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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 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
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 sarco-
phytes, 28

-description of fibrin in blood clot,
36

Adenoid tissue, 20

Age, in relation to hæmoptysis, 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. W. P., opposed to Laen-
nec's views on the non-inflammatory
origin of tubercle, 9

-on chemical conversion into fat, 44
Altitudes, influence of high, 106
-treatment of phthisis by, 394
Amoeba, 30

Amoeboid properties, 27

- cells, influence of heat on, 32

Ancell, Mr., on hereditary transmission
of phthisis, 116

Andral, Prof. G., on inflammatory
origin of tubercles, 8

on red and grey hepatization, 73
-proportion of hæmoptysis to tubercle,
139

on duration of phthisis, 288
Aneurism of pulmonary artery as cause
of hæmoptysis, 146

BOW

Aneurism, case of, 151
Animals, experiments on, 86

hereditary tuberculosis of, 113
Antiphlogistic treatment, 319, 332
Antiphthisical treatment, 320
Antiseptic treatment, 361
Aplastic deposits, 37

Arrest of phthisis, 1st stage, 242

2nd stage, 247

3rd stage, 250

Asthmatic phthisis, 207

BARDSLEY, Dr., sen., used eod-liver
oil 70 years ago, 350

Bartlett, Dr., U.S.A., phthisis a sequela
of fever, 129

Bastian, Dr., on amoeboid properties of
sarcophytes, 27

Baümler, Dr., on hæmoptysis, 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 Sarcophytes.
Blaand, 386

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

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CON

INDEX.

Consumption produced by inflamma-
tion, 24, 61

in the lymphatics, 40, 84
Causation of, artificial and natural,
96-108

family predisposition and other
causes of, 109-137
infection in, 137
hæmoptysis 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 hæmoptysis, 147

on percentage of hæmoptysis in
phthisis, 298

inutility of hypophosphites in
phthisis, 326

Cruvelhier, Prof., on inflammatory
origin of tubercle, 8

Cure, mountain, 329

grape, 377

of phthisis. See Cases

per centage of, 305

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FAT

Degeneration, fatty, 44

of sarcophytes, 33
Degradation of tissue, 11

397

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

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Exercise, varieties of, 380

Expectoration, varieties of, 81

Extension of disease from one lung to

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Exudation, theory of, 29

AMILY predisposition, 110

explained, 112

percentage of, 115
influence of sex on, 116

influence on age of attack, 118
-on duration, 124

symptoms, 120

statistics of. See Tables

Fatty degeneration, discovery of, 44

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