les seuls efforts de la nature. Mais ce qu'il y a de singulier, c'est qu'il n'y a eu que les célibataires qui aient été attaqués de cette maladie." M. Littré, who quotes the above passage, does not say whether M. Rossignoly subjoined to his statement an account of the coincident meteorological phenomena. With reference to the last fact, that the mumps only attacked single men, it must be remarked that Hippocrates (op. cit.) distinctly says that "they attacked lads, adults, and especially those engaged in the palæstra and gymnasium." We know that those who exercised in the Palæstra were generally youths, and probably single; on the other hand, the Gymnasium was more used by men who were training, and, as a general rule, trainers are, for the time being, "célibataires."

(b) Fevers. This was evidently not a year favourable to the development of fevers; they were moderate, unattended by bleeding (from the nose), and were never fatal. We shall find in the sequel that Hippocrates considered that droughty years were most conducive to acute fevers. The constitution of this year could hardly be considered so; in fact, there seems to have been plenty of rain, with a southerly tendency in the wind during the preceding autumn, and although altogether a dry year, yet there was no drought, except during the winter.

(c) Phthisis.-Consumption was very fatal during this year; and it will be interesting to trace the relation borne by this dreadful disease to the constitution of a year in which it was so prominent a cause of death, and in doing so we must compare the opinions of modern physicians with the observations of Hippocrates, and the other great medical authorities of antiquity.

Hippocrates says that the autumn is obnoxious to consumptive persons; to which Galen adds, in his commentary on this passage, "if it be dry, cold, and unequal." On reference to the table, we find that the summer in which the consumptive cases began to develope themselves was dry, the winds irregular, and the sky overcast of the state of the weather during the

succeeding autumn nothing is said. However, it appears that phthisis committed great ravages during both these seasons. In England we learn from the statistical returns that the spring is the most fatal to consumptive patients, whether male or female; but with regard to the other seasons there is considerable variability. For instance, suppose we take the seasons of 1838 in the order of their fatality to males, they would stand thus: spring, 1137; winter, 1048; summer, 968; autumn, 904. To females: spring, 972; summer, 937; winter, 896; autumn, 825. Then again, although the spring invariably takes the lead, the other seasons change places with each other from year to year; and what is remarkable, this inconstancy does not seem to be dependent upon temperature, as we shall presently see. In the returns for 1853, the following statistics on deaths from consumption appear:-Winter, 1872; spring, 1971; summer, 1745; autumn, 1914. The order of fatality in the years above quoted would therefore be

1838. Males. 1, spring; 2, winter; 3, summer; 4, autumn. Females. 1, spring; 2, summer; 3, winter; 4, autumn. 1840. Total. 1, spring; 2, winter; 3, summer; 4, autumn. 1853. 1, spring; 2, autumn; 3, winter; 4, summer. So far, therefore, as seasons are concerned, the above tables prove that spring-i. e. April, May, June-is the most inimical quarter to phthisical patients, and that probably autumnOctober, November, and December-the least so. In London at least, if not throughout England generally, the spring is undoubtedly the most obnoxious to consumptive cases; and this statement is in accordance with the experience of those physicians who have opportunities of seeing the rise, progress, and end of many hundreds of phthisical cases during the year. Dr. Richard Quain observes "that the cold easterly wind of spring completes the work which the winter had left undone."

Temperature. We have already alluded to the effect of temperature in consumptive cases. Its relation, however, to this disease requires something more than a mere passing notice.

On referring to the Table Nos. I. and II., which show at a glance the fluctuations in the mortality from diseases of the lungs, it will be observed that phthisis does not seem to be so much influenced by the increasing temperature of the year as the other two diseases, bronchitis and pneumonia. The constitution of the year under discussion seems to have been especially obnoxious to the organs of respiration. There had been a great deal of rain, and a northerly tendency in the wind, during the seasons previously to those grouped together under this First Constitution; and it may be conjectured that then the seeds of pulmonary diseases were sown, to be redeveloped during the succeeding unseasonable summer and autumn, in which, although they were dry, yet we find that the sky was overcast, and the Etesian winds were rare, small, and irregular: these winds have a northerly direction. Altogether, we may safely conclude that the temperature of this year was considerably below the average. It must be borne in mind, however, that probably the cases classed under phthisis by Hippocrates were not all genuine; for it is more than likely that he included many fatal cases of bronchitis, which, from the general southerly direction of the wind during the first autumn and the following winter and spring, may have prevailed especially in the chronic form, which a south-westerly wind is exceedingly prone to aggravate.* In genuine phthisis there can be no doubt that, as the temperature of the year rises, there is a slight declension in the amount of the mortality. Diseases that decline in the number of fatal cases as the temperature of the year increases -take, for instance, bronchitis and pneumonia—form a certain angle on the table whose apex is at the period of minimum mortality; and it will be found that the acuteness of the angle thus formed is in the direct ratio of the insusceptibility of the disease to be modified by temperature. Whilst pneumonia has an angle of declension of 23°, and bronchitis one of at least 41°, showing how much temperature has to do with these diseases, phthisis has only an angle of 13° for the year 1854, which

*See Table No. I.

equally well proves that its course is more steady, and less influenced by the rise in the mean temperature. The apex of the angle ought to be placed at the week in which the number of fatal cases from any disease is at the lowest, at the time when the mean temperature of the year is about its height; and whilst the lower leg of the angle is horizontal, the upper one is carried up to the week wherein the greatest mortality took place, either soon after or before the week in which the thermometer indicated the lowest mean temperature.* The following numbers will give some idea of the effect of temperature on the number of deaths from phthisis:

The above tables give the following annual average for each

These tables certainly indicate a relation between the mean annual temperature and the mortality from phthisis in London;

For further illustration see the Notes on Tables I. and II.

a less number of deaths taking place at 51° than at 48° and 47° by, although it will be seen that the number of deaths were greater when the temperature was 48° than when it was a degree lower, 47°; and the same obtains between the degrees 50° and 49°. We are inclined to think that other causes than temperature operated to bring about this apparent relation. Even the average daily range of the thermometer seems to have very little to do with this disease; for when in 1853 it was at its maximum, which occurred in spring and summer, the number of deaths was at its maximum and minimum.

This table bears out the above observations, and tells us that phthisis was most and least fatal during those seasons in which the temperature was highest, and when the daily range of the thermometer was at its maximum.

Humidity and dryness of the air.-In the winter of this year there were droughts, and the succeeding seasons were dry. We have seen that Galen believes a dry air in autumn to be injurious to consumptive cases; and Hippocrates remarks, in Sec. 3, Aph. xvi. that phthisis is one of the diseases of dry seasons. Now in the year 1853 the greatest number of deaths took place during the two seasons when the dryness of the atmosphere was at its maximum and minimum, as the opposite table will prove. The moisture of the atmosphere is ascertained by the difference in the readings between the dry- and wet-bulb thermometer, and the amount of aqueous vapour suspended in the atmosphere is estimated according to the number of degrees which express this difference. For instance, suppose the drybulb thermometer stands at 50°, and the wet-bulb at 40°, the