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 hæmoptysis, 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 ABERCROMBIE, Dr., on the natural origin tubercular disease, 9 Abscess, chronic, of lung, 202 - gangrenous of lung, 206 Acute consumption, forms of, 2 Addison, Dr. T., on indurations of the Addison, Dr. W., microscopic observa- observations of pale corpuscles, 26 -description of fibrin in blood clot, Adenoid tissue, 20 Age, in relation to hæmoptysis, 150 of attack, 294; with family predis- Aged parents, offspring of, consump- Air, pure, 329, 388 Albuminous variety of phthisis, 82 -on chemical conversion into fat, 44 Amoeboid properties, 27 - cells, influence of heat on, 32 Ancell, Mr., on hereditary transmission Andral, Prof. G., on inflammatory on red and grey hepatization, 73 on duration of phthisis, 288 BOW Aneurism, case of, 151 hereditary tuberculosis of, 113 Arrest of phthisis, 1st stage, 242 2nd stage, 247 3rd stage, 250 Asthmatic phthisis, 207 BARDSLEY, Dr., sen., used eod-liver Bartlett, Dr., U.S.A., phthisis a sequela Bastian, Dr., on amoeboid properties of Baümler, Dr., on hæmoptysis, 143 duration of phthisis, 288 Beale, Prof. Lionel, his terms, germinal has proved bioplasm to exist be- observation of living properties of Bed-sores, treatment of, 373 Bennett, Dr. Hughes, first book on cod- Bennett, Dr. Risdon, on good diet in Bioplasm, 30 Bioplasts. See Sarcophytes. Blistering, utility of, 333 best mode of, 333 Bolivia, efficacy of climate, 106 CON INDEX. Consumption produced by inflamma- in the lymphatics, 40, 84 family predisposition and other summary of treatment of, 316-330 Counter-irritation, modes of, 333, 366 Cotton, Dr., on family predisposition on the non-infectious nature of -on pulmonary aneurism as a cause on percentage of hæmoptysis in inutility of hypophosphites in Cruvelhier, Prof., on inflammatory Cure, mountain, 329 grape, 377 of phthisis. See Cases per centage of, 305 FAT Degeneration, fatty, 44 of sarcophytes, 33 397 De Jongh, Dr. brown oil inferior to Dewar, Dr., recommendation of sul- Exercise, varieties of, 380 Expectoration, varieties of, 81 Extension of disease from one lung to Exudation, theory of, 29 AMILY predisposition, 110 explained, 112 percentage of, 115 influence on age of attack, 118 symptoms, 120 statistics of. See Tables Fatty degeneration, discovery of, 44 |