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other high stations, where he can remain till the approaching winter renders his return to the warm station desirable.

The great purity and somewhat exciting quality of the air in all these places has a vivifying influence on the bioplasm, and on all the vital functions, and generally produces a change soon in the colour and spirits of the patients, and in time on their strength and flesh also. But in order to ensure the good effects of the air, exercise must be regularly taken, and as patients are seldom strong enough to walk for the requisite time in the open air, riding or driving should be much resorted to.

We may here remark, that even patients, who are deemed fit cases to pass the winter in high level resorts, will be wise to commence their sojourn in the elevated district in summer, and thus become gradually inured to the vigorous climate, and reap all the good which can accrue from it.

It is the custom in America to send consumptive patients for the winter to dry inland localities, of no great elevation, as St. Paul's in Minnesota, and certain parts of Canada; and we have seen patients who have wintered there, but up to this date the evidence collected by us has not been altogether favourable to these climates, of which we imagine the dryness to be the best feature.

One of the most approved methods of giving a phthisical invalid change of air is by a long sea-voyage, as, for instance, to Australia and back ; and facts are tolerably numerous to testify to its beneficial effect, not only in the very early stages of the disease, but even where limited cavities have formed. This mode, however, of change of climate, is liable to some drawbacks, which are: want of opportunities for exercise, very variable weather and temperature, sometimes bad accommodation and food, and often ennui and home sickness. If the patient can go in comfort, pleasure, and hope, and start in the month of October, provided that his disease is not very extensive, he may reap considerable benefit.

Before we close this short notice of climate in relation to consumption, we ought to mention what patients ought not, in our opinion, to be sent abroad. These are, cases of acute phthisis, both tuberculosis and scrofulous; pneumonia, if the latter be in an acute stage, though if its progress, as happens sometimes, be rendered more chronic, the patient may possibly be excepted from our rule.

While patients with lungs in various stages of the disease may benefit greatly by going abroad, provided the amount of lesion be not very extensive, we must add our warning to that of other medical writers against the cruelty and madness of allowing those, whose extreme state precludes all hope of recovery and who are obviously near their end, to exchange the comforts of a home in their native land for the miseries of foreign exile, for it is far better for them to sink into their graves surrounded by all that art can suggest and affection supply, to assuage their sufferings, than to close life by a death-bed in a strange land, and often among strange people, to whom many of the luxuries which smooth the dying pillow are unknown. Some patients, who have been greatly reduced by inflammatory attacks, or by haemoptysis, have the appearance of being in extreme phthisis, but an examination of their lungs, will show that they are not really so. These are the patients who are said to have been placed on board ship, in a dying state, and to have recovered, and it would not be well to place an absolute veto on such treatment in their cases.

In conclusion, we would state that too much must not be expected from climate alone, in the treatment of so formidable a disease as pulmonary consumption ; but that when its influence is joined to that of medicine and hygiene, much may be done towards mitigating, arresting, and even curing, the dread malady.

INDEX.

ABE

I BERCROMBIE. Dr., on the natural
A origin of tubercular disease, 9
Abscess, clironic, of lung, 202

— gangrenous of lung, 206
Acute consumption, forms of, 2
Acute tuberculosis, 2

Addison, Dr. T., on indurations of the
lung, 73, 74

Addison, Dr. W., microscopic observa-
tions on tubercle, 14

— observations of pale corpuscles, 26

— discovery of migration of sareo-
phytes, 28

— description of fibrin in blood clot,
36

Adenoid tissue, 20

Age, in relation to haemoptysis, 150

— reached in hereditary phthisis, 127

— influence of, on duration, 311

— of attack, 294; with family predis-
position, 118

Aged parents, offspring of, consump-
tive, 113

Air, pure, 329, 388

Albuminous variety of phthisis, 82

Alison, Prof. \V. P., opposed to Laen-
nec's viewson the non-inflammatory
origin of tubercle, 9

— on chemical conversion into fat, 44
Altitudes, influence of high, 106

— treatment of phthisis by, 394
Ama'ba, 30

Amoeboid properties, 27

— cells, influence of heat on, 32
Ancell, Mr.,on hereditary transmission

of phthisis, 116
Andral, Prof. (!., on inflammatory
origin of tubercles, 8

— on red and grey hepatization, 73

— proportion of ha?moptvsis to tubercle,
139

— on duration of phthisis, 288
Aneurism of pulmonary artery as cause

of hemoptysis, 146

BOW

Aneuriam, cane of, 151
Animals, experiments on, 86
— hereditary tuberculosis of, 113
Antiphlogistic treatment, 319,332
Antiphthisicol treatment, 320
Antiseptic treatment, 361
Aplastic deposits, 37
Arrest of phthisis, 1st stage, 242

2nd stage, 247

3rd stage, 2f,0

Asthmatic phthisis, 207

BARDSLEY, Dr., sen., used cod-liver
oil 70 years ago, 350
Bartlett, Dr., L.S.A., phthisis a sequela

of fever, 129
Bastian, Dr, on amoeboid properties of

stirtophytes, 27
BaOmler, Dr., on haemoptysis, 143
Bayle, Prof., description of miliary
granulations, 7

— duration of phthisis, 288

Beale, Prof. Lionel, his terms, germinal
matter and bioplasm well applied to
protoplasm, 30

— has proved bioplasm to exist be-
fore cells, 36

— observation of living properties of
pus globules, 50

Bed-sores, treatment of, 373
Bennett, Dr. Hughes, first book on cod-
liver oil in 1841, 350
Bennett, Dr. Risdon, on good diet in

phthisis, 375
Bioplasm, 30
] Bioplasts. See Sureophvtes,

Blaand, 386
1 Blistering, utility of, 333
| — best mode of, 333
Blood drinking, 377
Bolivia, efficacy of climate, 106
'Bowditch, Dr., U.S.A., on dampness
of soil as a cause of phthisis, 132

BOW

Bowman (ami Tod 1) on the vaicu-
larity of the nasal membrane, 140

Brehmer, Dr., immunity of high alti-
tudes from phthisis, 107

Brett and Bird, on chemical composi-
tion of expectoration, 83

Briquet, M., on hereditary transmis-
sion of phthisis, 119

Brompton Hospital Report (1st), on
hereditary influence in phthisis, 116

on influence of sex and age,

149

on the duration of phthisis,

288

Bronchial glands, 57

— hemorrhage compared with epig-
taxis, 140

— and nasal tracts compared, 140
Bronchitis followed by phthisis, 298

per centage of cases, 298

Broussais, Prof., considered tubercle

inflamed lymphaties, 8

Buchanan, Dr. G., report on the influ-
ence of damp soils in producing
phthisis, 131

Budd, Dr. W, on the zymotic nature
of phthisis, 98,135

Buhl on tuberculosis from caseous
matter, 80

Butchers, rarity of consumption among,
376

riACOI'LASTIC deposits, 12, 37
\J Calcareous expectoration, 304
Calcification of lung, 79
Cancer compared with tubercle, 18
Cancerous disease of the lung, 145
Caseation of inflammatory products,
47

— of fibrin, 48

— remarkable instance of, 47'

— of bronchial glands, 24
Caseous hepatization, 77

Cases, division and selection of, 181, 291

— tabulation of, 293

— of calcareous transformation, 78

— of remarkable caseation, 47

— of hemoptvsis, 150

— of hemorrhagic phthisis, 84, 262

— of fibroid phthisis, 182, 187, 188, etc.

— of phthisis after pleuropneumonia,
182, 184

pleurisy, 183, 185, 190

pneumonia. 189

— of asthma and phthisis, 208-211

— acute, 216-231

— scrofulous, 232, 241

— chronic, 212, 272

— with pregnancy, 273, 276

COX

Cases with pneumothorax, 279, 282

acute rheumatism, 283

lithuria, 284

— after injury to chest, 277, 278

— senile, 285

— miscellaneous, 273

— of suppuration, 54
Catarrhal variety of phthisis, 81
Causation, twofold, of phthisis, 106,

387

Causes of phthisis, 104

general and local, 109

predisposing or exciting, 110

Cavity in lung, 302, 304

arrest of, 250

percentage of, 301

Cavities, double, 271, 304
Cell, theory of formation of, 29

— amoeboid, 32

Cessation of discharges, cause of

phthisis, 130
Charlton, Dr., theories of immunity

from consumption, 386
Chemical constitution of tubercle, 49
Churchill, Dr., on the use of hypophos-

phites in phthisis, 326
Chronic pneumonic phthisis. Ste

Cases

Clark, Dr. Andrew, on fibroid pht hisis,
36

— on artificial tuberculosis, 86
Classification of consumptive diseases,

60

Climate, 385

— inland, 389 varieties of, 389

— marine, 388 varieties of, 388

— winter, 390

— summer, 392
Clothing, 377

Cod-liver oil, wonderful benefits from,
317

see Cases.

mode of action, 343

plan of exhibition, 353

penetrative power of, 352

objections to dark-brown, 350

pale to be preferred, 352

in unction with, 352

preparation of, 351

palatable, 354

Cohnheim, Prof., on emigration of

sarcophytes, 27
Conservation of strength, 338
Consolidation. See Induration
Constipation, 371

Consumption, pulmonary, defined, 1

— examples and progress of, 2-6

— pathology and nature of, 7-108

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CON

Consumption produced by inflamma-
tion, 24, 61

— in the lymphaties, 40, 84
Causation of, artificial and natural,

96-108

— family predisposition and other
causes of, 109-137

— infection in, 137

— haemoptysis in, 138-167

— physical signs of, 168-179

— going into asthma, 215

— duration of, 287-315

— prognosis in, 309

— summary of treatment of, 316-330

— improvement in treatment of, 317

— antiphlogistic remedies in, 331-338

— antiphthisical remedies in, 340-362

— cod-liver oil in, 321, 342, etc.
Other matters concerning pulmonary

consumption, passim

Contraction of cavity, 304

Copland, Dr., on hereditary transmis-
sion of phthisis, 114

Cough, treatment of, 364

Counter-irritation, modes of, 333, 366

Corrigan, Sir D., on cirrhosis of the
lung, 35, 63

Cotton, Dr., on family predisposition
in phthisis, 114

— on the non-infectious nature of
phthisis, 136

— on pulmonary aneurism as a cause
of haemoptysis, 147

— on percentage of haemoptysis in
phthisis, 298

— inutility of hvpophosphites in
phthisis, 326

Cruvelhier, Prof., on inflammatory

origin of tubercle, 8
Cure, mountain, 329

— grape, 377

— of phthisis. See Cases

— per centage of, 305

DAMP, cause of consumption, 131
Darling, Dr., used cod liver
oil fifty years ago, 350
Davy, Dr. John„ on conversion of
flesh into fat, 44

— his detection of fat in old exuda-
tions, 46

Deaths, number of, 305

— causes of, 305

Decline, general, preceding or accom-
panying consumption, 346

— counteracted by anti-phthUical re-
medies, 347

*- may take place without phthino
plasm, 347

FAT

Degeneration, fatty, 44

— of sarcophytes, 33
Degradation of tissue, 11

De Jongh, Dr. brown oil inferior to
pale, 350

Dewar, Dr., recommendation of sul-
phurous acid in phthisis, 327

Diagnosis, difficulties of, 315

Diarrhoea, 370

Diet, effects of, 373

Dieteties. See Food and Stimulants

Digital clubbing, 203

Disintegration of fibrin, 49

Dobcll, Dr., pancreatic emulsion in
phthisis, 349

Drainage, 384

Duration of phthisis, estimates of, 288

— analysis ol 1,000 cases, 306

— in males, 310

— in females, 310

— understated, 295

— instances of long. See Cases

— causes of long, 309

— influence of age on, 311

— of life in phthisis quadrupled, 318
Dusty occupations cause of consump-
tion, 135

Dyspnoea, treatment of, 372

ECTASIA, 147
Edwards, Mr. Virtue, statisties of
Brompton Hospital in disproof of
infection, 136
Emphysema, with contractile disease,
212

— with suppurative bronchitis, 214
Empyema, 49, 304

— varieties of, 304

— threatening phthisis, 240
Endemic phthisis, 133
Epistaxis, 140
Euplasia, 68

Exercise, varieties of, 380
Expectoration, varieties of, 81
Extension of disease from one lung to

the other, 304 greater liability of right lung

to, 304
Exudation, theory of, 29

IjlAMILY predisposition, 110 explained, 112

percentage of, 115

influence of sex on, 116

influence on age of attack, 118

on duration, 124

symptoms, 120

statisties of. See Tables

Fatty degeneration, discovery of, 44

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