undergo expatriation, the unfortunate invalid often sank before he reached his destination, or he was doomed soon to add another name to the long and melancholy list of his countrymen, who seem to have sought a foreign land, far from friends and home, only to find a premature grave. When it is considered, however, that all remedial agents have proved so inefficacious against this fearful foe, as to place it emphatically among the opprobria medicorum, it is no ways surprising that its victims should seek beneath the influence of a more genial clime, the relief, however uncertain, denied them in their own. On the capabilities of climate afforded to such classes of invalids by our own country, Dr. Forry thus remarks:

"Among the various systems of climate presented in the extensive region of the United States, that of the Peninsula of Florida is wholly peculiar. Possessing an insular temperature not less equable and salubrious in winter than that afforded by the south of Europe, it will be seen that invalids requiring a mild winter residence, have gone to foreign lands in search of what might have been found at home. Florida, therefore, merits the attention of physicians in our northern States; for here the pulmonary invalid may exchange for the inclement season of the north, or the deteriorated atmosphere of a room to which he may be confined, the mild and equable temperature, the soft and balmy breezes of an ever-green land. Instead of that feeling of loneliness and abandonment which often casts a gloom over the sensitive mind of him who goes to foreign lands in search of health, he finds himself still among his fellow-citizens, with whom he is bound by the common ties of language, laws and customs; and should he require a physician, the difficulty of communicating with a foreigner, perhaps by means of an interpreter-a circumstance peculiarly vexatious to an invalid-is not here presented."

It is satisfactorily shown by Dr. Forry, that a comparison with the most favored localities on the continent of Europe, and the various islands of the Mediterranean and the Atlantic held in highest estimation for mildness and equability of temperature, is no way disparaging to the climate of East Florida. Compared with Italy, which is alternately exposed to the icy winds which sweep from the snow-clad Alps, and to the sirocco, with its depressing

high dew-point, from the desert sands of Lybia, peninsular Florida possesses decided advantages.

Dr. Forry also determines by statistical facts, based on an aggregate mean strength of 47,220 soldiers of the United States army, embracing the reports for a period of ten years, that the class of pulmonary diseases, with the exception of tubercular consumption, is dependent chiefly on atmospheric laws. That the ratio of catarrhal affections, pleurisy, inflammation of the lungs, and chronic bronchitis, (chronic inflammation of the lining membrane of the wind-pipe), increases and decreases in proportion as the seasons are contrasted, thus maintaining a direct relation with the extreme range of the thermometer as connected with the seasons, appears to have been fairly demonstrated by Dr. F.; or, in other words, it would seem to be a law that in proportion as the high temperature of summer makes an impression upon the system, do the lungs become susceptible, so far as inflammatory diseases are concerned, to the morbific agency of the opposite seasons. These constitute the predisposing causes, to which the exciting ones of moisture and variability of temperature are subordinate. The error of ordinary observation has arisen from the circumstance that the former are less obvious than the latter. As vicissitudes in temperature are more appreciable by our senses, it is to such that our attention is most attracted; and it could not have been à priori inferred that the effects thus produced are of less importance than the predisposition arising have an explanation of the fact that the Hence we from the law just stated. diseases of the pulmonary organs are generally less rife along our northern frontier than in the middle States, and less prevalent in our northern region in the moist and changeable climate peculiar to the sea-coast and large lakes, than in the dry atmosphere of the opposite locality; and hence, too, is afforded a rational explanation of the advantages to be derived from change of climate in the way of a winter residence.

These general conclusions are confirmed by recent statistical facts in Europe. It is found that consumption, as in the middle regions of the United States, is much more frequent in the temperate regions of Europe, comprised

between the fifty-fifth and the forty-fifth degrees of latitude, than it is further to the north. That a cold temperature is not essentially, per se, favorable to the development of consumption, as well as pleurisy and inflammation of the lungs, seems, therefore, an established point. Dr. Forry thus remarks:

"So potent is the influence of early opinion, that the ideas of consumption and a changeable climate, seem almost inseparable. In countries, however, in which the disease occurs most frequently, 'those who are least exposed to its influence are

precisely those most exposed to the vicissitudes of the climate." Now, as it has been satisfactorily ascertained that the maximum of liability to consumption in England is found among those who suffer the least exposure to climatic variations, it follows that the influence of the latter must be regarded as secondary to the action of other causes, as, for example, occupation, food and habits. Although it cannot be doubted that a changeable climate exercises an evil influence on constitutions predisposed to consumption; yet, as we find the most variable climates are best, adapted for the development of the various mental and bodily powers, it is apparent that the agency of this cause in the production of consumption has been much exaggerated, or much too exclusively considered. Confirmatory of these remarks is the observation of Dr. Rush, that among our Indians and the frontier inhabitants, consumption is very uncommon."

Notwithstanding moisture, of all the physical qualities of the air, has been regarded as the most injurious to human life, it is also stated, on the authority of Cowan, in the work just quoted, that as regards its agency in the production of pulmonary consumption, all evidence "tends strongly to expose the fallacy of theoretical opinion." But what is yet more surprising is that the same fact is demonstrated by Dr. Forry by means of the army statistics, throughout every region of the United States, in reference to pleurisy, inflammation of the lungs, and catarrhal affections; for these diseases are invariably less prevalent in the moist and changeable climate peculiar to the sea-coast and large lakes on our northern frontier, than in the dry atmosphere of the oppo

site locality. This opinion is likewise confirmed by the British army statistics, on comparing the results given by the cold and extremely foggy regions of Nova Scotia with the dry inland climates of the same parallel, or even of more southern latitudes.

Since the days of Hippocrates it has been a generally, indeed universally, admitted opinion, that change of climate is beneficial in many forms of pulmonary diseases; but recently it has been deduced from the "Statistical Reports on the Sickness, Mortality, and Invaliding" among the British troops in every by no quarter of the globe, that it is " means likely that any beneficial influence can be exerted by climate itself" in these affections. Upon the strength of these statistics, the opinion that it was worse than useless to visit southern regions in pulmonic complaints, was very generally embraced, not only by all the medical journals of the day, but the question was deemed of sufficient general importance to be made the subject of newspaper paragraphs. This deduction is controverted at length in Dr. F.'s work, not only on the ground of the statistics of the United States army, but of those of the British army itself; and notwithstanding their strictures were in turn severely criticised in London, they have since been fully sustained by such distinguished authorities as Sir James Clark and Dr. John Davy, Inspector-General of Army Hospitals.

The conclusion at which Dr. Davy, the brother of the illustrious Sir Humphrey, arrived from various statistical facts, and an ingenious train of reasoning upon the attending circumstances,a knowledge, the acquisition of which was especially favored by his official situation as president of the medical committee of Malta,—is as follows:"As the statistical facts show that pulmonary complaints are more fatal amongst our troops serving at home than in the Mediterranean; and as all the circumstances, independent of climate, so far as I am acquainted with them, affecting the question, appear to be in favor of the troops serving at home, especially the cavalry, I am not only not able to adopt the opinion referred to, that the climate of the Mediterranean is more productive of diseases

Although the influence of different climates in the causation as well as the alleviation and cure of diseases, is a fact universally conceded; yet the attempts hitherto made to explain the modus agendi of this power are not wholly satisfactory. This, however, will not be a matter of surprise, when it is recollected that the problem of physical climate remains, in a great measure, unsolved. How much more complicated, then, must the subject become, when involved with the elements of organic life, and all the complexity of their combinations resulting

from health and disease.

As regards the benefit which invalids experience by a removal from a cold to a warm climate, Sir James Clark seems, however, to give a satisfactory explanation in the obvious agency of a warm and dry atmosphere in promoting an equable distribution of the circulating fluids, and more especially in relieving that congestion of the internal vessels which generally obtains in chronic disorders, by augmenting the activity of the capillary circulation, or extreme vessels, on the surface. Its influence is, indeed, manifested on perhaps every function of the animal economy. Another very evident explanation of the effects observed may be reasonably ascribed to the influence of a bland atmosphere on the extensive surface of the respiratory organs, which is fully equal in extent to that of the external surface of the body. To this we may add the impression made on the nervous system generally, and on the mind through the medium of the external senses, and conversely the reciprocal influence of the mind on the corporeal functions. But these influences have already been brought under notice, as well as other incidental circumstances,

not directly ascribable to climate, which contribute to the same end; such as change of scene and of occupation, the influence of the journey or voyage, as well as the hope inspired. Most important of all, however, as regards the advantages of a winter residence in more southern latitudes, is the avoidance of the extremes of the seasons, and consequently the predisposing causes of pulmonary diseases. Along the coast of New England, for example, the annual ratio treated for catarrhal affections per 1000 of our troops is 233; but the average of each season is by no means the same, that of the first quarter of the year being 63, the second 49, the third 36, and the fourth 85.

"These facts having been determined," says Dr. Forry, "the advantage of a winter residence in a more southern latitude to a person laboring under chronic bronchitis, becomes at once apparent. tion having the closest relation to acute [Chronic bronchitis is a form of consumpcatarrhal diseases, and it is by far the most under the control of remedial manage

ment.]

If he can avoid the transition of the seasons, that meteorological condition of the atmosphere, which stands first among the causes which induce catarrhal diseases, he will do much towards controlling his malady. Let us suppose him on the coast of New England, in the third quarter [of the year], the ratio of catarrhal affections being as low as 36, when the sudden transition of the season brings it up to 85 [in the last three months of the year.] The consequences will inevitably which he is predisposed; for the respirabe an aggravation of that disorder to tory organs, even when healthy, are peculiarly susceptible, at this season, to morbid action. Let us, on the contrary, suppose him gradually moving south with the change of the season, and the fourth quarter will find him in a climate whose ratio is even lower than that of the preceding quarter in the region which he had left. On the coast of New England, the ratio of the third quarter is 36, and that of the fourth is 85, whereas the average of the latter quarter in peninsular Florida is only 33. These are not isolated facts, but uniform results obtained from ten tains in every system of climate, it is easy years' observation. As the same law obto apply the remedy."

As there is a general opinion prevalent that it is consumption alone that is

benefited by change of climate, a few words may be here given to the several other forms of specific diseases, in which the invalid will no doubt realize advantages equally great.

But first we will observe that the south-western coast of a country, especially when lying like England on the western coast of a continent, is generally mild and humid, and consequently soothing but rather relaxing. In diseases accompanied with an inflammatory condition of the general system, or dependent on an excited state of particular organs, this variety of climate has been found more especially beneficial. Decided advantage may reasonably be anticipated in chronic inflammatory affections of the lining membrane of the air passages, attended with a dry cough and little expectoration; but when such cases occur in individuals of a languid and relaxed state of constitution, accompanied by copious expectoration from the mucous surfaces, the disease is as likely to be aggravated as relieved. These remarks are equally applicable to all other diseases attended with great relaxation of the general system. It is, therefore, obvious that, in recommending a change of residence to invalids, attention to these distinctions, both in regard to varieties of climate and peculiarities of disease, is absolutely necessary.

"The climate of Florida," says Dr. Forry, "has been found beneficial in incipient cases of pulmonary consumption, and those threatened with the disease from hereditary or acquired predisposition. It is in chronic bronchial affections [those implicating the lining membrane of the air passages], more particularly that it speedily manifests its salutary tendency. To distinguish the bronchial from the tuber

cular form of the disease, often demands considerable powers of discrimination; and upon this distinction frequently hangs the propriety of a removal to a southern clime. The application of the physical means of exploration, now so ardently cultivated, has fortunately given a greater degree of certainty to our diagnosis. The same remarks apply to the more mild and simple grades of chronic laryngitis."

But even patients having tubercles in the lungs, when mostly limited and merely nascent, often experience remarkable benefit from such a change.

In these cases, our object must be not only to remove these local disorders, but also that low degree of febrile irritation, or that unhealthy condition of the nutrient matter of the blood, which causes the deposition of tuberculous indurations in the lungs. Hence, in the management of consumptive patients, constitutional treatment should always hold a prominent place; but it is in cases in which local disorders have been the chief cause of the mischief, that we have the best chance of success. In the constitutional treatment, our remedial agents must be calculated to give at once tone to the system, and promote the free action and balance of all the functions; such as, the most nutritious food that the digestive organs can readily assimilate without inducing excitement of the vascular system, pure air and a climate well adapted for regular exercise, and proper clothing to maintain the activity of the circulation on the surface of the body. But it is not intended to enter into a detail of the treatment, which must be constantly adapted to individual cases. The remedial measures applicable to the local disorders and particular symptoms, may be so combined as to act, at the same time, favorably on the functions at large. It must be constantly borne in mind that this disease is a secondary one, originating in a morbid state of the general system.

In this form of consumption, pure country air may be considered indispensable. A dry sea-coast, under these circumstances, is truly an antidote to the poisonous effects of a town residence, more especially if conjoined with gentle exercise, both by walking and riding on horseback. If the locality, however, is much exposed to the east and north, and is not dry, the evil may be changed to a worse condition But should a marine atmosphere be of the lungs an actual inflammation. found, from peculiarity of constitution, to disagree, the patient may resort to the dry air of the interior, which, in conjunction with the aroma of pine forests, as in Florida and Georgia, is found very congenial to delicate lungs. Indeed, the Greeks, as we are told by Hippocrates, and also the Romans, sent their consumptives to the pine forests of Egypt. Moreover, much benefit would also be derived from the sea-voyage, both in going and returning-a remark