 easterly ; in January, February, March, and April, 
 southerly. The southerly and westerly winds are 
 soft and warm. The north-easterly are cold, but not 
 keen. The sirocco is never felt at the Azores. 
 Gales and strong winds blow from the southward and 
 westward, and are not unfrequent. 
 
 Fayal is about 160 miles to the north-west of St. 
 Michael's Its principal town is Horta, which is plea- 
 santly situated on the east side of the island, on rising 
 ground sloping down to the margin of a fine bay. It 
 contains several thousand inhabitants, many Americans 
 and their consul, besides an English consul and 
 physician. There is a boarding-house, and houses 
 
AZORES. 
 
 301 
 
 may be rented. The country around affords a con- 
 siderable variety of pleasant walks and rides. 
 
 There is constant communication between the 
 Azores and England during the winter, when the 
 oranges are exported. The communication between 
 the different islands is frequent after March, but un- 
 certain during winter. In all the islands, poultry, 
 eggs, and fish are abundant and cheap. In the chief 
 towns, beef and mutton can be procured as well as 
 milk and butter. The bread is light and good ; the 
 wines indifferent, but unadulterated. 
 
 Water at St. Michael's is good and abundant. The 
 soil when cultivated is rich and productive. The 
 whole of the islands abound in fine scenery, but there 
 is a deficiency of trees, though not of vegetation. 
 
 The climate of this group of smaU islands, situated 
 in the centre of the Northern Atlantic, nearly equidis- 
 tant from the poles and the equator, and surrounded 
 on all sides by a vast extent of ocean, is purely oce- 
 anic, and aftbrds one of the best examples of a mild, 
 humid, equable climate to be met with in the northern 
 hemisphere. It is slightly colder and more humid 
 than Madeira, but probably even more equable. 
 
 In diseases in which a soft, soothing climate is 
 indicated — such as gastritic or inflammatory dys- 
 pepsia, and in bronchial irritation, accompanied with 
 little secretion — the climate of the Azores will prove 
 beneficial. On the other hand, in a relaxed state 
 
302 EASTERN ATLANTIC CLIMATE. 
 
 of the system, — ^in those morbid conditions of the 
 mucous membranes, attended with copious discharges, 
 — and in an enfeebled state of the digestive organs 
 (atonic dyspepsia) it will decidedly disagree. 
 
 There are many cases of a mixed character, where 
 irritation of the mucous surfaces co-exists with a 
 relaxed state of system. In such the climate may 
 prove beneficial for a time, but, as soon as the state of 
 irritation is abated, its relaxing efiects will prove in- 
 jurious. A removal to a drier and more bracing cli- 
 mate would then be desirable and even necessary. 
 
 The most prevalent disease among the natives is 
 gastrodynia, or a painful affection of the stomach ; a 
 dull, continuous pain, lasting many hours. This is 
 not surprising, the principal food of the poor (whose 
 diseases were those which chiefly fell under the 
 observation of Dr. Bullar) consisting of cabbage and 
 potatoes chopped up with a little lard. Painful 
 affections of other parts are next in frequency ; such 
 as rheumatic neuralgia; lumbago; sciatica; neuralgic 
 pains of the face, neck, and arms ; hemicrania and loss 
 of power ; partial paralysis. Of acute diseases, bron- 
 chitis was the most frequent ; asthma also prevailed ; 
 phthisis is very rare.* 
 
 * For the above account of the Azores, I am indebted to my 
 friend Dr. Bullar, who passed the winter and spring of 1839-40 
 there ; and who, in conjunction with his brother, has published an 
 entertaining work descriptive of these islands, entitled, * A Winter 
 in the Azores ;' to which I beg to refer for a full and very inte- 
 resting account of these islands. 
 
AZOKES. 308 
 
 Comparing Madeira, the Canaries, and the Azores, 
 it will be observed that, although in some respects 
 they are alike, they are very dissimilar in others. 
 They have the same form and geological structure, 
 being all mountainous and of volcanic origin, but 
 differ materially in their vegetable productions, 
 and in the character of their cKmate, both as 
 regards humidity and temperature. There is a 
 gradual transition from the humid, soft, equable cli- 
 mate of the Azores, of which the mountains are 
 covered to the very summit with evergreens, to that 
 of Teneriffe, where the want of rain during the 
 greater part of the year has the effect of rendering 
 the island dry and sterile. Madeira, situated con- 
 siderably more to the south than the Azores, and more 
 distant from the African coast than the Canaries, 
 presents an intermediate climate in comparison with 
 these two groups. Less humid than the Azores, and 
 less dry than Teneriffe during the winter, it has the 
 advantage of a cooler summer than either. This it 
 owes chiefly to its being within the limits of the traded 
 winds during the hot season. 
 
 A change from the Azores to Madeira, and from ^ 
 thence to Teneriffe, would in many cases prove more 
 beneficial than a residence during the whole winter in ^ 
 any one of these islands. 
 
304 WESTERN ATLANTIC CLIMATE. 
 
 WESTERN ATLANTIC. 
 
 BERMUDAS. 
 
 The Bermudas consist of a cluster of small low 
 islands. The largest is only twelve miles long and 
 about three broad ; and the whole extent of the group, 
 from one extremity to the other, is not more than 
 twenty miles. The highest point of land in any 
 of the islands does not exceed 200 feet above the 
 sea level. They consist chiefly of a coarse, shelly 
 sandstone of an extremely poi'ous quality, and so soft 
 as to be cut easily by the saw and adze into the vari- 
 ous forms necessary for building, &c. From the 
 absorbing nature of the Bermuda rock, the soil, which 
 is naturally thin, is extremely arid. There are no 
 springs, the inhabitants being almost entirely depen- 
 dent upon rain water, which is collected on the roofs 
 of the houses, and by other artificial means, and pre- 
 served in covered stone cisterns. The supply is 
 occasionally deficient in very dry seasons. Although 
 the Bermuda Islands are low, they are by no means 
 flat, the surface being of an undulating and indeed 
 hilly character. The high grounds are mostly covered 
 with cedar trees, which, while they form a peculiar 
 feature, are the most beautiful ornament of these 
 islands, and, at the same time, their most valuable 
 production. But there can be no doubt that Bermuda 
 
BEHMUDAS. 
 
 305 
 
 might be made much more productive by proper culti- 
 vation ; as has indeed been proved during the non- 
 intercourse with America. It is, however, in general, 
 supplied with provisions from the United States and 
 our North American colonies. 
 
 From the small size and little elevation of the Ber- 
 mudas, they are fully exposed to winds from every 
 quarter, and are under the immediate influence of all 
 the changes which occur in the atmosphere of the 
 surrounding ocean ; which, as we have already re- 
 marked, is more liable to great and rapid changes of 
 temperature, and more subject to storms, than the 
 Eastern Atlantic. 
 
 RANGE OF THE THERMOMETER AT ST. GEORGE'S, 
 
 (On an Average of Five Years.) 
 
 MONTHS. 
 
 THERMOMEl'ER. 
 
 DIURNAL RANGE. j 
 
 
 Max. 
 
 Min. 
 
 Med. 
 
 Greatest. 
 
 Least. 
 
 Mean. 
 
 
 o 
 
 o 
 
 
 
 o 
 
 o 
 
 o 
 
 January . . 
 
 72 
 
 55 
 
 65f 
 
 8 
 
 1* 
 
 4 
 
 February 
 
 
 
 71 
 
 53 
 
 64| 
 
 10 
 
 1 
 
 5§ 
 
 March . 
 
 
 
 72 
 
 54 
 
 65 
 
 9| 
 
 u 
 
 
 April 
 
 
 
 71 
 
 56^ 
 
 64f 
 
 10 
 
 1* 
 
 5^ 
 
 May. . 
 
 
 
 75 
 
 57 
 
 70 
 
 11 
 
 2 
 
 6i 
 
 June 
 
 
 
 86 
 
 68 
 
 79 
 
 10 
 
 3 
 
 7 
 
 July . . 
 
 
 
 89 
 
 75 
 
 83^ 
 
 12 
 
 2 
 
 H 
 
 August . 
 
 
 
 89^ 
 
 75 
 
 83 
 
 12 
 
 1 
 
 8 
 
 September 
 
 
 
 87 
 
 74 
 
 82A 
 76i 
 
 9 
 
 4 
 
 6 
 
 October . 
 
 
 
 86« 
 
 65 
 
 10 
 
 1 
 
 4f 
 
 November 
 
 
 
 82 
 
 64 
 
 76^ 
 
 7 
 
 0^ 
 
 4 
 
 December , 
 
 
 
 76 
 
 56 
 
 693 
 
 8 
 
 o| 
 
 4i 
 
 Mean 
 
 
 
 79f 
 
 63 
 
 73^ 
 
 9i 
 
 1§ 
 
 5§ 
 
 Bermuda may be considered as upon the whole 
 a healthy place. There are no endemic diseases. 
 
306 WESTERN ATLANTIC CLIMATE. 
 
 although, occasionally, during the autumn, fevers of 
 a character resembling those which form the scourge 
 of the West Indies prevail with considerable violence ; 
 but this is by no means an annual occurrence. Bowel 
 complaints are the most common diseases. Consump- 
 tion is also frequently observed among the inhabitants ; 
 and it appears from the Army Reports that inflamma- 
 tion of the lungs and consumption are very prevalent 
 among the troops stationed there ; the ratio of morta- 
 lity from consumption being nearly nine per thousand 
 of the strength annually, which is more than among 
 the troops in the United Kingdom, or in any of the 
 Mediterranean stations. 
 
 The cool season, that is, from October till May, is 
 the most healthy, and the only part of the year 
 during which this climate is at all suited to invalids. 
 One of the principal objections to Bermuda, as a 
 winter residence for pulmonary invalids, is the pre- 
 valence of strong winds; which are such as to 
 justify the epithet applied by Shakspeare to these 
 islands, the " still- vex'd Bermoothes." Of these 
 winds the damp, oppressive south-west prevails the 
 most; but the most violent and injurious to deli- 
 cate invalids during the winter and spring are the 
 north-west winds, which are generally dry, sharp, 
 
 i and cold. Compared, however, with the climate of 
 the coast of America, under the same latitude, Ber- 
 muda may be said to have no winter. The summer 
 
 \ is very hot ; being generally admitted, I believe, by 
 
BERMUDAS. 307 
 
 those who have experienced both climates, to be 
 more oppressive than the same season in the West 
 Indies. This may be accounted for partly from the 
 absence of the trade winds, and partly from the bare, 
 arid nature of the soil, which becomes quite parched 
 during the summer. Vegetation almost disappears 4- 
 at this season ; the cedar and wild sage alone resist- 
 ing the heat. Dew is occasionally deposited in 
 winter, when a cold night succeeds a hot day, but 
 ^ever in the summer. The principal fall of rain is 
 between August and October; there are also very 
 heavy showers in January and February, but seldom 
 any during the summer months. 
 
 From what has been stated, a tolerably accurate 
 opinion may be formed respecting the general qual- 
 ities of the climate of Bermuda. It is variable and 
 windy during the winter, and hot and oppressive in 
 the summer. Compared with that of Madeira, which 
 lies in the same parallel of latitude, it is much more 
 unequal. The temperature of the two places during 
 the winter may be much the same ; but there is a 
 wide difference in that of summer. The coolness of 
 this season at Madeira forms a striking contrast with 
 the oppressive heat of Bermuda. 
 
 "With so few advantages in point of climate, the 
 Bermudas are not likely to become the resort of 
 invalids from this country. Their great distance, 
 the infrequency of communication with England, and 
 the defective accommodations for strangers, form 
 
308 WESTERN ATLANTIC CLIMATE. 
 
 additional objections. Provided, however, that 
 domestic circumstances rendered Bermuda a con- 
 venient residence, invalids might pass the winter 
 there safely, and perhaps with benefit. There are 
 many beautiful spots in these islands, where, pro- 
 tected from the northerly gales by the cedar-clothed 
 hills, the invalid might find sufificient space to enjoy 
 exercise in the open air almost every day during 
 the winter. The neighbourhood of the little town 
 of Hamilton, situated nearly in the centre of the 
 islands, affords perhaps the most favourable situation 
 for such a residence. 
 
 BAHAMAS. 
 
 Were we to consider the latitude only of these 
 islands, they might almost be classed with the "West 
 Indies, as they are on the very limits of the tropics ; 
 but their vicinity to the American continent so modi- 
 fies their climate as to give it a diflferent character 
 from that of the intertropical islands. The Bahama 
 Islands form a very numerous group, of which about 
 twelve are of considerable size. They are all low, 
 and chiefly of coralline formation. They contain no 
 natural springs, water being procured only by dig- 
 ging deep weUs ; and in many places the water thus 
 obtained is not good. 
 
 The easterly, or trade wind, although the prevail- 
 ing wind, is much less regular here than in the same 
 
BAHAMAS. 
 
 309 
 
 latitude on the eastern side of the Atlantic. South- 
 erly winds, which are hot and oppressive, often occur, 
 and are generally accompanied with a heavy depo- 
 sition of dew during the night. The north-west is 
 a prevalent wind, and, as it blows with very consider- 
 able force, produces a rapid fall of temperature, espe- 
 cially when it immediately follows a southerly wind. 
 
 The following table shows the monthly range of 
 the thermometer at Nassau, on an average of five 
 years,— (1830 to 1834 inclusive) : 
 
 Months. 
 
 Jan. 
 
 Feb. 
 
 Mar. 
 
 Apr. 
 
 May. 
 
 June. 
 
 July. 
 
 Aug. 
 
 Sept. 
 
 Oct. 
 
 Nov. 
 79 
 
 Dec. 
 76^ 
 
 Max. . 
 
 77^ 
 
 76 
 
 804 
 
 83 
 
 86i 
 
 89 
 
 92 
 
 90 
 
 89 
 
 83^ 
 
 Min. . 
 
 66 
 
 69^ 
 
 69 
 
 7^ 
 
 77 
 
 80 
 
 83 
 
 83 
 
 81 
 
 73^ 
 
 67 
 73 
 
 63^ 
 70 
 
 Med. . 
 
 71 
 
 73 
 
 75 
 
 79 
 
 81^ 
 
 84^ 
 
 86 
 
 86J 
 
 85 
 
 79 
 
 Average,— Max. 83:^, Min. 74, Med. 78^. 
 
 From May to November the range of the thermo- 
 meter is from 75° to 85**, seldom rising above 90°. 
 This increase of temperature is generally accom- 
 panied by southerly winds or calms, which are 
 described as being very oppressive. 
 
 According to these tables, the mean annual tem- 
 perature is 78^° ; and the range 28^° ; namely, from 
 631° to 92°. In the West Indies, the former is 80°, 
 the latter 20°. The temperature of the seasons is as 
 follows : winter 71°, spring 77% summer 83°, autumn 
 80°. At Barbadoes the winter is 76°- 7 7, spring 79°, 
 
310 WESTERN ATLANTIC CLIMATE. 
 
 summer SP, autumn 80°. From this comparison it 
 appears that while the winter is nearly 6°, and the 
 spring 2° colder, the summer is 2*' warmer than at 
 Barbadoes ; the autumn temperature at both places 
 being the same. The explanation of the high tem- 
 perature of the Bahamas during the two latter 
 seasons, is probably to be found in the frequent 
 occurrence of southerly winds during that period of 
 the year, and in the less degree of regularity of the 
 trade winds at these islands than within the tropics. 
 In the winter and spring, however, the temperature is 
 considerably lower, and this is the period of the year 
 which chiefly interests us in our present inquiry. 
 
 At New Providence, the weather during the cold 
 season, which extends from November to May, is 
 generally fine, clear, and dry ; the thermometer in 
 the shade being generally from 60** to 70°, the mid- 
 day heat tempered by a constant breeze, and the 
 evenings cool and agreeable. 
 
 The Bahama Islands, generally speaking, are not 
 unhealthy ; although there is considerable differ- 
 ence in this respect between the different islands. 
 That of New Providence, in which is the capital, 
 Nassau, the only town in the colony, is not by any 
 means one of the healthiest, on account chiefly of 
 some swampy ground which it contains. The small 
 island called Harbour Island, close to Eleuthera, 
 one of the largest of the group, is esteemed particu- 
 larly healthy, and forms the chief resort of invalids 
 
BAHAMAS. 811 
 
 and convalescents from New Providence. There 
 are several other healthy spots, as on the island of 
 Abaco; but at all these places there is a great defi- 
 ciency of accommodations, and moreover, they are 
 sixty miles distant from Nassau, the only place 
 where medical advice is to be found. 
 
 The most prevalent diseases are fevers, chiefly of 
 the intermittent and remittent character, and bowel 
 complaints ; cholera is not uncommon, and occasion- 
 ally the Bahamas are visited by epidemics of yellow 
 fever; but the two first-mentioned diseases are by 
 far the most prevalent. 
 
 From the above description, it appears evident that 
 the Bahama Islands are not well calculated for the 
 generality of invalids. The climate is not suited for 
 consumptive patients, on account of the rapid changes 
 of temperature, and the prevalence of winds, often 
 of a dry, cold character. At the same time persons 
 for whose cases a warm climate is indicated may 
 pass the winter in the Bahamas safely ; and residents 
 in the West Indies might derive considerable benefit 
 by a change to these islands for a few months during 
 this season. The wet and dry seasons occur pretty 
 regularly at the same periods of the year as within 
 the tropics. The same rules which are laid down in 
 the article on the West Indies, respecting the arri- 
 val and departure of invalids, and the conduct to be 
 observed during their residence, are generally appli- 
 cable to those visitin<? the Bahamas. 
 
312 WESTERN ATLANTIC CLIMATE. 
 
 WEST INDIES. 
 
 I CONSIDER it necessary to notice the West India 
 Islands, because they are occasionally recommended 
 as a winter residence to patients labouring under 
 pulmonary and some other chronic diseases ; and 
 because the climate, as regards either its physical 
 characters or its influence on disease, does not seem 
 to be generally understood by medical men in this 
 country. 
 
 The mean annual temperature of the West India 
 Islands near the sea is about 79® or 80° ; the mean 
 daily range about 6° only ; and the extreme annual 
 range not more than 20°. The mean temperature 
 of the sea at considerable depths in the vicinity of 
 these islands is 80°; and this is also the temperature 
 of the springs near the level of 'the sea in Jamaica, as 
 noticed by Dr. Hunter.* The mean temperature of 
 the seasons, according to the European division 
 adopted in this work, is at Barbadoes as follows — 
 winter, 76°-7 ; spring, 79°; summer, 81°; autumn, 80°. 
 
 The above applies to the whole of these islands 
 near the level of the sea ; the difference in difierent 
 islands being scarcely worth remarking. The mean 
 
 * Observations on Diseases of the Army in Jamaica.' 
 
WEST INDIES. 313 
 
 temperature of Barbadoes, according to Hillary, is 
 79°* 3; the greatest range in six years being 17°, 
 viz. from 70° to 87°: and Dr. Thomas makes this 
 18°, viz. from 70° to 88°. Sir Gilbert Blane once 
 found the thermometer in this island at sunrise, in 
 December, at 69°.* Dr. Hunter observed it once 
 only at the same degree ; and twice only as high as 
 91° in Jamaica, t The greatest range which I find 
 noticed by any author at the sea level is 22°, viz. 
 from 70° to 92°. Dr. Ferguson says the mean daily 
 range in summer is from 80° to 86°, and in winter 
 from 70° to 80°. The mean temperature of Gre- 
 nada, at noon, according to Dr. Chisholm, is 84°, and 
 at seven a.m. 78°'5. This gentleman gives the 
 following as the diurnal progression of temperature : 
 — " The thermometer (Fahrenheit's) almost uni- 
 versally exhibits the following movements. At 
 seven a.m. the mercury begins to rise, and continues 
 to do so till one p.m., from which time till four p.m. 
 it is stationary. It then begins to fall, and continues 
 to do so till ten p.m., from which time till seven a.m. 
 it is again stationary. This routine of temperature 
 is disturbed only when any remarkable change takes 
 place in the atmosphere, such as much rain attended 
 with strong wind : the greatest change from this 
 cause I have observed is 10°, the least 4°. The 
 thermometer, exposed to the direct rays of the sun. 
 
 * ' Diseases of Seamen.' f QP- ^*^^^* 
 
 P 
 
314 WEST INDIES. 
 
 has risen in ten minutes to 130°, or 42*' above its 
 stationary point at one p.m. of that day ; 30° may, 
 however, be considered the medium difference be- 
 tween the heat in the shade and in the sun.* The 
 medium difference between the heat of the atmo- 
 sphere at one and ten p.m. is 90°. "f At Jamaica, 
 Dr. Arnold always observed the mercury begin to 
 rise about 10 or 15 minutes before the sun emerged 
 from the horizon. Its ascent was gradual until it 
 
 • This great increase of temperature is not produced by the 
 direct power of the sun's rays, but is caused chiefly by the con- 
 centration and reflection of heat from the surface of the earth. If 
 the influence of reflected heat be avoided, the difference between 
 the sun and the shade amounts, in the West Indies, to a few 
 degrees only. Baron de Humboldt often endeavoured to measure 
 the power of the sun between the tropics by two thermometers of 
 mercury perfectly equal, one of which remained exposed to the 
 sun, while the other was placed in the shade. The difference 
 resulting from the absorption of the rays in the ball of the instru- 
 ment never exceeded 6°'6 Fahr. ; sometimes it did not even rise 
 higher than one or two degrees. Mr. Daniell's observations go 
 far to show " that the power of solar radiation in the atmosphere 
 increases from the equator to the poles, and from below upwards." 
 — Meteorological Essays and Observations. 
 
 The temperature in the shade often rises higher in northern 
 latitudes than in the West Indies. It is the duration of heat 
 much more than its intensity, as Humboldt justly remarks, which 
 characterises the climate of the tropics. And I may add, that 
 it is this unceasing heat which is one of the principal causes 
 of the injurious influence of tropical climates on European con- 
 stitutions. 
 
 t * Manual of the Climate and Diseases of Tropical Countries,' 
 &c., by Colin Chisholm, M.D. 
 
WEST INDIES. 315 
 
 reached its maximum, which generally happened 
 between two and four p.m. He tried many ther- 
 mometers for the purpose of ascertaining the extreme 
 solar heat, and often observed the mercury rise to 
 130<* Fahr. in the month of September. 
 
 The winter and early part of the spring are in 
 general remarkably dry, and the weather fine; the 
 wind being more northerly than usual. The sum- 
 mer is dry and hot, and autumn the season of the 
 heavy rains ; but there is seen little of that con- 
 tinuous rain which occurs in temperate climates. 
 
 J The annual fall of rain is probably about 65 inches ;* 
 but in the quantity of rain which falls in the different 
 islands there is a much greater difference than in 
 their temperature. In the mountainous islands gene- 
 rally, the fall much exceeds that in the low islands. 
 At Martinique, for example, the fall is said to amount 
 
 ; to 100 inches ; while at Barbadoes, acccording to 
 Hillary, it is 58 ; and at Antigua only 45 inches. 
 The greatest fall of rain takes place in October. In 
 November the weather generally begins to clear up, 
 the north-easterly winds resume their regularity ; 
 and from the beginning of December till the vernal 
 rains of April and May, the weather is dry, settled, 
 and comparatively cool. 
 
 * Edwards gives firom 60 to 65 inches as the average fall 
 throughout the whole of the islands. — History of the West Indies^ 
 vol. i. p. 12. 
 
 p2 
 
316 WEST INDIES. 
 
 From the rapid manner in which the rain descends 
 within the tropics, a large proportion of it is carried 
 off in torrents, and it must be remembered that the 
 evaporation is extremely rapid. At Antigua this 
 amounted in 1818 to 28 '26 inches, the fall being 
 65. The evaporation in the different seasons was as 
 follows : — "Winter, 6*26 ; spring, 6*99 ; summer, 8-09; 
 autumn, 7 '06; leaving unevaporated — winter, 5*41 ; 
 spring, 6*22; summer, 6*39 ; autumn, 19*53. I am 
 not aware of any series of hygrometrical observations 
 having been made in the West Indies.* In the lower 
 islands little dew is deposited ; but in the higher 
 islands, where the range of temperature is greater, 
 dew falls in considerable quantity, but still in a very 
 small proportion when compared with the opposite 
 continent of America. In Jamaica dew is often 
 heavy, and Dr. Melville informs me that it is not 
 unfrequent in St. Vincent's. 
 
 The range of atmospheric pressure is remarkably 
 small. At Antigua, in 1818, this amounted to half 
 an inch only ; and, according to Dr. Chisholm, it 
 does not exceed an inch in any year. 
 
 From the small size of the greater number of these 
 islands, there do not occur the regular alternations 
 of land and sea breezes which prevail generally in 
 tropical climates, but the same circumstance admits 
 
 * I am informed by Dr. Musgrave that such are now in pro- 
 gress of being made by his colleague Dr. Nicholson. 
 
WEST INDIES. 317 
 
 of the influence of the easterly, or trade wind, with- 
 out intermission. This wind prevails, with great 
 regularity, for nine months of the year. During 
 August, September, and October, the trade winds 
 are much more irregular, but still the prevailing wind 
 is decidedly the east. It is chiefly owing to the full 
 influence of the trade wind that the climate of the 
 West India Islands is not only tolerable, but infinitely 
 more agreeable than Europeans who have never 
 visited them can possibly imagine, when the tempera- 
 ture, as indicated by the thermometer, is alone con- 
 sidered. It would appear from a register now before 
 me, kept on board one of H.M.'s ships, that the tem- 
 perature of the air at sea is very nearly the same as 
 on the small islands.* 
 
 We have now to inquire into the influence of this 
 climate on disease, and more especially upon Con- 
 sumption. 
 
 Respecting the prevalence of consumption in the 
 West Indies, there exists considerable difference 
 in the statements of those who have had ample 
 opportunities of observation. Dr. Musgrave remarks 
 of the occurrence of phthisis among the whites, that 
 the subjects of it are almost invariably of families 
 
 * In this journal, the temperature of the sea- water is often 
 noted in the harbours, and at great distances from land, at various 
 depths short of 100 feet. It varied from 76° to SS^'-S. On one 
 occasion the temperature of a torrent of rain as it fell is marked 
 77°, the temperature of the air being 78°. 
 
318 WEST INDIES. 
 
 in which hereditary predisposition has been long 
 established. Amongst the blacks, Dr. Musgrave's 
 patients have been chiefly native Africans, dis- 
 banded soldiers, for example, or their immediate 
 offspring ; the Creole negro of many generations 
 being comparatively free from pulmonary disease of 
 every kind.* 
 
 On the other hand, it appears from the Army 
 Reports, that nearly twice as many cases of con- 
 sumption originate among our troops in the West 
 Indies as at home ; twelve per thousand of the 
 aggregate strength of our troops serving in the West 
 Indies being attacked annually, while of the Dragoon 
 Guards serving in Great Britain, the proportion is 
 only 6J per thousand. The disease, according to 
 the same reports, is even of more frequent occur- 
 rence among the black than the white troops. 
 
 If we have found cause to condemn Italy as a 
 summer residence for consumptive patients, there 
 
 * A communication received from Dr. Davy, Inspector of 
 Military Hospitals in the West Indies, while revising this sheet, 
 contains the following interesting information: — "Amongst the 
 clergy in the West Indies, during the last seventeen years, I 
 cannot learn that a single one has died of pulmonary consumption > 
 or of disease attended with cough. The average mortality among 
 them appears to be 3 per cent. , and arises chiefly from acute dis- 
 eases. In some years there has not been a single death. This 
 information I have obtained from the Lord Bishop of Barbadoes, 
 and it may be considered as correct. It seems to indicate that the 
 lungs are little subject to disease here." 
 
WEST INDIES. 319 
 
 seems no just reason why we should commend the 
 West Indies, even in winter, the temperature of 
 which is above the summer temperature of any place 
 in the South of Europe. 
 
 More extended experience, however, and more 
 accurate observation than has hitherto been applied 
 to the cases of pulmonary invalids sent abroad, can 
 alone enable us to speak positively on this point. In 
 the mean time, everything that we know regarding 
 the nature of consumption, and the influence of a 
 high temperature on it, supported by our practical 
 experience of the effects of the climate now under 
 consideration, warrants us in laying it down as a 
 general rule, that the climate of the West Indies is 
 an improper one for patients wdth tuberculous dis- 
 ease of the lungs. 
 
 As my own personal experience on the subject 
 is rather limited, it may be as well to notice the 
 opinions of those whom a residence in the West 
 Indies has afforded ample opportunities of j udging. 
 Dr. Hunter, speaking of Jamaica, observes : — '* Pul- 
 monary consumptions rarely originate in the island, 
 but those who come from England with that com- 
 plaint already begun, are not benefited by the 
 warmth of the climate ; on the contrary, the disease 
 is precipitated, and proves sooner fatal than it would 
 have done in a more temperate air. Of this we had 
 repeated examples among the soldiers, several of 
 whom arrived in the island with beginning consump- 
 
320 WEST INDIES. 
 
 tions, and were all quickly carried off by that 
 disease." * Dr. Musgrave and Dr. Arnold agree in 
 this opinion ; and Dr. Chisholm states that catarrh, 
 pulmonic inflammation, and phthisis pulmonalis, are 
 very frequent in the West Indies ; that these dis- 
 eases are very rapid in their progress ; that when 
 phthisis is fully established, there is no safety in re- 
 maining in the climate. A sea voyage, and tempe- 
 rate or cool climate, present then the only, or at least 
 the best, chance of life.t The opinions of Dr. Fer- 
 guson, Sir Alexander Dickson, and Dr. M'Arthur 
 are equally strong on this subject ; and these gentle- 
 men, as well as Dr. Chisholm, had peculiar oppor- 
 tunities of observing the effects of climate on a very 
 large scale. Dr. Ferguson had the direction of the 
 army medical department in these islands for several 
 years ; Sir A. Dickson was physician to the fleet in 
 the West Indies six years ; and Dr. M^ Arthur had 
 charge of the Royal Naval Hospital at Barbadoes for 
 six years. It was customary in our navy at that time 
 to draught seamen labouring under chronic pul- 
 monary diseases into ships going to the West Indies; 
 and it was constantly observed that the progress of 
 consumptive cases to a fatal termination was much 
 more rapid than is generally observed in more tem- 
 perate climates. Dr. Ferguson remarked the same 
 thing among the military ; the disease, to use his 
 
 Op. citat. t ^^'^d- 
 
WEST INDIES. 321 
 
 own words, '^ resembling, in its progress, an acute 
 rather than a chronic affection ; " and Sir A. Dick- 
 son's language is equally strong on this point.* 
 
 It is unnecessary, I presume, to adduce further 
 evidence to prove the injurious effects of the West 
 India climate on confirmed Consumption. 
 
 The next point for consideration is the influence 
 of this climate on persons predisposed to consumption. 
 Those who have had the best opportunities of judg- 
 ing, are in favour of it as a prophylactic means. Dr. 
 Ferguson, who had extensive opportunities of ob- 
 serving the influence of the climate upon our troops, 
 and Dr. Melville, who has long practised in St. Vin- 
 cent's, are of this opinion. Dr. Musgrave, who has 
 practised twenty-six years in Antigua, says, that it 
 has never fallen to his lot to see a single case of con- 
 sumption commencing in a European, whether here- 
 ditarily predisposed or not, who had arrived in the 
 "West Indies in perfect health. Dr. Arnold found 
 the climate of Jamaica very favourable to young 
 persons from fifteen to twenty years of age, here- 
 ditarily predisposed to consumption. 
 
 * So well convinced was Dr. M'Arthur of this, that he thought 
 it his duty to communicate the fact officially to the head of the 
 Navy Medical Department, Sir William Burnett ; by whom I am 
 informed that the practice of sending consumptive sailors to this 
 and other hot climates has long since been discontinued. 
 
 p3 
 
322 WEST INDIES. 
 
 Dr. Jackson^ of Boston, U. S., whose experience 
 has been somewhat large, thinks favourably of the 
 West Indian climate in consumption ; but he does 
 not define the periods of the disease in which he 
 finds it most useful. He sends patients chiefly to 
 Cuba ; there to remain till the end of April ; then to 
 change to Georgia, or South Carolina, and to return 
 to Boston very slowly, so as not to reach New Eng- 
 land till the end of June. 
 
 Much will depend upon the nature of the constitu- 
 tion — whether it is such as is calculated to bear a 
 tropical climate well, or likely to sink under the 
 irritating and exhausting effects of heat. When the 
 morbid condition of the system, which gives reason 
 to fear the approach of phthisis, depends chiefly upon 
 hereditary predisposition, and occurs in early life, 
 especially in feeble irritable constitutions, the climate 
 of the West Indies will rarely agree. At a more 
 advanced period of life, and in constitutions free 
 from much disorder of the nervous system and of the 
 digestive organs, the climate may prove useful. The 
 revolution effected in the distribution of the circula- 
 ting fluids and in the secretions may have the effect of 
 enabling a constitution, in which there exists consider- 
 able power, to overcome the tuberculous diathesis. 
 
 Independently of the nature of the patient's con- 
 stitution, other circumstances will deserve consider- 
 ation ; for instance, whether the invalid can command 
 the accommodations and comforts necessary upon a 
 
WEST INDIES. 323 
 
 voyage, and during liis residence in the West 
 Indies ; whether he may have the power of selecting 
 a proper situation, and of quitting the country on the 
 approach of the summer heat, &c.* 
 
 It follows from what has been stated, that the cases 
 of Pulmonary Consumption in which the climate of 
 the West Indies promises advantage are very few, 
 and their character scarcely ascertained, while those 
 in which it produces mischief are numerous and 
 generally well marked. Of persons predisposed to 
 the disease, a certain proportion are likely to be 
 benefited by the climate ; but the nature of the 
 constitution should be well considered before it is 
 recommended even as a prophylactic. 
 
 The affections of the chest most likely to derive 
 benefit from a residence in the West Indies are 
 chronic diseases of the bronchial membrane, occur- 
 ring in persons otherwise of a tolerably sound con- 
 
 * The regular communication now established between this 
 country and the West Indies, by means of the mail steam-packets, 
 affords an excellent opportunity of sending invalids whose cases 
 are likely to be benefited by a winter in a tropical climate, to 
 these islands ; and if these vessels were properly ventilated, the 
 voyage, in place of proving injurious to invalids, as it often does, 
 would be an efficient means of improving the health. The 
 Peninsular and Oriental Steam Navigation Company, by adopting 
 a proper system of ventilation in their vessels, are setting an 
 example that ought to be followed in all steam-vessels conveying 
 passengers. The present state of the sleeping-places in all steam 
 vessels is most injurious to the health of passengers. 
 
324 WEST INDIES. 
 
 stitution. "Persons," says Dr. M^Arthur, "labour- 
 ing under chronic cough, about the middle period of 
 life, and whose health is otherwise good, derive much 
 benefit from the climate." In asthma, however, the 
 same gentleman has generally observed the climate 
 injurious. In both these statements. Dr. Melville's 
 experience leads him to coincide. Dr. Arnold, how- 
 ever, did not find it so in Jamaica, where he has seen 
 many cases of this disease benefited by the climate. 
 I have not myself had sufficient experience to enable 
 me to form an opinion on the subject; but I can have 
 no doubt that the cases in which the climate will 
 prove most useful, are those in which the disease 
 is chiefly confined to the bronchial membrane, the 
 digestive organs being in a sound state. 
 
 In stomach complaints the West Indies are very 
 generally unfavourable. The extreme activity of the 
 cutaneous circulation, excited and kept up by the 
 great heat of the atmosphere, although it may di- 
 minish internal congestion, induces, I am inclined 
 to think, after a time, an irritable condition of the 
 mucous membrane of the stomach and bowels, com- 
 bined with a state of relaxation, which greatly pre- 
 disposes to dyspepsia, dysentery, and other disorders 
 of the adominal viscera, and to gastric fevers : — 
 diseases which make up almost the sum of mortality 
 among Europeans in the West Indies. At the same 
 time I do not mean to deny that in certain cases of 
 dyspepsia of long standing, a residence in this 
 
WEST INDIES. 325 
 
 elimate may prove beneficial ; just as we find other 
 great changes, of various and even opposite kinds, in 
 the condition of the individual, effect a cure in this 
 and other diseases, of which, in our limited know- 
 ledge of the animal economy, we are unable to 
 render a satisfactory explanation. 
 
 Chronic Rheumatism. — The marked benefit de- 
 rived in this disease from a mild climate, probably 
 led to the belief that the West India and other 
 tropical climates would prove still more beneficial. 
 Experience, however, has not justified the expecta- 
 tion. While some cases of the disease are benefited 
 by the climate of the West Indies, others are, on the 
 contrary, aggravated by it. When the rheumatic 
 aflPection is symptomatic of, or accompanied with an 
 irritable state of the digestive organs, or a feeble 
 relaxed state of the system, the climate will disagree. 
 " Chronic rheumatism," says Dr. M'Arthur, " when 
 the general health is unimpaired, is much relieved, 
 but when the health is deteriorated, the powers of 
 the digestive organs much weakened, or the disease 
 attended with profuse perspirations, nothing but a 
 return to a cooler climate can save the patient." 
 In my own opinion, the climate is too hot for the 
 generality of rheumatic patients. Our soldiers and 
 sailors are frequently invalided from the West Indies 
 on account of rheumatism. Dr. Grainger says that 
 this disease, in the chronic form, is more prevalent 
 
326 WEST INDIES. 
 
 there than in this country, especially sciatica ; and 
 Dr. Wright adds, that acute rheumatism is frequent in 
 the West Indies.* Hereditary gout, Dr. Musgrave 
 says, is often as severe in the West Indies as in 
 England. On the other hand. Dr. Arnold states that 
 gout and rheumatism, according to his experience, 
 are of rare occurrence in Jamaica, and he has 
 known many cases of these diseases benefited by 
 a temporary residence in the West Indies ; but in 
 Jamaica, it is to be remarked, rheumatic affections 
 are much less prevalent among our troops than in 
 the AVindward and Leeward Command, or in Great 
 Britain, t 
 
 Calculous disorders are rare in the West Indies. 
 Dr. Musgrave has met with stone in the bladder 
 once only, but he has seen several cases in which 
 renal calculi, after the usual symptoms, were passed 
 by the urethra. Dr. Arnold, during an extensive 
 practice in Jamaica of twenty years, met with two cases 
 only of calculus. Diseases of the heart and large 
 vessels are also rare, and the osseous deposits, which 
 are so generally found in the coats of the larger 
 arteries in persons who die at an advanced age in 
 cold climates, are said to be rarely met with in those 
 who die at a similar age in the West Indies. 
 
 The climate generally proves serviceable in scro- 
 
 * * Essay on the more Common West India Diseases,' by James 
 Grainger, M.D. 
 t Army Reports. 
 
"NVEST INDIES. 827 
 
 fula, which is a rare disease in the West Indies. Dr. 
 Ferguson, in particular, speaks in strong terms of 
 the beneficial ejffects he has observed the climate 
 produce in scrofulous diseases ; Dr. Melville coin- 
 cides in this; but Dr. Arnold limits the utility of 
 the climate to incipient states only. 
 
 In the higher districts of the interior of Jamaica 
 the children are uncommonly fine ; and the children 
 of Europeans and Creoles continue to thrive well 
 till they attain the age of eight or nine years, after 
 which they generally begin to droop. At this age, 
 therefore, children should be sent to a more tem- 
 perate climate. Dr. Arnold remarks that measles, 
 scarlatina, and other diseases of childhood, are gene- 
 rally mild. 
 
 To persons of weak irritable constitutions, or with 
 irritable bowels, deranged digestive organs generally, 
 an irritable skin, or subject to cutaneous eruptions 
 of an irritable character, or too copious perspirations, 
 the West Indies will prove injurious. Persons sub- 
 ject to severe headaches, or who have any here- 
 ditary disposition to cerebral disease, or to insanity, 
 and fair plethoric people generally, should also avoid 
 the tropics. 
 
 Having given an account of the climate of the 
 West Indies in general, I shall now notice the islands 
 which are considered the most healthy, and where 
 invalids may obtain all the advantages which the 
 
328 WEST INDIES. 
 
 climate affords. These are Jamaica, Barbadoes, St. 
 Vincent's, Antigua, and St. Kitt's. 
 
 In many other islands there are perhaps to be 
 found situations equal in point of salubrity to any of 
 these ; and there are among the small islands more 
 than one entirely free from all endemic sources of 
 disease.* Yet the islands just named possess advan- 
 tages which, upon the whole, render them preferable 
 to the others as the resort of invalids. Of these, St. 
 Vincent's and St. Kitt's are mountainous; Barbadoes 
 and Antigua are considered low islands. As St. Vin- 
 cent's lies in the vicinity of Barbadoes and Antigua, 
 near St. Kitt's, the invalid may without much incon- 
 venience or difficulty change his residence, and in 
 some degree his climate, by passing from one island 
 to the other. This, as we shall have occasion to show, 
 is a matter of considerable importance. 
 
 Jamaica. — On account of the size of the island, 
 and the height of its central ridge of mountains,t the 
 climate of Jamaica differs in some respects from that 
 of the other islands. It has a greater range of tem- 
 perature, and therefore a greater variety of climate. 
 
 * Of this kind is one of the small islands called the SainteSj 
 situated between Guadaloupe and Dominica, which possesses an 
 excellent harbour. But there are here no accommodations for 
 invalids. 
 
 t The altitude of the highest of the three peaks of the Blue 
 Mountains is 8500 feet above the level of the sea. 
 
WEST INDIES. 329 
 
 There is a considerable difference bet\Yeen the lower 
 and higher parts, and between the north and south 
 sides of the island. It has also the advantage of a 
 sea and land breeze, which the smaller islands have 
 not. Dews are abundant. More rain falls on the 
 north than on the south side of the island. On an 
 average of five years it rained 116 days ; the fall is 
 fifty inches. The difference of temperature between 
 the north and south sides of the island amounts to 
 5° during the whole year, and in the first three 
 months of the year to from 8° to 1 0°. 
 
 In the mountainous districts of St. Andrew and 
 Port Royal, there are residences and settlements 
 three or four thousand feet above the level of the 
 sea, where the air is temperate and salubrious all the 
 year round, but more particularly from the month 
 of January to the end of May. Probably the most 
 healthy district is the mountainous part of the parish 
 of St. Ann, which is nearly in the centre of the 
 island. 
 
 The mean temperature of the year at this place is 
 76°. It is generally speaking a dry district; there 
 are no morasses or jungle, and the carriage roads are 
 excellent. 
 
 Convalescents from other parts of the island often 
 derive considerable benefit from a residence of a few 
 weeks only in this region. It is also a safe temporary 
 retreat for consumptive as well as other invalids. 
 
 Lucia also has a high reputation for salubrity 
 
330 WEST INDIES. 
 
 among the inliabitants, and is often resorted to by con- 
 valescents; the climate is cool and pleasant except du- 
 ring the months of July, August, and September. 
 
 Barbadoes, — although classed among the low is- 
 lands, is low by comparison only, much of the island 
 being hilly, and some parts even mountainous. The 
 highest point is 1100 feet above the level of the sea ; 
 a large portion is 600 feet, and many dwellings are 
 as high as 800 and even 1000 feet. These higher 
 parts are among the best cultivated and healthiest 
 portions of the island.* 
 
 There is some marshy ground in Barbadoes. The 
 climate is considered dry, but the winter as well as 
 the autumn is rainy. The winds during November 
 and December, as well as during the preceding months, 
 are irregular; although the east is the prevailing 
 wind throughout. Bridgetown, the capital, although 
 less unhealthy than most of the sea-ports in these 
 
 * Dr. Davy, in the communication referred to, observes : ** Since 
 I have been here, now five months, since 7th July, an unusually 
 hot season, there has always been much moisture in the air : 
 10° is the greatest difference I have seen between the dry and 
 moistened bulbs of the thermometer ; often there is not more 
 than 4^ or 5°. I have noticed dew very frequently." — Mr. Law- 
 son's observations accord with those of Dr. Davy. From the 11th 
 of May 1841 to 31st January 1842 we found the mean temperature 
 79°-212, the mean dew point 70°-96 : the smallest difference ob- 
 served between the temperature and dew point was about 5°; the 
 greatest difference about 13°. — {Edin. New Phil. Journal, 1843.) 
 
WEST INDIES. 331 
 
 islands, should be avoided as a residence by the in- 
 valid. The vicinity of Bridgetown may be consi- 
 dered healthy, and the suburbs abound in pretty 
 garden villas. But the most desirable situations for 
 invalids are the higher grounds, from 600 to 1000 
 feet high, bordering on the district called Scotland.* 
 These higher positions have the advantage of being 
 open to the constant influence of the trade winds, and 
 are cooler than the lowest parts of the island, with- 
 out being subject to the great and sudden alternations 
 of temperature which are experienced in the more 
 elevated situations of the mountainous islands. This 
 district is also remarkably healthy. So high an opi- 
 nion did the late Dr. Ferguson form of its salubrity, 
 that after a careful topographical survey of the whole 
 Caribbean Archipelago, with which he was occupied 
 three years, he recommended it officially to Govern- 
 ment as the best situation for establishing a general 
 convalescent depot for the debilitated invalid troops 
 of all the other islands instead of sending them to 
 Europe, as was the usual custom. 
 
 Notwithstanding the uniformity of temperature 
 
 * "A friend's house that I visit there," says Dr. Davy, *'at 
 an elevation of about 900 feet, has an in-door temperature, all the 
 year, varying from 80° to 70°, where a fire is never required, 
 where there are few insects, and where one can be in the open 
 air and take carriage exercise at all hours, and exercise on horse- 
 back at most. The interior of Barbadoes, I am told, never has 
 been visited by the yellow fever." 
 
332 WEST INDIES. 
 
 which prevails among these islands, the effect of a 
 change from one to another is often very remarkable 
 in improving the health. This has been observed 
 frequently, on a large scale, among our troops sta- 
 tioned in the West Indies; and indeed I believe 
 one of the most powerful means of diminishing the 
 sickness among our troops in that climate would be 
 to remove them frequently from one healthy island 
 to another ; or, still better, send them to sea for a 
 few weeks. 
 
 St. Vincent's lies directly to the westward of 
 Barbadoes, from which it is distant only a few hours' 
 sail. Its capital, Kingston, is almost peculiar. Dr. 
 Ferguson remarks, in being built on a healthy site 
 on the shores of a fine bay. A cool situation may be 
 found by ascending the mountains which compose 
 the greater bulk of this beautiful and romantic island. 
 But here the difficulty of finding accommodations 
 will be still greater than in the higher parts of Bar- 
 badoes. 
 
 Antigua, although one of the low islands, is in 
 many parts considerably more elevated than Barba- 
 does. There are some unhealthy spots in this island, 
 but the greater part of it is healthy ; and many posi • 
 tions on its rounded hills favourable to health may be 
 found. The fall of rain is forty five inches. Dry- 
 ness of atmosphere characterizes the climate both of 
 
WEST INDIES. 333 
 
 Barbadoes and Antigua. Antigua bears the same 
 relation, in point of elevation, to St. Kitt*s that Bar- 
 badoes does to St. Vincent's. The climate of Anti- 
 gua, according to the Army Reports, may be consi- 
 dered as more favourable both to white and black 
 troops than most of the others in the Command. 
 
 St. Kitt's (or St. Christopher's) is one of the most 
 beautiful islands in the West Indies, and among my 
 medical friends who have visited the Caribbean 
 Islands I think the greater number give this island 
 the preference, as regards the salubrity of its climate, 
 over all the others, certainly over all the high islands. 
 The greater part of St. Kitt's is healthy ; and from 
 its mountainous character, it aifords the invalid an 
 opportunity of seeking a cooler climate : but here, 
 unfortunately, the means of accommodation are 
 greatly limited ; and we speak rather of what this 
 island might afford, than what it really possesses. 
 St. Kitt's has also the advantage of excellent roads. 
 Considering all things, St. Kitt*s, as a high, and 
 Barbadoes as a low island, appear to deserve the 
 preference over all the other islands. But a more 
 advantageous and better plan for the invalid, than 
 residing in any one island, would be to cruize among 
 or make short visits to the different islands. St. 
 Kitt's, from its situation among a group of islands, is 
 well situated for the head-quarters of an invalid 
 having such a plan in view. 
 
334 WEST INDIES. 
 
 The little island of Nevis, in the immediate vici- 
 nity of St. Kitt's, and similar to it in its physical 
 characters, deserves perhaps to be mentioned. It is 
 considered very healthy. 
 
 By referring to what has been stated respecting 
 the seasons in the West Indies, the proper time for 
 the residence of the invalid in that country will be 
 found to be from the beginning of December to the 
 end of April. This period is alone suited to invalids 
 who visit the "West Indies for the recovery of their 
 health. It is the coolest and most healthy part of the 
 year, — the epithet healthy being applied to it, in 
 contradistinction to the autumn, which is termed 
 the UNHEALTHY season, from being the time during 
 which the endemic diseases, which are the scourge of 
 the West Indies, prevail with the greatest force. 
 By leaving England in the end of October, or be- 
 ginning of November, the invalid would reach the 
 West Indies at the proper season ; and he should 
 contrive, if possible, not to return to this country 
 until the end of June. 
 
 Before concluding the subject of the West Indies, 
 it may be well to add a few remarks on the manage- 
 ment of the invalid during his voyage to, and resi- 
 dence in these islands, as this is a subject on which 
 he is likely to receive very contradictory, and often 
 very erroneous counsel. 
 
WEST INDIES. 335 
 
 On approaching the tropics, when about the 25th 
 or 24th degree of latitude, where the temperature 
 ranges from 70'' to 80°, a degree of general excite- 
 ment is very often experienced, and a disposition to 
 catarrhal affections, which demand particular atten- 
 tion on the part of the invalid labouring under any 
 chronic pulmonary disease. 
 
 The proper means to prevent any injurious effects 
 from the increase of temperature, is to live somewhat 
 more abstemiously than usual, and upon less ex- 
 citing food. The quantity of wine generally drunk 
 should be diminished, or it may be advisable to 
 abstain from wine altogether. Long exposure to 
 the direct rays of the sun should also be avoided. 
 Attention to these rules, with the occasional use of a 
 little cooling laxative medicine, will generally be 
 all that is necessary on arriving in the West Indies. 
 For some time afterwards a continuance of the same 
 simple unexciting regimen should be persevered in, 
 in order that the system may become habituated to 
 the exciting influence of a high temperature, and 
 until the increased cutaneous secretion, which ap- 
 pears to be one of the principal means employed by 
 nature to enable the living body to bear the heat of 
 a tropical climate without injury, is fully established. 
 Whether approaching or residing in the West Indies, 
 this, says Dr. Arnold, is the grand secret for the 
 preservation of health, and to the neglect of it, and 
 the adoption of an opposite mode of living, are to 
 
336 WEST INDIES. 
 
 be attributed in a great degree the sickness and mor- 
 tality among the European residents in these islands, 
 and indeed in all tropical climates. Exercise in the 
 middle of the day, and exposure to currents of air 
 while in a state of perspiration, should be carefully 
 avoided. From these two causes, and an over- 
 exciting diet, are produced a great proportion of the 
 diseases which prove so fatal to Europeans in the 
 West Indies. "With respect to clothing, it is now 
 universally admitted, I believe, by those who have 
 resided in a tropical climate, that flannel next the 
 skin is the safest and best covering. Although the 
 general temperature of the winter is very high, yet 
 dry cool winds frequently occur, and give rise to 
 catarrhal and other inflammatory affections of the 
 lungs. In March and April, when the greatest 
 difference exists between the temperature of the day 
 and that of the night, Dr. Hunter found catarrhs fre- 
 quent in Jamaica. Dr. Chisholm states, that in those 
 parts of the islands especially which are exposed to 
 the sharp northerly winds of the spring, called norths, 
 the inhabitants are annually afflicted at that season 
 with pulmonary and hepatic inflammation. He adds 
 further, that it is a grievous error to believe that 
 catarrhal complaints are rare in the torrid zone ; and 
 in addition to his own experience he cites that of 
 M. Desportes, an intelligent French physician, who 
 practised many years in the island of St. Domingo, 
 who observes that "les habitans des pays chauds 
 
WEST INDIES. 337 
 
 sont encore plus sujets aux catarrhes que ceux des 
 temperes." A medical friend^ who long enjoyed an 
 extensive practice in Barbadoes, and to whom I am 
 indebted for some useful information on the subject 
 of this article, informs me, that epidemic catarrhs are 
 frequent in that island, and often prove fatal to the 
 black inhabitants ; and Hillary also describes ca- 
 tarrhal fevers as of frequent occurrence in Barbadoes 
 in his time, and often epidemic, spreading over the 
 whole island, and sparing neither whites nor blacks. 
 
 It must not be believed from this that Barbadoes 
 is more subject to catarrhal affections than the other 
 islands ; they have only been better described. Dr. 
 Grainger, who practised in St. Kitt's, observes, that 
 coughs are common in the West Indies from the 
 latter end of October to the latter end of February.* 
 Dr. Arnold, in his work, has also remarked the oc- 
 currence of bronchial affections in Jamaica, but 
 describes them as mild compared to the same diseases 
 in England, and as being curable by mild treatment. f 
 Dr. Musgrave agrees in this, and says that epidemic 
 influenza sometimes prevails in Antigua, but is a mild 
 disease, easily yielding to the simplest remedies. 
 
 There is one circumstance in the character of some 
 tropical diseases, which Europeans visiting these 
 
 ♦ Op. citat. 
 
 t * A Practical Treatise on the Bilious Remittent Fever,' &c. 
 To which is added, * Medical Topography of the Different Mili- 
 tary Stations in Jamaica.' London, 1840. 
 
 Q 
 
338 WEST INDIES. 
 
 colonies should be fully impressed with, and that is, 
 their violence and very rapid progress. This is more 
 especially the case with fevers and inflammations; 
 in which the remedies require to be applied early, 
 and with an energy proportioned to the violence of 
 the disease. On this account it is advisable to call in 
 medical advice the moment disease makes its attack. 
 From what has been said, it is manifest that he 
 who visits the "West Indies, more especially with a 
 view to the restoration of his health, should con- 
 duct himself with great circumspection.* Nor must 
 his care cease with leaving these islands. On return- 
 ing to England he has to guard against the effects 
 of the change of climate, and ought to provide for 
 it by suitable clothing. In this respect he should 
 anticipate the change of climate, and avoid exposing 
 himself long on deck to damp cold winds. The 
 complaints most likely to attack persons returning 
 from a hot to a cold or temperate climate are diar- 
 rhoea, catarrh, and rheumatism, or a relapse of any 
 disease to which the person had been subject. All 
 these may be prevented by warm clothing, attention 
 to diet, and avoiding unnecessary exposure in cold 
 and damp weather. 
 
 ♦ For more detailed information respecting tropical diseases 
 and hygiene, the reader is referred to a work entitled, ' The In- 
 fluence of Tropical Climates on European Constitutions,' by James 
 Johnson, M.D., and James Ranald Martin, Esq. Sixth Edition : 
 London, 1841. 
 
APPENDIX. 
 
 Q 2 
 
APPENDIX. 
 
 SOUTHERN HEMISPHERE. 
 
 I HAVE limited my observations in the foregoing 
 pages to the climates of the Northern Hemisphere ; 
 but the Southern Hemisphere also affords climates in 
 every way congenial to the European constitution, 
 and calculated to exert on the health a beneficial in- 
 fluence equal to that of the best northern climates. 
 The Cape of Good Hope, Australia, and New Zealand, 
 among the British possessions, present themselves for 
 choice to those whose inclination or circumstances 
 lead them to seek a permanent settlement in the cli- 
 mate which is most likely to suit their constitution. 
 
 Although we have not any very extensive data by 
 which to estimate the precise characters of the climates 
 of these southern regions, we have the experience of 
 a considerable period, during which, with the excep- 
 tion of New Zealand, the countries above named 
 have been inhabited by the English ; and even re- 
 specting New Zealand we possess information which 
 enables us to form a tolerably accurate opinion of the 
 climate, and its influence on the health of natives of 
 
342 
 
 SOUTHEflX HEMISPHERE. 
 
 this country, and to compare it with the other places 
 referred to in the Southern Ocean. 
 
 From the situation South of the Equator of the 
 countries under consideration, their seasons are the 
 reverse of ours. Thus September, October, and No- 
 yember constitute the Spring months ; December, 
 January, and February, Summer ; March, April, and 
 May, Autumn ; and June, July, and August, Win- 
 ter. 
 
 CAPE OF GOOD HOPE. 
 
 For the few remarks to be made on the climate of 
 the Cape I am indebted chiefly to the Army Returns, 
 so often referred to. 
 
 Table or Tempekature for Cape Town, showing the average 
 of seven years (1827—33). 
 
 
 Max. 
 
 Min. 
 
 Med. 
 
 
 Max. 
 
 Min. 
 
 Med. 
 
 January- 
 February 
 March 
 April . 
 May . 
 June . 
 July . . 
 August 
 Septembei 
 
 
 
 o 
 
 86 
 841 
 82 
 78 
 73 
 67i 
 65^ 
 67 
 68 
 
 70 
 
 61 
 57 
 56 
 56 
 57 
 
 o 
 
 78 
 76^ 
 75 
 71 
 66^ 
 61 
 59i 
 61 
 62^ 
 
 October . . 
 November . 
 December . 
 
 Spring . . 
 
 Summer . . 
 1 Autumn . . 
 1 Winter . . 
 
 Year . . . 
 
 77 
 80 
 
 o 
 
 60 
 63 
 69 
 
 70 
 74 
 
 63 
 
 74 
 
 68J 
 
 The character of the climate is that of dryness ; 
 but the scarcity of rain and moisture, which renders 
 a great part of the interior in certain seasons a barren 
 desert, is experienced in a much less degree in the 
 
CAPE OF GOOD HOPE. 343 
 
 Cape district. The number of days on which rain 
 fell on an average of a series of years was 75, and the 
 quantity which fell averaged 41 inches, annually. 
 
 The most common winds at Cape Town are from 
 the South-east and North-west. The former is the 
 prevailing wind of the summer season, and from its 
 blowing over the sandy flats between the town and 
 Simon's Bay, is usually sultry, relaxing, and debili- 
 tating ; the latter, the prevailing wind of the winter 
 months, being a sea-breeze, is cold, chilly, and often 
 accompanied by heavy falls of rain and violent gales. 
 
 South-westerly winds prevail during spring and au- 
 tumn, and from passing over the wide expanse of the 
 Southern Ocean are generally surcharged with mois- 
 ture, which wraps the summits of the mountains over 
 Cape Town in dense fogs. As the upper stratum of 
 the air becomes cooled, the fogs rapidly descend in 
 tempestuous blasts, causing an immediate reduction 
 of temperature, with an equally sudden transition 
 from an extremely dry to a damp raw state of atmo- 
 sphere. These South-west winds are also often accom- 
 panied with rain, which, however, is never so heavy 
 as that brought by the North-west or winter wind, 
 being only what is commonly known by the name of 
 a " Scotch mist." 
 
 From the Army Medical Reports it appears that 
 the climate of the Cape district is at least as favour- 
 able to the health as that of Britain. The troops are 
 less subject to diseases of the lungs at Cape Town 
 
344 SOUTHERN HEMISPHEEE. 
 
 than in our other colonies; and there is a smaller 
 proportion of deaths from Consumption than has been 
 observed on any foreign station, except the East 
 Indies. Rheumatism, which is more frequent among 
 the civil inhabitants even than among the troops, 
 prevails among the latter to a greater extent than at 
 home, or in the other colonies. Fevers of the inter- 
 mittent and remittent type are extremely rare among 
 the troops, and unknown among the inhabitants.* 
 
 The Eastern Province, including the new settle- 
 ment of Albany, although subject to sudden variations 
 of temperature, is in an eminent degree favourable to 
 the European constitution. From the Army Reports, 
 as well as from what is known in regard to the mor- 
 tality among the civil population, there can be no 
 doubt that this portion of the colony is more favour- 
 able to health than the United Kingdom. The low 
 ratio of sickness and mortality among the troops has 
 been mainly attributable to the extreme rarity of 
 diseases of the lungs. Pneumonia and Consumption 
 
 * In regard to the frequency of Rheumatism at the Cape, Dr. 
 Smith, Deputy Inspector of Army Hospitals, who resided long 
 in that colony, attributes it to the injudicious practice which pre- 
 vails among persons of all classes of seeking comfort in currents 
 of cold air while in a state of perspiration, and often while much 
 of their clothing is thrown off. It is to be remarked, that in 
 New South Wales, which is similar to the Cape in point of 
 climate, rheumatism is also prevalent. 
 
CAPE OF GOOD HOPE. 
 
 345 
 
 in particular are still less frequent than at Cape 
 Town. Fevers also are even more rare and less fatal, 
 but Rheumatic diseases are exceedingly common. 
 
 The places chiefly resorted to by invalids from India 
 and England at the Cape of Good Hope are Ronde- 
 BoscH about five and Wynberg about eight miles 
 from Cape Town. 
 
 These places are much cooler than Cape Town, 
 owing chiefly to their being open to the south-east 
 wind, which blows nearly the whole summer. There 
 are also shady walks and rides, but the roads are 
 very dusty. At both places many comfortable com- 
 modious houses may be hired, and there are three 
 public boarding-houses. There is also a church at 
 each place, and good English society. 
 
 The following will give an idea of the climate to be 
 obtained during the summer months. The observa- 
 tions were taken in a sitting-room at Rondebosch, 
 not much exposed to the sun, the door and windows 
 being generally open, by the late Rev. Mr. Ash, who 
 went to the Cape for the benefit of his health. 
 
 Aver. Range 
 of 24 hours. 
 
 Aver. Tem. 
 at 2 o'clock. 
 
 Extremes. 
 Min. Max 
 
 Rain 
 
 fell on 
 
 From Dec. 
 Dec. 31st 
 
 January . 
 
 February 
 
 March 
 
 17th to] 
 
 6.5^ to 69 
 
 67^ to 70| 
 67f to 7 If 
 65f to 69| 
 
 69i 
 69f 
 671^0 
 
 61 
 
 65 
 65 
 61 
 
 76 
 78i 
 
 74 
 
 2 days. 
 
 7 days. 
 7 days. 
 7 days. 
 
 q3 
 
346 SOUTHEKN HEMISPHEEE. 
 
 AUSTRALIA. 
 
 In a tract of country of such extent as Australia, 
 various climates must necessarily be found. The 
 settled districts extending from the 30th to the 43rd 
 degree of South latitude, possess generally a climate 
 which, though it may be characterised as temperate, 
 and such as is congenial to the European constitution, 
 presents several peculiarities. 
 
 New South Wales. — We are better acquainted 
 with the climate of New South Wales, perhaps, than 
 that of any other part of Australia. The peculiarity 
 of the climate is its liability to occasional great 
 droughts, and the prevalence of dry sultry winds. 
 '^ The most singular phenomenon," says Dr. Lang, 
 '' in the meteorology of New South Wales is the occa- 
 sional prevalence of hot winds from the north-west- 
 ward. These winds occur on an average four times 
 every summer, and blow from twenty-four to thirty- 
 six hours each time, the atmosphere all the while 
 feeling like a current of heated air from a furnace, 
 and the thermometer generally standing at from 90° 
 to 100° of Fahrenheit. It has even stood as high, 
 on one occasion within my own experience, as 11 2^°, 
 This hot wind is usually succeeded suddenly by a 
 wind from the south, which causes the mercury in the 
 thermometer to descend with great velocity."* 
 
 * * Historical and Statistical Account of New South Wales.' 
 London, 1837. 
 
AUSTRALIA. 
 
 347 
 
 The following Tables for Sidney afford a pretty- 
 good idea of the climate. 
 
 Mean Tbmpeeature for the Months, Seasons, and whole 
 Year, at Port Jackson.* 
 
 September . . . . 59 •341 
 
 October 63-51 (• Spring 
 
 November 67*73^ 
 
 December . . . . 69 -201 
 
 January 71*67?^ Summer 
 
 February 71*6P 
 
 March 69-64] 
 
 April 64*05 > Autumn 
 
 May 59-68' 
 
 June . 
 July . 
 August 
 
 -911 
 •86> 
 •3lJ 
 
 Winter 
 
 63-45 
 
 70-93 
 
 64-03 
 
 54-62 
 
 Year. 
 62-89 
 
 Mean Quantitt of Rain which fell at Port Jackson from 
 1841 to 1843 (inclusive). 
 
 September 
 
 October 
 
 November 
 
 Inches. 
 
 December 3-671 
 
 January 4-34> Summer 
 
 February . • . . 
 
 March 
 April 
 
 June 
 July 
 August 
 
 2-97 
 
 2-40> 
 
 1-74] 
 
 3-67] 
 4-34> 
 7- 94 J 
 
 4-081 
 l3'71> 
 6 -30 J 
 
 1»671 
 7-29> Wi 
 6-OlJ 
 
 Spring 
 
 Autumn 
 
 Winter 
 
 Inches. 
 . 7-11 
 
 15»95 
 
 24-09 
 
 14-97 
 
 Year. 
 
 Inches. 
 62-12 
 
 * The results of nearly five years' observations (from April 1840 
 to Dec. 1844), taken daily at 8^ a.m., 2i p.m., sunset, and 9 p.m. 
 
348 
 
 SOUTHERN HEMISPHERE. 
 
 Mean Number of Rainy Days at Port Jackson, from 
 1841 to 1843 inclusive.* 
 
 
 1841-43. 
 
 1841-43. 
 
 1841-44. 
 
 September . . 
 
 . . in 
 
 
 
 October . . 
 
 . . 10 > Spring . 
 
 . . 33 ' 
 
 
 November . . 
 
 . . loj 
 
 
 
 December . . 
 
 . . 121 
 
 
 
 January . . 
 
 . . 14 > Summer 
 
 . . 43 
 
 Year. 
 
 February • . 
 
 . . 12J 
 
 
 . 151 
 
 March . . . 
 
 . . 17] 
 
 
 
 April . . . 
 
 . • 1 1 > Autumn 
 
 . . 41 
 
 
 May ... 
 
 . . 12/ 
 
 
 
 June . . . 
 
 . . Ill 
 
 
 
 July . . . 
 
 . . 12 > Winter . 
 
 . . 35 
 
 
 August . . 
 
 . .12/ 
 
 
 
 In winter the cold is but little felt in the lower 
 parts of the colony bordering on the sea ; but in the 
 interior, the frosts during night are often strong 
 enough to leave upon the shallow pools ice of the 
 thickness of a shilling. 
 
 South Australia. — The climate of South Aus- 
 tralia is described as pleasant, except during the sum- 
 mer months, when the heat is disagreeably great. It 
 
 ♦ There is a great difference in the quantity of rain which falls 
 at Sidney during different years. This arises from the very heavy 
 falls — deluges they may with some justice be called — which occa- 
 sionally take place. One such fall occurred during the three 
 years' observations from which the tables are taken — namely, on 
 April 29th, 1841, when 20*12 inches fell in twenty-four hours. 
 
AUSTRALIA. 349 
 
 is also liable to great vicissitudes of temperature. 
 *' The only objection I have to the climate," says Mr. 
 James, " is the extreme changes of temperature^ ge- 
 nerally three times a day, increasing greatly the diffi- 
 culty of escaping colds. At present, for example, 
 the thermometer in the morning may be about 66^* ; 
 96° or 98° at mid-day ; and 66% or even lower, again 
 by night." 
 
 From the general dryness of the air, however, the 
 heat is much less oppressive than might be expected 
 from the height of the thermometer. 
 
 Swan River. — The climate of Western Australia 
 is much the same as that of New South Wales, only 
 more moist, and not so liable to droughts. 
 
 The climate of Australia is, according to all ac- 
 counts, remarkably healthy. Europeans enervated 
 by a residence in India become very much invigo- 
 rated and improved in health by a short stay in this 
 country. 
 
 Dysentery is the most prevalent and most fatal 
 disease to which the colonists are subject. Few new 
 comers, it is stated, escape an attack ; and of the con- 
 victs who die in the civil hospitals, it is the cause of 
 death in one half. 
 
 By a statistical report of the cases treated in the 
 civil hospital at Sydney, in the year 1835, it appears 
 that the most prevalent diseases were dysentery. 
 
350 SOUTHERN HEMISPHERE. 
 
 rheumatism^ ophthalmia, and catarrh ; the number of 
 cases of these four diseases being together 1937, out 
 of a total number of 2654. 
 
 Catarrh prevails as an epidemic from time to time. 
 
 Owing to some deficiency in the returns, the Mili- 
 tary Statistical Report on the Diseases of Australia 
 has not yet been completed ; but in the Introduction 
 to the volume last presented to Parliament we find it 
 stated that " the extreme salubrity of the climate may 
 be estimated from the circumstance that on the ave- 
 rage of twenty years, from 1817 to 1836 inclusive, the 
 mortality did not exceed fourteen per thousand of the 
 force annually, whereof more than a fifth part arose 
 from violent or accidental deaths, principally attri- 
 butable to the nature of the duties on which the 
 Troops were employed. Thus the mortality from 
 disease alone could have amounted to little more than 
 one per cent, annually, being lower than in any other 
 Colony, except the Eastern Provinces of the Cape of 
 Good Hope, to which the climate of AustraHa is in 
 many respects similar." 
 
 Van Diemen's Land. — The climate of Van Die- 
 men's Land diflfers considerably from that of the Aus- 
 tralian Continent. It is more changeable but cooler 
 and less subject to droughts than the latter. 
 
 The following is the result of Sir Thomas Bris- 
 bane's thermometrical observations made at Hobart 
 Town during the year 1822 : — 
 
VAN DIEMEN'S LAND. 
 
 351 
 
 September .... 47*12^ o 
 October .... 53*96VSpring . . 52 '88 
 November . . . . 57*56) 
 
 
 December . . . • 62*96) 
 
 January .... 62*96 ["Summer . . 62*96 
 
 February . . . . 63' 14^ 
 
 March 55 •40) 
 
 April 53'60fAutmnn . . 51*44 
 
 May 45»68^ 
 
 Year. 
 ^52*34 
 
 June 41»00) 
 
 July 40'10>Winter . , 42*26 
 
 August 45*50' 
 
 
 " The climate," as described by Mr. Scott, "is very- 
 
 peculiar, presenting phenomena as if the different 
 
 seasons were blended together. There are more 
 frequent and sudden changes of the atmosphere than 
 in many other climates; but these seem to operate 
 by reducing the susceptibility to disease, instead of 
 increasing it, as the alternations from heat to cold, 
 from clear weather to foul, and vice versa, are not 
 succeeded by the same baneful consequences to the 
 human body as in other countries, nor are they fol- 
 lowed by epidemic or contagious diseases. Epide- 
 mics, indeed, can as yet scarcely be said to have 
 appeared, except on two occasions : the first of these 
 was an epidemic influenza, attended by great deter- 
 mination to the head and congestion, with prostration 
 of strength, which carried off many persons infirm 
 from age; the second was an epidemic continued 
 fever, accompanied with a more than usual deficiency 
 
352 SOUTHERN HEMISPHERE. 
 
 of nervous energy and serious local determinations to 
 the peritoneum, intestines, and membranes of the 
 brain.*'* 
 
 Mr. Scott remarks, that for phthisical patients the 
 climate is too variable ; and when that disease is fully 
 formed it assumes an acute character, and the sufferer 
 sinks rapidly. 
 
 In the work just referred to, a summary of the 
 diseases treated in the Colonial Hospital at Hobart 
 Town, for a period of eleven years (1821 to 1831 in- 
 clusive), is given by Mr. Scott, t As this return 
 seems to have been prepared with considerable care, 
 it is possible, from the proportion which the diseases 
 therein enumerated bear to the general mass, com- 
 pared with the proportion which the same diseases 
 bear to the whole number under treatment in the 
 military hospitals at other foreign stations, to form an 
 approximation to an estimate of the influence of the 
 climate of Van Diemen's Land. In this comparison 
 
 * ' A Return of Medical and Surgical Diseases treated at H.M. 
 Colonial Hospital, Hobart Town, Van Diemen's Land, for the 
 years 1821. to 1831.' By James Scott, Esq., Colonial Surgeon. — 
 In the Transaction of the Provincial Medical and Surgical Asso- 
 ciation, vol. iii. 1835. 
 
 t In regard to the cases comprehended in this summary, it is 
 to be observed, that the greater number of the acute diseases 
 were brought on by intemperance, imperfect clothing, and expo- 
 sure to wet and cold, and that the greater part of the patients 
 were European convicts, of the most dissolute habits and broken 
 constitutions. 
 
VAN DIEMEN'S LAND. 
 
 353 
 
 we shall confine ourselves to diseases of the chest, 
 which seem to be of rather unfrequent occurrence in 
 that part of Australia. 
 
 Table showing the proportion of Diseases of the Chest to the 
 whole number of Diseases, occurring in the Hospitals at 
 Hobart Town, the Cape or Good Hope, Gibraltar, 
 Malta, and the Ionian Islands. 
 
 
 Cases. 
 
 Pneumonia 
 
 and 
 
 Pleuritis. 
 
 Haemo- 
 ptysis. 
 
 Consump- 
 tion. 
 
 Catarrh. 
 
 Hobart Town . 
 
 Cape of Good) 
 Hope . . ./ 
 
 Gibraltar . . 
 
 Malta . . . 
 
 Ionian Islands . 
 
 30102 
 
 25506 
 
 58227 
 46639 
 84438 
 
 1 in 
 516 58 
 
 673 33 
 
 2543 23 
 1391 34 
 2272 37 
 
 lin 
 98 307 
 
 55 409 
 
 189 308 
 106 440 
 
 147 574 
 
 lin 
 104 290 
 
 125 180 
 
 394 148 
 335 198 
 
 239 249 
 
 lin 
 1657 18 
 
 1320 17 
 
 5186 11 
 3041 15 
 3401 25 
 
 From the preceding Table it will be seen that com- 
 paratively fewer cases of pneumonia and pleuritis, 
 of haemoptysis and of consumption occur in Van Die- 
 men's Land than in any other of our colonies, and that 
 as regards catarrh the proportion of cases also is less, 
 with the exception of the Ionian Islands. 
 
 With regard to other diseases, it appears that fe- 
 vers are exceedingly rare, even compared with the 
 healthy colonies above referred to ; dysentery and 
 dyspepsia very common, and constipation extremely 
 so, while diarrhoea is but little experienced. Dis- 
 
354 SOUTHEEN HEMISPHEEE. 
 
 eases of the liver are more rare than in any other 
 climate with which we are acquainted, but rheuma- 
 tism is a disease of great frequency, and also of more 
 than usual severity ; and it is very remarkable, that 
 of the 30,102 cases, no fewer than 1134 were from 
 toothache. 
 
 Scrofula and glandular diseases are rare. Idiopa- 
 thic intermittent fever, malignant sore-throat, small- 
 pox, measles, scarlet fever, hydrophobia, &c. have not 
 been met with in the colony. Hooping-cough was 
 once introduced, and for a short time extended as 
 rapidly and widely as in England, but gradually be- 
 came milder, and in a few months disappeared. There 
 have been no epidemics in the colony except on the 
 two occasions already noticed. All diseases, both 
 acute and chronic, are generally mild, and of compa- 
 ratively short duration, and yield easily to the usual 
 remedies. 
 
 The frequent and sudden changes of weather in 
 Van Diemen's Land do not appear to be attended 
 with the same hurtful consequences to the health as 
 in other countries ; and it is remarked by Mr. Scott 
 that " situations apparently unhealthy are inhabited 
 with the utmost freedom, without injury to the con- 
 stitution, though in any other country they would 
 probably be attended with inevitable destruction, or, 
 at least, much hazard to human life." 
 
NEW ZEALAND. 355 
 
 NEW ZEALAND. 
 
 The New Zealand group consists principally of two 
 large islands, about 800 miles in length and 100 miles 
 in breadth, situated between 8** and 34** of South lat- 
 tude, and between 166'' and 179° East longitude. 
 
 Both islands are intersected in the greater part of 
 their length by a chain of very high mountains per- L- 
 petually covered with snow; hence the country 
 abounds in streams and rivers. 
 
 The climate of New Zealand appears to be mild, 
 j|^oft, and equable. Unlike New South Wales, it is 
 not subject to drought and hot winds, but is plenti- 
 fully supplied with rain, which appears pretty equally 
 distributed throughout the year. The temperature 
 ^ is never very high in summer nor very low in win- 
 ter, so that the annual range is within narrow 
 limits. 
 
 According to Dr. Dieffenbach,* the climate resem- 
 bles thatof England more nearly than that of any other 
 
 * ' Travels in New Zealand, with Contributions to the Geo- 
 graphy, Geology, Botany, and Natural History of that Country,' 
 by Ernest Dieffenbach, M.D. London : 1843. 
 
 To Dr. Dieffenbach's excellent work I am indebted for much 
 of my information respecting New Zealand ; and I recommend 
 his work to every one desirous of making himself acquainted with 
 the natural history and capabilities of this important colony. 
 
356 SOUTHERN HEMISPHERE. 
 
 country with which, he is acquainted. " It is mode- 
 rate in every respect, the range of its temperature 
 throughout the year and during the day being very 
 inconsiderable. This is principally owing to the im- 
 mense expanse of ocean which surrounds these narrow 
 islands on all sides, preserving a temperature little 
 varying, and moderating alike the cold of the antarc- 
 tic regions and the heat of the tropics. But it is 
 ^ obvious that marked differences must exist in a coun- 
 ^try extending through nearly thirteen degrees of 
 latitude, and in which there are central and coast 
 positions, hills covered with forest, and mountains 
 reaching above the limits of perpetual congela- 
 tion." 
 
 " The East Coast, on which Wellington, Auckland, 
 and the Bay of Islands are situated, is colder than the 
 Western, where the settlements of Nelson and New 
 Plymouth have been founded, and where the air is far 
 softer and milder. I ascertained this by actual com- 
 parisons, and in this respect the Western Coast must 
 have great advantages over the Eastern. In the in- 
 terior of the islands the climate is colder and less^ 
 changeable in consequence of the presence of a snow- 
 clad mountain group and the greater distance from 
 
 the ocean Uniformity of temperature is charac-^ 
 
 teristic of the climate of New Zealand .... There 
 is no great heat in summer, no severe cold in winter ;^ 
 sometimes, indeed, in the winter nights the thermo- 
 meter sinks to the freezing-point, and the stagnant 
 
NEW ZEALAND. 357 
 
 waters in the interior are covered with a thin crust of 
 ice ; but during the day it is very rare that the tern- v 
 perature is below 40°." 
 
 " Along the whole coast, the natives plant their 
 ^potatoes at all seasons of the year, the forest remains 
 evergreen, and the opening of the flower-buds is 
 merely a little retarded during the season of winter, 
 the presence of which is only indicated by more fre- 
 quent rains and winds. . . . Dews are also particularly ;^ 
 heavy during the winter months." 
 
 Another characteristic of this climate is its liability 
 to wind, which is particularly felt on the coast. Dr. 
 DieiFenbach remarks, " Owing to the continual inter- 
 change which takes place between the heated air 
 of the equator and the cold air of the antarctic re- 
 gions, an almost continual wind is kept up, which blows 
 either from the north and the north-west, or from 
 the south and the south-east. Out of 365 days — the 
 entire year — there were only twelve which could be 
 called calm days ; during 213 it blew from the north 
 or north-west, and during 119 from the south or 
 south-east." 
 
 To the frequency of the winds may be owing in a 
 
 /great measure the healthiness of the country. " The 
 
 purity of the atmosphere resulting from the continual 
 
 wind, " Dr. D. remarks, " imparts to the climate a 
 
 j vigour which gives elasticity to the physical powers 
 
 and to the mind. Heat never debilitates, not even so 
 
 ^ much as a hot summer's day in England ; and near the 
 
358 SOUTHEBN HEMISPHERE. 
 
 coast especially there is always a cool and refreshing : 
 breeze."* 
 
 Dr. Martin, who resided during a much longer pe- 
 riod in New Zealand than Dr. Dieffenbach, describes 
 the climate in still more glowing terms. In point of 
 salubrity and pleasantness of climate, being free from 
 all extremes of heat and cold, Dr. Martin considers 
 it infinitely preferable to any other colony in the 
 southern hemisphere, and much better adapted to 
 the European constitution. " If any climate in the 
 world deserves to be called temperate," he adds, "it 
 is that of New Zealand, which may properly be called 
 -^one eternal spring.'* 
 
 The quantity of rain during the winter, and the 
 gales of wind, are complained of by some residents ; 
 but the former Dr. Martin thinks little more than is 
 . required by the nature of the soil; the latter he con- 
 siders, with Dr. Dieffenbach, as a great advantage,^ 
 and the cause of the general healthiness of the country 
 and its freedom fi'om fevers and all epidemic and'p^ 
 endemic diseases. The vicinity of marshes and stag- 
 nant waters is as free from diseases in New Zealand 
 as dry and elevated situations. Scrofula and consump- 
 tion are said to be prevalent among the natives; 
 rheumatism, cutaneous diseases, and inflamed eyes 
 are also common. 
 
 The subjoined Tables, reduced from those in Dr. 
 Martin's work, will afford a good idea of the climate. 
 
 "* Op. citat., ch. ix. 
 
NEW ZEALAND. 
 
 359 
 
 They are the result of four years' observation made at 
 Auckland by Dr. Johnson, late Colonial Surgeon. 
 
 Mean T empeeaturb of Aucklaxd, New Zealand, from 
 Sept. 1840 to Aug. 1844 inclusive ; taken daily at 8 a.m., 
 2 P.M. and 8 p.m. 
 
 September 
 
 October 
 
 November 
 
 December 
 
 January 
 
 February 
 
 March 
 
 April 
 
 May 
 
 June 
 July 
 August 
 
 •99] 
 .4l[ 
 •08 J 
 
 63*91 1 
 
 67*91 
 
 67-33 
 
 51-41] 
 48-99> 
 51 -66; 
 
 Spring 
 
 Summer 
 
 Autumn 
 
 Winter 
 
 56-821 
 
 . 66*38 
 
 . 59-82 
 
 . 50*68 
 
 Year. 
 58-43 
 
 Mean Quantity of Rain which fell at Auckland, New Zea- 
 land, from Sept. 1843 to Aug. 1844. 
 
 Inches. 
 September . . . . 3*70] Inches. 
 October .... 5 -50} Spring . .10*84 
 November . . . . 1*64 J 
 
 December . . . . 0-81] 
 
 January .... 0*36 > Summer . . 2*37 
 
 February . . . . l-2oJ 
 
 March 1*55] 
 
 April 4-49 > Autumn . . 8*01 
 
 May l*97j 
 
 June 3-10] 
 
 July 4-82^ Winter . . 10*42. 
 
 August 2-50j 
 
 Year. 
 
 , Inches. 
 31-64 
 
360 
 
 SOUTHERN HEMISPHERE. 
 
 Mean Number of Showery and Rainy Days at Auckland, 
 New Zealand, from Sept. 1840 to Aug. 1844 (inclusive). 
 
 Days. 
 
 September . . . . 15*01 Days. 
 October .... 15-2 > Spring . . 44-0 
 November . . . . 19 -2] 
 
 December . . . . 15 '51 
 
 January . . . . 13*5 > Summer . . 24-2 
 
 February . . . . 15 -5] 
 
 March 15-01 
 
 April 8-5> Autumn . . 38-9 
 
 May 7*7j 
 
 June ..... 8-0] 
 
 July 8'7> Winter . . 49*9. 
 
 August 15*2j 
 
 Year. 
 ' 157 
 
 The table of the temperature shows the remark- 
 able equability of the climate. The summer heat 
 rarely exceeds 70°, and only on one occasion reached 
 78** ; and the winter temperature seldom sinks below 
 50** during the day on the coast. It is to be regretted 
 that a register thermometer was not employed; but 
 there can be no doubt, from the general character of 
 the climate, that the diurnal range of temperature is 
 very small. The fall of rain is moderate, and distri- 
 buted very equably over the year. 
 
 The following Table shows the mean temperature 
 of places in nearly corresponding latitudes north and 
 south of the equator. 
 
APPENDIX. SOUTHERN HEMISPHERE. 
 
 361 
 
 PLACES. 
 
 Yearly 
 Mean. 
 
 Spring. 
 
 Summer. 
 
 Autumn. 
 
 Winter. 
 
 North. 
 Funchal , . 32° 30' 
 
 64 '96 
 
 62-36 
 
 69-56 
 
 67°- 30 
 
 60° 60 
 
 Malta ... 36 55 
 
 67-30 
 
 62-76 
 
 78-20 
 
 71-03 
 
 57*46 
 
 Rome ... 41 52 
 
 60-70 
 
 57-65 
 
 72-16 
 
 63-96 
 
 48-90 
 
 Nice . ... 43 20 
 
 59*48 
 
 .56-23 
 
 72-26 
 
 61-63 
 
 47-82 
 
 South. 
 
 
 
 
 
 
 Sidney ... 4^* 0' 
 
 62'89 
 
 63'45 
 
 70-93 
 
 64-03 
 
 54-62 
 
 Cape Town . 34 
 
 66*56 
 
 65-66 
 
 74-30 
 
 67-28 
 
 58-64 
 
 Auckland . . 36 51 
 
 58-43 
 
 56-82 
 
 66-38 
 
 59-82 
 
 50-68 
 
 HobartTown 43 
 
 52-34 
 
 52-88 
 
 62-96 
 
 51-44 
 
 42-26 
 
 These observations on the climate of our colonies 
 in the Southern Ocean may, I hope, lead to the farther 
 prosecution of the subject, which is one of great in- 
 terest. Extended and accurate observations on the 
 topography and climate of these regions will not only 
 afford positive information regarding them, but may 
 correct some of the opinions at present entertained 
 respecting the causes of disease in the more unhealthy 
 parts of the globe. Some striking differences in the 
 influence of certain localities upon health have been 
 already observed. It is remarked in ^ The Statistical 
 Reports on the Health of the Navy,' that on the 
 South American station there are land-locked har- 
 bours where, under a powerful sun, ships lie for 
 months or years, surrounded by a country abounding 
 in marshes and rank vegetation, and all the other 
 circumstances which elsewhere are considered the 
 essential cause of the fevers which prove so destruc- 
 
 R 
 
362 APPENDIX. SOUTHERN HEMISPHERE. 
 
 tive of life among Europeans, without the occurrence 
 of a single case of concentrated fever ; the crews, on 
 the contrary, enjoying good health.* Analogous to 
 this is the circumstance above quoted from Mr. Scott's 
 Report, that in Van Diemen's Land situations which 
 in other countries are found to exert a prejudicial 
 influence on health have there no such effect. We 
 have also just seen that living in the vicinity of 
 marshy grounds, which would prove fatal in many 
 parts of the world, is not found unhealthy in New ^ 
 Zealand. 
 
 * * Statistical Reports of the Health of the Navy :' prepared 
 by John Wilson, M.D., F.R.S., Inspector of Hospitals and 
 Fleets. 
 
( 363 ) 
 
 MINERAL WATERS. 
 
 The influence of climate in the cure of some of the 
 principal diseases treated of in the foregoing pages 
 may be so effectually promoted by the use of Mineral 
 "Waters, that a few observations on their proper 
 application to these diseases will form an appropriate 
 supplement to this volume. It is not my intention, 
 however, to give a particular account of the mineral 
 waters which I shall have occasion to notice : on this 
 point the reader will find ample information in the 
 various works published expressly on that subject. 
 My object in the few following remarks is to indicate the 
 diseases which are benefited by mineral waters, and 
 the waters suited to particular diseases. This is the 
 kind of information most useful both to the practical 
 physician and to the invalid. 
 
 I would remark in the first place, that it is in dis- 
 eases of the organs more immediately concerned in 
 digestion and assimilation that mineral waters produce 
 the most beneficial efiects. The diseases of the skin, 
 of the joints, &c., in which these remedies are often 
 so efficacious, have their origin very generally in dis- 
 order of the digestive apparatus ; and the correction 
 of this constitutes the first step in the cure. 
 
 r2 
 
364 APPENDIX. MINERAL WATERS. 
 
 Disorders of the Digestive Organs. — ^The fa- 
 vourable influence of climate and a suitable regimen 
 may be sufficient to cure the milder forms of dyspep- 
 sia ; but in protracted cases something more active is 
 required to remove the congestion of the liver and 
 other abdominal organs, with which such cases are for 
 the most part complicated. With this view, I consider 
 a well-directed course of mineral water very efficacious, 
 and capable of effiscting, in many cases, what no other 
 remedy with which I am acquainted has the power to 
 effect. Mineral waters, by increasing the action of the 
 secreting and excreting organs, produce the most bene- 
 ficial effects by removing congestion, and restoring 
 the functions of the affected organs, and also, by excit- 
 ing a depurative process, may even restore the blood 
 itself to a more healthy state, and thus improve the 
 condition of the whole system. Certain it is, that 
 after a well-directed course of mineral-water the dys- 
 peptic invalid enjoys a degree of activity of body 
 and energy of mind to which he had long been a 
 stranger. 
 
 But, as it is with every other remedy, the degree of 
 benefit to be derived from the use of mineral waters 
 will depend upon their proper adaptation to the 
 individual case. Besides, it is to be remarked that 
 every case of dyspepsia will not be benefited by 
 mineral w^aters ; on the contrary, many cases would 
 be injured by the mildest of them. When there is 
 present even a slight degree of gastritic dyspepsia, in- 
 
APPENDIX. MINERAL WATERS. 365 
 
 dicated by red or dry tongue, thirst, or the other symp- 
 toms of that form of gastric disorder, or when there exists 
 organic disease, mineral waters, like all other existing 
 remedies, will prove injurious. The cases of dyspepsia 
 in which mineral waters are most decidedly beneficial 
 are those of long standing, where the mucous membrane 
 and abdominal organs generally are in a state of conges- 
 tion unaccompanied with much irritation, in persons 
 of a torpid rather than an irritable constitution, and 
 of a full rather than a spare habit. 
 
 The selection of the water must depend upon the 
 nature of the derangement and susceptibility of the 
 digestive organs, and upon the secondary disorders 
 with which the original disease may be complicated. 
 
 "When the mucous surfaces, and the liver and ab- 
 dominal venous system generally, are in a congested 
 state, or when the functions of the uterus are defec- 
 tive, and there is not much relaxation of the system, 
 the mineral waters of Ems, of Vichy, or of Plom- 
 BiERES, will be useful, particularly the two first. In 
 cases of dyspepsia, complicated with chronic bronchial 
 disease, or where the skin is in an unhealthy state, 
 the waters of Cauterets, among the Pyrenees, are 
 very efiicient. 
 
 When the abdominal viscera are in a more obsti- 
 nately congested and torpid state, the waters of Ma- 
 RiENBAD, of Carlsbad, and of Kissingen, will be 
 more beneficial than any of these. When the diges- 
 tive organs are easily excited, and a full action on the 
 
366 APPENDIX. MINERAL WATERS. 
 
 bowels is required, the cold aperient waters of Ma- 
 rienbad are indicated; when the digestive organs are 
 in a languid state, the more exciting waters of Kiss- 
 ingen wiU be preferable. The Carlsbad water, in its 
 operation on the animal economy, may be considered 
 as holding a medium place. In some cases, a course of 
 the Ems water may precede these more active waters 
 with great advantage. When a state of atony of the 
 stomach exists with general nervous debility ; or when 
 the uterine system is debilitated and relaxed, but free 
 from organic disease, a cold chalybeate water, such 
 as that of Pyrmont, or Schwalbach, will be very 
 useful, and, in many cases, still more so, if preceded 
 by a course of Ems, of Carlsbad, or of Kissingen 
 water. And in like manner, a short course of a cold 
 chalybeate water may in many cases be employed 
 very advantageously, with the view of giving tone 
 to the system, and confirming the eifects of these 
 deobstruent waters. When it is desirable to keep up 
 some action on the bowels, the waters of Eger will 
 answer well; when the purely tonic efifects of the 
 waters are desired, those of Schwalbach or Pyrmont 
 will be preferable. But to derive essential benefit 
 from this tonic class of waters, the digestive organs 
 must be free from irritation, and from structural dis- 
 ease. 
 
 All these waters, at the same time that they are 
 used internally, may generally be employed in the 
 form of bath with great advantage. The temperature 
 
APPENDIX. MINEKAL WATEKS. 367 
 
 and the duration and repetition of the bath can be regu- 
 lated only by the physician residing at the place ; and 
 the same observation applies to the duration of the 
 course, the quantity of water to be drunk, &c. 
 
 From a well-directed course of one or more of 
 these waters, the dyspeptic invalid will, I believe, 
 derive all the advantage which is to obtained from 
 this class of remedies. 
 
 After the use of mineral waters, a residence for 
 some time in a bracing air, or by the sea-side, will 
 be very beneficial. When the intention is to pass the 
 winter in Italy, the journey, if well conducted, is not 
 likely to interfere with the good effects of the waters ; 
 but rapid travelling should be avoided, and whatever 
 is likely to excite or heat the system. 
 
 Bronchial Diseases. — Several mineral waters 
 on the Continent have a high reputation in this class 
 of diseases. Ems on the Rhine, Bonnes and Cau- 
 TERETS among the Pyrenees, and Mont d'Or in 
 Auvergne, are held in greatest estimation. A resi- 
 dence during one or two winters in Italy, and a course 
 of one or other of these waters, according to the nature 
 of the case, during the summer, afford, I believe, the 
 most effectual combination of means which we possess 
 for the relief of the more obstinate and deeply-rooted 
 cases of bronchial disease. 
 
 The selection of the particular mineral water must 
 depend on the nature of the case. Where the disease 
 
368 APPENDIX. MINERAL "WATERS. 
 
 is accompanied with much general delicacy of con- 
 stitution, Ems deserves the preference. In cases of 
 less delicacy, and those especially in which a moun- 
 tain air promises benefit, or where the bronchial 
 disease is complicated with chronic cutaneous erup- 
 tions. Bonnes, or Cauterets, will be more effectual. 
 Where there exists a very torpid state of the system, 
 and especially a languid or defective action of the 
 skin, or where the occurrence of the bronchial disease 
 has coincided with the disappearance of any cutaneous 
 eruption, the exciting system of bathing adopted at 
 Mont d'Or will, I believe, effect cures where the 
 other waters fail ; but the plan of using the bath at a 
 high temperature, adopted by Dr. Bertrand at this 
 place, requires much judgment and discrimination on 
 the part of the physician. 
 
 When the bronchial disease is consequent upon 
 hepatic or abdominal congestion, a course of Ems 
 water, followed by one of Carlsbad, of Marienbad, or 
 of Kissingen water, as the case may indicate, will 
 prove a very efficacious combination ; and a subse- 
 quent short course of chalybeate water will in some 
 cases give permanency to the effects of those waters. 
 
 Asthma. — When treating of asthma in the first 
 part of this work, it was remarked that when the 
 disease is complicated with chronic irritation of the ' 
 bronchial membrane, or of the digestive organs, or 
 with a congestive state of the hepatic system, or an 
 
APPENDIX. MINERAL WATERS. 369 
 
 unhealthy condition of the skin, a course of warm 
 mineral water proved very beneficial. 
 
 There is more difficulty, however, in selecting a 
 mineral water for the asthmatic patient than for any 
 other, as the source, most suitable in other respects, 
 may be in a situation which decidedly disagrees with 
 the asthma. However well suited the waters of the 
 Pyrenees or of Mont d'Or might be as regards the 
 bronchial disease, it would be useless to propose a 
 residence at either of those places to an asthmatic 
 invalid who could not breathe at a great elevation, or to 
 send a patient to Ems or Carlsbad who could not live 
 in a valley, although the waters of these places might 
 be admu'ably adapted to the bronchial or abdominal 
 diseases with which the asthma is complicated. I 
 need not repeat here what I have just stated, under 
 the heads of Dyspepsia and Bronchial Diseases, re- 
 garding the use of the mineral waters, as they are 
 equally applicable to the cases under consideration. 
 
 When asthma is complicated with disease of the 
 heart, the use of mineral waters is inadmissible, and 
 might be productive of serious injury. 
 
 Gout. — For the relief of chronic gout, the most 
 efficient waters are those of Ems, of Carlsbad, of 
 Marienbad, of Aix-la-Chapelle, and of Wiesbaden. 
 
 Used internally, the waters of Ems and Carlsbad 
 are well calculated to benefit the gouty constitution. 
 The soothing eflfects of the former prove an excellent 
 
 B 3 
 
370 APPENDIX. MINERAL WATERS. 
 
 preparative, in many cases, for the more exciting but 
 more deobstruent and depurative waters of the latter ; 
 and these again may often be advantageously followed 
 by bathing and the application of the douche at Wies- 
 baden or Aix-la-Chapelle ; more especially when 
 frequent attacks of the disease have left the joints 
 stiff and swollen. The combination of the douche 
 and friction employed at the latter place is very useful 
 in removing these local affections. 
 
 But before prescribing a course of mineral waters 
 in gout^ or indeed in any other disease, it should be 
 ascertained that the heart and large vessels are in a 
 sound state, and also that there is no disposition to 
 cerebral congestion. The neglect of this precaution 
 may lead to fatal effects. 
 
 Rheumatism. — Climate and mineral waters com- 
 bined form an efficient remedy in chronic rheumatism. 
 The baths of Aix, in Savoy, have long enjoyed a high 
 character in obstinate cases of this disease. The 
 waters of Cauterets and Bagneres-de-Luchon, 
 among the Pyrenees, and those of Aix-la-Chapelle 
 are very beneficial, especially when the rheumatism 
 is complicated with cutaneous affections. When the 
 disease, however, is symptomatic of or complicated 
 with a deranged state of the digestive organs, a 
 course of mineral water, calculated to remove this, 
 will be more beneficial, and ought to precede the use 
 of waters directed to the affection of the joints only. 
 
APPENDIX. ^FACTITIOUS MINERAL WATERS. 371 
 
 FACTITIOUS MINERAL WATERS. 
 
 As many persons, in whose complaints mineral 
 waters are indicated, must find it inconvenient to take 
 a course of them at their respective sources, it may not 
 be irrelevant to our present subject to say a few 
 words respecting the Factitious Mineral Waters 
 introduced into this country by the late Dr. Struve 
 of Dresden. When in Germany, I made particular 
 inquiries regarding the estimation in which these 
 waters were held by the physicians of the different 
 cities in which Dr. Struve had establishments. The 
 information which I obtained, more especially at 
 Berlin, where these factitious waters are extensively 
 employed, was invariably in favour of their decided 
 utility ; and the remarkable similarity of their effects 
 to those of the natural waters was generally admitted. 
 The respectability of Dr. Struve, and his skill as a 
 chemist, were also universally acknowledged. 
 
 After such satisfactory information, obtained from 
 physicians of the highest character in Germany, I 
 had no hesitation in prescribing the waters of the 
 German Spa at Brighton in the same cases in which 
 I should have recommended a course of the natural 
 waters of Ems, Carlsbad, &c., had not the distance 
 of these places presented obstacles to their employ- 
 ment. I have had abundant experience of the 
 beneficial effects of Dr. Struve's waters in various 
 diseases ; and I feel satisfied that when their effects 
 
372 APPENDIX. FACTITIOUS MINERAL WATERS. 
 
 are more generally known to the profession, and the 
 manner of using them is better understood, they will 
 be extensively and beneficially employed in a 
 numerous class of diseases, and especially in dis- 
 orders of the digestive organs dependent upon or 
 complicated with abdominal congestion. At the 
 same time, if the patient could conveniently take a 
 course of the natural mineral water at its source, I 
 should generally prefer this. 
 
 In one respect, however, the patient has an ad- 
 vantage in taking the factitious mineral waters, as 
 they may be changed according to the circumstances 
 of the case during the progress of the course. Por 
 example, in many cases it will be very desirable to 
 begin with a mild water, such as that of Ems, of 
 Salzbrunnen, or of Saratoga, as a preparative for the 
 more active and more exciting waters of Marienbad, 
 Carlsbad, and Kissingen ; and these again may be 
 succeeded by a short course of the chalybeate waters 
 of Eger, of Pyrmont, or of Spa. 
 
 The warm sea-water bath will in the greater 
 number of cases promote the action of the waters ; 
 and at Brighton this can be had very conveniently. 
 The effects of the dry bracing air of this place will 
 also contribute, more especially in relaxed constitu- 
 tions, to the salutary operation of the waters. 
 
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NOTES 
 
 METEOROLOGICAL TABLES. 
 
 I 
 
 It is much to be regretted that a more perfect comparison 
 of the Climate of various places has hitherto been unat- 
 tainable, in consequence of the different methods adopted 
 and instruments employed by observers, as well as the 
 difficulty which frequently exists as to the proper position 
 of the instruments ; a difficulty which in many instances 
 can hardly be surmounted, from the peculiar circumstances 
 of the localities in which the observations are made. 
 Thus the Temperature will be found to differ considerably 
 between thermometers placed at a distance from any build- 
 ing or shelter, and those attached to the wall of a house, 
 or suspended outside a window :* the influence exerted by 
 the vicinity of an inhabited dwelling in raising the tem- 
 perature of the air surrounding it, is too well known to 
 require remark. 
 
 In making observations for comparison, a spot should 
 be selected at some distance from any dwelling, and as 
 little surrounded as possible by walls or high ground. 
 The Thermometers should be placed upon a framework 
 
 ♦ A difference of 3° in the minimum temperature has been fre- 
 quently observed between a thermometer placed in this manner, 
 although at a distance of eighteen inches from the sash, and one 
 placed in a similar aspect away from the houses. 
 
390 NOTES ON THE TABLES. 
 
 of wood, facing the north, between five and six feet from 
 the ground, and defended by a pent roof to prevent the 
 rain falling on the bulb ; or, what would be still better, 
 the instruments might be fixed on a frame of wood, under 
 a thatched roof placed at some height above them, open 
 to the north, but projecting some distance downwards 
 towards the east, south, and west, so as to cast a shadow on 
 the ground and prevent as much as possible any directly 
 reflected heat ; the floor of the little observatory should be 
 boarded. 
 
 As the majority of observers have other occupations, 
 and are unable to devote a large portion of their time to 
 the subject, one daily observation at 9 a.m. will, without 
 entering too scientifically into the matter, be suflScient for 
 all general purposes. The Temperature at that hour 
 should be noted, but the important observations are 
 the maximum and minimum temperature during the 
 twenty-four hours. The maximum temperature should be 
 inserted in the Journal kept for the purpose, with the 
 observations of the preceding day, and the minimum on 
 the day on which it is taken. The reason for this is, that 
 in marking the registering instrument once only in the 
 24 hours (at 9 a.m.), and the warmest part of the day 
 occurring, in our climate, about 2 p.m., the registering 
 thermometer obviously gives the maximum temperature of 
 the preceding day ; whilst the coldest period usually occur- 
 ring a short time before sunrise, the minimum temperature 
 is, as has been already noticed, that of the day on which 
 the observation is made. 
 
 The Mean Temperature of each month, &c. (Table I.) 
 may be ascertained witli sufficient accuracy for our pur- 
 pose, by adding the whole maxima together and dividing 
 theni by the number of days in the month ; or, in case any 
 omission in that time should have occurred, by the num- 
 
NOTES ON THE TABLES. 391 
 
 ber of days on which observations were made ; this will 
 give the mean maximum. By pursuing the same plan 
 with the minima, the mean minimum will be obtained, and 
 by adding this to the mean maximum and dividing by 2, 
 the mean temperature of the month is shown. 
 
 Table II. sufficiently explains itself, and therefore no 
 remark upon it is needed. 
 
 The Mean Daily Range (Table III.) is easily as- 
 certained by subtracting the mean mniimum temperature 
 from the mean maximum. But it is also advisable to note 
 the daily range (the difference between the maximum and 
 minimum) each day, and by adding the results together at 
 the end of the month and dividing them by the number of 
 days in the month (or the number of observations made), 
 ascertain the mean ; on comparing the result with that 
 obtained by the former method, any little error which may 
 have crept into the calculations will at once be shown. 
 
 The Mean Successive Daily Range (Table IV.) is 
 obtained by simply calculating the difference between the 
 mean temperature of each succeeding day, adding the 
 results together, an.d dividing them by the days in the 
 month, or the number of observations made. 
 
 The Extreme Range of Temperature (Table V.) is 
 ascertained by deducting the Lowest Temperature of the 
 month from the Highest. 
 
 The Observations on the Barometer (Table VI.) should 
 be taken if possible twice a day, viz. 9 a.m. and 9 p.m. 
 Should the latter hour however be inconvenient, an earlier 
 hour in the afternoon might be substituted. In making 
 the observations, the height of the Barometer above the 
 ground, and above the level of the sea, should especially 
 be noted, as also the description of instrument, and 
 whether corrected for temperature. 
 
 The Range of the Barometer (Table VII.) is very 
 
382 NOTES ON THE TABLES. 
 
 readily obtained by merely marking the difference between 
 the lowest extreme and the highest. 
 
 In placing the Rain Gauge for the purpose of register- 
 ing the fall of Rain (Table VIII.), many industrious 
 observers are perhaps unaware of the fact that less Rain is 
 registered in an instrument placed at a height from the 
 ground, than in one fixed nearer the surface ; but it is 
 equally undesirable to place an instrument too close to 
 the surface as it is to elevate it too high. Perhaps be- 
 tween three and four feet may be taken as a proper height, 
 and this will allow of the graduated glass measure (if one 
 is used) being inserted under the tap. The quantity of 
 moisture, whether rain or melted snow, should be noted 
 and drawn off every morning at the time of the other 
 observations, and it may be as well to surround the gauge 
 with a circular wall of stone or brickwork, within which 
 the water may be thrown when measured ; the first will 
 protect the instrument from the sun, and the latter keep 
 the air around it in a state of moisture least favourable to 
 evaporation. 
 
 With respect to the Number of Rainy Days (Table 
 IX.), a great comparative variation will be observable in 
 different places ; in some, days are included on which only a 
 few drops of rain fell ; while in others, rain is marked as 
 having been measured in the gauge, and yet the day is not 
 inserted in the Journal as one on which rain has fallen, 
 but in some instances is even noted as fair ; the error pro- 
 bably has arisen from its having fallen during the night. 
 It might perhaps be better for comparison to insert those 
 days only as days on which rain falls in which any mois- 
 ture, however small the quantity, is deposited in the Pluvio- 
 meter ; this will make a much better standard of compari- 
 son. 
 
 Much disappointment has been felt that, with the excep- 
 
NOTES ON THE TABLES. 393 
 
 tion of three or four places, no data have been attainable on 
 which to form a Table for the Hygrometer. A just com- 
 parison of the relative humidity of different places can 
 hardly be obtained when one morning observation only is 
 taken in one place, and two, if not more, are made at vari- 
 ous hours of the day, in another. If one observation alone 
 is made, the proper period would be perhaps about 3 P.M. ; 
 but it is desirable that two at least should be taken, one 
 A.M., and another p.m. 
 
 It is hoped these remarks may tend to call the atten- 
 tion of observers to an important want in a series of ob- 
 servations, and that the deficiency at present existing may 
 be hereafter supplied. 
 
 TEMPERATURE. 
 
 TABLE I. 
 
 The Mean Temperature is deduced from the average of mean 
 maxima and minima, unless where otherwise expressed. 
 
 1. LONDON. 
 
 Howard ; from the observations made at the apartments of the Royal 
 Society, Somerset House, 1797—1816 ; 1787—1816, 50° • 456 :— C^t- 
 mate of London. — Mean of maxima and minima, 1820 — 1822, 49°'30. 
 Daniel], Essay on the Climate of London. Range of mean annual 
 temperature during 30 years, 4°*8 : Howard. 
 
 2. TORQUAY. 
 
 Edward Vivian, Esq. From observations by register thermometers 
 from 1842 to 1845 inclusive. The instruments are placed about six 
 
 s3 
 
394 NOTES ON THE METEOKOLOGICAL TABLES. 
 
 inches from the first-floor window of the house, in a nortli aspect, 
 about 160 feet above the sea level, and out of the town. 
 
 3. COVE. 
 Dr. Scott. From September 1834 to August 1841 inclusive. From 
 register thermometers suspended in a latticed screen five feet from 
 the ground and standing in a spacious yard, bounded in front by a 
 house and at the back by high ground. 
 
 4, PENZANCE. 
 E. C. Giddy, Esq. Average of 12 years, from 1821 to 1832 inclusive. 
 From Dr. Forbes's Medical Topography of the Land's End, in vol. ii. 
 of the Transactions of the Provincial Medical and Surgical Associa- 
 tion. 
 
 5. UNDERCLIFF. 
 Dwi. Crawford and Grant. Winter and spring 1831-32-33-34. Dr. 
 Martin, Dec. 1838 to Dec. 1845 inclusive. From register thermo- 
 meters placed in a north aspect at six feet from the ground, at a distance 
 from any house or building, and perfectly protected from radiation 
 and reflection ; about 160 feet above the level of the sea, and away 
 from all shelter of high ground. 
 
 6. CLIFTON. 
 
 W. H. Gore Langton, Esq. During the years 1836 to 1845 inclusive. 
 The observations were taken four times in the twenty-four hours ; 
 three times during the day, viz. at 9 a.m., 2 p.m., and 9 p.m. ; and by 
 register thermometer during the night. The instrument was placed 
 in a N.W. aspect, about 35 feet from the ground, and 160 feet above 
 the sea level. 
 
 7. EXETER. 
 
 Dr. Shapter On the Climate of Devon. 
 
 8. HASTINGS. 
 — Loyd, Esq. From very careful observations made with well-placed 
 register thermometers during the years 1843-44-45. 
 
NOTES ON THE METEOKOLOGICAL TABLES. 395 
 
 9. GOSPORT. 
 Dr. Burney. By common thermometer, corrected each month by 
 Brewster's Table. 
 
 10. SIDMOUTH. 
 
 Dr. Cullen. From register thermometers during the years 1841-42- 
 43-44-45. 
 
 11. CHISWICK. 
 
 From observations made at the Horticultural Society's Garden during 
 19 years, viz. from 1826 to 1844 inclusive. 
 
 12. NEWPORT. 
 
 John C. Bloxam, Esq. From very careful observations made with 
 register thermometers, from 184(Xto 1845 inclusive. 
 
 13. OXFORD. 
 Dr. Robertson, Radcliffe Observatory, 1816 — 1821 ; mean of maxima 
 and minima. Edinburgh Philosophical Journal. 
 
 14. ALDERLEY. 
 
 Alderley Rectory, near Knutsford, (Cheshire). The Rev. E. Stanley ; 
 1815 — 1824, mean of 8 a.m., 2 p.m., and 10 p.m., corrected for each 
 month by Dr. Brewster's Table, as deduced from theLeith Fort Obser- 
 vations. 
 
 15. KENDAL. 
 Daltou. 
 
 16. EDINBURGH. 
 A. Adie, Esq.; 10 a.m., 10 p.m., 1824-1825; at Canaan Cottage, IJ 
 mile south of Edinburgh Castle, 3 miles from the sea, and 260 feet 
 above its level. Edinburgh Journal of Science. Mean of year, 
 47°.8;— Winter, 38°-6 ; Spring, 46°-4 ; Summer, 58°'2; Autumn, 
 48° '4 ;— warmest month, 59°* 4 ; coldest month, 38°- 3. Playfair. 
 
396 NOTES ON THE METEOEOLOGICAL TABLES. 
 
 17. LEITH. 
 
 Sir David Brewster; from the valuable observations made at Leith 
 Fort, 1824, 1825. 
 
 18. BUTE. 
 
 Robert Thorn, Esq., of Ascog. Average of 19 years, 1821 to 1839, in- 
 clusive; the observations taken hourly for 12 years during that 
 period ! 
 
 19. DUBLIN. 
 Kirwan. 
 
 20. ISLE OF MAN. 
 
 Average of 5 years from 1824 to 1828 both inclusive. These observa- 
 tions only approximate to the true mean, having been taken by 
 common thermometer at 9 a.m. and 11 p.m. 
 
 21. JERSEY. 
 Dr. Hooper. Average of 5 years. From 1831 to 1835 ; generally mo- 
 derate winters, andjncluding the mild winter of 1833-34. 
 
 22. PARIS. 
 Royal Observatory. Mean of extremes. M. Boward, 1806 — 1826. 
 
 23. TOULON. 
 
 ^. Bwrel, Naval Hospital; 1749 — 1781. Statistique des Bouches du 
 Rhone. 
 
 24. MARSEILLES. 
 Thulis and Blanpain. Royal Observatory ; about 160 feet above the 
 level of the sea; 1806—1815. Statistique des Bouches du Rhone. 
 60°- 10. St. Jaque de Sylvabelle. Aix 56° -66 ; 309 feet above the 
 level of the sea. — Range at Marseilles, 93°— 20^ = 73°; at Aix 
 102°— 19° = 83°. 
 
 «5. AVIGNON. 
 
 ^. Guerin. Mus^e Calvet ; about 70 feet above the level of the sea ; 
 
 sunrise and 2 p.m. 
 
NOTES ON THE METEOEOLOGICAL TABLES. 397 
 
 26. MONTPELIER. 
 
 Poitevin; 1796—1806. Sur le Climat de Montpelier. 58° mean of 
 
 12 years; Mejan. Nismes, 60° •26. 
 
 27. PAU. 
 
 M. Mermet. Mean of 5 years, 1837 to 1841 inclusive. Dr. Taylor on 
 the Climate of Pau. 
 
 /GENEVA. 
 Plctet. Mean of sunrise and 2 p.m. ; 1080 feet above the level of the 
 sea. Saussure, 50°'74. Berne, 49°*. 30 : difference of warmest and 
 coldest month, 36°* 12. Zurich, 47° '8; difference of warmest and 
 coldest month, 31°- 10. 
 
 28. ROME. 
 Observatory of the Roman College, 163 feet above the level of the Me- 
 diterranean, and 101 feet from the level of the ground ; 1811 — 1823. 
 The mean of the evening observation at 9 p.m. has been preferred to 
 the mean of 7 a.m. and 2 p.m. Effemeride AstronomicJie. 60°* 08, 
 Calandrelli. 63°- 44, W. Humboldt. 
 
 29. Idem. 
 Dr. Deakin, average of mean maxima and minima for the months 
 of November, December, January, February, March, and April, 
 during the years 1838 to 1845 inclusive. 
 
 30. NAPLES. 
 Broschi. Observatory at Capo di Monte; 148 metres above the level of 
 the sea ; mean of sunrise and 2 P.M. ; 1821 — 1824. Toaldo, 63°'5. 
 Palermo, 63° '60. Scina, Topogrqfia di Palermo. 
 
 31. PISA. 
 Deduced from several Journals. 60°' 0. Piazzini. 
 
 32. GENOA. 
 I. Fratelli Mojon. Humboldt, 60° -26. 
 
398 NOTES ON THE METEOROLOGICAL TABLES. 
 
 33. NICE. 
 
 M. Risso; 1806 — 1825; mean of 8 a.m. and of 8 p.m., corrected by 
 Brewster's Table. Histoire Naturelle de V Europe M^ridionale. 
 Dr. Skirving, November 1820 to February 1826 ; mean of sunrise 
 and 2 p.m. These two series of observations nearly coincide. 
 
 34. FLORENCE. 
 Ximenian Observatory, Scuole Pie ; 205 feet above the level of the sea ; 
 mean of three daily observations ; 1824 — 1825. Temperature within 
 doors 61°'50, out of doors 58°'75: Humboldt 61°«52. Bologna 56^-30. 
 Verona 55^'76. Venice 66° -48. Padua 56° '30. 
 
 35. SIENNA. 
 At Belvidera; 1786 — 1791 ; furnished by Professor Grotanelli. 
 
 36. BATHS OF LUCCA. 
 Dr. Todd. 
 
 37. MALTA. 
 
 Mean of observations taken at the Military Hospital from 1820 to 1840 
 inclusive. See Dr. Schembri's pamphlet, Sulla Temperatura delV 
 Atmosfera nelVIsola di Malta. 
 
 38. CORFU. 
 
 Dr. John Davy. Mean of the thermometer for the years 1821-27. 
 
 39. CADIZ. 
 
 Dr. Skirving; September 1810 to August 1812, on board ship in 
 Cadiz Bay, at noon and 6 p.m., corrected by Brewster's Table; Madrid 
 59^-0; 2040 feet above the level of the sea. Lisbon 62°. Balbi. 
 Essai Statistique sur le Portugal. 
 
 40. SANTA CRUZ. (Isle of Teneriffe.) 
 
 VonBuch, from the Journal of Don Francisco Escolar; mean of sunrise 
 and of noon. 
 
NOTES ON THE METEOEOLOGICAL TABLES. 399 
 
 41. MADEIRA. 
 Drs. Heineken and Renton. From observations taken at Funchal with 
 register thermometers during six years, viz. 1826 to 1831. The instru- 
 ments were placed about 15 feet from the ground and 89 above the 
 level of the sea. 
 
 " Such pains were taken by us to avoid every source of error, in 
 respect to shade, exposure, instruments, &c., that I do not believe it 
 possible to obtain results now equally worthy of confidence. ... As a 
 proof of the general correctness of our observations, I may mention that 
 living then in the town, and at about the same level above the sea, our 
 means agreed to within a fraction with each other, and that the mean 
 afforded by our daily observations gave almost exactly the same results 
 as that shown by deep wells in which the temperature remains the same 
 throughout the year." Letter from Dr. Renton, March 1842. 
 
 42. ST. MICHAEL'S. 
 
 Thomas Blunt, Esq. 1825. Mean of 8 a.m. and 8 p.m. See also Dr. 
 Bullar's observations in his work on the Azores. 
 
 43. CAIRO. 
 Humboldt, from Nouet. 
 
 44. CEYLON. 
 W. S. Grey, Esq. From observations taken with a common thermometer 
 during the years 1842 — 43, at 6 a.m., noon, and 6 p.m., on the Can- 
 delawewe estate in the hill district of Ceylon. 
 
 45. PORT JACKSON. 
 
 From Meteorological Journal kept at the station on the South Head of 
 Port Jackson, New South Wales. Mean of observations taken four 
 times a day, viz. 8^ a.m., 2J p.m., sunset, and 9 p.m., during five 
 years, 1840 — 44 inclusive, at a height of 254 feet above tlie level of 
 the sea. 
 
 46. PORT PHILIP. 
 From Meteorological Journal kept at Melbourne, Port Philip, New 
 South Wales. Mean of observations taken 4 times a day, viz., 
 
4©0 NOTES ON THE METEOROLOGICAL TABLES. 
 
 8^ A.M., 2J P.M., sunset, and 9 p.m., from 1840 — 43 inclusive; 130 
 feet above the sea level. 
 
 47. AUCKLAND. 
 
 Mean for 4 years, 1840 — 44 inclusive, from observations three times 
 
 a day ; 8 a.m. ; 2 p.m. ; and 8 p.m. Dr. Martin's New Zealand. 
 
 TABLE II. 
 
 This Table sufficiently explains itself. The authorities are the 
 same as in Table I, 
 
 TABLE III. 
 
 The average Mean of the Range during each day and night, 
 unless when otherwise expressed. 
 
 LONDON. 
 
 Average difference of the higher and lower mean, 1797 — 1806. Howard. 
 Mean daily range according to Daniell, 13°'6 ; mean maximum, 
 56°* 1 ; mean minimum, 42°* 5. 
 
 PENZANCE. 
 Mean difference of 7 a.m. and 2 p.m. 
 
 ENVIRONS OF LONDON. 
 Average difference of the higher and lower mean, 1807 — 1816. 
 
 LEITH. 
 ** The measure of the daily change of temperature." Brewster. Edin- 
 burgh Journal of Science. 
 
 GENEVA. 
 
 Difference of the mean of sunrise and of 2 p.m. Annual range at Sion, 
 
 92°— 9°=83"; 1819, 92°+2°=94°. 
 
NOTES ON THE METEOROLOGICAL TABLES. 401 
 
 AVIGNON. 
 
 Mean difference of sunrise and 2 p.m. Extreme range in 12 years, 
 101°— 12^=89°. 
 
 PAU. 
 
 Mean difference of 9 a.m. and noon. Range at Toulouse, 81°— 24° = 57°. 
 
 NAPLES. 
 
 Mean difference of sunrise and 2 p.m. Extreme range during 5 years, 
 95°— 26^ = 69°. 
 
 ROME. 
 
 Mean difference of 7 a.m. and 2 p.m. Extreme range during 13 
 years, 101°— 22°= 89°. 
 
 NICE. 
 Dr. Skirving. Mean difference of sunrise and 2 p.m. 
 
 TABLE IV. 
 
 The Difference of the Mean Temperature of each succeeding day, 
 unless where otherwise expressed. 
 
 LONDON. 
 Mean difference of the temperature of the same hours of successive 
 days; calculated from Daniell's Meteorological Journal, 1820 — 1823. 
 
 PENZANCE. 
 Forbes, Climate of Penzance, 
 
 PAU. 
 
 Mean difference at 9 a.m., 12 a.m., and 4 p.m. 
 
 NICE. 
 Dr. Skiiving. Mean difference of successive days at sunrise and 2 p.m. 
 
402 NOTES ON THE METEOROLOGICAL TABLES. 
 
 ROME. 
 Mean difference of successive days at 7 a.m., 2 p.m., and at 9 p.m. 
 
 NAPLES. 
 Mean difference of successive davs at sunrise and 2 p.m. 
 
 TABLE V. 
 
 The Extremes of Temperature will be found to differ considerably 
 in this table according as they have been observed by register or 
 common thermometers, and also from the situation of the instru- 
 ments. Thus the Foreign Climates show a comparatively smaller 
 range, from having been taken, with the exception of Madeira, 
 with common thermometers. 
 
 LONDON. 
 Deduced from the average extremes; 1820 — 1823. Daniell. Maxi- 
 mum temperature, during 30 years, 96°, 13th July 1808. Mini- 
 mum during the same period 5°, 9th February 1816. Howard. 
 
 PENZANCE, 
 Annual range, average extremes, 1821 — 1827. Monthly range, average 
 extremes for 12 years, 1821 — 1832. Extreme range during 21 
 years, 84°— 19° = 65°. 
 
 BUTE. 
 Deduced from the data in Table X. 
 
 BAROMETER. 
 
 TABLE VI. 
 Mean Atmospheric Pressure. 
 
NOTES ON THE METEOROLOGICAL TABLES. 403 
 
 LONDON. 
 
 Daniell's Meteorological Essays. 
 
 TORQUAY. 
 Edward Vivian, Esq. Average of 4 years, 1842—1844, from one 
 daily observation at 9 a.m. Height of barometer above the level of 
 the sea about 160 feet. 
 
 COVE. 
 Dr. Scott. Mean of observations for 7 years; from September 1834 
 to August 1841 inclusive. The first three years were taken from 
 three daily observations, 9 a.m., 3 p.m., and 9 p.m.; the latter four 
 years from one observation daily at 9 a.m. 
 
 UNDERCLIFF. 
 Dr. Martin. Mean of 7 years, 1839 to 1845. From two daily observa- 
 tions, 9 a.m. and 6 p.m. in summer j and 9 a.m. and 5 p.m. in 
 winter. Taken with a mountain barometer, by Newman, at a height 
 of about 150 feet above the level of the sea^ 
 
 CLIFTON. 
 
 W. H. Gore Langton, Esq. From observations taken twice a day, 10 a.m. 
 
 and 10 P.M., during 9 years, 1837 to 1845 inclusive. 
 
 EXETER. 
 
 Average of 10 years, 1825 to 1834 inclusive. Dr. Shapter On the 
 Climate of Devon. 
 
 HASTINGS. 
 
 From one daily observation, 9 a.m., for one year, 1841. Dr. Mackness 
 
 On the Climate of Hastings. 
 
 SIDMOUTH. 
 
 Rev. N. S. Heineken and Dr. Cullen. The average of one daily 
 
 observation, at 9 a.m., from May 1836 to the end of 1845. 
 
 NEWPORT. 
 John C. Bloxam, Esq. The mean of one daily observation at 9 a.m. 
 
404 NOTES ON THE METEOEOLOGICAL TABLES. 
 
 corrected for temperature, for 6 years, 1840 to 1845 inclusive. Taken 
 with a mountain barometer, by Newman, placed at a height of 28 
 feet above the sea level. 
 
 MALTA. 
 Sir Howard Elphinstone. The average of three daily observations, 8 
 A.M., 4 P.M., and 10 p.m. from May 1832 io November 1834 in- 
 clusive. Dr. Davy's Ionian Islands and Malta. 
 
 CONSTANTINOPLE. 
 Mr. Redhouse. From October 1839 to December 1840 inclusive ; at a 
 height of about 200 feet above the level of the sea. Dr. Davy's 
 Ionian Islands and Malta. 
 
 MADEIRA. 
 Drs. Heineken and Renton. Mean of one daily observation at 10 a.m., 
 for six years, 1826 to 1831 ; corrected for temperature. The baro- 
 meter was a mountain one by Newman, placed at a height of about 
 90 feet above the sea level. 
 
 PORT JACKSON. 
 From four daily observations, 8J a.m., 2^ p.m. sunset, and 9 p.m. 
 during five years, 1840 to 1844, at a height of about 240 feet above 
 the level of the sea. 
 
 PORT PfflLIP. 
 
 From four daily observations, 8^^ a.m., 2J p.m., sunset, and 9 p.m., from 
 April 1840 to the end of 1843, at 130 feet above the sea level. 
 
 TABLE VII. 
 Range of Barometer. 
 
 LONDON. 
 Howard. 1806—1816. Corrected for temperature. 
 
NOTES ON THE METEOROLOGICAL TABLES. 405 
 
 PENZANCE. 
 Dr. Forbes. 1818—1819. 
 
 GOSPORT- 
 Dr. Bumey. 1827. 
 
 KENDAL. 
 S. Marshall, Esq. Philosophical Magazine. 
 
 EDINBURGH. 
 Medical Observations, 1734-35. Corrected for temperature. 
 
 BUTE. 
 
 R. Thom, Esq., 1821 — 1829, from hourly observations. 
 
 MONTPELIER. 
 M. Mejan. 
 
 ROME. 
 Calandrelli. 1811—1823. 
 
 NAPLES. 
 Broschi. 1821—1824. 
 
 FLORENCE. 
 Ximenian Observatory. 
 
 FALL OF RAIN. 
 
 TABLE VIII. 
 
 I 
 
 In estimating the Quantity of Rain for each place comparatively, 
 allowance must be made for the height of the pluviometer from 
 the surface of the ground, and notice will be taken of this cir- 
 cumstance whenever the information is sufficient. 
 
406 NOTES ON THE METEOROLOGICAL TABLES. 
 
 LONDON. 
 Howard. Mean for 20 years. 
 
 TORQUAY. 
 
 Edward Vivian, Esq. From 1842 to 1845 inclusive. The rain gauge 
 
 stood about 3 feet from the ground. 
 
 COVE. 
 Dr. Scott. Mean for 3 years; from Sept. 1834 to Aug. 1837 inclusive. 
 
 PENZANCE. 
 Mr. E. Giddy. Mean for 12 years. 
 
 BRISTOL. 
 
 Bristol Institution. These observations are given to supply as far as 
 
 possible the want of observations on the fall of rain at Clifton. 
 
 UNDERCLIFF. 
 Dr. Crawford, 1831. — Dr. Martin: mean from December 1838 to 
 December 1845 inclusive. The pluviometer stood about 3^ feet 
 from the ground and 150 feet above the level of the sea. The amount 
 also includes melted snow. 
 
 EXETER. 
 Mean for 10 years, 1825 — 34 inclusive. Dr. Shapter, Climate of Devon. 
 
 HASTINGS. 
 Mean for 5 years, 1841 — 1845 inclusive. 
 
 GOSPORT. 
 Dr. Burney. 1827. 
 
 SIDMOUTH. 
 Dr. Cullen. Mean from April 1843 to December 1845 inclusive. 
 The gauge is placed on the top of a house about 6Q feet from the 
 ground. 
 
NOTES ON THE METEOROLOGICAL TABLES. 407 
 
 It is feared some fallacy must exist in these observations, as during 
 the nine months in which they were made, in 1843, 30*36 inches of 
 rain fell, while in the whole year of 1845 the singularly small quantity 
 of 14*10 inches only are noted; being as much below the quantity for 
 the same year observed in other places as the former is above. 
 
 CHISWICK. 
 
 Mean for 19 years, 1826 to 1844 inclusive. From observations made 
 
 at the Horticultural Society's gardens. 
 
 NEWPORT. 
 Jolin C. Bloxam, Esq. Mean for 5 years, 1841 to 1845. 
 
 WHITEHAVEN. 
 Mr. Miller. 1845. 
 
 GRASMERE. 
 Mr. Miller. 1845. 
 
 KENDAL. 
 Dalton. 25 years. 
 
 LIVERPOOL. 
 Dalton. 18 years. 
 
 MANCHESTER. 
 Dalton. 33 years. 
 
 EDINBURGH. 
 
 Adie. 1824—1825. 
 
 GLASGOW. 
 Mean for 7 years, 1839-45. Observed at Hillhead, 2 miles from Glas- 
 gow, in the western suburb. 
 
 DUMFRIES. 
 Dalton. 16 vears 
 
408 NOTES ON THE METEOROLOGICAL TABLES. 
 
 BUTE. 
 R. Thorn, Esq. 19 years. 
 
 LSLE OF MAN. 
 R. Stewart, Esq. 1824—1828. 
 
 PARIS. 
 
 Dalton. 15 years. The rain-gauge stood a considerable height from 
 the ground. 
 
 TOULON. 
 Burel. 33 years. 
 
 MARSEILLES. 
 Blanpain. 10 years. The gauge was at a height from the ground. 
 
 MONTPELIER. 
 Poiteven. 1796—1806. 
 
 ROME. 
 
 Calandrelli. 181 1 — 1823^ The rain-gauge was at a considerable height 
 from the ground. 
 
 NICE. 
 M. Troubaudy. Mean of observations for 8 years. 
 
 FLORENCE. 
 
 Ximenian Observatory. Tlie pluviometer was placed at a height from 
 
 the ground, 
 
 MILAN. 
 Cesaris. 1793—1807. 
 
 GIBRALTAR. 
 
 Mean for 25 years, 1811—1835. The pluviometer stood about 100 
 
 feet above Ihe level of the sea. Davy's Ionian Islands and Malta. 
 
NOTES ON THE METEOROLOGICAL TABLES, 409 
 
 CONSTANTINOPLE. 
 Mr. Redhouse. From October 1839 to December 1840 inclusive. 
 The gauge stood about 20 feet from the ground and 200 above the 
 level of the sea. Dr. Davy "s Ionian Islands and Malta. 
 
 MADEIRA. 
 
 Drs. Heineken and Ren ton. Mean of 7 years, 1825 to 1831, about 25 
 feet from the ground and 99 above the level of the sea. 
 
 PORT JACKSON, 
 Mean for 3 years, 1841 to 1843 inclusive. 
 
 PORT PHILIP. 
 Mean from April 1810 to December 1843 inclusive. 
 
 AUCKLAND. 
 From September 1843 to September 1844 inclusive. 
 
 I 
 
 TABLE IX. 
 
 Average Number of Days on which Rain falls. 
 
 LONDON. 
 Howard, 1807—1816. 
 
 TORQUAY. 
 
 Edward Vivian, Esq. 1842—1845. This includes those days on which 
 any rain fell during the night, and when the quantity was not per- 
 ceptible in the rain-gauge. 
 
 COVE. 
 
 Dr. Scott. Mean from September 1834 to December 1843 inclusive. 
 
 This includes those days on which snow fell, 
 
 T 
 
410 NOTES ON THE METEOROLOGICAL TABLES. 
 
 * 
 
 PENZANCE. 
 Forbes. 1807—1820. 
 
 UNDERCLIFF. 
 
 Dr. Martin. Mean number of days and nights on which rain or snow 
 
 fell, even a. few drops, for 5 years, from 1841 to 1845 inclusive. 
 
 CLIFTON. 
 
 W. H. Gore Langton, Esq. Mean for 10 years, 1836—1845. This 
 
 includes falls of snow. 
 
 EXETER. 
 Dr. Shapter On the Climate of Devon. 
 
 HASTINGS. 
 Average of 5 years, from 1841 to 1845. 
 
 SIDMOUTH. 
 Mean for 3 years, 1843 to 1845. 
 
 NEWPORT. 
 John C. Bloxam, Esq. Mean for 6 years, 1840 to 1845. This in- 
 cludes days on which snow, as also those on which sijew drops only of 
 rain fell. 
 
 WHITEHAVEN. 
 Mr. Miller. 1845. 
 
 GRASMERE. 
 
 Mr. Miller. 1845. 
 
 MARSEILLES. 
 Thulis and Blanpain* 
 
 MONTPELIER. 
 Poiteven. 1796 to 1806. 
 
NOTES ON THE METEOROLOGICAL TABLES. 411 
 
 PAU. 
 
 Mean of 5 years, 1837 to 1841, including those days on which snow 
 fell. Dr. Taylor On the Climate of Pau. 
 
 ROME. 
 Calandrelli. 1811—1823. 
 
 NAPLES. 
 Broschi. 1821—1824. 
 
 FLORENCE. 
 Xitnenian Observatory, 1825. 
 
 GIBRALTAR. 
 Average from 1811 to 1836. Dr. Davy's Ionian Islands and Malta. 
 
 CONSTANTINOPLE. 
 Mr. Redhouse. 2 years, 1839—40. 
 
 MADEIRA. 
 Drs. Heineken and Renton. Mean for 4 years, 1827— 1 830. 
 
 PORT JACKSON. 
 Mean for 3 years, 1841 to 1843. 
 
 PORT PHILIP. 
 Mean from April 1840 to December 1843 inclusive. 
 
 AUCKLAND. 
 Mean for 4 years, 1810 — 1844 inclusive. 
 
 TABLE X. 
 
 The Maxima and Minima of the Barometer and Thermometer in 
 the last line of the table are the highest and lowest points reached by 
 the mercury during the whole of tlie 19 years. 
 
412 NOTES ON THE METEOROLOGICAL TABLES. 
 
 Column 7 gives the greatest difference of temperature, during the whole 
 of the 19 years, for each month and for the whole 19 years. 
 
 The mean of the barometer and that of the thermometer, as given in the 
 table, are not the means between the maxima and minima, but have 
 been deduced by dividing the sum of all the degrees noted during 
 the whole 19 years by the total number of observations made during 
 that time. 
 
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