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blished-that is, when the character of the cough and expectoration, the hectic fever and emaciation, give every reason to believe the existence of tuberculous cavities in the lungs, and still more, when the presence of these is ascertained by auscultation-he thinks that no benefit is to be expected from change of climate. Under such circumstances, the patient should try the most favorable residences of his own country, or even wait the result-it is needless to say what it will be— amid the comforts of home and watchful care of friends. It is indeed natural for the relations of such a patient to cling to that which seems to afford even a ray of hope. But did they but know, says Dr. Clark, the discomfort, the fatigue, the exposure, and the irritation, necessarily attendant on a long journey in the advanced period of consumption, they would shrink from such a measure! Nor will the experienced medical adviser, when he reflects upon all the accidents to which the poor patient must be liable, condemn him to the additional evil of expatriation. Alas! such unfortunate patients often sink a prey to their disease long before they reach the place of destination. Almost all-nay all the restthrough pain and suffering, find, in a distant country, an untimely grave. But there are chronic cases of consumption, in which the disease of the lungs, even though arrived at its last stage, may derive benefit by a removal to a mild climatethose in which the disease has been induced in persons little disposed to it constitutionally, and in whom it usually occurs later in life than when hereditary. The tuberculous affection in such persons is occasionally confined to a small portion of the lungs, and the system sympathises with the local disease. Residence in a mild climate, by strengthening the system, may save the patient. In those fortunate, but rare cases, where the progress of disease in the lungs has been ar

rested by nature, but in which a long period must elapse before the work of reparation is completed, a mild climate has often been of great avail. In nicely balanced cases, life may be preserved for many years by constant residence in a warm climate-nor would there probably be any consumption at all, if, with the cuckoo, we could make

"Our annual voyage round the globe,
Companion of the spring."

Supposing a removal to a mild climate to be decided on, which is the best climate? No one climate or situation is the best in all cases. In the first part of his book, Dr. Clark gives the character of the climate of all the different places resorted to by invalids, and has endeavored to draw a comparative view of their respective merits. It was our declared intention to enrich our pages with much of that most valuable information; but this article has already grown to such a length, that we must omit it. However, it may be remarked of the climates of the south of France and Italy, that, for consumptive invalids in whom there exists much sensibility to frost and keen winds, and more especially, if the immediate vicinity of the sea is known to disagree with them, Rome and Pisa are the best situations for a winter residence. When, on the contrary, the patient labors under a languid or oppressed circulation, with a relaxed habit, and a disposition to congestion or to hemorrhage, rather than to inflammation, and more especially when the season is known by experience to agree with the individual, Nice deserves the preference. But in cases complicated with gastric irritation, Nice is an improper residence. Indeed, Dr. Clark is of opinion, that where this state of the stomach exists, no climate which disagrees with it can do the patient good, whatever be his other ailments, and however favorable to them the climate may be.

The climate which of all others

he thinks the best suited to consumptive patients, generally, is that of Madeira-for reasons assigned by him--and next to it, that of Teneriffe.

The profession are divided on the question, whether the preference is to be given to a seaside or an inland situation. Dr. Clark, from all he has been enabled to learn and observe, thinks that consumption, ceteris paribus, is more frequent on the sea-coast than in the interior; but still, that the greater mildness of many maritime places, as of those on the south and south-west coasts of England, may more than compensate for this difference, especially when they are resorted to only for a part of the year. But of two climates, the physical character of which being alike favorable, the one on the sea-shore and the other inland, he would certainly prefer the latter as a residence for a consumptive patient. There was once a foolish idea prevalent even in the profession, that the air of a marshy country was beneficial in consumption; but scrofula and consumption are more frequent in many aguish countries, than in others of a different character, and an attack of ague is surely more likely to prove the occasion of consumption than to prevent it. Thus, in the province of Frise, in the Netherlands, agues abound; and it appears by a statistical table sent to our author by Dr. Lombard, that consumption is more frequent there than in Edinburgh. A humid atmosphere in a cold climate is indeed one of the most powerful causes of consumption.

Is a sea voyage to be recommended or not, in cases of consumption? Dr. Clark is decidedly of opinion that a sea voyage is beneficial in its early stages, and most of all, when the disease is accompanied with hæmoptysis (spitting of blood). He agrees with Dr. Gregory, who expresses this opinion in his celebrated Conspectus, that the unceasing motion of a ship, and the constant

exercise which it produces, are principal agents in the cure, while it seems also to act in a particular manner on the nervous system. Many striking instances of the beneficial effects of sea voyages in consumption, are authenticated. They are also much preferable to land journeys, in all consumptive cases which are complicated with palpitation, or increased action of the heart, whether functional or depending upon organic disease. But there may exist complications, on the other hand, which would render a sea voyage unadvisable - as, when there is much nervous sensibility, a strong disposition to headach, and an irritable state of the stomach; a sea voyage, it is plain, must either do much good or much evil to an invalid, for it works strongly, for life or for death. Dr. Clark recommends a cruise-and not in the Mediterranean, but in the Atlantic.

In place of sending consumptive patients to pass the winter in a milder climate, it has been proposed to keep them in rooms artificially heated, and maintained at a regular temperature. What says Dr. Clark to this proposal? He says what seems to be the most rational, that with the advocates of such a measure, the state of the lungs appears to be the only consideration; whereas, it need not be told, that without improving the general health, which cannot be done without exercise in the open air, all measures, directed to the local disease, will be fruitless. By such means, undoubtedly, the inflammatory action in these organs may be kept down; but they all favor the very condition of the system which led to the disease, and the removal of which condition can alone afford the patient a hope of recovery. Therefore, in the incipient stages of consumption, he holds justly such a measure to be generally most improper; but in the advanced stages, when all hopes of recovery have vanished, and when removal to a distant climate is

totally useless, life may be prolonged, in many cases, by keeping the invalids in apartments, the temperature of which is regulated in such a manner as to maintain the air in the purest possible state. Females, from their habits, bear such a system of confinement better than males-and both sexes, at the more advanced periods of life. In cases of inflammation of the lungs, also, which have occurred during the winter, such a measure is good; but the patient ought certainly, if possible, to pass the following winter in a climate where confinement will not be necessary, that his general health may be improved by exercise in the open air. Comparing, then, the benefits likely to result to consumptive patients from a mild climate, and confinement to rooms regulated to an agreeable temperature, there can be no question of the decided superiority of the forBut when circumstances preclude the possibility of changing the climate, then confinement to apartments of a proper and equable temperature, is the best measure that can be adopted to avoid the injurious effects of our cold, damp, and variable climate during the winter season.

mer.

Can any general rule be given with respect to the length of time which a consumptive invalid may be required to pass in a mild climate, in order to overcome the disposition to the disease? No. When it is had recourse to for the removal of the disordered health which precedes tubercular cachexy, a single winter may be all that may be necessary when tubercular cachexy is established, and still more, when there is reason to suspect the presence of tubercles in the lungs, several years may be requisite. In consumption, properly so called, Dr. Clark, throughout the whole work, expresses his belief that climate, with rarest exceptions, will be of little or no service.

When the disease is cured, the patient should never forget that it 11 ATHENEUM, VOL. 5, 3d series.

may, and indeed will, recur, should he expose himself to the influence of any of its chief causes. And in recovering from a very bad case, he ought to remain long-perhaps for years-in the climate which wrought the cure. Perhaps he may never again be able to live in any othernever again be the man he once was--and infatuated will he be, if he lives as a strong man might, and ever forgets that both his feet were once on the edge of the grave.

In conclusion, Dr. Clark submits the following corollaries as a summary of his views regarding the nature and causes of consumption, and its treatment, more especially as connected with the effects of climate.

1st, That tubercles in the lungs constitute the essential character and immediate cause of consumption.

2d, That tubercles originate in a morbid condition of the general system.

3d, That such a state of system frequently has for its cause hereditary predisposition; in other instances being induced by various functional disorders; while in a third class of cases, perhaps the most numerous, it arises from the conjoint effects of both these causes.

4th, That consumption is to be prevented only by adopting such means as shall counteract the hereditary predisposition, where it exists, and maintain a healthy condition of the various functions from infancy to the full development of the body.

5th, That in the general disorder of the health which leads to tubercular cachexy, or in tubercular cachexy itself, and even when tubercles are formed in the lungs, unattended with much constitutional disturbance, a residence in a mild climate will prove beneficial; and also in cases of chronic consumption, at any stage, where the lungs are not extensively implicated in tubercular disease, and where the

system does not sympathize much with the local disorder.

6th, That in cases of confirmed consumption, in which the lungs are extensively diseased, and where hectic fever, emaciation, and the other symptoms which characterize its advanced stages, are present, change of climate can be of no service, and may even accelerate the progress of the disease.

7th, That climate, to be effectual in any case, requires to be continued for a considerable time-in most cases for years.

We have now given, as we said we should do, the sum and substance of Dr. Clark's opinions on consumption. They are, like all true views, simple; there is nothing startling about them, for sagacity never hunts after novelty, and wisdom seeks not for what is strange. He is perfectly

justified in his anticipations that his book will be perused by many persons not of the profession, but who are yet deeply interested in the subject of climate, in relation to its effects on disease. His wish was to express himself in as plain language as possible, that he might make himself intelligible to the generality of readers, without at all diminishing the utility of the work to the members of his own profession. He has completely succeeded; and we hope that other physicians will lay aside the stilts and the veil,-and when speaking about diseases which in one sense may be said to be "their bread and other men's poison," will walk on the same sort of feet, and wear the same sort of face, and use the same sort of tongue-as far as may bewith ordinary mortals.

ALL IS NOT DARK BELOW.

COLD and ungrateful must the bosoms be
Of those who look upon the sunlit earth,
And trace the finger of the Deity,

Yet own no cheerfulness and feel no mirth;
Who deem all dark the lot of man below,
One changeless gloom, one all-pervading woe.

Hath God then made for naught each lovely thing,
That sheds its beauty o'er this world of ours;
The feather'd warblers, that so sweetly sing,

The ever-waving wood, the scented flowers?
I cannot think of these, and yet believe
That man was only form'd to mourn and grieve.

But who can look upon the azure sky,

And mark the glorious orbs revolving there,. Or turn his glance towards earth's verdant dye, And deem, where all is form'd so bright and fair, That man was made to wander on in gloom, Then sink in sorrow to the silent tomb?

"Tis true earth's joys are ever mix'd with care,
And men are fated to one common curse;
But should we therefore cherish dark despair,
And make our too imperfect being worse?
Though " weep with them that weep
He bids us, too, "with those who joy rejoice."

is God's own voice,

A YEAR-an age shall fade away (Ages of pleasure and of pain), And yet the face I see to-day Forever shall remain,

ON A CHILD.

In my heart and in my brain!
Not all the scalding tears of care
Shall wash away the vision fair;
Not all the flocking thoughts that rise-

Not all the sights that feed my eyes
Shall e'er usurp the place
Of that little gentle face:

But there I know it will remain,-
And when joy or pleasant pain

Turn my troubled winter gaze

Back unto my April days,

There, amongst the hoarded past,
I shall see it to the last,-

The only thing, save poet's rhyme,
That shall not own the touch of Time!

SIR,

LETTER TO THE EDITOR.

My aunt Adelgitha Penelope Smith was a most worthy old lady; and her memory will long be held in respect, in consequence of her various good properties; but more especially for the inflexible resolution with which she defended herself against the attacks of a legion of lovers, and, at length, departed this life, leaving many grounds of consolation to her relatives. Yet, during her valuable life, she lived not for herself alone. She was kind to the poor, and supported a school for their children, which was holden daily in a small building, in the roof of which dwelt an aged favorite, whose habits and temper, in his latter days, rendered him an unfit companion for her boudoir, wherein he had whilom spent much of his time. The animal, thus banished from society, became morose and ascetic, which we should not have wondered at, had we been aware that he had taken to scribbling, a propensity which commonly leads the victim thereunto to believe himself a very important animal, whatever other people may think or say to the contrary. So there he seems to have sat," alone in his glory," profiting by the instruction of the schoolmaster, and hugging himself, according to the manner of his kind, in the belief that he was inditing what would astonish the world.

It was my lot to discover his papers, which have been sadly nibbled by the mice; and I forward you two or three of the most perfect sheets, thinking that they may be found to contain matter quite as important as the "Reminiscences" of certain bipeds which have lately been given to the public. I am, Sir, Your most obedient servant, J. SMITH.

THE REMINISCENCES OF AN OLD MONKEY.

FOR the last few days I have felt myself extremely uncomfortable. My appetite has failed me, and I have been troubled with unpleasant dreams and strange fancies, both by day and night. "Why is this?" I ask myself; "what can the matter be? I cannot surely be in love in my old age ??? Oh, no! The

years of such pleasing folly have long since past, and all the gaieties and frolicsome pranks of my youth are but as a dream. I recall them to memory alternately with a smile and a sigh; and, as I sit and mumble my nuts in solitude with my few remaining teeth, and view the grey

hairs which cover my emaciated
and shriveled frame, I find it diffi-
cult to imagine that I am the same
monkey that was once the life and
soul of every party. And as for
love-even if my years did not ex-
empt me from the torments of the
tender passion, who could I be in
love with? I have often felt a con-
viction that I am the only survivor
of my race; and love cannot exist
without hope!

My occasional lowness of spirits
at the present period, proceeds, I
am convinced, from very different
causes. Alone as I am, in a coun-
try far distant from the place of my

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