PULMONARY CONSUMPTION.

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appears in the expectoration, and where the stethoscope indicates that a considerable portion of the lungs is unfitted for respiration, a southern climate is more likely to accelerate than retard the fatal event-and takes away the few chances that remain of final recovery.

If this be a correct estimate (it is at least an honest one) of the influence of an Italian climate on constitutions disposed to, or affected by PULMONARY CONSUMPTION, it shews that medical men incur a fearful responsibility in proposing to the parents and friends of invalids, a measure which is fraught with danger, involved in uncertainty, and too often attended by the most destructive sacrifices of the feelings as well as the finances of the parties concerned !

Those who have not witnessed lingering illness and deathbed scenes in distant climes, can form no just conception of the tide of mournful emotions which daily rushes over the mind of the dying stranger in a foreign land. Death is deprived of more than half his terrors by the sympathy of friends, and the consciousness that our ashes shall be deposited in the land that gave us birth, near those whom, in life, we cherished, loved, or revered! This may be a prejudice—perhaps even a weakness; yet it is NATURAL-it is instinctive-and the instincts of Nature can seldom be entirely repulsed, even by the most philosophic minds.

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Expellas NATURAM furca tamen usque recurrit."

But the sigh of sorrow, perhaps of regret, is not always buried in the grave of the sufferer, on these occasions. The COMPANION, who counts the tedious hours of protracted disease, and closes the eyes of the departed friend in a foreign country, undergoes a terrible ordeal, always harrassing to the feelings, and not seldom hazardous to life ;-while the surviving relatives, at home, are subject to the painful anxiety of suspense—sometimes to the poignant stings of remorse, for having suffered the victim of an irremediable malady to expire on a foreign shore !

Heaven forbid that, on such a momentous question as this,

involving the lives of my fellow-creatures, I should throw the weight of a feather in the scale against the preservation, or even the prolongation of human existence; but I have lived too long, and seen too much, not to know the errors of discrimination and the fallacies of hope, that send PULMONARY invalids from the gloomy skies but comfortable abodes of England, to lands where comfort is unknown, even by name, and whose atmospheres cannot work miracles, whatever their saints may do. The balance, indeed, between permanent benefit and blighted expectation, or even actual injury, is so nearly poised, that a breath may turn the scale. That breath is as often one of error as of judgment. The consequences are obvious.

But there is a large class of complaints which resemble conSUMPTION, and which, I have no doubt, contribute much to the reputation of southern climates, for the cure of that terrible scourge. These are bronchial affections, viz:-chronic inflammation or irritation of the mucous membrane of the lungs. The journey to Rome or to Pisa, and the mild air of the Winter in those places, with care to avoid sudden transitions, often cure or greatly relieve these complaints, and the individuals are said to be saved from tubercular consumption. The greatest caresometimes considerable power of diagnosis, is required to discriminate the bronchial from the tubercular affection—and yet, upon this discrimination, often hangs the fate of the patient, or, at all events, the propriety of migrating to a southern clime. The science of auscultation, now so ardently cultivated, will prevent much injudicious advice being given by the profession, and much serious injury being sustained by invalids.

It is also probable that, in some cases where there is a very partial or circumscribed tuberculation of the lungs, (the rest of the apparatus being unaffected) a Winter's residence in Rome, Pisa, or Nice, might be beneficial. This is the opinion, at least, of Dr. Clark; but here the greatest care is to be taken, in examination with the stethoscope, to ascertain that the expectoration comes from a very small excavation, the lungs being elsewhere in a sound state.

NERVOUS DISORDERS.

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There are several other infirmities, for the cure or mitigation of which, the climate of Italy is recommended. One of these is CHRONIC RHEUMATISM-and we have the testimony of Dr. Clark and others, that benefit is often derived, in this complaint, from a residence of some duration at ROME or NICE. This is probably the case; since the cold winds of Italy are dry, and the hot winds are moist-circumstances rather favourable to rheumatism. But it should be remembered that rheumatism is very closely allied to neuralgia, and produced, not seldom, by the same cause-MALARIA. We shall probably therefore be no greater gainers by depositing rheumatism in the Eternal City, and bringing back TIC DOULOUREUX, or some other malarious disease in its stead. Whatever advantage, then, the rheumatic invalid may derive from the climate of Rome or Nice, during the Winter, one position may be safely laid down-that he should avoid those seasons and those places where MALARIA obtains-in other words, that he should quit Italy in Summer.*

NERVOUS DISORDERS.

Under this vague term a host of dissimilar and really different maladies is comprehended. There is no doubt that a journey to Rome would generally be beneficial to people affected with nervous complaints; but it is very questionable if a residence there would be productive of substantial good. It is a remarkable fact that the inhabitants of the Eternal City are characterized by a peculiar sensibility of the nervous system-evinced by a disposition to convulsive affections, from causes quite inadequate to the production of such phenomena in other people and in other countries. The inordinate sensitiveness of the

* Dr. Clark, when speaking of rheumatism, as benefited by Italy, thus concludes:-"But even these cases seldom bear a second Summer in Italy. Indeed, by far the greater number of invalids who have derived benefit from the Italian climate, during the Winter, will do well to quit it on the approach of Summer."

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Roman ladies to perfumes is well known, and might be almost taken for freaks of the fancy, were it not so well authenticated, It is a susceptibility, too, of recent origin. The Roman matrons of old were fond of perfumes-those of the present day often faint, or go into convulsions, on perceiving the odour of the most pleasant flower. And not females only, but effeminate males evince the same morbid sensibility to odoriferous emanations.* The causes of this phenomenon have given rise to diversity of opinions. The Roman physician (Mattai) attributes it to "the daily increasing mobility of the nervous system, produced by the luxurious and listless life of the Roman people."† But Dr. Clark, while he admits that such a life may have tended to originate this morbid sensibility, and that, when once acquired, it may be transmitted from parent to progeny-believes that "the climate of Rome has some specific effect in inducing this state of the nervous system." I have no doubt of it. And my only wonder is, that Dr. Clark, during ten years' residence, there, did not find out what this something is. He says, in the same page:-"Even a temporary residence of some duraration at Rome, produces a degree of the same morbid sensibility, and, in cases where the Roman mode of living cannot be adduced as the cause." I think I hear the reader ask, what is this cause, then, which has so much puzzled the doctors? If compelled to answer, I would say that it is the habituation to the STINK of the Roman streets, which perverts the sensibilities of the olfactory nerves-renders them unaccustomed to decent smells-and throws them into convulsions on contact with a perfume. I accord entirely with Mr. Matthews, in the opinion that the former MISTRESS of the WORLD is now the dirtiest city in Europe-with the exception of Lisbon. This

* Dr. Mattæi (whom I had the pleasure of knowing in Rome) states, in his clinical work, as follows:-"Nostra vero ætate nervosæ affectiones, vulgo tirature, seu convulsiones communissimæ sunt, fæminis presertim, effeminatisque viris, quorum corpora a tam levibus causis commoveri solent, ut odorum licet gratissimorum vis ea facile perturbet ac male afficiet."

"A molli inertique vita in Romanis incolis."

solution explains another part of the phenomenon which puzzles Dr. Clark. "It is to be remarked, (says he) that it is not disagreeable odours which produce such effects on the nervous system, but the more delicate, and, to northern nations, agreeable odours of flowers and other perfumes." No doubt of it. If mal-odorous exhalations had been capable of inducing convulsions, Rome would, long since, have cured the evil effectually, by removing from the presence of her insulted ruins, the cause of it-MAN!

But there is another and a much more formidable malady, or rather class of maladies, to which the Romans are peculiarly prone-namely, sudden death-or, as it is coolly called, ACCIDENTE-which is sometimes sporadic, sometimes EPIDEMIC in Rome. Whether this terrific agent of the Grim Tyrant acts through the medium of apoplexy or diseases of the heart, the Roman physicians have not ascertained—but one thing is clear, that the climate of the Eternal City is extremely hostile to the brain and nervous system-and consequently all who have any tendency to fulness about the head should be shy of residence there. Dr. Clark observes that "head-aches are common at Rome, and, among strangers, he has found them of very fre quent occurrence." The same author, however, informs us than bronchial affections (chronic inflammation of the mucous membrane of the air-tubes) are generally benefited by a Winter's residence in Rome-as also chronic rheumatism. But the passage which I have already quoted, some pages back, from Dr. Clark, respecting the frequency and severity of inflammatory affections of the chest, during Winter and Spring, in Rome, casts strong doubts on this utility of the climate in CHRONIC BRONCHITIS. That the Italian winds, like the satyr's breath, blow hot and cold, almost at the same moment, I am ready to grant; but, in a strictly medical sense, I leave my talented friend to explain how a climate, in which "acute inflamma

*." Şubitanea scilicet mors, vulgo accidente, quæ a diversis causis ortum ducens, modo sporadica, modo quasi epidemica obrepit.”—Mattæi.