J!LV.<'>:'j»iVijyA'i»V-Vvv HE CLIMATE E OF THE ^w|||Aj|mw^W^' OF FRANCE WILLIAMS I p 'lii£i-f THE CLIMATE OF THE SOUTH OF FRANCE Nearly ready for publication, PULMONARY CONSUJirXION Its Nature, Treatment, and Duration, exemplified by an Analysis of One Thousand Cases selected from upwards I of Twenty Thousand. By C. J. B. WILLIAMS, M.D. F.R.S. Consulting Phyeician to the Hospital for Consumption at Brompton ; AND CHARLES THEODORE AVILLIAMS, M.A. M.D. Oxon. Assistant-Fhyeicion to the Hospital for Consumption at Brompton. London: LONGMANS and CO. sj^^' TROPICAL VKGETATION OF THE SOUTH OF FRANCE. THE CLIMATE OF THK SOUTH OF FEANCE AS SUITED TO INVALIDS WITH NOTICES OF MEDITEKKANEAN AND OTHER WINTER STATIONS. BY CHARLES THEODORE WILLIAMS, M.A., M.D. OXUX. ASSISTAST-PHYSICIAS TO THE HOSPITAL FOR COSSUMPTION AXI) DISEA.SRS OF THE THKST AT BROMPTON. SEiCOnSTD EIDITIO^sT. LONDOX : LONGMANS, GREEN, AND CO. 1869. THE CLIMATE OF THE SOUTH OF FEANCE A3 SUITED TO IXYALID3 WITH NOTICES OF MEDITERRANEAN AND OTHER ^TN'TER STATIONS. BY CHAELES THEODOEE WILLIAMS, 1I.A., M.D. OXOX. 9EXIOB ASSISTAST-PHTSICIAS TO THE HOSPITAL FOB COSSdlPTIOS ASD DISEASES OF THE CHEST AT BBOirPTOS. SECOND EDITlOy, IDitf) an ^C^ggcntiij: ON ALPiXE s^^r^fEE quaeters for ixvalibs, AND ON THE MOUNTAIN CUBE. LOXDON : LGXaMAXS, GREEN, AXD CO. 1870. LOyDOX : PBI5TED BT SPOTtlSWOODR AN'D CO.. JJEW-STBEET SQUABS A.ilD PABI.lAUUil SliLEJil P E E F A C E . The object of the first edition of this book was to give a brief and impartial survey of the Climate of the South of France, and of its varieties best suited to pulmonary invalids; and the fact that a second edition is now called for, shows that such an account, when written in a spirit free from local interest or bias, has proved acceptable to a large number of readers. My information has been derived partly from friends resident in the localities described, but chiefly from my own personal observations made during four visits to, and a prolonged sojourn in, this beautiful region. To render the little work more complete I have enlarged its boundaries, and it now contains de- scriptions of the principal Mediterranean winter stations, including those of France, Italy, Spain, and North Africa. Notices of some summer stations have been inserted in an Appendix; and, to render the 1077136 VIU PREFACE. whole subject more intelligible, a map has been added. A chapter has been devoted to the hygienics of consumption, in which will be found practical hints as to the invalid's life in the south of Europe, and his food, clothing, exercise, &c. I have to acknowledge valuable aid from the ex- perience and suggestions of my father, Dr. C. J. B. Williams'; and my brother, ]Mr. H. S. Williams, late Scholar of St. John's College, Cambridge, has greatly assisted me in the meteorological portion of the work. In connection with this subject I think it right to mention, that although the general re- sults of meteorological observations alone have been stated, the ample data which supply them have been carefully examined, but are too voluminous fur publication. 78 Park Stheet, Ghosvenoh Square : Septeynber 1869. CONTENTS CHAPTER I. GEXEEAL ADVANTAGES OF THE SOUTH OF FEAXCE. PAGES Accessioility — Sunshine and fine weather — Facilities for outdoor exercise — Influence on the mind — Medical staflF — Disadrantages of the climate — Drainage- — Aspects of climate divided into Physical and Medical — Dry earth system . . . . . . . . .1-10 CHAPTER n. PHYSICAL ASPECTS. Thermometrical phenomena — Comparison of Nice with Tor- quay and the Cove of Cork — Hy^res and Kew — Sources of warmth — The sun — Day and night temperature — Mediterranean Sea — Absence of tide — Its saltness — Cause — Its warmth— Causes — Soundings of Admiral Smyth, Captain Spratt, and others — Contrast with Atlantic — Influence of seasons on temperature — Efiect on vegetation. Hygrometrical phenoraena — Rainfall and rainy days — Atmospheric moisture — Hygrome- trical comparison of Mentone, Hyeres, Nice, and Kew. Other meteorological phenomena — Winds — Mistral — Force — Causes — Theories of M. Martins and Dr. Bennet — Probable cosmical origin of the mistral — Southerly and other winds — Influence of neighbouring mountain ranges . ....... 11-37 X CONTENTS. CHAPTER III. HEALTH RESORTS OF THE REGION. CHAPTER IV. MEDICAL ASPECTS — EFFECTS OF THE CLIMATE ON HEALTH AND DISEASE. Acute disease common — Chronic and degenerative rare — M. Riehelmi's experience — Low death-rate of Consump- tion — Dr. Chambers's Genoa and London statistics — Negative eflFects of the climate — Positive effects — Stimulating influence — Causes — Good and bad results — Clioice of a health resort — Bronchitis, humid and dry — Asthma — Phthisis — Mediterranean climate, where beneficial, where hurtful — British watering-places. Pau — Its calm atmosphere — Its climate compared with that of Nice. Madeira — Decreased popularity — PAGES Hykres — Distance from sea — Luxuriant vegetation — Palms — Wild flowers — Iks d'llyeres — Military hospital — Hotels — Its less dry and exciting climate — Costa belle — Its high mean temperature. Cannes — Its beautiful site — Proximity to the sea — Vegetation — Seent-pru- ducing plants — Dry and stimulating climate — Hotels — Canni't — Its inland and softer climate. Nice — Its situation and shelter — Its suburbs, Cimiez, Caraba9el, and St. Barthelemy — Their more sheltered position, and vegetation — Dry climate of Nice — Its vicissitudes — Its beneficial effect in some diseases — Intermittent fever — Its origin — Moister climate of Caraba^el and Cimiez — Its resemblance to that of Hyeres — Hotels — Monaco. Mentone — Rich vegetation — Lemons — Carob trees — Complete shelter from northerly winds — Climate warmest and driest of the health resorts — Its defects — Proximity to sea — Closeness of atmosphere — The two Bays — Inland accommodation — Facilities for outdoor exercises in the different health resorts . . 38-61 CONTENTS. XI PAGES Causes, alleged and real — Prevalence of fever — Intro- duction of the sugar-cane — Soft nature of climate — Experiment of Brompton Consumption Hospital . . 62-75 CHAPTER V. HYGIENICS OF CONSUMPTION IN THE SOUTH OF FRANCE. Food, ^c. — Cooking — Cod-liver oil — Vegetables — Their abundance and excellence — Fruit — Alcoholic drinks — Tonics. Clothing — Importance of warm clothes. Ven- tilation — Pure air — Temperature to be considered — Sleeping with open windows — Its danger. Exercise — Its benefits — Active exercise — Its varieties— Kowing — Swinging — Climbing — Gymnastics — AValking — Moun- tain ascents ^ — Passive exercise — Carriage — Sailing — Their effects— Eicling 76-87 CHAPTER VI. WINTER STATIONS OF ITALY. BoEDiGHEEA — Palm grove — Temperatvire. San Eemo — its situation and shelter — Vegetation — Climate — Com- parison with Mentone — Future winter stations — Diano- alassio — Eastern Kiviera — Nervi and Promontory of Ruta— View of Gulf of Genoa — Santa Margherita — Chiavari — Spezia. Pisa — Its unsheltered position and moist climate. Rome — Climate — Fevers — Twofold origin of malaria — Parts of city attacked — Connection with depopulation — Causation of malaria — Sun's in- fluence on porous and absorbent soil — Rapid evapora- tion — Its relation to malaria — Dr. Topham's theory — Rome unsuited to invalids — Objections to large Italian cities. Naples — Its drainage — Capri — Salerno — Amalfi — vSorrento, a summer retreat — Influence of the Mediterranean 88-108 Xll CONTENTS. CHAPTER VII. OTHER MEDITERRANEAN WINTER STATIONS. PAGES CoBSiCA — Its lofry ranges and sheltered harbours. Ajaccio, a well protected winter station — Meteorological observa- tions — Intermittent fever prevalent in summer — Dr. Bennet's explanation. Malaga — Shelter afforded by double rampart of mountains — Prevalent winds — Small rainfall and high mean temperature — Bad drainage. Tangiers — Great fertility — Climate tempered by Atlantic — Excellent food. Algeria — Climate greatly influenced by Atlas mountains and Sahara desert — Large rainfall owing to prevalence of moist winds — Marshes and fevers. Algiers — Sahel hills — Plain of the Metidja — Hot and rainy seasons — Unequal distri- bution of rainfall in the three provinces — Its cause — Climate of Algiers compared with that of Riviera — Diseases for which it is suitable — Hill stations . 109-125 APPENDIX. Deep-sea temperatures — Summer stations — St. Dalmas de Tende, Dr. Battersby's report — Ccrtosa di Pesio, Dr. Daubeny's report — Upper Engadine ; its extremes of temperature — Danger to Invalids — Hotels — Other summer resorts — Nuovi Bagni of Bormio ; its advan- tages and beauties — Le Preso — Eligible Alpine sites in Switzerland, with Hotel accommodation — The Enga- dine as a winter residence for consumptive invalids. . 127-134 CONTEXTS. sni APPENDIX II.— 1870. FURTHER OBSERVATIONS ON SUMMER QUARTERS FOR INVALIDS, AND ON ALPINE SANATORIA IN 1870. PAGE Superior salubrity of mountain districts — Unhealthy aspect 1 35 of inhabitants of low valleys — Alpine resorts arranged according to height : — I. Low valleys — Borders of lakes relaxing — Often malarious- — Examples. II. Mode- rate heights, from 2000 to 4000 feet, well suited as summer quarters for invalids — Glyon — St. Cergues — Champery — Sepey — Comballaz — Ormond Dessus — and others in the Diablerets district — Anderlenk — Zweisimmen — Engelberg — Sonnenberg — Grindelwald — Miirren — Kosenlaui, &c. III. High level resorts, from 4000 feet upwards — invigorating effects — Cau- tions necessary in selection — Curative power of high altitudes in Pulmonary Consumption and Scrofula — Dr. Archibald Smith's observations in Peru, &c. — In Switz- erland, &c. Observations of Drs. Lombard, Erehmer, Kuchenmeister, and Hermann Weber — Required heights varying with latitude — Dr. Weber's cases — Question as to the suitability of the mountain climate in winter — Notes on Alpine summer quarters for in- valids, by Dr. C. J. B. Williams — Thusis — Journey by Schyn Pass and over the Julier to the Engadine— Severity of the climate in August — Disagrees with some visitors — Highly invigorating to others — Cau- tion and discrimination necessary — Consumption cured in the Engadine — Favourable circumstances and cases — Choice of situation — St. Moritz considered — Samaden, &c. — Tarasp — Davos — Journey in search of another high sanatorium — Over the Bernina — Le Prese — Up the Valtelline — Bormio, new and old Baths — Situation and climate described — Temperature, dryness, &c., compared with other high places — Establishment of the New Baths — Suitable for summer and winter — Thermal waters and baths — Beautiful neighbourhood — Stelvio — Santa Caterina — Routes A 7 XIV CONTE^'TS. PAGES to Bormio — Other mountain sanatoria — Rigi Kaltbad and Scheidcck — Lcukerbad — Cournia3'eur — Gressoney St. John — Monte Gencroso — Laucnen — Evolena — Other high resorts for travellers, not well suited for invalids : Andermatt, Furca, Splugen, &e. — Other mountain inns not sufficiently accessible: iEggischhorn, Riffel, &c 135-161 Concluding Remarks 101-102 C'ind's origin as unsatisfactory. In France, the mistral is only known in the parts lying near the Mediterranean coast, and to the east of the Cevennes range of mountains ; for north-west winds experienced in other parts of that country are of an entirely different nature, being more or less moist, and not possessed of great force. Therefore, as it has been shown that the mistral cannot have a 30 PHYSICAL ASPECTS. mere local origin, it exists probably as an upper current and descends on the region under consi- deration. And this is the more probable, because the formation of powerful upper aerial currents is attended with less difficulty than that of surface winds, in consequence of their not being subjected to friction with the earth's surface. It will be seen that the foregoing conclusion affords a satisfactory explanation of the dryness of this wind. For even if the upper atmospheric current were saturated with moisture, yet the amount of vapour held in suspen- sion must be small on account of the lowness of the temperature; and when that temperature is raised by the compression which follows its descent into the lower atmospheric regions, the aerial current must be far from a state of saturation. In fact, as the mistral must come from the direction of the Atlantic, I do not see how its dryness can be satis- factorily accounted for in any other manner. But why does such a current descend upon this particular region ? Doubtless because the air over the warm Mediterranean basin becoming heated and rarefied, a partial vacuum is produced, into which the cold upper current descends. I think, therefore, I am fully justified in assuming that the mistral must be caused by an upper aerial current descending on this PEOBABLE COSMICAL OEIGIN. 31 region. It remains for me to explain how such an upper current may be formed. A glance at the map shows that the south coast of France is in the same latitude with the south of Canada, where the winters are extremely severe, mercury having been known to freeze ; and on cast- ing our eyes farther north we come to the cold reofions of British Xorth America and the cn-eat Arctic Archipelago. There will be no difficulty in accounting for the low temperature of any wind blowing from this quarter. It will also be seen, on inspecting any map of America showing the lines of equal mean January temperature, that the coldness of the British Xorth American climate increases rapidly as we proceed westwards into its interior, such increase of coldness being fully as great as what would be encountered in proceeding from south to north. The intense cold of the interior parts of this region tends to produce an atmospheric current outwards in a direction at ricrht angles to these isothermal lines. This will be found to be a di- rection from west-north-west. Such a current, which would probably extend to a considerable height in the atmosphere, would be raised in altitude by encountering the high lands of Labrador, lately surveyed by Professor Hind ; after which, it, or at 32 PHYSICAL ASPECTS. any rate the upper portion of the current, might con- tinue its course at a height above the Atlantic, crossing the North Polar current and the Grulf stream as an upper atmospheric current. But, it may be asked, why should not this current descend to supply the partial vacuum caused by the heating and rarefaction of the air in contact with the Gulf stream ? Such a descent is rendered impro- bable by the nature of the stratum of air overlying this warm stream. It must be loaded with aqueous vapour. Now, the experiments of Dr. Tyndall show that the heat-absorbing powers of aqueous vapour are enormous ; that although in pure atmospheric air its amount in atoms is only 1 to 200 of oxygen and nitrogen, the single atom of aqueous vapour absorbs more heat than the 200 atoms of oxygen and nitrogen collectively, and, compared with the action of a single atom of oxygen or nitrogen, its heat-absorbing power is 16,000 times as great. The stratum of air in contact with the Gulf stream is, as has been stated, loaded ^vdth aqueous vapour, and therefore is possessed of absorbing properties suffi- cient to form a screen nearly impervious to the heat radiated from the warm body of water. Owing to this, and also to the feeble radiating power of water, the decrease in temperature in ascending to the upper INFLUENCE OF AQUEOUS VAPOUR. 33 strata of the atmosphere overlying this stream must be much more rapid than in ascending into atmo- spheric strata overlying land. Such being the case, it is clear that the rarefaction produced by the warmth of the Grulf stream would not extend to any consider- able height in the atmosphere. Moreover, the partial vacuum before mentioned is supplied by the upper equatorial current, which here descends and forms the south-west wind prevalent in the temperate re- gions of the Atlantic. The west-north-west current would, therefore, continue its course as an upper U atmospheric current little affected by the warmth of the Gulf stream, and could not hold any great amount of moisture by reason of its low tempera- ture. This current would, if not acted upon by disturbing influences, cross the Atlantic as an upper west-north-west current. But as the effect of the earth's rotation upon a north wind in the northern hemisphere is to give it an easterl}'^ tendency, and transform it into a north-east wind, so this easterly tendency, in the case of a west-north-west current, would convert it into a north-west current. This north-west current would, as before pointed out, de- scend upon the warm Mediterranean basin as a dry north-west-wind. Hence the mistral. It appears from hygrometrical observations, that D 34 PHYSICAL ASPECTS. the mistral, although dry, is not so dry as the bise or north-east wind prevalent at Nice, and in some other parts of the south of France — a circumstance which is evidently in complete harmony with this theory, as the aerial current in passing above the Atlantic must receive some vapour; and although not suflficient in amount to prevent its being a dry wind for the reasons before indicated, yet we should expect to find it moister than the north-east wind, which must have crossed the Alps before its arrival at Nice and other southern places. I am aware that this theory would require a con- siderable amount of evidence to establish its truth ; but it appeared to me reasonable, as it suggests a cause worthy of so powerful an effect as the mistral, by assigning to it a cosmical origin. This is analo- gous to the explanation given of other powerful cur- rents, as the monsoons and the south-west equatorial current, &c. However, as yet I can oifer it only as an hypothesis, the truth of which must be tested by subsequent observation. The southerly winds, which prevail in the south of France, are for the most part moist, and generally accompanied by clouds and rain. Beyond their bringing saline breezes and occasionally boisterous weather, they are not injurious. An exception, how- SOUTEEELT -VTINDS. 35 ever, is the south-east, a sirocco -wdnd, which is in general warm, and in the more sheltered watering- places occasionally causes a decidedly oppressive state of atmosphere. At Hyeres, it is annoying, because it blows into the town the dust of the plain intervening between Hyeres and the sea. It is, however, a moist wind, and rain soon follows to lay the dust. Dr. Bennet describes this wind at Mentone as having ' all but lost the languor-giving properties which distinguish it at Naples.' He states that it sometimes becomes exceedingly cold in winter from the presence of a large amount of snow on the moun- tains of Corsica ; and that it may even cause a fall of snow at Mentone, which occurred in the very severe winter of 1863-64. My own experience of this wind at Nice and Mentone is, that it is moister than in South Italy, but at times veiy warm and enervating. The east wind, which is scarcely felt except at Nice and Cannes, is less dry than in England ; and the west wind retains its usual character of greater humidity, but is not so loaded with moisture as in England. Secondly. The climate is considerably influenced by the neighbourhood of mountain ranges. This is an important feature of this climate, as it is through this region being situated to the south of D 2 36 PHYSICAL ASPECTS. mountains that it owes its general protection from northerly winds. There is an im])ortant point to be considered when we attempt to judge of the shelter which a mountain to the north of a town affords — namely, whether the town is situated immediately under the mountain or at some distance from it. This constitutes the chief cause of difference between the climates of Nice and Mentone. Nice is situated upwards of three miles from the base of its projecting chain, and therefore does not enjoy the same immu- nity from northerly winds that Mentone does, which lies immediately under an amphitheatre of mountains. The health resort should be situated immediately under, or on the lower slopes of, the protecting range, which should be wooded to the summit, and not sufficiently lofty to allow snow to rest for a long period in winter ; or the streams which descend its sides will be reduced in temperature, and bring down currents of cold air with them. Hyeres is greatly favoured in these respects, as it is sheltered by wooded hilJs of no gi'eat height, and lies at a considerable distance from snow ranges and moun- tain torrents. Cannes is much nearer to the snow- capped mountains ; but' the adjoining hills are well wooded, and few streams reach its yalley. Nice is unfortunately influenced by the torrent Paillon, MOUNTAIN EANGE. 37 which is cooled by the glaciers of the Col de Tende range : and Mentone, though enjoying excellent shel- ter, is intersected by torrents which, descending from the Maritime Alps, traverse its protected area. 38 CHAPTER III. HEALTH RESORTS — HYERES — COSTABELLE — CANNES NICE — CIMIEZ CARABAgEL MENTONE. The principal meteorological phenomena presented by the climate of the whole region having been con- sidered in the last chapter, we can now direct our attention to the modifications of it found iu the individual health resorts ; and these will be described briefly, but faithfully, in the order in which they are approached by rail from Paris. The first arrived at, after one hour and three quarters' journey from Mar- seilles, or nineteen hours from Paris, is Hijeres, a town of 10,000 inhabitants, situated in latitude 43*7° N., and the nearest and the most southerly of all the French winter resorts. The town is built on the most southern slope of one of a range of hills called the Maurettes, and faces south and south-east. It is distant about three miles from the Rade d'llyeres, an inlet of the Mediterranean, the intervening space consisting of a very fertile plain. The valley of HTEEES. 39 Hyeres runs in a north-westerly direction back from the sea, between the well-wooded ranges of the Pciradis and the Maurettes, and opens on to the town and harbour of Toulon, another inlet of the Mediterranean, beino- to a certain extent closed in bv the picturesque mountains (wer that seaport. On approaching Hyeres from Toulon, a sensible differ- ence, as Dr. Edwin Lee justly remarks, is experienced in the temperature, owing to the southern portion of the valley being more sheltered ; and its increased fertility is shown in the extreme luxuriance of the vecfetation. The ranches of the Paradis and Mau- rettes, instead of being bare, like the majority of the mountains of Provence, are clothed to their summits with pine and cork trees. In the valley abundant crops of corn, wine, and oil are produced apparently on the same spot of ground, the wheat and the vine crops attaining to maturity even under the shade of the olive trees. Oranges and lemons are neither so fine nor so abundant as at Nice and Mentone ; but the aloe and cactus, common throughout this region, grow in great luxuriance and profusion at Hyeres. The striking feature of the vegetation, and one which im- parts a tropical aspect to the landscape, is the presence of the palm-tree in numbers and rare beauty, attaining a greater height and a finer growth here than in any 40 HTERES. other part of France. In M. Denis's garden are to be seen no less than fifteen different varieties of this tree, many of which are natives of the Cape of Good Hope, flourishing in the open air. The date-palm, Phcenix dadylifera, is the most common ; but other varieties, including the fan-palm, Chamcerops For- tunei, are not wanting. M. Denis exhibited some fine date-palms in the Jardin Eeserve of the Paris Exhibition (1867); and one of them was of remarkably vigorous growth, and had growing around it young ones self-sown. The wild flowers are abundant, and of varied and brilliant colours. According to Mr. Timins's observations, they bloom somewhat earlier here than at Cannes.* » The Ecv. D. C. Timins, M.A., Oriol Coll., Oxon., has kindly favoured me with the time of appenrauee of the following plants in "bloom at Hyeres and at Cannes respectively. These observations were made by Mr. Timins, at Cannes, in 1865, and at Hyeres, in 1866. Anemone hortensis coronaria pavonina Ranunculus ficaria Narcissus tazetta Cerintha asjicra Linum fla^nim . Tulipa oculus solis Muscari cornosum Erica arborea . Arisariura vulgare Hyeres. Cannes. Difference. Jan. 17 ... Jan. 26 ... 9 days Feb. 6 ... Feb. 17 ... 11 „ Feb. IG ... March 17 ...29 „ Jan. 22 ... Feb. 13 ... 22 „ Jan. 30 ... Feb. 14 ... 15 „ Jan. 30 ... Feb. 12 ... 13 „ Feb. 6 ... Feb. 13 ... 7 „ Feb. 15 ... March 1 ... H „ Feb. 14 ... Feb. 28 ... 14 „ Feb. 2 ... March 8 ... 34 „ Jan. 27 ... Feb. 14 ... 18 „ VEGETATION. 41 The lies d'Hyeres, the ancient Stcechades, lie off the coast, and, with the Presqu'ile de Gien, help to form the Eade d'Hyeres. These islands are hilly and precipitous, and to a certain extent screen the Hyferes. Cannes. Difference. Arum italicum . March 10 ... April 5 ... 26 days Iris germanica . Feb. 15 ... April 11 ...24 „' pseudacorus . Feb. 15 ... April 11 ...24 „ Helianthemum album . March 30 ... April 5 ... 6 „ polyfolium . Feb. 28 ... March 15 ... 15 „ Gladiolus germanicus . April 12 ... April 15 ... 3 „ Borago officinalis . Jan. 31 ... Feb. 14 ... u „ Vinca minor . . Jan. 17 ... Feb. 7 ...21 „ In order to judge better of these comparisons, I have compared the temperature of the two seasons at Cannes and other places ; and although I find that the season of 1865 was, on the whole, colder than that of 1866, the difference of mean temperature in the month of February amounting to as much as 4° Fahr., yet the difference of the seasons is not, I think, sufficient to account for the striking contrast presented by Mr. Timins's table ; more especially as the mean temperature of April 1865 was actually 6° Fahr. higher than that of 1 866. It will be seen that, out of twenty plants, two flowered at Hyeres a month and upwards earlier than at Cannes ; six, three weeks and upwards ; nine, one week and upwards. Mr. Timins has also furnished me with a list of the principal species of Lepidoptera, and their time of appearance at the two places taken during the same seasons as the plants. It is here sub- joined, as it may probably interest some of my readers. Species. Appeared at Hyferes. At Cannes. Papilio Machaon . March 25 April 7 Podalirius . . Feb. 26 April 8 Thais Cassandra . March 27 April 5 Thais Medecicasta April 12 April 10 42 ILES d'HTERES. town of Hyeres from the sometimes rather boisterous sea winds. Their appearance, as seen on a fine day from the Place des Pahniers, is strikingly beautiful ; their fine outlines rising hazily from the blue Species. Appeared at Hy6re 3, At Cannes. Rbodocera Cleopatra . . . Feb. 13 April 7 2nd brood Oct. 29 .. Oct. 10 Rhamni March 31 . April 7 Colias Edusa Jan. 29 Jan. 27 inyrmidone , Feb. 14 .. April 10 Colias Hyale . Feb. 19 .. March 12 2nd brood. Oct. 30 None seen Aporia Cratcegi April 25 None seen Pieris Belia .... Feb. 3 .. Feb. 7 Ausonia March 6 .. March 28 Diiplidice . Feb. 5 .. Fob. 4 Bellidice Jan. 30 Jan. 27 Cardamines April 4 .. April 12 Euphreno April 8 April 26 Leptosia Candida . March 27 April 17 Lathyri . Feb. 28 April Erysimi . April 15 None seen Arco Psyche . April 25 None seen Satyr us Xiphia Feb. 17 March Egeria March 28 April 6 Megaera . Feb. 2 March 1 adrasta None seen April 26 Vanessa cardui . Feb. 8 March polychloros Fob. 8 March 1 lo Feb. April Antiopa 9^ ^ :- a. March 17 April 10 Atalanta pq M . Feb. 1 .. Jan. 23 Grapta C. album . . April 12 April 10 triangulum March 11 April 10 Limenitis Camilla. . Ai^ril 12 ... May 7 MILITARY HOSPITAL. 43 Mediterranean, and forming an important feature in the sunny view enjoyed from that spot. On the largest island, Porquerolles, remarkable for the great size and fragrant odours of its shrubs, the French Government have established an Hospital for the in- valid and wounded Algerine troops, thus giving a practical proof of their opinion as to the mildness of the climate. The east end of the town of Hyeres is completely sheltered from the mistral by the Castle Hill, a spur of the Maurettes ; but the west end is open to its influence. Its force is broken by the mountains over Species. Appeared at Hyferes. At Cannes. Melitsea Deione . April 12 May 6 Cinxia April 12 April 20 Provencialis . April 12 None seen Didyma . April 25 None seen Dia .... None seen April Argyxmis Lathonia April Feb. 7 Thecla rubi .... Feb. 9 March 18 Lyesena ballus March 17 None seen Hippothoe April 24 April 18 Polyonnatus Argiolus . Feb. 28 April 7 Hylas Feb. 27 April 6 Melanops . April 12 May 6 Boeticus Oct. 29 Nov. 5 Spring brood . April 24 None seen Telicanus . Oct. 29 Nov. 5 Amynfas . Oct. 30 None seen Battus None seen April 26 Hesperia alveolus . March April 44 HYERES. Toulon, the Coudon and the Pharon, and its blasts are not quite so dry as at Marseilles, probably on account of the seaboard over which it passes before reaching Hyeres. The town is protected from east winds by the chain of Les INIaures : but it is affected by the south-east wind, which, as has been before stated, is sometimes irritating from the dust it brings up from the plain below. The Hotel du Pare and the Hotel d'Orient are situated at the east end of the town, and are therefore protected from the mistral ; the Hotel des lies d'Or and the Hotel des Hesperides lie at the west end, and consequently are exposed to some of its gusts. The mean winter temperature is 47*3° Fahr. — i.e. lower than that of Mentone, and not differing much from that of Nice. The average annual rainfall is twenty-seven inches — i.e. greater than that at Nice, and probably greater than that at Mentone. The amount of rainfall is curious, and contrasts with that of Toulon, which is eighteen inches, and doubtless this difference, combined with a higher mean tem- perature, accounts for the great luxuriance of the vegetation in the neighbourhood of Hyeres. The number of rainy days, according to M. de Valcourt, is sixty-three — i.e. less than that at Mentone or Nice : but the difference in the amount of moisture EFFECTS OF ITS CLIMATE. 45 is best shown by the hygrometer. During the winter 1864-65, as has been before stated, the mean differ- ence between the bulbs was 6*7° Fahr. at Mentone, while at Hyeres it was 5° Fahr. The climate of Hveres is the least exciting and the least stimulating of all health-resorts of this re- gion. In fact, it sometimes has a sedative effect ; for Dr. Griffith, the resident English physician, informed me that many patients coming from Mentone and Cannes in a state of nervous excitement and wake- fulness, brought on by the stimulating effect of the air, have slept well and soundly at Hyeres. This quality in the climate has its origin partly in its somewhat greater humidity when compared with that of Mentone, as seen above ; partly in the luxuriance of the vegetation ; and partly in the fact of the town beino- at some distance from the sea, and to a certain extent screened from saline breezes. Though not so perfectly sheltered from the mistral, nor enjoying so high a mean temperature as JMentone, the openness and breadth of its valley gives Hyeres the advantage of a freer circulation of air, and of a larger space of level or gently sloping ground; thus affording greater facilities for exercise in those cases where mountain climbing is unadvisable, and where drives or walks on level ground are preferable. 46 COSTABELLE. I must not omit to mention a sunny spot called Costabelle, lying one mile from the sea, and about a mile and a half from the town of Hyeres. It is completely sheltered from the mistral by the Pic des Oiseaux, a spur of the Paradis range, and, according to M. Denis, enjoys a mean temperature two degrees of Fahrenheit higher than Hyeres ; but its closer vicinity to the sea renders it more open to the southerly winds. The exotics growing in the villa gardens testify to the mildness of the climate ; and as it is a small place, and consists for the most part of detached villas, it possesses advantages in a hygienic point of view over most parts of the town of Hyeres, where the houses are crowded, and the drainage arrangements by no means perfect. Cannes, a town of 8,000 inhabitants, may be reached in about three hours by rail from Hyeres, and in one hour from Nice. It is prettily situated in the deepest recess of the gulf of Napoule, opposite the low islands, Les Lerins. From the Pointe de la Croisette, the eastern boundary of the gulf, the wooded hills of Vallauris run back in a north-westerly direction, and protect from easterly winds a fertile plain separating them from the sea. These hills rise to a considerable height, and are continuous with some undulatincf ranjres, situated to the north of CANNES. 47 the plain, which afford to Cannes its chief shelter from the northerly blasts. The line of protecting ridges, by no means an unbroken one, is completed by the Estrelles themselves, which are separated from Cannes by the wide plain of Laval and the Siagrtes stream. Further on they descend in graceful masses into the Mediterranean, forming the western boun- dary of the Grulf of Napoule, whose calm waters lave their bases, and of whose exquisite scenery their rugged and varied outlines are the great charm. The basin thus formed is a wide one, and portions of it lie too far from the protecting barriers to be completely sheltered by them. These portions can- not enjoy the same immunity from cold winds which others lying immediately under them obtain ; and for this reason there is a great difference in the degree of shelter enjoyed by different parts of the Cannes basin. The town of Cannes is divided by the Mont Chevalier into east and west por- tions, the eastern being situated chiefly on level ground in close proximity to the sea ; while the western, rising on the slopes of some wooded heights, is further removed from the shore, and looks to- wards the Estrelles mountains. Cannes is well sheltered from the north and north- east winds, and, to a certain extent, from the north- 43 CANNES. west or mistral, but owing to the depressions in the Estrelles range and the distance of the town from them, this wind at times prevails with considerable power. The hills of Vallauris give some protection from the east wind, which is of an irritating char- acter, though less so than at Nice. Cannes is exposed to the blasts of all the southerly winds, as the islands, Les Lerins, are too flat and lie too near the sea level to afford efficient protection. The winter mean temperature is 48° Fahr. — i.e. lower than at Mentone, and higher than at Hyeres. The average number of rainy days in the year is fifty-two, the smallest number in this region. The annual rainfall is twenty-five inches, the same as at Nice. (I have been favoured with some hygro- metrical observatious, diligently and carefully re- corded by Mrs. K. Cocks, who has passed several winters there. As far as they admit of comparison with those of Mentone, they show Cannes to have a less dry climate.*) The vegetation is very rich and * During the months of January and February 1865, the difference between the bulbs was 4-8° Fahr. At Mentone Dr. Bennet's obser- vations, taken during tlie same months, and at about the same hour of the day, showed a difference of 7° Fahr. It is only fair to state that my friend Dr. Frank, after comparing the observations of Dr. de Valcourt at Cannes, and Mr. Freeman at Mentone, made daring the same months of 1865, has arrived at a different conclusion from the above. SCENT-PEODUCING PLANTS. 49 of varied description, as is seen iu the villa gardens ; but the chief feature is the prevalence of scent- producing plants. Whole fields are devoted to the cultivation of the jessamine, cassia, and geranium, so that the air is redolent with these perfumes. Another fine feature of the vegetation is the graceful Pinus pinea, or umbrella pine, which is extremely abundant here, and attains to a very great size, probably from the favourable nature of the soil, which is of a sandy character. The climate is warm, dry, and decidedly stimu- lating ; as might be expected from the situation of the town on the coast, and from the sandy and schistose nature of the soil. Cannes enjoys the advantage over Nice, of being less exposed to sud- den changes in temperature, on account of its supe- rior protection from northerly winds. The climate is nearly as stimulating, and contrasts greatly with the sedative cjualities of that of Hyeres. Of the numerous and excellent hotels which Cannes possesses, the Grand Hotel de Cannes, Hotels Imperial, des Princes, and de la Mediter- ranee are built on the Boulevard de I'lmperatrice, close to the sea, on tlie eastern side of the town ; while, on the same side, but situated at a con- siderable distance inland, are the Hotels de Pro- vence and de I'Europe, Victoria, and Beau Sejour. E 50 CANNET. At the west end is the Hotel Pavilion, standiucr a short distance from the shore, while further re- moved, and occupying elevated positions, are the Hotels Bellevue and Beausite. The recently com- pleted waterworks now furnish the town with a bountiful supply of good water. The pretty village of Cannet lies only two miles from Cannes, nestling on the wooded side of Vallau- ritf, and its admirable position at the end of a well- sheltered valley, enjoying a beautiful view of the coast line, seems to render it very suitable for a winter station for invalids. As Cannet promises to supply a want much felt at Cannes, and only par- tially provided for by the Hotels de I'Europe and Pro- vence, viz. a well-sheltered inland retreat from the too boisterous sea winds, it is curious that the ad- vantages offered by the spot have not as yet been fully developed. Dr. Frank, one of the Euglish physicians at Cannes, informs me that villas are now springing up in the neighbourhood ; and it is to be hoped that ere long Cannet and the Vallauris district will form a winter station, whose climate, as judged of b}' its position, would much resemble that of Hyeres. The valley of Vallergues, too, on the road to Grasse, at some distance from the shore, enjoys NICE. 51 many of the same advantages as Cannet, being well sheltered and away from the sea. Nice is a considerable town of some 40,000 in- habitants, situated on the Mediterranean coast be- tween Cannes and Mentone. It faces the south, is built on a plain, formed probably by the deposits of the Paillon torrent; and is surrounded, except on the seaboard, by an amphitheatre of mountains. Tliis plain runs back from the sea to the distance of three miles and upwards ; but laterally it occupies a far greater space. The protecting amphitheatre of mountains consists of spurs of the Maritime Alps, forming a succession of ranges, of which the nearer ones are low wooded hills, pleasantly besprinkled with villas, while the more distant are lofty and bare. The higher chain of mountains does not afford by any means complete shelter to the town, partly on account of its distance, and partly on ac- count of various gaps and depressions in the range. The chief gap in the Nicean amphitheatre is to the north-east, and is caused by the wide valley of the Paillon, a torrent, which flows down from the snows and glaciers of the Col de Tende, and discharges itself into the Mediterranean at Nice. The hise, or north-east wind, reaches Nice through this valley, and is very cold and cutting. The mistral comes E 2 52 CIMIEZ AND CAEABA9EL. through a depression to the north-west, and is more felt here than at any of the four health-resorts. The east wind prevails in INIarch, and is dry and of an irritating nature ; and all the southerly breezes blow unchecked by obstacles of any sort. The mean winter temperature is, as has been stated before, 47*8° Fahr. Tlie average rainfall is twenty-five inches, and the average number of rainy days, sixty. Cimiez and Carabapel are suburbs of Nice, and from their situation enjoy a much greater amount of protection than the town itself. Cimiez is placed on the slopes and near the summit of one of the low ranges to the north of Nice, while Carabapel^ lies immediately at its foot. Carabapel is upwards of a mile from the sea, is nearly entirely protected from northerly winds by the hill of Cimiez, and but slightly influenced by southerly and easterly breezes. Cimiez is still further from the sea, and enjoys equal protection ; and in both these places the vegetation is very luxuriant, and exotics of varied description flourish in the open air. To the north-east of Nice, at about two miles from the sea, lies the district of St. Barthelemy, the greater part of which k sheltered from the mistral by wooded hills, which rise to the north and west of it. Its distance from the sea, and sheltered posi- CLIMATE OP NICE. 53 tion, render its climate similar to that of Carabapel and Cimiez, and as both these places are over- crowded, it is to be hoped that accommodation for invalids will be forthcoming at St. Barthelemy, and thus the number of our winter refuges will be increased. The climate of Nice itself is warm, very dry, and rather stimulating; but its chief defect lies in its liability to sudden and rapid changes of temperature, which arise from its imperfect protection from north- erly and easterly winds. When snow falls on Mont Chauve, a mountain to the north of Nice, and the wind blows from that quarter, a bitter state of at- mosphere is experienced in the town. Although the uncertainty of climate precludes Nice from being suitable for the majority of pulmonary complaints, the absence of moisture, and the combination of bright sunshine and saline breezes, renders it emi- nently suitable for rheumatic and gouty affections, as also for the atonic forms of dyspepsia and for many scrofulous complaints. The appearance of intermittent fever in Nice and its neighbourhood, and the increase in the number of cases admitted into the hospital, have naturally drawn attention to the causes of the malady. The Paillon and Var torrents, which formerly desolated 54 MALARIA. a wide tract of country, have been confined within certain limits by aid of embankments, and thus a great deal of land for cultivation has been gained ; in which, as is usual in this country, artificial irriga- tion has been established. The embanking, while it has narrowed the course of the streams, has raised the level of their beds, which in some districts is above the neighbouring land ; and it is in these dis- tricts that the malarious influence is chiefly felt. Sir Eauald Martin tells me of a similar example in India. Through a plain, previously healthy, a canal was carried at some height above the neighbouring country ; and shortl}^ afterwards intermittent fever appeared among the inhabitants dwelling on either side of the canal. Near the Var embankments, a good many cases have occurred, and Dr. Pantaleone, who, during his residence at Rome had great expe- rience of this kind of fever, told me that cases of a very severe type had fallen under his notice, and that in most cases the disease had been contracted by visitors frequenting picnics in this neighbour- hood. A great deal of the land on the right bank of the Paillon lies below the bed of the river ; but in the suburbs of Nice the new roads are constructed at a high level, and the ground lying between them is CLIMATE OP SUBURBS. 55 always raised previously to being built on. In course of time, therefore, ' the levelling up ' of the country will (unless the beds of the rivers are also raised) abolish this cause of malaria, which in the Paillon district is now only slight. The climate of Carabapel and Cimiez presents a decided contrast to that of Nice, and some similarity to that of Hyeres, being less exciting, less liable to sudden change, and moist er than that of Nice. The hygrometrical observations, taken at the military hospital near Carabapel, show the amount of moisture to be nearly the same as at Hyeres; and several medical friends have informed me that this climate exercises the same sedative influence on patients coming from Cannes and Nice itself, as Dr. Grriffith states is exercised by the climate of Hyeres. This decided contrast to the climate of Nice, displayed by its suburbs, is to be accounted for by their distance from the sea, by their large amount of vegetation, and by their superior shelter from all winds. Pul- monary invalids may therefore find a safe refuge in these localities, if they are content to remain within their bounds. But this is too often not the case ; they complain of being dull and moped in the quiet retreats of Cimiez and Caraba^el ; and, tempted by the attractions and promenades of Nice, they en- 66 MENTONE. counter the sudden changes and chills which are so prejudicial to such cases, and may frustrate all the objects for which they have left their native land. The Hotels Victoria, Mediterranee, Grand Bre- tagne, Angleterre, and des Anglais, are close to the sea. The Grand Hotel, the Hotel de France, and Hotel Chauvin are on the right bank of the Paillon, at a short distance from the shore ; while in sheltered positions, at a considerable distance from the sea, are to be found the Hotel Royal, and the Hotel du Louvre in the Eue Grimaldi, and the Pension Milliet in the Rue St. Etienne. At Carabajel, the Hotels de Nice and Paris, and at Cimiez, the Pension Garin, are tolerably protected from cold winds. The railway at present only extends as far as Monaco, which is reached in about an hour from Nice ; and a drive of another hour brings us to Mentone. The exposed situation of Monaco, perched on a rocky peninsula, which is open to nearly all the winds of heaven, unfits it for invalids ; but the sheltered and lovely coast road to Mentone, on which there are at present some villas, seems to offer advantageous sites for further building. Mentone^ a town of 5000 inhabitants, situated twenty -two miles east of Nice, and close to the Italian frontier. It is beautifully placed at the foot of some LUXUEIAXT VEGETATIOX. 57 wooded hills, backed bj the Maritime Alps, which here rise to the height of 3000 or 4000 feet, and form a semicircle, completely protecting the town from all northerly winds. A line bay, bounded on the east by the Murtola Point, and on the west by the Cape St. Martin, is divided into two smaller ones, the eastern and western bays, by a peninsula, on which the town of Mentone stands. A number of small valleys run back from the town towards the pro- tecting range ; and it is in these, and in the gardens immediatelv behind Mentone, that the vesfetation is so very luxuriant, and that the lemon-tree attains a degree of perfection unequalled elsewhere in France. The fruit falls off the branches if the temperature sinks to 27° Fahr., and the tree itself is killed at 24° Fahr. ; so that the appearance of this tree furnishes a tolerably fair indication of the thermometrical changes taking place. Olive and carob trees grow to a great size, and are very productive. The houses occupied by visitors are built for the most part close to the sea, and though a few villas have been erected away from it, the short distance that intervenes between the sea and the protecting ranges will prevent a large number being built, except in the immediate vicinity of the sea. I will not enter into a fuller description of this beautiful and well-protected spot, which has had full 58 MENTOXE. justice done it by Dr. Henry Bennet, in bis charm- ing work on ' Winter in the Soutb of Europe,' and by Dr. Siordet and other authors. Mentone is com- pletely sheltered from all northerly winds, including the mistral ; but it is open to the east wind, and to all the southerly breezes, including the sirocco, which is, perhaps, the only objectionable wind that visits this town, and causes a very close state of atmosphere when it has been blowing for some days. The mean winter temperature is 49*5° Fahr. (Bennet), 48*5° Fahr. (Valcourt), the highest in this region. The average number of rainy days is eighty, and the rainfall is said to be greater than at Nice. The hygrometical observations of Dr. Bennet, as cited above, for the winter 1864-65, show Mentone to be the driest of all the four localities where registered hygroraetrical observations are kept. The climate is warm, very dry, and stimulating. It is also very equable, being much less liable to sudden changes of temperature than Nice or Cannes. There is a want of circulation in the atmosphere, particularly of the eastern bay ; and the close proxi- mity of most of the houses to the sea subjects patients too much to the noise and stimulating effects of that element.* * This defect in Mentone may some day be supplied by Kocca- THE TWO BAYS. 59 Of the two bays, the eastern is the warmer and more sheltered, except from the east wind, the houses being built immediately under the protecting moun- tain range ; but the western bay, though less shel- tered from all winds except the east, offers a better chance of inland accommodation, and is sometimes preferred on this account. Dr. Frank informed me that the plateau of Plan, in the eastern bay, situated about 100 feet above the sea, was admirably suited for invalid residences ; and he hoped that it would not be long before it was made available for the pur- pose. The Hotels de la Paix, Grande Bretagne, de la Pension Anglaise, and the Grrand Hotel, are in the eastern bay close to the sea, while at an elevation, away from the shore, is situated the Hotel d'ltalie. In the western bay, near the sea, are the Hotel Victoria — in which there is a lift, a great convenience for invalids — the Hotel de la Mediterranee, and the Hotel de Londres; outside the town, in the same direction, is the Hotel Pavilion ; while in more inland positions, away from the sea, are the Hotels du Louvre and Beau Sejour ; but there is, unfortunately, bruna, a well-sheltered village, affording some accommodation, and situated 800 feet above the level of the sea, three miles from Mentone, on the Nice Koad. My father. Dr. C. J. B. WiUiams, pointed it out to me as one of the warmest spots on the Eiviera, during a tour which we made together through this region in 1856. 60 FACILITIES FOR EXERCISE. a lack of hotel accommodation in positions at a distance from the shore. We have now reached the frontier, and in our next chapter we will consider the effects of the French southern climate on health and disease. Its physical aspects have been examined, and it has been shown that the climate is warmer and drier than our own ; that it has more sunshine, and counts fewer rainy days, and therefore gives greater oppor- tunities for out-door exercise ; and it is doubtless the principal recommendation of the south of France as a winter resort, that it affords facilities for out-of- door exercise in a pure, mild, and invigorating air, comparatively secure from the chills, changes, fogs, and wet or bleak weather, which pretty generally prevail in this country. In reviewing the several localities in reference to their facilities for this health-giving exercise, Hyeres and Cannes may be named as those which afford the greatest extent of sheltered rides, drives, and walks available for invalids. In the former place there are wanting only improvements in the roads and in the character of the vehicles to excel the other places in these respects. Cannes, with better roads, and a somewhat better supply of carriages and horses, does not enjoy an equal amount of shelter; but even in THE HEALTH EESORTS COMPAEED. 61 this point it surpasses Nice, which, with all the choice of equipage belonging to a large town, and with all the enchantment which beautiful scenery can give to its environs, has the disadvantage that in some of its beautiful drives the traveller may experience an excessive fall of temperature in the course of a few minutes. Mentone enjoys the protection of being almost hemmed in by mountains ; but it thereby loses the advantao^e of numerous level walks and drives suitable for many invalids. It is, therefore, best adapted either to infirm patients who require a ■warm atmosphere with little locomotion, or to those much stronger and more active, who, on foot or on donkeys, can scramble up its mountain valleys 62 CHAPTER IV. MEDICAL ASPECTS — EFFECTS OF THE CLIMATE ON HEALTH AND DISEASE. The testimony of all the medical men practising among the natives is to the effect that, though acute disease occurs often, and is very fatal, chronic disease is rare; and many forms of degenerative diseases common in this country are scarcely known there. Dr. Griffith informs me, that no cases of Bright's kidney disease have occurred in the Hyeres hospital ■vAdthin the memory of the present medical officers ; and I may mention that Dr. Francis gives some- what similar testimony concerning the hospitals of Spain : for he states that after carefully examining the principal hospitals of the Spanish peninsula for cases of this disease, he only succeeded in finding a few at Carthagena. I regret that I have been unable to collect statistics to decide the per-centage and mortality in each class of disease. Dr. Benuet states CHRONIC AND ACUTE DISEASE. 63 that the deaths from pulmonary consumption at Mentone are only one in every fifty-five of the total number, instead of one in five, as at Paris and London.^ Mr. Kichelmi,t who practised for 34 years in the Eiviera, gives even stronger testimony. He states that out of 7000 deaths, which occurred at Villafranca, Monaco, Mentone, San Eemo, and other places on the coast, only 107, or 1 in 65, were due to pulmonary consumption. When we remember that the researches of Drs. Bowditch and Buchanan in America and England have, beyond doubt, established that ivetness of soil is a cause of consumption to the population living on it, an explanation of the comparative exemption of this region from consumption is to be found in the great dryness of the soil. Dr. Chambers, in his admirable Lectures on the Climate of Italy, has drawn attention to the regis- tered mortality of Genoa, a city enjoying a climate much resembling that of the south of France, though liable to greater changes ; and he has compared it with the registered mortality of London for the year 1862. Allowing for differences of nomenclature in * One in eight is the mortality from phthisis, according to the Registrar-G-eneral's Eeport for 1862.' t Thorowgood's Climatic Treatment of Consumption, p. 52. G-4 MEDICAL ASPECTS. the two registers, Dr. Chambers shows that, of the total number of deaths, the proportion from chronic disease is smaller at Genoa than at London — e.g. at Genoa it is 1 in 5*6, whereas at London it amounts to 1 in 3*2. He cites the following? strikingf instances: — Anasarca, or general dropsy, caused I in 93 deaths at London ; 1 in 239 at Genoa. Chronic affections of the respiratory organs, including asthma and bronchitis, but excluding pulmonary phthisis, caused at London 1 in 10 deaths ; at Genoa 1 in 20. Aneurism at London caused 103 deaths in the year; at Genoa none. Chronic disease of the heart caused at London 1 in 27 deaths ; at Genoa 1 in 33. No deaths from nephria, or kidney disease, were regis- tered at Genoa, but probabl}'^ some were included under deaths from anasarca. Dr. Chambei-s remarks that the more decidedly chronic and degenerative the disease is, the more marked is the difference between the two cities. On the other hand, the registers show the proportion of deaths from acute disease (excluding zymotics) in Genoa to be more than double that of London — i.e. at Genoa 1 in 3*3 ; in London 1 in 7*7 deaths. Acute affections of the respiratory organs caused in Genoa 1 in 9 deaths; in London 1 in 16. Acute affections of the intestinal canal (including enteritis, gastritis, diarihoea, and dysentery) caused in Genoa 1 in 8*9 ; GENOA AND LOXDON COMPAEED. 65 in London 1 in 30*3 deaths. Acute affections of the nervous centres caused in Genoa 1 in 59 ; in London I in 119 deaths. Apoplexy and cerebral congestion caused in Genoa 1 death in 12 ; in London 1 in 40. Acute inflammation of the heart caused in Genoa 1 death in 44 ; in London 1 in 606. These comparisons are very striking ; but it must be allowed that the force of them would be greater if we could be quite certain that the diagnosis of disease is as accurately carried out at Genoa as it is in London. The entire absence of deaths from aneurism seems almost improbable among an indus- trious population, a large number of whom are en- gaged in the laborious task of lading or unlading heavy ship cargoes, and in other occupations which exercise a decided strain on the vascular system. The high rate of mortality from acute disease of the respiratory organs is owing, probably, to the sudden atmospheric changes to which Genoa is peculiarly liable, on account of its unprotected position ; and in this respect the health-resorts which we have been considering enjoy a great superiority over the Italian city. The general effects of the climate of the south of France on patients may be divided into negative and positive. 66 MEDICAL ASPECTS. Negative. — e. g. The avoidance of the exciting causes of so many diseases — namely, cold and damp. Many invalids, particularly those suffering from phthisis, asthma, emphysema, and chronic bronchitis, by simply avoiding catching fresh colds, prolong life and escape much suffering. Positive. — e. g. The stimulating influence of the air, and the abundant out-door exercise which can be taken in this region. The functions of dio-estion and assimilation are improved, the standard of nutrition is raised, healthy tissue is formed, and morbid deposits are absorbed and eliminated. This stimulating character of the air is to be referred partly to the saline breezes coming from one of the saltest seas known, and partly to its dryness. The effect of this last quality on the skin is remarkable ; for it might be thought that perspiration is promoted by a dry atmosphere more than by a moist one ; but it is really found that an arid state of the skin checks the superficial circulation and secretion, and that a certain amount of moisture in the atmosphere considerably increases the amount of sensible per- spiration. In the south of France it takes a great deal to make one perspire, as I have myself experi- enced. This bracing effect of the climate is well seen in the cessation of the nocturnal sweats of NEGATIVE AND POSITIVE EFFECTS. 67 phthisical patients, who, after a time, only perspire like other people — viz. during exercise. This dry- ness sometimes amounts to a hurtful excess ; and I have known patients suffering from dry bronchitis, who have been obliged to add to the moisture of their apartments by hanging damp sheets in them, or by the diffusion of steam from hot water. It is probably to the stimulating quality of the air that the want of sleep, so common among visitors, is due. Patients seldom sleep so soundly as in England, and often for only a few hours of the night. Many take a siesta in the day. But evil results seldom follow from this wakefulness ; for the nervous system, as Dr. Chambers remarks, being in a healthier con- dition, seems to require less repose, and refreshes itself more rapidly. This stimulating quality, which is to be found to its greatest extent near the sea, does absolute harm to patients already suffering from an excited state of the nervous and vascular systems ; as in cases of hypersesthesia, cerebral erethism, gastritic dyspepsia, and of inflammatory and feverish affections generally. Such patients ought rather to avoid the Mediterranean region of France ; or, if they should go there, they should choose the inland climates of Cimiez and Hyeres in preference to those nearer the sea. F 2 68 MEDICAL ASPECTS. Some information uith regard to giving a prefer- ence to some of these localities over others for cer- tain forms of diseases may be acceptable, and I will now state the results of m}'' enquiries and experience on this point. It has been my object to show that the climate of the individual health-resorts depends on their proximity to, or their distance from, the sea; that the air of the places immediately on the coast is exciting, while that of the more inland is less stimulating and softer; and it is on these dif- ferences that the selection of a locality should be based. In cases of bronchitis the type must be borne in mind. If it be humid, accompanied by iiee expectoration, and devoid of febrile symptoms, Cannes,* Mentone, or even Nice, would be suita,ble. If it be dry, and attended by inflammatory symp- toms, the softer climates of Hyeres and Cimiez would be preferable. As regards spasmodic asthma, Dr. Bennet says that some cases do well at Men- tone, but the majority do not derive benefit. This may be accounted for by the closeness of the * Cannes answers particularly well when the amount of expecto- ration is in excess of the patient's strength, as in bronchorrhroa of the aged. Dr. "Whiteley, of Cannes, informs me that the climate is very effective in stopping any discharge of the nature of a flux, and arising from a relaxed state of system, unaccompanied by inflamma- tory symptoms. THE SELECTION OP A HEALTH RESORT. 69 Mentonian atmosphere. Cannes does not always suit this disease according to Dr. Battersby ; but the climate of Hyeres has answered very well for many such cases. Cases of emphysema, in which the avoidance of bronchitis is necessary, do well at any of the localities except Nice. In pulmonary phthisis, as in bronchitis, the type must be taken into consideration. Cases of non-inflammatory phthisis in all stages, except the last, derive marvellous benefit from the climate of this region. For these Cannes, Mentone, Hyeres, and the suburbs of Nice are suitable ; Nice itself, on account of its sudden changes of tempera- ture, is less safe. The inflammatory form, accompanied by fever and gastric irritation, is better at Hyeres and Cimiez. Dr. Battersby does not recommend Cannes for such cases. According to Dr. Siordet, the effect of the Mentonian climate in these cases is to bring on hectic fever and to hasten the fatal termination. The Mediterranean climate generally is, I think, too dry and stimulating for this form ; and a moister, softer atmosphere is desirable. Such can be found, although at a sacrifice of warmth, in some of the British watering-places, e. g. Torquay, Ventnor, Bournemouth, &c., where saline breezes are com- 70 MEDICAL ASPECTS. bined with a lower mean temperature and a con- siderably greater amount of moisture. Should the large number of wet days, and the prevalence of wind in these localities during the winter months, present objections, the dryer and remarkably still atmosphere of Pan may prove more beneficial. It may be well to direct our attention for a short space to this interesting climate. Pan is eighteen hours distant by rail from Paris, and stands on a terrace of gravel at an elevation of 150 feet above the river. It faces south towards the Pyrenees, distant about twenty miles, and overlooks a rich valley through which the clear Gave flows. According to Sir Alexander Taylor, ' it is protected on the north by the Landes of Pont Long, which ascend very gradually to the distance of eight miles from Pau. The north wind is thus directed into currents, which being attracted by the lofty moun- tains to the south, pass at an elevation considerably above the town : so that the clouds may be often seen quickly sailing onwards, when the leaves are unmoved on the lower level.' The town is to a certain extent screened from the north-west and west winds, but it is open to the southerly and easterly breezes. The chief feature of the climate is the wonderful stillness of the atmosphere. The leaves of the trees scarcely PAU. 71 move, and the rain descends almost perpendicularly ; and even when the wind does blow, its gusts are of short duration, and of no great force. Sir A. Taylor states that during a period of six months' obser- vations the presence of wind was recorded only 13 tioies. The mean winter temperature is 42-8° Fahr., 5° Fahr. lower than at Nice ; and snow falls occa- sionally. The average rainfall is 43 inches com- pared with 25 at Nice ; and the average number of rainy days is 119, compared with 60 at the latter place. My friend Dr. Bagnall has kindh' forwarded the hygrometrical observations for the last two win- ters, and, on comparing them with those of Nice and the other Mediterranean resorts, I find that durincr the winter 1865-66 the average difference between the bulbs amounted to 2*7° Fahr. at Nice, and to 2*4° Fahr. at Pau, the Kew difference for the same period being 1*65° Fahr. The hygrometrical results for the \\inter 1866-67 at Nice and Pau tallied with those of the preceding year, but the month of March, 1867, presented a marked contrast at the two places. At Nice the average difference between the bulbs was 2*3° Fahr., while at Pau it was 4*2° Fahr. : so that during this month Pau actually enjoyed a drier climate than Nice. This was probably exceptional. 72 MEDICAL ASPECTS. When we consider the large amount of rain that falls at Pan, and the prevalence of moist westerly breezes, it is rather surprising that the hygrometer should not indicate a greater amount of humidity during the winter, and the phenomenon can only be accounted for by the absorbent nature of the gravelly soil on which the town stands, and the natural * draining ' of the place by the Gave stream. The calmness of the atmosphere, combined with a certain degree of moisture, imparts a sedative quality to the climate, which acts beneficially on the inflammatory type of phthisis, and Pau can be recommended for this form of disease. The number of rainy days, and the decidedly cold and cloudy weather to which Pau is at times subject, prevent the same freedom of exercise which can be taken in the more southern region, and which is of great importance to a large number of pulmonary invalids; but in fine weather Pau has the recommendation of a large choice of beautiful drives, which cannot be said of all the Mediterranean resorts. In our brief notice of the claims of different locali- ties as a winter residence for pulmonary invalids, we must not omit the mention of Madeira, as one which was long supposed to stand foremost in the list. In the last few years this island has not MADEIEA. 73 maintained its place in the favour of the profes- sion or of the public ; and its comparative de- sertion has been ascribed by a recent writer to its 'seeming rather to satisfy the rec^uirements of the bygone period of the professional mind, when pul- monary consumption was considered a species of inflammatory disease, than to satisfy present re- quirements,' when ' phthisis is considered a disease of debility, of anaemia, of organic exhaustion, and of defective nutrition.' Now, although we may admit that the advance of patholo^v has thrown light on both the nature and treatment of con- sumptive diseases, we can hardly allow that there is such a change in the ' professional mind ' as to deny altogether to inflammation any share in pro- ducing or aggravating these maladies. It is still the opinion of those who have had the largest experience, that a considerable number of cases of phthisis take their origin from inflammatory attacks ; that inter- current inflammations are the most common causes of acceleration of the disease in this country; and that a climate which supplies fresh air without cold, damp, and sudden changes, owes much of its salutary influence to its excludino- these causes of inflam- mation. The declining popularity of ]Madeira may be attributed partly to its distance from England, 74 MEDICAL ASPECTS. and its isolation, involving the necessity of an irk- some sea voyage, and removing the patients so far from friends and home ; and partly to a temporary cause — the establishment of a quarantine — which, in latter years, proved a most serious obstacle to the reception of invalids. PVora recent information it must be added, that the climate of Madeira is deteriorated in its salubrity, in consequence of the substitution of the sugar-cane for the vine, since the ravages of the oidium have destroyed the pro- ductiveness of the latter. In the cultivation of sugar-cane constant irrigation is required, which keeps the ground in a damp state ; and the evil effects have already become manifest in the preva- lence and mortality of fever in the island. Even before this change took place the air of Funchal was never healthy ; and for many years my father's experience led him to the conclusion that patients rarely benefited much by wintering in Madeira, unless they were strong enough to ride daily on the mountain roads above the town. The climate of Funchal and the neighbouring country is remarkable for its steady mildness throughout the winter, being exempt from sudden changes, and from wind, except to a very limited extent ; and it counts few rainy days : but the air FAILURE OF CLIMATE WITHOUT MEDICI^^E. 75 contains a considerable quantity of aqueous vapour, which imparts to it a softness, highly beneficial in the inflammatory type of consumption, but relaxincf and enervating for other forms, and even for healthy persons. It may therefore be said generally, that Madeira is best suited for the early stages and inflammatory forms of the disease, and is not likely to benefit those in whom the cachexia or degenerative tendency is well marked. It may not be out of place to notice the experi- ment which was lately made, by the Committee of the Hospital for Consumption at Brompton, in send- ing twenty patients, selected for the purpose, to Madeira, for the benefit of the climate in winter. The result was by no means so favourable as had been anticipated: not more than three out of the number returned in an improved condition. One died in the island; and the others generally lost flesh and strength ; and the disease in them made considerable progress. .It must be added that these patients, although well fed and cared for, had little or no medicine administered to them, and they thus show that the climate alone, unaided by cod-liver oil, tonics, and other aids in treatment, is truly of inferior efficacy. 76 CHAPTER V. HYGIENICS OF CONSUMPTION — FOOD — CLOTHING VENTILATION EXERCISE. A FEW remarks on the hygienics of consumptive patients will not be out of place ; comprising hints with respect to food, clothing, ventilation, and exer- cise in this region ; as these may aid the beneficial influence of the climate, and considerably increase the probability of the patient's recovery. Food. — xA.s might be expected in a country devoted to the culture of the olive, vine, orange, and lemon, there is a scarcity of pasture for sheep and cattle ; and consequently meat is neither so abundant nor so good as in the grazing countries of the north. It often has to be brought some distance, and is seldom really tender. Added to this, the cooking, except in the best hotels, is not of that plain wholesome character which best agrees with the delicate appetite of an invalid ; and often contains a large amount of grease FOOD. 77 and oil, which in a warm climate tends to produce biliousness and liver disturbance. By strict injunc- tions to the cooks, this objectionable quality in the food may be corrected, and a tolerably wholesome diet procured, and it is of the utmost importance that this point should receive due consideration ; for not only may inattention to it induce bilious derange- ments, but it may prevent the regular and sufficient administration of cod-liver oil, which is the most potent of all means to promote recovery in phthisis. It is mainly through want of attention to this point, that an impression prevails with many practitioners in the south, that patients cannot take the oil in warm climates. But we now have the best evidence, that not only in the south of France and Italy, but in Madeira also, and even in India, this remedy can be given regularly and freely with excellent results. A patient will find that the two daily doses of the oil, with the butter eaten at meals, will be as much, in the way of fatty matter, as his digestive powers can manage in this region, and any extra suppl}^ in the form of rich dishes will only disagree. If he avoids these, and only remembers to take the oil iTnmediately after meals, he will be able to con- tinue its use through the winter, and will gain flesh and strength thereby. The bread is tolerable, and 78 VEGETABLES AXD FRUIT. the butter excellent ; but the latter is not the produce of the country, being imported from Milan and other distant places. The vegetables of this reoion are abundant and in perfection. Their variety, their profusion, and the rapid succession of their crops in winter cause con- siderable surprise to visitors. They are astonished to find themselves eating new potatoes in January, and deliciously tender asparagus in March ; while all through the winter they can depend on an abundant and constant supply of green peas, dwarf beans, cauli- flowers, brocoli, and artichokes, all excellent in flavour and quality. The artichokes are particularly tender, and the cauliflowers of very fine growth. But it is in the form of fruit that we see the effect of that bright sun, those clear skies, and that genial soil, most marked. Nature, aided but little by Art, pours forth a bounteous feast of oranges of various kinds and sizes, of lemons sweet and acid, of shaddocks, pomegranates, almonds, apples, and pears. The Japanese medlar, a tree very sensitive to the slightest degree of frost, bears a delicious and highly prized fruit ; and dates are produced from the palms, but it must be confessed they are hardly eatable. The oranges of Nice are particularly refreshing to the invalid in this warm climate, and the fragrant CLOTHIXG. 79 odour of their rind is only equalled by the sweetness of their taste. These and many other fruits the invalid can enjoy throughout the winter; and pro- vided that he does so in moderation, he will suffer no injurious effect from them. With regard to alcoholic beverages, it may be stated that the stimulating influence of the climate considerably diminishes the necessity for their use. Spirits and the stronger wines, port and sherry, ai"e quite out of place. As Dr. Chambers justly observes, ' one does not feel to want them. A single glass of Orvieto or Capri there seems to produce as much exhilarating relief as an allowance of the domestic port and sherry containing five times the quantity of spirit.' The same influence is to be taken into account in prescribing medicines. The strong tonics are as a rule to be avoided, and the milder ones substituted. Clothing. — This region owes much of the warmth of its winter climate to the prevalence of sunshine ; iu which one mav bask with all the sensations of a fine English summer : but cloudy days and even shady places have their chilly influences, against which the patient shoidd be protected by always wear- ing a flannel or merino imderdress. This is especially required in driving in an open carriage : and the more 80 VENTILATION. SO, early in the morning, or late in the afternoon, when invalids should be provided with a shawl or overcoat. Light-coloured suits of thick texture are the most suitable ; as, while sufficiently warm to prevent the differences of sun and shade being felt, they do not absorb the sun's rays so much, nor present so sorry a figure under the influence of dust, as the darker ones. The light-coloured parasol with a dark lining is useful to protect the head from the sun's heat, and the eyes from its glare ; and is freely used not only by ladies, but also by gentlemen, who are wise enough not to allow the effeminacy of the proceeding to prevent their experiencing its comfort. The great object to be aimed at in clothing is to render the body independent of slight changes in the temperature resulting from alternations of sun and shade, and at the same time to protect the head from the evil effects of powerful sunshine ; for in this climate sunstroke is far from uncommon, although it is easily guarded against by the above precautions. Ventilation. — ^^^lilst we fully admit the importance to a consumptive patient of pure air and its abundant supply, to improve the assimilative and nutritive powers, to raise the standard of products, to facilitate the formation of healthy fibrin and albumen, and to prevent the production of degraded tissues,as tubercle; VENTILATION. 81 in short to remove the tuberculous cachexia, — we must not overlook certain conditions necessary to ensure its full and beneficial influence. The pure air must be of a certain temperature, or at any rate within a certain range, otherwise the alternations of heat and cold will induce fresh attacks of catarrh, bronchitis, pulmonary congestion, and possibly pneu- monia, any of which complications may considerably aggravate the original disease. The practice of sleep- ing with open windows, sometimes recommended to consumptive patients, is a very questionable one. It is questionable during summer in England, where there is less variation of temperature, owing to the influence of the large quantity of aqueous vapour present in the atmosphere, which reflects back to the earth the heat lost by radiation, and thus prevents a great fall of temperature. Even with this equalis- ing influence of the British climate, the coolness and dampness of the night air in summer is often suffi- cient to induce chill of the body and its sundry evil consequences. But in the south of France the prac- tice is doubly hazardous ; for here, during the winter, the fall after sunset is rapid, and the diurnal range very considerable ; owing, as I explained in the com- mencement of this work, to the amount of moisture present in the atmosphere being small and the 82 VEXTILATION. effects of radiation in a clear sky being unchecked. The temperature may be that of summer at noonday, and towards midnight it may fall to 40° Fahr. ; and it is this change that is a fertile cause of bronchitis, pleurisy, and pneumonia in consumptive cases. Apart from the general chill of the body, which may sometimes be obviated by an abundant supply of blankets and coverings, the local effects on the lungs produced by the changes in the air are of some importance. Against these nature has to a cer- tain extent provided a safeguard in the nasal passages, where a large and tortuous plexus of veins furnishes an apparatus for warming the air previous to its entry into the lungs. The mouth, however, is not equally well armed, and air entering by that passage is not so likely to be raised to the proper temperature for respiration as the portion which passes through the nose. Many persons sleep with their mouths open, and breathe almost entirely through them, and in these the inspired air loses the warming influence of the nasal passages. How common it is for even healthy persons, after sleeping with their bedroom windows open, to awake the next morning with a slieht cold in the head. This, in the case of the strong, passes off in the course of a few hours, but in pulmonary invalids may lead to further mischief. EXERCISE. 83 One of the great objects in the treatment of phthisis being the avoidance of all secondary complications, it is evident that the patient shonld be protected from this injurious influence as much as possible, and it is better for him to be kept too warm than too cold. He will have full opportunities in the daytime to enjoy a pure and warm atmosphere, and if the air of his bedroom at night be not so fresh and pure as that which he has been breathing in the day, he can console himself that it is far better to inhale it, than to subject his frame, especially in a dormant state, to all the variations of night temperature. After all, it must never be forgotten that cold is a greater evil than heat, especially in lung complaints ; and it is wiser therefore, after airing the bedroom with widely opened windows in the day, to close them at night- fall and to trust to the chimney and to an occasional fire for ventilation. Exercise. — It may be broadly stated that, in all cases of phthisis, exercise in some form or other is beneficial ; but whether it should be of the active or passive kind, and what varieties of each are admis- sible, depends on the stage and type of the disease, and also on the strength of the patient. In the early stages, where the symptoms are not active, where there has been no recent blood-spitting, and G 2 84 VARIETIES. where the cough is not hard or frequent, those varieties of active exercise are of most advantage which most effectually expand the upper portions of the chest, thereby bringing into play the upper lobes of the lungs, so generally the seat of tubercle ; and by causing the blood to circulate freely through the pulmonary tissue, thus prevent local congestions and fresh deposits, and aid materially in the absorption of old ones. What are the varieties of exercise which best accomplish this end ? Those in which the upper extremities are raised, and the muscles connecting them with the thorax brought into activity. When the arm is raised, the numerous muscles which arise from the ribs, and are inserted into the bones of the upper extremity, e.g. the pectoralis major and minor, the subclavius, the serratus magnus, &c., in contracting, raise the upper ribs, and thus increase the size of the chest cavitv. This necessitates the inspiration of a larger amount of air. Dr. Silvester has called attention to this important principle, and on it has founded his excellent system of restoring respiration in cases of drowning, narcotism, &c. He has also recommended a modification of it in the incipient stages of phthisis. The forms of exercise which carry out this principle are — rowing, particu- GYMNASTIC EXERCISES. 85 larly the pull and backward movement ; the use of the alpenstock in mountain ascents ; swinging by the arms from a horizontal bar, or from a trapeze : climb- ing ladders or trees. Dumb-bells, as commonly used, are calculated to develop the arms more than the chest ; and rather tend to depress the latter, by their weight. Various special gymnastic exercises, of which there is a great choice and variety nowadays, may more or less answer the purpose; but there is one form which is particularly applicable to the object above mentioned, viz. the gymnast^ invented by !Mr. Hodges, 89, Southampton Eow. But to make this instrument answer the purpose of a chest ele- vator or expander, it should be fixed, not as usually done, at the height of the operator, but considerably above his head, in or near the ceiling, with the handles reaching down about to his shoulders ; then by holding the handles, and walking a few paces for- wards and backwards, the arms are brought into a species of action, which, while it exercises the whole body, especially tends to expand and elevate the upper part of the chest. "Walking exercise, as a rule, does not work the upper extremities, or raise the upper ribs, but acts generally on the system, by drawing the blood to the extremities, and cjuickening the circulation through 8G ACTIVE AND PASSIVE EXERCISE. the Inng's. In mountain ascents, and in fast walking, the quickening of the circulation brings the whole lungs into play ; and in this way the upper lobes come into full use. If the alpenstock be used in mountain climbing, the beneficial local effects of raising the upper ribs may be combined with the general advantages of walking. Walking exercise can be taken in all stafjes of phthisis, provided there be no active symptoms pre- sent. Even where cavities are formed, if there be no recent inflammation, a limited amount, and per- formed on level ground, is beneficial ; but great care must be taken not to overtax the patient's strength. Passive exercise may be used by the weak and delicate, even in advanced stages of phthisis, or when it is of the inflammatory type. Open carriage exercise, sailing, or being rowed in a boat, are in- stances, in all of which little muscular exercise is involved ; and they may be considered as means of supplying a constant change of air, with the least fatigue, while their effect in improving the circula- tion and appetite, and in promoting sleep, is often very apparent. But even these make some demand on muscular and nervous Dower, and must not be carried to the extent of producing exhaustion in weak subjects. The roughness of many of the roads, HOESE EXERCISE. 87 and the not always luxurious construction of the carriao"es in the south, sometimes invalidate the dis- tinction between active and passive exercise. Eiding may be considered intermediate between the two forms, for rapid paces, and even the management of a high-mettled steed, may well be classed as active exercise; but the general mode of equitation in the south, on donkeys, mules, or very quiet ponies, hardly rises above the standard of passive exercise. From the time of Sydenham, horse exercise, has always been acknowledged to be peculiarly beneficial to those pulmonary patients that can bear it ; and any one who closely studies the effect of the motions of riding, on the respiration, may perceive that there is a remarkable relation between the process of breathing, and the paces of the horse. This, in addition to the inspiriting effect of the air and exer- cise, may have its share in the salutary results. 88 CHAPTER VI. WINTER STATIONS OF ITALY BORDIGHERA SAN KEMO NERVI PISA ROME — CAPRI — SALERNO — AMALFI. If after quitting Mentone we cross the Pont St. Louis, and enter Italy, we shall find along the beau- tiful Eiviera route several localities, sheltered from cold winds by the Maritime Alps, and enjoying the full effects of the sun's rays and the Mediterranean sea. These localities, though not as yet, with the excep- tion of San Eemo, equal in point of accommodation to the French health resorts, are rapidly developing their resources ; and with regard to position, have already proved to be safe wintering places for many pulmonary invalids. As it is advisable that this class should have a large selection of southern refuges from northern winters, I propose in this chapter to mention briefly some of the more shel- tered spots of Italy ; regretting much that, through BOEDIGHEEA. 89 lack of meteorological data, I cannot speak with certainty as to the climate in every case. Bordighera lies about eleven miles from Mentone, on a promontory jutting far out into the sea, from which exquisite views are obtained of the coast as far west as the Estrelles. The splendid palm-groves, descending even to the shore, and containing trees upwards of 1000 years old, form the chief feature of the scene, and testify powerfully to the warmth of the climate. According to the observations of the Eev. A. Craig, the English chaplain, for which I am indebted to Dr. Daubeny, of San Remo, the mean temperature, during the months of January, Feb- ruary, and March, 1867, was lower than that of San Eemo ; but the daily range was less. The hygro- metrical observations taken at 9 a.m. showed a difference of 2*8° Fahr. between the bulbs, as com- pared with 2*4° Fahr. at Xice for the same period. The Hotel d'Angleterre is good ; and invahds have passed the winter in it with tolerable comfort to themselves, and benefit to their health. San Remo, a town of 11,000 inhabitants, about three and a half hours' drive from Mentone, rises like a white pyramid from the shore of the Mediter- ranean ; contrasting stronglv with the sombre colour of the vast olive-grove, which extends for miles in 90 SAN EEMO. its neighbourhood, covering the nearer range of hills, forming the principal feature of the scenery, and con- tributing, by its produce, in no small degree to the prosperity of the town. The protecting range, sloping gently back from the shore, is intersected, but not penetrated, by numerous valleys remarkable for the luxuriance of their vegetation, and running out on either side to the sea, forms the Capes Nero and Verde, which enclose a fine bay four miles in width. The nearer and olive-clad chain is backed by one more lofty, w^iich rises in the Monte Bignone to the height of 4270 feet, and on which the vegetation is less abundant and more hardy, including varieties of the pine and oak. The town itself faces south, and is built on a spur of the nearer range, with a valley on either side. It is well sheltered to the north, north-east, north-west, and east ; but it is exposed to all the southerly winds, including the south-east. Lemon-trees abound, and, from their thriving state and the size of their fruit, show how rarely frost occurs. Palms are to be seen, and the olive oil pro- duced is of excellent quality. Villas are sprinkled over the hillsides in beautifully sheltered positions, many of them at a distance from the sea ; and some of the hotels are well placed ; being outside the town, and removed from the disagreeables of noise and bad drainage. WIDE SHELTEEED AEEA. 91 On the western side of the town is the Hotel de Londres, and on the eastern the Hotels Victoria and d'Anorleterre, while in the town itself is the Hotel d'ltalie. The mean temperature is 49-1° Fahr. (Sigmund): nearly as high as Dr. Bennet's estimate of that of Mentone, and it would appear from a comparison of the thermometrical tables kept by Dr. Daubeny, one of the resident English physicians, with those of Dr. Bennet for the same winter (1864-65) at Mentone, that the mean range of temperature is much less at San Eemo. At ^lentone it amounted to 12-6° Fahr.; at San Eemo to 9'7° Fahr. : leaving a difference in favour of the latter place of nearly 3° Fahr. On com- paring Professor Ooiran's record of mean temperature for the months January, February, and March, 1865, with that of Nice, I found a difference of nearly 2° Fahr. in favour of San Eemo. The number of rainy days is 45 ; the smallest number of all the places described ; and Dr. Daubeny found the average difference at 9 a.m. between the bulbs, for the winter 1866-7, to amount to 3*7° Fahr.: while at Nice it was 2-7° Fahr., and at Hyeres 2-9'' Fahr. The climate is warm and dry ; and from the pro- tecting ranges not rising precipitously, as at Men- tone, but sloping graduallr back, the shelter from northerly winds is not quite so perfect as at the last- 92 FUTURE WINTER STATIONS. named place. At the same time the vast olive- grove screens the locality from any cold blasts, and the breezes which filter through the olives impart a pleasing freshness to the atmosphere, and remove sensations of lassitude often experienced in well pro- tected spots. The size of the sheltered area gives patients a considerable choice of residences, which can be found either close to, or at varying distances from, the sea, according to the requirements of the case : while the numerous wooded valleys, abounding in exquisite wild flowers, provide plenty of donkey and foot excursions.* As far as San Eemo the resources of this beautifid and sheltered coast-line may be said to have been fairly developed, and an invalid can find good ac- commodation at any of the places we have described. Beyond San Remo, on the Genoa road, and again between Genoa and Spezia, the case is different ; sheltered places suitable for winter residences are not wanting; but unfortunately, with some few excep- tions, the accommodation is not sufiicieutly good for invalids. Considering the large and increasing num- ber of visitors, and the crowded state of some of the * For further information on San Remo I would refer the reader to Mr. Aspinall's little work, entitled ' San Eemo as a Winter Resi- dence, by an Invalid.' DIAXO AXD ALASSIO. 93 French health-resorts, it is of the greatest importance that fresh ones should be established on the Italian side, and I will therefore notice some spots which, from their sheltered position, appeared to me, during a recent visit, worth}" of being chosen for winter stations. After passing Oneglia we come to the spacious valley of Diano, open to the sea, but de- fended from the cold blasts of the north, north-east, and north-west winds by a fine range of hills, clothed with olives, ' prodigal in oil and hoary to the wind.' Several wooded dells run back towards these hills without penetrating them, and, what is of some im- portance, but few torrents traverse the valley. It contains some villages, rather devoid of accommoda- tion ; Diano Marino on the shore, inhabited chiefly by fishermen, and Diano Castello, which peeps out, half-hidden, from the olive-covered slopes above. The former might supply the nucleus of a marine residence ; and the latter that of an inland one. Alassio, about 14 miles from Oneglia, lies on the sea margin, flanked like Diano by olive-clad hills, and seemingly enjoying much shelter. On the east- em Eiviera, between Genoa and Spezzia, there are several favom'ed spots, whose resources the comple- tion of the railroad will probably develope, and I may mention that, during my last visit to this portion 94 NERVI. of the coast, the mistral was blowinfr with jxreat vio- lence, and I thus had a good opportunity of judging of the amount of protection enjoyed by each locality. Nervi, about an hour's drive from Genoa, stands on a ledge of level ground, which descends in rocky masses into the Mediterranean ; here affording boat- ing, bathing, and tolerable fishing. The place is well sheltered to the north and east by wooded hills, on whose sunny slopes the orange and lemon flourish. Olive groves, besprinkled with villas and picturesque hamlets, rise about the village ; and the view from this spot of the Bay of Genoa and the Col de Tende range is exceedingly beautiful. A good hotel and moderate boarding house (Hotel de la Pension An- glaise) with well sheltered grounds, pleasant walks and rides, and its short distance from Genoa, render Nervi attractive to invalids, many of whom have safely wintered there. A magnificent view of the Gulf of Genoa is obtained by ascending the bold promontory of Euta, the rocky coast of the Western Riviera, above which towers the snowy range of the Col de Tende, con- trasting with the gentler, and yet scarcely less exquisite features of the Eastern Eiviera, where a succession of hills, rich in varied vegetation, slope, curve Avithin curve, and outline within outline, in PEOMONTOKT OP RUTA. 95 voluptuous beauty to the sea ; the scene enlivened by picturesque hamlets above, each crowned with its pretty campanile, while below are the busy little ports, gay with the many-coloured sails of the feluccas which glide so gracefully over the blue expanse of the Mediterranean. The northern side of the Ruta promontory is, from its aspect, unfit for a winter residence ; but the southern is beautifully sheltered from all northerly winds, and abounds in luxuriant vegetation, extend- ing even to the water's edge. On the coast, facing south-east, is a good-sized village called Santa Margherita, near which appear to be several de- sirable sites for building; but, curious to say, no carriage-road connects the place with the mainland ; communication being kept up by water only. Passing Eapallo, where the mistral was only too plainly felt, the road ascends again, and we enter a lovely bay, on whose slopes, clad with olives and vines, nestles the pretty village of Zoagi, containing some villas. A few miles further is Chiavari, the west end of which is charmingly placed on the southern side of a bold ascent, but the east end is slightly exposed to the mistral ; here there is toler- able hotel accommodation. Sestri di Levante has been mentioned as a future wintering place, but no 96 PISA. one who has visited it, when the mistral is blowing, can fail to agree with Dr. Bennet, that it is quite unfit for the purpose. The Italian Admiralty Works preclude Spezia from becoming a winter resort ; though its neigh- boiu'hood, as furnishing sites for invalid residences, fully deserves the encomium passed on it by Dr. Chambers. Leaving the Riviera, we now come to — Pisa, a most interesting city, situated six miles from the Mediterranean, on the banks of the swift- flowing Aruo. It lies in the midst of a large plain, parts of which are marshy ; and as far as I could judge, after inspecting its position from the top of its far-famed leaning tower, it does not enjoy much protection on any side. The Apennines, which rise to the north of the tovra, and are snow-capped in winter, are too distant to afford it much shelter. On the east the Tuscan hills give some protection ; but it is open to winds from all the other quarters. The mean winter tem- perature is 44'8° Fahr., and the annual rainfall 45 inches. The climate is moist, unstimulating, and sedative, and bears certain resemblances to that of Pau : but the locality, is damper and not so well sheltered. The Lung' Arno, the principal promenade, is tolerably well protected : but excursions in the SEDATIVE CLIMATE. 97 neighbourhood, particularly the one to * Le Cascine,' are open to the dangei's which arise from exposure to cold winds. The climate of Pisa has a hioh repute among the Italians themselves ; and its sedative character may perhaps recommend it for the inflammatory type of phthisis. The hotel ac- commodation is excellent, the Hotel de la Grande Bretagne being one of the most comfortable and moderate in Italy. Rome was formerly recommended by Sir James Clark and other eminent physicians as a winter resi- dence for patients in the early stages of phthisis, and for some other forms of pulmonary disease. It enjoys a higher mean teniperature in winter than might be expected from its isolated position in the midst of a vast plain, and situated at a consider- able distance from the surrounding mountains. The range of temperature is great ; and the number of rainy days rather large when compared with the num- bers at Nice and in the Riviera. It is exposed to the influence of winds from all quarters, and notably of the Tramontana, or north wind ; and the Sirocco, or south-east wind ; and the alternations of tempera- ture accompanying the changes between northerly and southerly winds render Eome by no means a safe winter residence for pulmonary invalids. The H 98 ROME. surrounding campagna, with its marshes, exercises an undoubtedly malarious influence on the city and its neighbourhood ; and unfortunately visitors are liable even in winter to suffer in some way or other from this influence. Intermittent and remittent fever are the most severe forms of disease; but to the same cause may be traced the headaches and migraine often complained of at Rome. My colleague. Dr. Pollock, who practised for seven years at Rome, informs me that during that period he always had cases of intermittent or remittent fever under his care, even in winter. The sources of this fever, its connection with the depopulation of the country, the extent of its influence, and the con- ditions which modify its prevalence, form topics too comprehensive to be treated of here ; but as, during a recent visit, I paid considerable attention to the subject, a passing notice of the principal causes of the fever, with a view to their prevention, may prove of service to some of my readers. The malaria seems to have a near origin in the neighbouring campagna ; but it has a more re- mote one in the Pontine Marshes, a very dan- gerous district about thirty miles south of Rome; for in the summer months, when the wind blows from that quarter, an increase of fever takes place, CAUSES OP MALAEIA. 99 especially at the end of the city lying nearest the marshes. Again, some parts of the city itself appear to be sources of malaria, while others enjoy perfect im- munity, and it is worth noting that tlie more airy and fashionable quarter of the town, which includes several open spaces, as the Piazza di Spagna and the Piazza del Popolo, is generally the first attacked ; while the crowded dirty Ghetto, or Jews' quarter, with its narrow streets, bad drainage, and deficient ventila- tion, often escapes altogether. One of the best as- certained facts with regard to Eoman malaria, is that it diminishes directly as the population increases, and vice versa, that it increases as the population dimin- ishes ; and in this way is explained its great spread since the days of the empire ; for the population of the city has fallen from upwards of 2,000,000 (Dr. Dyer's* estimate) to 180,000, the present number of inhabitants ; and the campagna, once thickly peo- pled and well wooded, is now bare, and contains but a few scattered towns and villages. The chief agents involved in the production of this malaria appear to be, — firstly, the sun's rays acting en the moist soil, and thus promoting evaporation. Fever is found to prevail in proportion to the sun's power, and the * Article ' Roma,' Smith's ' Greek and Eoman Geography.' H 2 100 ROME. states of the atmospliere, which determine the anioiint of sunshine, exert no small influence over the ma- laria. When the sky becomes cloudy, or when the rain falls heavil}^ — when, in fact, the conditions necessary for evaporation cease for a time, a dimi- nution in the number of fever cases takes place. Secondly, the soil, which in the malarious districts generally consists of pozzuolana, a species of tufa, is porous and has a remarkable power of absorbing mois- ture. A piece of it when brought into the house becomes quite damp, and in a short time will be found to have increased in weight. In the cam- pagna, when the foimdation of a house is dug, it is often necessary to have a pump continually at work to prevent the accumulation of water. The sun's rays striking on so moist a soil causes it to exhale quickly, and rapid evaporation, the condition neces- sary for the production of the poison, is the result. We find, too, that obstacles to evaporation are also obstacles to the production of malaria ; as the ob- scuring of the sun's rays by cloud on the one hand, and the covering of the soil by buildings and pave- ment on the other, both tend to arrest the develop- ment of the miasma.- In this way we can explain the unequal distribution of the fever in Eome. The Ghetto is closely built over, and well paved, and RAPID EVAPOEATION PROM SOIL. 101 thus the action of the sun on the soil is virtually prevented ; whereas the Piazza del Popolo is not covered with pavement," and therefore offers no obstacle to evaporation. My friend Dr. Topham, one of the resident phy- sicians, suggests an ingenious explanation of the malaria, founded on the water ■ system of ancient Eome. To obtain a sufficient supply for the vast population, whose bathing propensities are shown by the colossal baths of Titus, Caracalia, and Diocletian, water was conveyed to Eome by fourteen magnificent aqueducts, and these, some of them reaching be- tween 40 and 50 miles, conducted the streams of the surrounding mountains into the heart of the city. Thus a large supply of water was collected, and now that only three aqueducts are used, and the rest broken down and in ruins, this body of water, diverted from its original course, spreads itself over the campagna, rendering it marshy and deleterious. The prevalence of acute disease of the respiratory organs at Eome, to which so many physicians bear testimony, may be ascribed to the vicissitudes of temperature, and not to any stimulating influence of the climate, which, on the contrary, is rather moist and sedative, and somewhat resembles that of Pisa. The air is soft and warm in fine sunny weather ; and 102 OBJECTIONS TO LARGE ITALIAN CITIES. when the Tramontana and Sirocco are not blowing, there is a calmness of atmosphere which is suitable to some forms of chest dfsease. But, according to my experience, few places are so unfit for a pulmo- nary invalid as Rome. If he wanders on the sunny and sheltered slopes of the Pincian he is tolerably safe ; but a drive into the campagna exposes him to cold winds, and possibly to malaria ; a walk in the well-like streets, so narrow and so walled in by lofty palaces that the sun hardly reaches the paven:ent, is not beneficial ; and visits to the icy museums and galleries, to which his inclinations and his friends direct him, are often fraught with grave dangers. I may, however, generally state, that a careful survey of the large cities of Italy, such as Rome, Florence, and Naples, has convinced me, as it has many other medical men, that the excitement and fatigue of sight-seeing, the gaiety, and the exposure to extreme temperatures, which a residence in them commonly involves, render them quite unfit winter stations for pulmonary invalids. These, in the midst of the temptations offered by the treasure- houses of ancient and modern art, forget the objects for which thev have .been exiled from home, and foolishly expose themselves to cold, fatigue, and other dangers; thereby frustrating the intentions of NAPLES. 103 their physicians, who have recommended a winter in the south ; relying that patients, if they quit their native land for the improvement of health, will have the good sense to keep the object of their exile always in view, and not expose themselves to un- necessary and often fatal dangers; but rather devote their attention wholly and solely to reaping the full advantacres to be derived from the substitution of a southern for a northern winter. Far safer and wiser is it to lead a quiet and tranquil life in one of the above-described health resorts, apart from the fasci- nations of draughty picture galleries, and cold mu- seums of sculpture: and to rest contented with the ever-varying and beauteous feast of nature's charms, bounteously spread and safely partaken of, and the enjoyment of which is doubly enhanced by a know- ledge of the great laws of natural science, which by directing the attention to the wonderful harmony of nature, incites us to show forth the same in our own lives. Besides the above objections to the large towns of Italy as winter stations, Xaples lies under a still more powerful on'^, in its bad drainage ; which is so arranged that a large amount of the sewage of this densely populated city is conducted through the visitors' quarter, and discharged on the shore, or 104 CAPRI. into the almost tideless sea, in front of the public gardens and principal hotels. The Chiaja, where the chief accommodation for strangers is to be found, adjoins this outfall of large sewers, which directly communicate with the external air by means of holes constructed for the purpose of carrying off the rain- water, but serving also as vent-holes to conduct the smells and noxious vapours into the thoroughfare and the neighbouring houses. Should a pulmonary invalid wish to escape from the dangers of Naples, arising from its exposed situation and its unhygienic state, he may find refuges in its neighbourhood, not equal in point of protection to the French stations, but still having a certain amount of shelter from cold winds. The beautiful island of Capri, whose rocky outline rises in full view of Naples, and from the brilliant transparency of the southern atmosphere often ap- pears but a short distance from the shore, enjoys a mild and equable climate throughout the winter. A well-known English resident, who has much benefited by the climate, writes : — ' The formation of the island is limestone, and it is therefore very dry. Very little rain falls there, or much less than on the mainland, as the clouds are carried through the channels on either side ; and the peasantry often look with longing eyes on the rain, which is falling SALEENO. 105 on the continent. The southern part of the island is perfectly sheltered from every breath of the north wind, and here the vegetation is more luxuriant and earlier than in the northern portion.' The town of Capri, and several of the villas, are protected from most of the northerly winds by the precipitous rocks of Anacapri; but there is no shel- ter from other winds, and the island is occasionally subject to stormy weather. Wherever there is suffi- cient soil to til], the vegetation is rich, as shown by its fruits, oil, and far-famed wine ; and a variety of the fan palm is to be seen growing wild in the crevices of the rocks on the north side of the island. Capri is nineteen miles from Naples, and can also be reached by boat from Sorrento. The hotel accom- modation is good ; and patients have passed very tolerable winters there; but communication with the mainland is not always open. Salerno is situated on the northern shore of its gulf, at the foot of the St. Angelo mountains, which screen it from northerly and easterly winds, and afford it greater protection than is enjoyed by any town on the Grulf of Xaples. It faces south ; and the force of the Sirocco wind is broken bv the Posidian promontory, which limits the Gulf on that side. On the south-east lies a fertile strip of level coimtry, afterwards widening out into the malarious 106 AMALFI. plain of Psestum ; but, as a part of the Gulf sepa- rates this marsh from Salerno, the town is shielded from its dangerous effluvia by the intervention of salt water. I was informed by the intelligent chemist of the place that intermittent fever is rare in winter ; but in summer the whole tract of flat country be- comes malarious ; and then fever prevails among the inhabitants. The climate is mild and sunny ; and from the locality being situated on the sea-coast the air is stimulating. The town is only two hours by rail from Naples ; and is one of the cleanest and least smelling of those that I visited in South Italy. The Hotel d'Angleterre is excellent ; and many de- lightful excursions by boat and carriage can be made into the surrounding country ; always avoiding the popular but rather dangerous one to Paestum. Proceeding along the lovely coast-road on the north side of the Gulf, we pass the picturesque vil- lages of the Eastern Costiera, some day destined to be used as winter stations, and reach Amalfi, a town placed on the southern shore of the Sorrentine pro- montory, with mountains rising boldly in the back- ground, and protecting it from northerly winds. It is built at the mouth of the narrow Valle de' Molini, ending in, but not penetrating, the St. Angelo range. Down this gorge a torrent, which turns a number of maccaroni and paper mills, descends to the sea, and SORRENTINE PEOMONTORT. 107 impairs the otherwise complete shelter of the place, which has rocky masses rising north, east, and west, and is only open to the south, from which quarter it occasionally experiences stormy weather. The climate is probably warmer than that of Salerno; and excursions by land and water can be made mto its beautiful neighbourhood, the scenes and brilliant colouring of which have been made so familiar to us by the labours of many great artists. The maccarom here is excellent; and the Hotel Capucini is com- fortable, though placed in rather a n6isy spot. The northern side of the Sorrentine promontory is open to the full influence of the Tramontana; and therefore its numero.is towns, Sorrento, Vico, Massa, &c., furnish agreeable and cool retreats in the sum- mer • but their northern exposure, and their being shut' out from the south by the St. Angelo range, render them unfit for winter resorts for pulmonary patients. The accommodation of Sorrento is good, the food excellent, and the excursions in the neighbourhood numerous and charming ; but the hotels and houses are built facing the north, and not so well suited for winter as for summer. Generally speaking, it is advisable for pulmonary invalids to return to Eng- land at the end of the spring, and reap the advantage of a cool summer and more generous living Should a 108 PIANO DI SORRENTO. patient, however, find it inconvenient to do so, and prefer to linger near his southern refuge, he will find in the beautiful Piano di Sorrento, the vast garden of oranges and vines in which the town lies, a locality for a summer residence,^ as enjoyable as it is healthy ; combining the cool breezes of the Bay of Xaples with its lovely views. The plain is three miles in length, and at an elevation of about 300 feet above the Mediterranean. It is besprinkled with villas, and from the varied colours of its vege- tation forms a beautiful prospect from the adjoining hills. We must not close this notice of the Italian winter stations without a parting tribute to the beautiful sea, which by its genial warmth contributes so powerfully to the mildness of their climate, and forms so important an element of their healing influence. The Mediterranean, on account of the deeply indented character of the Italian coast line, and the numerous headlands and creeks which its waters lave, is closely intermingled with its sunny shores ; and from its high temperature throughout the winter, they derive as much warmth as they do beauty from its exquisite, and ever-varying hues. * For other summer stations see Appendix. 109 CHAPTER VII. OTHER MEDITEREANEAN WINTER STATIONS : AJACCIO MALAGA TANGIERS ALGIERS. We have hitherto, with few exceptions, confined our attention to the winter stations of the French and Italian coast line, but it has been represented to us that a description of some of the other Mediterranean sanitaria, such as are to be found in Spain and Africa, and whose climate is connected by so many links of resemblance with that of the Eiviera, would prove very acceptable to invalids, and render the book more complete. Our limits, however, do not admit of more than a few notices, in which we have endeavoured to sketch the most important features of each place in an impartial spirit. Of late years, the mountainous island of Corsica has attracted much notice among climatologists, who have considered that its position in the Mediterra- nean, between 41° and 43° north latitude, and its 110 AJACCIO. rocky conformation, including ranges of considerable height and sheltered harbours, indicated it as a likely sanitarium. Ajacclo, on the west coast, has been recommended by Drs. Bennet and Eibton as a winter station, and has been resorted to by several invalids. The bay of that name has a southerly direction, and is protected both by the snow-covered central range of Corsica itself, and by its lateral spurs which run down on either side of the harbour. Its calm atmosphere and exemption from stormy blasts, espe- cially in winter, have caused it to be regarded as a very safe haven by sailors, and the same qualities have attracted invalids to its shores. The town of Ajaccio is built on a small triangular promontory in the most sheltered part of the bay, and faces east towards the mountains, thus enjoying much pro- tection, as proved by the vegetation ; olives, oranges, and even lemon trees flourish, thickets of myrtle, arbutus, cistus, and Mediterranean heath, called maquis, abound in the neighbourhood, and magnifi- cent chesnut groves are seen in the island. The scenery is admitted to be very beautiful, the com- bination of sea, mountain, and wood lending great charm to the landscape.. The climate seems to be mild and remarkably free from cold winds, but the observations that have been hitherto taken do not extend over a sufficiently long period to warrant CLIMATE. Ill their being considered decisive. From Dr. Pietra Santa's report to the French government,* we find that, according to some observations of M. Nosa- dovvski, carried on for five years (1854-8), the mean winter temperature was 53° Fahr. and the difference between winter and spring mean temperatures 5*57° Fahr. M. Dupeyrat kept a three years' record of the days on which rain fell, and found the annual average to be 48. From these scanty particulars we should not be justified in making a comparison w^ith other winter stations, where meteorological records have been kept for a long period, but from these, and from the evidence given by vegetation, we may conclude that Ajaccio enjoys a mild wdnter climate. On the' eastern coast of Corsica, and particularly near Corte and Aleria, intermittent fever is rife in summer and autumn. The nature of the shore and the causes of the malaria are thus explained by Dr. Bennet : — ' The eastern range, composed, as stated, of secondary calcareous rocks, is more easily disintegrated and washed away by the action of the elements. Owing to this cause the rivers which descend from its sides, and from the central regions of the island, through clefts which these calcareous mountains present, have deposited at their base alluvial plains of considerable ' * La Corse et la Station d' Ajaccio.' 112 AJACCIO. extent. Through these rich alluvial plains several large streams meander to reach the sea. This they accomplish with difficulty, owing to the lowness of the shore, and the prevalence of the sirocco, or south- east Aviud, which constantly throws up large masses of sand at their mouths. Hence the formation, along the eastern shore, of large salt-water ponds, into which some of these rivers empty themselves. Under the burning glare of a INI edit erranean sun, these terrestrial conditions — large ponds of brackish water, marshes, and rich alluvial plains, liable to periodical overflow — embody all the elements cal- culated to produce malaria of the most deadly char- acter. By such malaria is this region rendered all but uninhabitable for half the year.' The eastern coast is the principal seat of this fever, but it exists in parts of the western, as near Calvi, and even Ajaccio is not quite free from it in early autumn, particularly when the wind blows from the mouths of the two rivers which empty themselves into the bay. Ajaccio contains several hotels, but from all ac- counts the accommodation, though tolerable, is very inferior to that of Nice or Cannes. Game and fish are said to be abundant,- but mutton is scarce. Malaga, the favourite wintering station of Spain, is situated on the Mediterranean coast, about 65 MALAGA. 113 miles east-north-east of Gibraltar, and can be reached by rail in 48 hours from Paris. The town, contain- ing more than 100,000 inhabitants, faces south-east, and is placed on the shores of a fine bay, four or five miles distant from the lofty mountains, which nearly encircle the rich and fertile plain in which the town lies. The semicircular barrier thus formed consists of two ranges. The nearer one is richly clothed with vines, and reaches an elevation of 3000 feet, sending off a spur to the shore, on the east side of the town, and thus affording some protection in that quarter ; and again, on the west side, forming a protecting point, Torre Molinos, the western boundary of the Bay of Malaga. The loftier range, composed of the Sierras Nevada, Eonda, and Antequera, is bare and partially snow-clad, and separated by deep valleys from the vine-clad one, but together thev form a double rampart of mountains, which, though not situated close to the town, affords it immense pro- tection. The town is thus shielded from all northerly winds, except the terral, or north-west wind, a dry searching blast, much resembling the mistral in char- acter, which reaches the town, through a deep fissure in the Antequera mountains called the Bocca del Asno, through which the river Guadalhorce flows to the sea. Malaga is open to all the southerly winds ; I 114 FINE CLIMATE OF MALAGA. the south-east or sirocco, from its passing over eighty miles of sea, is moister than on the African coast; and the south-west is cold, and owing to its brinsfine storms from the Atlantic, is called the vendehal; the west wind seldom blows, but the east, or levante, is more prevalent, and being moist and chilly in winter, is much dreaded by the inha- bitants. According to ten years' observations of Dr. Shortcliffe, the resident English physician, the mean winter temperature is 56° Fahr., the mean daily range small, and the difference between spring and winter mean temperatures does not exceed 6°. The rainfall is 16-^ inches, and the number of rainy days 40. The climate is warm and dry, its mean winter temperature being considerably higher and its rainfall considerably less than those of any winter station of Southern France. The transition from winter to spring is less marked than at Mentone, though more so than at Algiers. The vegetation is rich and varied, and, according to Dr. Bennet, shows evidence of a very mild southern winter.* Most authorities anfree that the climate is one of the mildest in Europe, and well suited to pulmonary invalids, but, unfortunately, there are many hygienic * The ' Gardener s Chronicle,' July 24, 1869. BAD DRAINAGE. 115 drawbacks to Malaga as a winter station. The large population is closely packed, the streets are narrow, and the drainage, according to Dr. Madden, who has written an excellent account of the place, is most imperfect ; the sewage is conducted in open channels on to the dry bed of the Eiver Gruadalmedina, where, under the sun's influence, it exhales unsavoury and noxious vapours. Again, the hotels are gloomy and uncomfortable, and the sheltered promenades are very limited, and as might be expected in so dry a climate, the dust is excessive. Dr. Madden says that the living includes a fair supply of fish, fowl, and game, but the meat is too tough for invalids, and the cooking being extremely bad, is not likely to render it more palatable. It will be seen that many of these drawbacks would disappear if villa resi- dences were provided ; and it is to be hoped, for the sake of invalids, that ere long this want will be sup- plied, for it were a pity that this spot, blessed with so fair a clime, whose natural advantages clearly fit it for a winter station, should be forbidden to invalids, on account of its disgraceful sanitary state. From accounts given by several residents we gather that Tangiers, in Morocco, thirty-eight miles distant from Gibraltar, has strong claims to be recommended as a winter station for invalids. The I 2 110 TANGIEES. town is built in the form of an ainpbitheatre, on the side of a hill, the summit of which is crowned by the Casbah, or Moorish castle. If vegetation be any- test of climate, that of Tangiers and its neighbour- hood would rank very high, for sua and soil have combined to render it one of the most productive regions in the world, and a great difference in fertility is observed in passing from Spain to this coast. Two crops of wheat are reaped in the year, the grain yielding an increase of from 25 to 35 fold, and oranges, lemons, figs, grapes, melons and dates are produced abundantly, and in great perfection. On the features of the climate Dr. Madden makes the following remai'ks : — 'The position of the town exposes it completely to cold damp winds, which rush through the funnel-shaped straits from the Atlantic, while its aspect, being open to the east, must render it far more subject to this wind than Gibraltar is. The annual rainfall is about thirty inches, which, as in most parts of Africa, principally occurs at one season, during the months of October and November. The rains being succeeded by great heat, vegetation is consequently rapid and early ; thus in January the fields are already covered with flowers, and in JNIarch the barley crops are reaped. Though the climate is hot, it is not parched or arid, CLIMATE TEIIPEEED BY ATLANTIC. H' as the province of El -Garb is protected by the inter- position of the two ranges of the Greater and Lesser Atlas mountains, on the south and south-east, from the hot winds of the desert; its proximity to the ^lediterranean and Atlantic on the north and west also modifying the temperature, which in this pro- vince seldom falls below 40° Fahr. in winter, or rises above 86° Fahr. in summer, at which season it should be a comparatively cool and agreeable resi- dence.' We have received from several English residents, who have had experience of other climates, a report much more favourable than the preceding quotation would represent, so far as regards the winter season. Protected as it is from the scorching blasts of the areat African desert, and from many of the winds which sweep over the INIediterranean, Tangiers enjoys a softer and more tempered climate than any part of Algeria, resembling in bome degree that of Madeira, but without the disadvantages of its relaxing influences and its remote isolation. It is easily accessible by the regular steam-packet service to Gibraltar, and it might be more confidently recom- mended if there were sufficient accommodation for visitors. This, however, is very limited, and is chiefly confined to the newly established Royal 118 ALGERIA. Victoria Hotel, which, in addition to comfortable domestic arrangements, has the advantage of large gardens facing the Atlantic, forming a good pro- menade near the sea. Provisions, including the meat, are reported to be both excellent and mo- derate. The environs of Tangiers are beautiful, and embrace extensive views of the Spanish coast : but owing to the unsettled state of the country, it is not considered safe to wander far from the town Avith- out military escort, a circumstance which will con- siderably interfere with Tangiers becoming a place of general resort. The French territory of Algeria lies between the 32nd and 37th parallels of north latitude ; bounded on the east by the regency of Tripoli, and on the west by the empire of Morocco. Its northern limit is the Mediterranean, which washes its indented shores for upwards of 600 miles ; while its southern borders extend into the Great Sahara desert, some of whose oases it includes. The mountain ranges of the Greater and Lesser Atlas traverse the province from west to east, and form two chains more or less parallel to each other for part of their course ; but here and there giving off numerous spurs, which either subdivide the intervening country into valleys and plains of irregular shape and extent, or else run I^S'FLUEXCE OF THE SAHARA. 119 north or south towards the sea or desert. These mountains attain the height of more than 7000 feet in the Warensis, the loftiest of the chain, and a great portion of them being snow-capped in winter, they form an important barrier whereby the land lying to the north of them is partially screened from the scorching influence of the sirocco. Dr. Henry Bennet, of Mentone, who has lately visited Algeria, with a view to observe its spring vegetation, considers that the climate of Algeria is greatly influenced by the neigh- bourhood of the Sahara, and in the following way : — The atmosphere which lies on this immense rainless tract, or desert, becoming heated both in winter and in summer, must rise into the higher atmospheric regions, and thus form a vacuum which the cooler and heavier air of the Mediterranean basin rushes down to fill. The latter is thus positively * sucked in' over the summits of the mountain region of the northern shore of the Atlas range. Consequently, in Algeria, the regular winds must be and are either north-east or north-west winds, and south winds can and do only reign exceptionally. These northerly winds coming from the sea, or the ocean, are moist winds, and when they come in contact with the Atlas hills and mountains on the very shore, are at once in win- ter cooled, and deposit their moisture in copious and 120 ALGERIA. frequent rain over the entire Algerine or Atlas re- gion, and right into the desert of the Sahara itself, for 2J0 miles or more from the sea.* The favoured position of the country, the great varieties of climate, which the differences of eleva- tion, and the neighbourhood of the sea on the one hand, and of the desert on the other, give rise to, have naturally pointed out Algeria to medical men as a region commanding great resources in climate ; and the experience of Drs. Bertherand, Bodichon, and Pietra Santa, testify to its favourable effects, particularly^ in diseases of the respiratory organs- The presence of marshes in parts of the province, e.g. in the plain of the Metidja and those near Bona, are accounted for by Dr. Scoresby Jackson (in his excel- lent workjf to which I am indebted for much infor- mation about Algeria and some other localities,) as the effect of the rivers, which, though dry in the summer, increase enormously in volume during the rainy seasons of autumn and winter and overflow their banks, converting the neighbouring plains into noisome marshes. Algiers, which is reached by steam in 48 hours from Marseilles, lies on the western shore of a beau- * 'Gardener's Chronicle,' June 12, 1869. t ' Medical Climatology,' page 96. PLAIN OF THE METIDJA. 121 tiful crescent-shaped bay, the horns of which are formed by the Cape Matifou on the east, and the Pointe Pescade on the west. The town faces east and north-east, being built on the slopes of the Sahel range in the form of a triangle, the base of which is washed by the sea ; and from the brilliant white of its houses and walls contrasting with the deep green margin of the surrounding slopes, it has been com- pared, not inaptly, to a diamond set in emeralds. The Sahel hills line the coast to some distance to the west of Algiers, rising to the height of 600 feet, and affording considerable shelter to the town from north-westerly winds. They are separated from the Atlas chains by the wide plain of the Metidja, which, commencing at the eastern shore of the bay, sweeps round the Sahel hills and rejoins the sea near Cherchell. This extensive plain, from 10 to 15 miles in breadth, like the Eoman campagna, was formerly richly cultivated, and had a large popula- tion, but later on was deserted ; and the parts near the coast became swampy and malarious. Since the French occupation, much has been done to reclaim this waste ; and large tracts, including the Lake Halloula, have been drained, cultivated, and rendered more healthy. Still there are malarious portions which are to be carefully avoided, but in the suburb 122 ALGIERS. of Mustapha Superieur, and on the slopes of the Bouzareah, the highest of the Sahel range, are to be found numerous villas and other residences fit for invalids. The year is divided into two seasons, the hot and the rainy, the former extending from April to November, and the latter from November to April, the greatest rainfall occurring in the months of No- vember, December, and January. Dr. Pietra Santa, who was appointed by the French Government to report on the climate of Algeria, states, as the result of 22 years' observations, from 1838 to 1859 inclu- sive, the winter mean temperature to be 56° Fahr.* ; the amount of rainfall 32*18 inches ; and the number of rainy days 87. For the last five years the rainfall has been much less, and the dry seasons have been the cause of famine and plagues of locusts. The mean temperature of the whole rainy season is 62°, and the differences between the winter and spring mean temperatures are small. The most prevalent winds seem to be westerly, and are the west, the north-west, and the south-west ; all of which contain moisture, and temper the extreme heat. The sirocco is here a terrible wind, injurious to man, and disas- * Dr. Scoresby Jackson gives, as the result of 13 years' observa- tions, a mean temperature of 62°, which is much higher than the above. DISTEIBUTIOX OF RAINFALL. 123 trous to vegetation; but I am informed bjDr. Stewart Gentle, the resident English physician at Algiers, that it prevails from June to the beginning of Octo- ber, and that it only blows mildly during the tem- perate months, and therefore does not much affect invalids. The rainfall of Algeria, curious to say, increases on proceeding eastwards ; for, of the three provinces into which the country is divided, Oran, the most westerly, has the least rainfall ; Constantine, the easternmost, has the greatest; while in Algiers, the central one, the rainfall is double that of Oran, and about half that of Constantine. This may pos- sibly be accounted for by the distribution of forests, which are most extensive in the province of Constan- tine, but, from various causes, have nearly disap- peared from Oran, and are much diminished in Algiers. The climate is warm and stimulating, but differs from that of the north coast of the Mediter- ranean in many respects ; the mean temperature being much higher, and the change from winter to spring being less marked. These features are not to be accounted for by the shelter of mountain ranges, for, though the Sahel hills give some protection on the west and north-west, the Atlas chain lies too dis- tant to afford much shelter, but it is in the more south- ern latitude, tempered by the equalizing influence 124 ALGIERS. of the Mediterranean, that an explanation may be found of this mild climate. The fact of the rainy season occurring in the winter, instead of in the autumn months, as in most of tlie North jNIediter- ranean stations, is certainly a drawback for invalids. The number of rainy days, too, is great ; but accord- ing to Dr. Scoresby Jackson, the rain does not last long: and what is called meteorologically 'a rainy day' at Algiers may in fact mean nothing more than a very heavy shower, of half an hour's or an hour's duration, not materially interfering with out-door exercise. Such brief showers have the beneticial effect of laying the dust, which is much complained of in Algiers in dry weather. All observers agree that the climate is eminentl}^ suited for chronic bronchitis and for the non-inflam- matory form of consumption, but on the inflamma- tory form it seems to have similar effects to that of Mentone. Of the hotels of Algiers, the Hotel d'Orient is near the sea, and faces south-east, across the bay, as also does the Hotel de I'Europe ; while the Hotel de la Eegence looks towards the south, and is there- fore warmer, but its drainage is complained of. The excursions into the Sahel and Atlas ranges are varied and charming, and many are of a nature to be un- dertaken bv invalids. At some of the hill stations. HILL STATIONS. 125 as Blidah, Milianah, and Medeah, tolerable hotel accommodation is to be had ; and the climate, as evidenced by the vegetation, is very mild. In ex- cursions in the Metidja plain care must be taken to avoid the marshy parts, for intermittent fever is far from rare, and cases occur of a severe type. For the same reason Mustapha Inferieur is to be avoided as a residence, as it lies low and is swampy. APPENDIX. ' Whereas according to researches of Eoss, Belcher,' etc., p. 20. Mr. Gwyn Jeffreys, F.R.S., who has lately been engaged in important deep sea dredgings off the west coast of Ire- land, has carried out a very interesting series of observa- tions on the temperature at great depths. He informs me that the results of previous thermometrical investigations were more or less erroneous, on account of the bulb of the thermometer not being protected from the pressure which the mass of superincumbent water exercises on it. This defect has been remedied by Dr. Miller, F.R.S., who has enclosed Six's self-registering instrument in a second glass tube, the interval being filled with spirit ; and thus varia- tions in external pressure are prevented from affecting the bulb of the thermometer, within, whilst changes of tem- perature in the surrounding mediiim are speedily trans- mitted through the interposed alcohol. It appears from reliable observations, made with this in- strument by Mr. Jeffreys, off the Rockall Bank to the north- west of Ireland, and by Professor Wy viUe Thompson, in the Bay of Biscay, that the temperature at the depth of 1476 fathoms is 36-9° Fahr., and at that of 2435 fathoms (nearly tlu-ee miles) 36° Fahr. ; and that at these great depths there is abundant evidence of animal life, but that the Faima, 128 SUMMER STATIONS. as might be expected from the temperature, is chiefly of the arctic description. Further researches in the Mediter- ranean and Atlantic, with instruments made on Dr. Miller's plan, are required before we can arrive at just conclusions as to the relative temperatures of these seas. SuMiiEii Stations. However beneficial warm sheltered localities may be to pulmonary invalids in winter, they become oppressive and enervating in summer ; and it is therefore usual to recom- mend a removal to a cooler and more bracing climate ; where the appetite, often impaired by a long spell of warm weather, may be rendered keener, the nervous system refreshed by sounder sleep than is tisually pro- curable on the Mediterranean coast, and the muscular power invigorated by better food, and by increased exercise. The majority of English consumptive patients, after an exile of so many months, prefer to return to their native land, whose moist climate seems an agreeable change from the dry air of the south, and whose wholesome and nu- tritious food forms a great contrast to that of most foreign countries. IMany invalids however, who intend to pass a second winter on the Mediterranean, wish to save the expense of a journey home, and would prefer to pass the summer in some cool mountain retreat, at no great distance from their wintering place. The Maritime Alps offer advantages in this respect, and the following mountain retreats, of which the descriptions have been kindly forwarded to me by Drs. C. H. Battersby and Daubeny, may prove available. SUMMER STATIONS. 129 ' 5^ D' Almas de Tende lies 50 miles distant from Nice, on the high road to Turin, about 2 miles on the Italian side of the frontier, in a wide valley formed by the junction of three mountain streams, Avhich imiting here form the river Eoya. The four valleys thus formed afford a free circulation of air, so often absent in an unbroken mountain valley, whilst the surrounding hills break the force of the winds, St. Dalmas is particularly Avell protected, on tlie north by the range of the Col de Tende, and owing to its altitude, nearly 3000 feet, and the neighbourhood of moun- tains, 9000 feet high, covered with snow for the greater part of the year, the nights at St. Dalmas are always cool ; and even in the hottest seasons there are few days on which it is not pleasant to go out in the middle of the day. The mean temperature of the summer months on an average of 6 years is as follows : Jime 65° Fahr., July 69° Fahr., August 68° Fahr., and September 63° Fahr. * The minimum in June and September is about 50° Fahr., and the maximum in July and August about 84° Fahr. : these limits are however seldom reached. There are frequent sliowers during the summer ; but notwithstanding this, and the abundance of running water in every direction, the air seldom feels damp, and there is no evening dew. The soil being limestone gravel, the roads dry so quickly that one can walk with pleasure as soon as the rain is over. The climate is very healthy, as is evidenced by the state of the peasantry, Avho are noted for being the most robust in the department, and for some years, since the imgation has been conducted on a better system, there have been no cases of intermittent fever, of which there were complaints at one time. Delicate children, and persons suffering from various diseases, appear to derive much benefit from a sojourn at St. Dalmas, regaining appetite and strength very K 130 SUMMER STATIONS. rapidly. The Hotel and Pension, formerly a Benedictine monastery, is well managed by the proprietor of the Hotel des Princes at Nice, and the terms are moderate. It is very pleasantly situated, partly surrounded by chesnut groves, •with a large and well wooded garden, sloping down to the river, affording level and shady walks for those who are unable to undertake the longer excursions, Avhieh are almost exhaustlcss, and interesting both on account of the lovely scenery, and the varied nature of the botany and geology. * C. H. Battkrsbv.' Another summer station is Certosa di Pesio, in the Maritime Alps, about two and a half days' journey from San Kemo, of which Dr. Daubeny has kindly furnished me with the following notice: — ' Certosa di Pesio is an old Carthusian convent on the river Pesio, built about the year 1450, and for the last three years used as a pension by the Signori Boggi, who are the proprietors of the Hotels de Londres at San Remo and at Mentone. The house is well furnished, and Avill accom- modate about 100 visitors, exclusive of servants. As a summer residence it js admirably situated in a very beauti- iuUy wooded park ; at an altitude of about 5000 feet, a grand torrent stream, Avhich supplies excellent trout fishing, running thiough the grounds. During the hot summer months, there are always plenty of shady walks, Avhile an Hydropathic Establishment there contains a great variety of baths, which can be used either for health or luxury. The journey from Oneglia, the point where the road diverges from the Riviera route, takes two days in a due SUMMER STATIOXS. 131 northerly direction. The hotels en the line, if properly chosen, are tolerable. All who contemplate this journey should apply to Signer Boggi at San Kemo, or at Mentone, for information. Certosa can likewise be approached from Turin by rail to Cuneo (two hours) and thence by half a day's drive to the Convent. The time for living at this place is from the first week in June, until the beginning or end of September, according to the season. The Hotel is well conducted, and there is a great variety of outdoor and indoor amusements for visitors, including fishing and shooting. ' I visited Certosa in June and found the climate de liciously cool and invigorating after that of the Mediter- ranean. * Henry Daubeny.' The valley of the Upper Engadine in the Swiss Canton of the Grisons is now much resorted to in summer, partly on account of its high altitude and consequent coolness, and partly on account of the virtues of the mineral waters of St. Moritz, one of its villages, situated 6000 feet above the level of the sea. The valley, one of the highest in- habited spots in Europe, is wide and traversed by the river Inn, here forming a series of picturesque lakes, over Avhich tower the mountains of the Bernina range, their sides clothed with firs, and their summits crowned with eternal snow and ice. The principal villages of this region are St. Moritz, Samaden, and Pontresina, and these all contain tolerable hotel accommodation for the summer season, wliich extends over barely three months. The atmosphere is clear, and 132 SUMMER STATIONS, tlie air is dry and bracing, but although the sun's rays are powerful and scorching during the day, the nights are very cold, and sometimes even frosty. These extremes of teni- ]ieratTu-e amount to as much as 50° Fahr. in the 24 hours, and are not without their evil results ; sometimes ffivinn: rise to feverish attacks and inHammations. In fict the upper Engadine is by no means a safe summer residence for pulmonary invalids. Those Avho thrive in a keen bracing air may go there witli advantage ; but tliey should be prepared with suitable clothing ibr the variations in temperature which they may encounter; and they should moreover make sure that they can get comfortable accom- modation in the best hotels, which is by no means an easy matter, now that tlie Engadine has become such a fashion- able summer resort. The Bernina Hotel at Samaden is the best in the Engadine, and is the only one open through the winter. The Kurhaus and Kulm at St. Moritz, and Krone at Pontresina, are much frequented in the summer season. For the plurality of invalids who reqiiire a bracing and moderately cool situation during the summer months, several places, about a thousand feet lower, will be found more genial than the upper Engadine. Tarasp-schuls, a large bathing establishment in the upper part of the lower Enaadine, with excellent accommodation ibr three hundred guests, at a height of 4000 feet above the sea; Davos am Platz, 5000 feet, with a large Kurhaus, where inmates are comfortably lodged on moderate terms ; and the Nuovi Bagni of Bormio, on the Italian side of the Stelvio pass, at a height of 45(j0 feet, — are all high, dry and hcaltliy siun- mer residences, in which the extremes of the upper Enga- dine are avoided, whilst the invigorating air and ever varying beauties of Alpine heights may be enjoyed in per- fection. The last mentioned place, the new baths of SUMMER STATIONS. 183 Bormio, especially deserves commendation. Situated at the head of the upper Valtelline, commanding the grand vista of that beautiful gorge, with two other valleys to the right and to the left, with their snow-topped peaks, and backed and sheltered from the north and east by the huge masses of Monte Cristallo and Piz Umbrail, the great mountains of the Stelvio, the highest pass in the Alps — it presents a rare combination of airiness and shelter, of dryness and luxuriant vegetation, of salubrity and beauty, not met with in any other place. The establishment receives two hundred invalids, and is to be further enlarged. The thermal springs supply warm and mud baths of various kinds, which are much in request during the season, which extends from the middle of June to the middle of Septem- ber. Bormio may be reached either over the Stelvio pass, which is now in good repair ; or from the Italian side, by the road up the Valtelline, from Como, or from the Bernina. Another charming summer retreat may be found at Le Prese, in the valley of Poschiavo, on the descent from the Bernina pass. This is another bathing establishment, the water being sulphurous and alkaline : but the hotel ac- commodation is also excellent, being managed by M. Mella, formerly of the Grande- Bretagne at Bellagio, and who made that delightful hotel so attractive to travellers. The height of Le Prese is only 3000 feet, and it cannot be equally bracing with those already mentioned ; but it forms a good intermediate between them and the sites on the lakes of Como and Maggiore. In Switzerland, also, are several comfortable Hotels at great heights, Avhich are available during the summer for those patients hkely to benefit by the Alpine air ; they are generally more accessible and less liable to extremes than 134 SUMMER STATIONS. the Engadine. Such is Leukerbad, above the Rhone Valley, at a height of 4642 feet ; Coraballaz, above Aigle, in the Lower Rhone Valley, 4416 ; Ormond Dessus, under the Diablerets, 3832 ; and the Rigi Kaltbad, 4728. The Engadine, I may remark, has lately been recom- mended by Dr. Hermann Weber and others as a winter residence for consumptive invalids, on account of the exemption from consumption Avhich its inhabitants are said to enjoy. For this Dr. Weber assigns as a cause the high altitude, and the state of atmosphere consequent thereon, and maintains that cold air, when dry, is not in- iurious to consumptive invalids, but rather beneficial. He gives an account of 31 cases which have been subjected to this treatment, and states that in the greater number of instances the disease was lessened and that blood-spitting was arrested. The cases have not been narrated fully enough to enable one to judge of the results of the climate, nor is their number (31 in all") large enough to justify conclusions being based on them. With regard to the theory that dry cold is not injurious to invalids, it is pos- sible that by bracing the constitutional powers it may ex- ercise a good effect on individuals predisposed to Phthisis : l)ut where the disease has already developed itself, severe cold, even when dry, is apt to induce catarrhal and inflam- matory complaints, and Avould thus render the patients considerably worse. A perfectly still cold atmosphere is less harmful than one in which winds prevail ; but, accord- ing to accounts, the Engadine is by no means free from wind, particularly in the winter months. I,0NT)OVl PKINTED BT BPOTTISWOOBE AND CO., NEW-STKEET 61QCAES A>'D PARLIAMENT STIiEET 135 APPENDIX 11. FURTHER OESERVATIONS ON SUMMER QUARTERS FOR INVALIDS, AND ON ALPINE SANATORIA IN 1870. "When it is considered what large numbers of British travellers resort every summer to Switzerland and other mountainous countries for the improvement of health as Avell as for enjoyment of scenery, it may not be out of place to add a few remarks on the summer quarters most suitable for invalids, and the considerations which ought to guide in their choice. That mountain districts, and high and dry situations generally, are more healthy than those which are low and damp, is too well established to require further discussion. In Switzerland and North Italy no traveller can fail to observe the striking contrast presented by the inhabitants of the low deep valleys, as compared with those of the mountains and elevated plains. Even the borders of the lakes, with their verdant banks, overhung by mountain.", and presenting the most enchanting combinations of scenerv that can delight the eye, are not favourable to the develop- ment or preservation of vigorous health. The inhabitants have generally pallid or sallow complexions, and goitrous, throats; and the visitor soon finds his enjoyment to assume the passive form of sailing on the lakes, and driving, or lounging, instead of the enterprising activity and elasticitv, recreating and invigorating, of the mountain climber. Those travellers Avhose object is not only beauty of scene but improvement of health, will do well to spend but a small portion of their time, and only such as stress of L 136 ALPINE SUMMER QUARTERS FOR INVALIDS. weather or fatigue may require, in tlie lower levels, and at once betake themselves to higher altitudes, Avhere they may experience the salutary effects of the dry pure atmosphere peculiar to those regions. These qualities of the atmo- sphere vary much according to the height and position of the place, affording us a great choice of situations suitable for different classes of invalids ; and on the discrimination with which the locality is selected may much depend the wellbeing of the patient. Alpine resorts may be arranged, according to height, in three classes : — I. Towns and villages at a comparatively low level, situated on the borders of large lakes, as Zurich, Lucerne, Brienz, Thun, Neuchatel, Geneva, Vevey, Montreux, and Evian ; or on plains not much raised above the lakes, as Interlaken, Glarus, Martigny, Berne, &c. The majority of these are more or less damp, and in summer often oppressively hot, and in several the drainage is very defective. Geneva has the advantage of the purify- ing and ventilating influences of the rapid Rhone sweeping through it, and to a less degree Lucerne and Thun are similarly favoured. On the other hand, Aigle, Bex, Mar- tigny, Sion, Brieg, and other places in the deep Rhone valley, have so much flat and marshy ground near them, as to be positively malarioiis, and the sooner travellers can get out of them the better. IL Moderately elevated situations, at heiglits ranging from 2000 to 4000 feet, where mountain air can be enjoyed, though not so bracino; in character as that of the hii^hest stations ; but being less liable to extremes of temperature, these places are more suitable for first trials and for deli- cate persons, especially those unaccustomed to mountain climates, INLiny of these, too, present advantages in supe- rior accommodation and ready means of access, which make them more available for the greater number of invalids. Over the lake of Geneva, the most attractive mountain abode is Glyon, above Montreux, at a height of 3000 feet MODEEATE HEIGHTS DIABLERETS DISTRICT. 137 above the sea. Comfortable quarters may be found at the Hotel du Kigi Vaudois and other hotels ; for the mag- nificent scenery of the east end of the lake makes Glyon a favourite resort. At the opposite end of the lake, over Nyon, at a height of between 3O00 and 4000 feet, up the Jura range, is St. Cergues, which in clear weather com- mands one of the grandest distant views of the Mont Blanc range to be seen in Switzerland. The following are other instances of this class : — Champery, .3412 feet above the level of the sea, situated close under the Dent du Midi and the Tour Sailliere, about nine miles from the Monthey station of the Ehone Valley railway, has good hotel accommodation, and abounds in interesting scenery for excursions. In the beautiful and easily accessible Diablerets district are, — Sepey, 3300 feet above the sea, 7-g- miles from the Aigle railway station, with fair hotels — some open during winter. Three miles firther, Combaliaz, 4416 feet above the sea, with good and moderate boarding-houses ; and at the head of the vaUey, another good hotel, at Orinond Dessus, 3832 feet above the sea. This Val des Ormonds, rich and wooded at its lower end, rises to grandeur at its upper extreme, in the Creux des Champs, under the snowy summits of the Diablerets, and contains as great a variety of scenes, gentle and savage, as the eye can desire. In a visit during June of this year (1870), I found Sepey very hot, notwithstanding its height; Vers I'Eglise, in Ormoud Dessus, and Combaliaz, cooler and more suited for summer quarters, and fairly sheltered from the coldest winds ; Plan des Isles, also cool, but rather marshy from its numerous rivulets. Above, on drier ground, stands the Hotel des Diablerets : in this, and several other hotels in this district, visitors are boarded at from three and a half to five francs a day; food good, but furniture scanty. An der Lenk, 3527 feet above the sea, six hours from Thun, lies at the head of the Simmenthal, on the north- west side of the snow-capped Wildstrubel — the valley being l2 138 ALPINE SUMMER QUARTERS : HIGHEST. closed with glaciers — and the visitor will find good accom- modation and no lack of interesting excursions in the neigh- bourhood. I have also heard a good account of the Krone at Zweisimmen, at a height of about 4000 feet in the Sim- menthal. Engelberg, 3300 feet high, is beautifully placed in a valley on the north side of the Titlis, with a large new hotel, much resorted to for health as well as for the scenery. It can be reached in a few hours' drive from Stanzstad, on the Lake of Lucerne. On the same lake, and accessible by the steam-boat station of Treib, and above Seelisberg, is Sonnenberg, with two good boarding-houses, at a height of 2759 feet, overlooking the Bay of Uri, Avith many points of interest — commanding magnificent views of the whole lake of the four cantons. Grindelwald (3737), with good hotel comforts, and Lau- terbrun (2595), near Interlaken, may be classed among the healthy siunmer quarters of moderate height and easy access; owing their coolness rather to the proximity of glaciers and the shade of their over-towering moimtains, than to their elevation. The mountain inns above, Miirren (5347), Little Scheideck (G696), and Baths of Rosenlaui (4397) belong to the next class; but, however welcome as halting-places in scenes of surpassing grandeur, they are not to be numbered among places suitable for invalids. III. High level resorts, ranging from 4000 feet upwards. In these the full bracing influence of moimtain air is to be obtained ; and where the powers of circulation are good, and the individual can endiu^e the considerable changes of temperature which the heat of the sun's rays by day, and the chill in their absence by night, occasion, he may profit greatly by a stay at these heights, and find himself invi- gorated and able to undertake increased mental and bodily exertion. This is especially the case Avith those persons who have long suffered from the oppressive and relaxing air of lower valleys and plains. Pulmonary and other invalids may also improve by a sojourn at these altitudes, provided CUEE OF COXSUMPTION IN THE ANDES. 139 that in selecting the place of residence some considerations besides those of height and purity of air be attended to. Shelter from the coldest winds, the absence of swamp or stagnant water, a sunny aspect, a comfortable hotel and good food — should be secured to the invalid ; otherwise he may suffer, instead of profit, by his high abode. It is at such considerable elevations that it has been declared by several trustworthy observers that pulmonary consumption and kindred scrofulous diseases rarely occur ; and that persons suffering from such maladies coming from lower regions into these altitudes, experience re- markable benefit, not merely in the mitigation of symptoms and improvement of present health, but in some instances amounting to the establishment of a curative process, by the removal of tubercles and inflammatory products, and a more or less complete restoration to health. The earliest notice of this curative power of high altitudes appears to be that of the late Dr. Archibald Smith, in a paper pub- lished in the ' Edinburgh Medical and Surgical Journal ' in 1840. In Lima and other towns in Peru, which lie low, pul monary consiimption is very prevalent, and it has been long the practice, popular as well as professional, to send invalids up into the Andes mountains, to an altitude of from 8000 to 10,000 feet, and with the most strikingly beneficial results. Dr. Smith quotes from Dr. Fuentes, of Lima, a statement that of patients in various stages of consumption sent from Lima to Jauja (an elevation of 10,000 feet) nearly 80 per cent, are cured. Dr. Williams has the notes of the case of a Peruvian gentleman who had become decidedly phthisical in this country, and returning to his native toAvn, Lima, he had repeated attacks of dangerous hsemorrhage ; in a state of great weakness he was carried up the mountains, and com- pletely recovered; he remained free from pulmonary symptoms, and died of fever some years after. The observations of Guilbert on the mountains of Peru and 140 MOUNTAIN CURE OP PHTHISIS. Bolivia, and those of Jourdanet, on the high plateau of Mexico, confirm the inferences of Dr. Archibald Smith on the curative power of great altitudes on phthisis. In Europe Dr. Lombard long ago drew attention to the fact that phthisis is of comparatively rare occurrence in the higher habitable districts in Switzerland ; and the positively curative power of high mountain air has re- cently been strongly advocated by Drs. Brehmer, Kiichen- meister, and Spengler in Germany and Switzerland, and by Dr. Hermann Weber in this country. A brief allusion has already been made (p. 134) to Dr. Weber's paper on this subject, which has, since the printing of that portion of this little Avork, been published in the fifty-second volume of the ' Medico- Chirurgical Transactions,' and gives valuable information and suggestions ' On the Treatment of Phthisis by prolonged residence in elevated regions.' Dr. Weber notices that the observed iunnunity of elevated regions with regard to phthisis varies greatly in diiFerent latitudes, requiring the greatest altitude — up to 9000 or 10,000 feet, within the tropics ; not more than 3000 or 4000 feet in the South of Europe ; whilst in the northern parts of Germany phthisis is said to be rare in places between 1500 and 2000 feet above the sea. Kuchenmeister suggests an ajproximative calculation that for the latitude of Germany and Switzerland, the exemp- tion falls about 375 feet for every degree of latitude from south to north. Dr. Weber questions the reality of any exact arithmetical relation between latitude and the alti- tude of the prevalence of consumption, and remarks that incongruities may be discovered even in the same moim- tain range. Thus he learns from Dr. Unger at Davos, that Dr. Boner of Klosters not rarely met Avith phthisis at Spliigen (over 4700 feet), 'while it scarcely ever occurred in the upper pai-t of Klostei's (rather below 4000 feet). Dr. Weber very judiciously suggests that other conditions besides elevation are probably required to secure the in- habitants of a mountain district from liability to consump- OBSERVATIONS OF DR. H. "WEBER. 141 tion ; and amongst others he particularly specifies dryness of soil, referring to the observations of Bowdich and Buchanan, to which we have already adverted (p. G3). Dr. Weber gives the history of seventeen cases of phthisis in various stages, which have more or less sig- nally benefited by a residence at great elevations. The most satisfactory of these are those who had resorted to the high station of Jauja in the Andes, the cures in some of these instances remaining complete for several years. Other cases are those of German and Swiss artisans who have become phthisical on exchanging their country abodes for the close habitations and impure air of London, and re- covered health on returning to their native homes in the Black Forest or in the Swiss mountains, but relapsed and fell victims to the disease on returning to London. These can hardly be taken in evidence of the peculiar efficacy of great elevations ; for the heights resorted to were quite moderate, and the resiilting temporary improvement not greater than that commonly experienced by workpeople who, after sickening in the unhealthy atmosphere and oc- cupations of town, are restored by the pure air of their native homes in the country. Another position assumed by Dr. "Weber, which is open to question, being by no means established by the amount of evidence yet adduced in its support, is that phthisical pa- tients benefit by residence at great elevations in winter even more than in summer, and that cold, however extreme, has not that injurious influence on such cases which it is com- monly supposed to have. On this point it will require a larger amount of evidence, in form of numerous well-observed facts, to reverse the common opinion, that whatever may be the power of cold to prevent phthisis, yet when the disease is actually present, with its usual inflammatory complications, cold is a hurtful agent from which the great pkirality of suf- ferers shrink with instinctive dread. There may be ex- ceptions, but this seems to be the rule. In slight and incipient cases the case may be different ; and all that has 142 ALPINE SUMMER QUARTERS FOR INVALIDS. been said for the salubrity of mountain climate is in favour of its trial being lirst made in the summer, and with due regard to other influences besides that of altitude. As a further illustration of the subject of mountain resorts for invalids, I have my father's permission to introduce a long extract from his ' Notes on Alpine Summer Quarters.'* They refer chiefly to the Engadine and Bormio. ' Our next halting-place was Thusis, at the foot of that wonderful triumph of engineering art, the Via Mala. Thusis is healthily placed — not so much from its absolute height (2448 feet), as from its being high and dry above the rich Domleschgerthal, and overtopped only on one side by the pine-clad rocks of the Via I\Iala. The small hotel there is also very comfortable. Travellers going to the Engadine, who Avish to see the Via Mala, may Avell halt here, and afterwards join the Julier or Albula routes by the new road just opened through the Schyn-pass to Tiefenkasten, which is by no means a good place to stop at. At Tiefenkasten, we took the diligence over the Julier, to make a second trial of the Engadine. All that I had heard of the crowded state of St. Moritz and Pontresina deter- mined me to try Samaden, Avhere I knew the Bernina Jlotel was sure to provide well in the way of food. Even here, although they have upwards of one hundred beds, and I had written a week before, we were obliged to be content with bedrooms in the village lor two days. How- ever, nothing could be more courteous than the conduct of the landlord, M. Frauconi ; and we were most comfortably lodged and fed afterwards, at prices quite moderate, con- sidering the demand of the season. And let me say here, once for all, that the comjolaints which were continually reaching our ears of the short commons at some of the establishments at St. INIoritz by no means applied to the Bernina at Samaden. In fact, we were assured that a good * 'Notes on Alpine Summer Quarters for Invalids in 1869.' By Charles J. B. Williams, M.D., F.E.S. 'British Medical Journal,' >iovcmber 1869. CLIMATE OF THE ENGADINE. 148 many visitors used to come from St. Moritz to the Bernina Hotel for the sole purpose of getting a good dinner. ' The ■weather, which had been wet the Avhole preceding day, and was showery on our passjige over tlie Julier, be- came fine on the descent ; and we entered the Engadine in bright sunshine. Still there was a scattering of fresh snow far below the usual snow-line ; and as we drove through Silvaplana, Campfer, and St. Moritz, we observed ladies wearing warm cloaks and even fiu-s — a very sensible pro- ceeding, but telling its tale of the climate in the middle of August. The weather continued generally fine during our week's stay at Samaden ; but there were several falls of rain towards evening, succeeded by the appearance of fresh snow on the mountains on the following morning ; and on four out of the seven nights, the grass of the valley of Samaden and of Upper Pontresina was white and crisp with frost in the early morning. Of course, all this vanished with the first approach of the sun's rays : in fact, so hot Avere they, that veils, white handkerchiefs, and umbrellas were brought into full requisition to avoid their scorching effect on the skin ; and, even with these protec- tions, few of the more zealous excursionists entirely escaped the branding and skinning of the face and neck, so familiar to holiday mountaineers. To many, these face burnings were trifles ; and by giving a ruddy glow to a hitherto pallid cheek, encouraged the impression that they were signs of new health and vigour. Iso doubt, to many, the bracing air of the high Engadine is reviving and invigor- ating, and especially to those who have long suffered from the oppressive and relaxing air of the lower A-alleys and plains. These feel new life and energy in the cool bracing air, and their appetite and strength rapidly improve under its influence. With others, again, the effect is quite dif- ferent : they are chilled without being braced, and scorched by the sun withoiit being permanently warmed. They feel a certain degree of excitement in the air, but it causes fever, instead of strength; and its injurious operation is 144 ALPINE SUMMER QUARTERS FOR INVALIDS. manifest in restless nights, and in failing, instead of im- proving, appetite for ibod. Our party, unfortunately, be- longed to this latter class; and, consequently, the week which we spent in the Engadine was by no means a pleasant one ; and we Avere not disposed to try a longer experiment of acclimatisation. We met with several others who made the same complaints. No doubt, the excursions in this neighbourhood are full of the beauty and interest attaching to the highest Alpine scenery. For example, Val Roseg is extremely picturesque and diversified in its pine- grown heights, forming an ever-varying framework to the dazzling glaciers and snow-peaks at its upper end. Con- sidering that the woods consit^ted chiefly of two species only, the larch and the Alpine cedar, with only here and there a Scotch pine, there was a surprising absence of monotony ; the grandeur of the rocky masses, and the brilliancy of the flowers and lichens, making up for the want of variety in the foliage. As usual in sunny days, the ascent was very hot, except where the way was shaded by the welcome trees ; but the descent was from west to cast, in the face of a cold wind, which became so cutting towards sunset, on our descent to the valley of Samaden, that we returned miserably chilled, in spite of all our wraps and the jolting of the rough berg-waggon, the only vehicle used for the by- roads. ' From these illustrations of the summer climate of the upper Engadine, it is pretty clear that it ought not to be re- commended indiscriminately to all classes of invalids ; and those that are likely to benefit by its exciting and bracing influences ought to be cautioned and prepared against its extremes, which are especially trying on first arrival. It appears to be the common experience of those Avho most benefit by the climate, that the powers of circulation and respiration so improve as to be able to bear the changes of cold and heat, which were found very trying at first ; and this kind of acclimatisation may be extended to the colder season, so that those who have gone in the summer gain WINTER EESIDE^rCE IX THE E^fGADIXE. 145 the power of so well enduring increasing cold, as to be able to pass through the almost Arctic winter of these heights without sufFerinff or inconvenience. ' When it is authentically stated that several consiunptive patients have passed the winter in the upper Engadine, not merely without suffering, but with considerable benefit to their general health, and with marked diminution of the symptoms and signs of disease in the lungs, the matter be- comes one of tact, not of reasoning or opinion. But it is of the utmost importance to test the accuracy of the fact by adequate investigation. I have had no opportunity of per- sonally examining any of the patients who are said to have benefited by passing the winter in the Engadine. Dr. Berry, the intelligent resident physician at St. Moritz, informed me that he had the history of ten or twelve such cases, several of which had been formerly under my care. My recollection of most of these is imperfect, but the following I have been able to identify. ' Mr. S., aged 20, consulted me on August 2nd, i865. At the age of ten, he had glandular swellings in the neck, which gathered and remained 0[)en for twelve months. Last autumn, he was much reduced by a local inflammation, and leeching for it, and remained weakly through the winter, with a slight cough. In May, he coughed up three ounces of blood, and, a few days afterwards, half a pint. He was treated with lead first, and subsequently with iron. The bowels were often costive. I found some dulness and rough breath-sound in the upper right back. There was slight bronchophony above the right scapula. I prescribed for him cod-liver oil in a mixture containing phosphoric acid, hypo-phosphite of lime, and strychnia ; an occasional aloetic pill ; and tincture of iodine externally. To winter at Torquay. ' 1 heard nothing more of him till August 1869, when his father called on me at Samaden, and told me that his son had continued my treatment with considerable benefit, and passed the winter at Torquay. He had little cough, but 14(> MOUNTAIN CURE OF CONSUMPTION. there were occasional recurrences of haemoptysis, and he several times expectorated calcareous matter. ' In June 18G6, he went to Silvaplana, in the upper Engadine ; and from that time there was no recurrence of haemorrhage. The pulse gradually was reduced from 108 to 70, and the respirations from 28 to 18, with a corre- Bponding improvement of strength and activity. The three subsequent winters he has passed at St. Moritz, going out daily, and enjoying skating, sledging, and other winter exercit=es, with impunity. ' In this case, there had never been much cough or other symptoms of bronchial or pulmonary irritation. The disease was in a quiescent state when he first went to the Engadine ; and, going there in the summer season, there was time for acclimatisation before the severe weather set in. Such, in truth, seem to me to be the chief conditions most favourable to safety and success in trials of the Alpine cure of con- sumption. To send patients in advanced, or even recent, active disease, with its attendant local inflammations and congestions, and with the general weakness of circulation and no power of resistance against cold, to such a climate as that of the Engadine in the beginning of winter, does seem most rash and irrational. But, in cases where the pulmonary deposits are moderate in amount, and attended with little vascular irritation, and especially when the system is relaxed, and there is a consciousness of refreshment and invigoration in a dry cool air — under such circumstances a mountain residence offers the best promise. ' Such a condition, favourable for the mountain cure, is not unfrequently presented by pulmonary invalids who hafe passed the winter in a warm situation, such as Men- tone, Cimiez, Hyeres, or Pau. By these means, and by •appropriate treatment, the disease has been br-ught into a quiet state ; but the patient may have become more or less relaxed and weakened by the increasing heat of May and June. Then, with proper precautions in the way of clothing and choice of weather, the ascent to the higher region may CHOICE OF PLACES IN THE ENGADINE. 147 be made with great probable benefit; and, should that benefit continue during the summer months, with improved strength and breath, and power to endure the changes of temperature occurring even at that season, there will be encouragement to prolong the stay through the winter, and thus prove the further efiicacy of the mountain abode. ' And now a few words as to the selection of this moun- tain residence ; for other points besides altitude require consideration. What absolute height — whether at 6000 or 5000 feet above the level of the sea^ — may be best, is yet to be determined by experience ; but there can be little doubt that shelter from the coldest ivinds, an aspect favour- able to receive all the sunshine obtainable in the tuinter, a dry xmswampy soil, and a comfortable house, with well-regulated stoves to warm, and a well -supplied larder to feed, the winter inmates — ivill be essential to their well-doing. ' Of the villages in the upper Engadine — St. Moritz, Samaden, Campfer, Silvaplana, and Pontresina — all have hotels and boarding-houses ; but the latter three of these are open only during the short summer season of three months. Pontresina, from its exposed situation, open to north and east, and irs proximity to the snow-mountains and glaciers of the Bernina range, is wholly unsuited to invalids even in summer. Silvaplana and Campfer are sheltered from the north ; but, being higher up the valley than St. Moritz, and between the lakes of the Inn, they are draughty, and liable to evening chills from the sheets of cold v/ater. The Kurliaus of St. Moritz is in even a worse position ; for it stands on a flat ground, very little above the lake. In fact, when I first visited it, seven years ago, this ground was little better than a swamp. Part of it has since been raised, and converted into a garden and croquet-ground ; but the whole establishment is so liir from the mountains Avhich protect the village of St. Moritz to the north, is so much under the shade of the huge pine-clad Piz Rosatsch to the south, and so open over the lake to the east, and up the valley to the west, that it may be said to be 148 MOUNTAIN CURE OF CONSUMPTION. open to every wind that blows ; and, even in the summer, it must be both damp and draughty. The village of St. Moritz is much moi-e favoiu-ably placed, being 400 feet above the lake, and 6085 above the sea, and considerably sheltered to the north by the mountains of the Julier pass, and to the east by a wooded hillock, which bars the valley, and forms the east bank of the lake. The hotels and boarding-hous:cs here have more or less the advantage ot this shelter, and of a declivity fully facing the south. The Rev. Mr. Strettell has built a comfortable house above any of the others on this slope, and he believes it to be the highest gentleman's residence in Europe. He told me that so warm are the sun's rays, even in winter, in this high yet sheltered spot, that the inmates have sometimes lieen able to sit with open windows, and even in the open air. The rooms are well warmed by means of the ordinary German stove ; but this causes an excessive dryness and close feel- ing in the air, which is neither healthy nor agreeable. It is said that ventilation may be safely supplied by occasion- ally opening a window ; and the extreme dryness may be prevented by placing on the stove shallow vessels of water. It appears, however, that as yet only one of the hotels has been kept open during the winter; and, as there have been hardly enough guests to make it profitable, it is doubtful whether any will be available for the coming winter.* ' The remaining village in the upper Engadine is Sama- den, which stands at the height of 5600 feet above the sea, and about 100 feet above the valley of the Inn. It is well .sheltered liy the grassy slopes of high mountains to the north, and less completely to the east, and has the advantage of a fine view of the Bernina range to the west, which, being distant, does not shut out the sun .so nuich as the nearer mountains to the south of St. Moritz. Still there is * The Engadin-Kulm Hotel was kopt open during the winter 1869-70, and several inmates remained with considerable advantage and enjoyment, beguiling their Arctic season with systematic ar- rangements for sledging and skating. SAMADEN — LOWER E:j;GADIXE. 149 a high range due south of Samaden, and this is the common disadvantage of the whole Engadine during the winter, that high mountains to the south shut out much of the sun's light and heat. Another objection to Samaden is the some- what marshy character of the valley at this part, the waters of the Inn sometimes spreading over its flat alluvium. I have seen, in the early morning, a thin stratum of fog brooding over this, like that on the lake and ilat about the Kurhaus of St, Moritz. Still the Bemina Hotel stands sufficiently high above this not to suffer materially from its influence. I have already spoken favourably of this hotel and its manager, M. Franconi ; and, as it is the only hotel which is constantly kept open during the winter, it must be considered the head-quarters of those Avho intend to make a long sojourn in the upper Engadine. I found in the livre des vo>jageurs several testimonials from those who had Avintered there, speaking in strong terms of the benefit which they had gained in their health, and of their entire satisfaction with the care and attention bestowed on them by M. and Mme. Franconi. ' I have already adduced many proofs that the upper Engadine is too high and too cold even in the summer for the comfort and well-being of delicate invalids, and even of some persons in health ; and it becomes a question whether suflSciently cool and bracing summer resorts may not be found at a somewhat lower elevation, and so accessible, and witli such comfortable accommodation, as to make them available. ' Lower down in the valley of the Engadine, at an eleva- tion of 4000 feet, is the large newly-built bathing esta- bUshment of Tarasp-Schuls, with accommodation for three hundred persons. The mineral waters, both for drinking and for baths, saline, chalybeate, and sulphurous, are the great attraction ; the saline, which are also alkaline, being stronger than those of Carlsbad or Kissingen. But the situation may also be recommended as a cool summer resi- dence, being shaded by lofty and well- wooded moim tains 150 MOUNTAIN CURE OF CONSUMPTION. to the south, with varied walks and drives on a dry soil, and with pure air. The high southern screen, however, unfits it for a winter abode, and it has no protection from the eastern blasts which come up the valley. ' There is a considerable hotel, or Kurhaus, at Davos am Platz, situated in a high valley to the north of the Enga- dine, near the Strela pass. It stands about 5000 feet above the sea, and is much frequented, on account of its cool pure air, and the whey-cure which is carried on there. I have passed some days there, and fomid the air pure and invigoi'ating, where not contaminated by the effluvia of liquid manure, so profusely laid on the pastures in many parts of Switzerland — no doubt very good for the vege- tation, but Avholly spoiling the fragrance of the mountain breeze. How the composts or cesspools for these manures haunt you wherever you go among the high Alps ! Even at Zermatt, that village of glaciers, at Breuil, on the other side of the Matterhorn — places from six to seven thousand feet high — and at most of the high mountain chalets, where you might expect to be above such nuisances, and to breathe the pure air of heaven, you find it poisoned by the stench from these cloactc, in which piirity and health are sacrificed on the altar of utilisation ! However, although I happened to encounter this nuisance at Davos, it might have been accidental. The place has a repute for great purity of air. One of my phthisical patients spent six weeks there this summer, and improved in appetite and general health, but without change for the better in the lungs ; and he com- plained much of the dulness of the place. It does not appear to be suitable for winter residence, as it has little or no shelter from cold winds.* * Dr. Mayer- Ahrens gives the mean temperature of the whole year at Davos at 37° Fahr. Nevertheless, Dr. Spengler, a physician resident at Davos, states that nearly a hundred guests have passed the last winter there 'with gratifying results.' ('Med. Times and Gazette,' April 9, 1870, p. 405.) Dr. S. also asserts with confidence that several patients with pulmonary disease had been greatly bene- fited, and some cured during their stay at Davos. FEOM SAMADEN TO BOEMIO. 151 * It was a chief object of my present tour to find a high site for summer sojourn, less in extremes than the Engadine, better sheltered from the bleak north and eastern winds ; and the new baths of Bormio, on the south ascent of the Stelvio pass, seemed likely to answer to this description. The pamphlet of my friend Dr. Fedeli (' Sulle Acque Ter- mali e Fanghi di Bormio '), and the fuller treatise of Drs. Meyer- Ahrens and Briigger (' Die Thermen von Bormio '), both published in the present year, had directed my atten- tion to this place ; and to these I must refer for details respecting the composition and properties of the waters, and their sundry applications for the cure of disease. My concern was chiefly with the situation as a mountain resi- dence for the many in summer, and possibly for the few in winter also. ' I may as well take the reader with us in our way from the Engadine. On August 23, we left Samaden at five o'clock, to cross the Bemina, on a fine morning, with not a cloud to be seen ; but the valley of the Inn and the grass- fields of Pontresina were white with frost. And, moimted on the banquette of the diligence, and whilst gazing with admiration on the magnificent views of mountain-peaks, pine-vroods, snow-fields, and glaciers, which the zigzags command in such variety, I was right glad to rise above the cold shade of the Piz Languard group into the sunshine of the little valley in which lie, side by side, the Lago Xero and Lago Bianco — the one pouring its waters into the Adriatic, the other into the Black Sea. Above these, near the summit of the pass, at a height of 7600 feet, stands the new Bernina Hotel, with fair accommodation, to tempt those aspiring individuals who do not find the Engadine high enough. It is a bleak dreary spot, more suitable to Alpine Club men than to invalids. ' Beautifid as are the views in the ascent of the Bernina pass from Pontresina, those on the descent to Poschiavo are even more striking, from the greater depth and steepness of the valley into which the zigzag and serpentine versa- M 152 SUMMER QUARTERS FOR INVALIDS. tility of the road carried us. At first, from the giddy heights of savage mountain-tops, diversified only with snow-peaks and glaciers, we gaze down into the blue haze beneath, and, in the far distance, discern the tracery of a rich valley, speckled here and there with buildings and towers, looking like a fuiry-land below iis. ISrot qiany minutes elapse, as we are rapidly whirled down, before we find ourselves among trees and shrubs — quite novelties, after the scanty silva of the Engadine. Birch, beech, ash, elm, oak, and chestnut, now appeared in succession ; then acacias, contrasting their varied hues of verdure with the sombre pine and dark brown rocks ; and soon the vine, the gourd, and other luxuriant creepers, gave tokens of the entire change of climate which we had made in this rapid descent. Poschiavo, the first town in the valley, is only 3300 feet above the sea ; so that, in little more than an hour, we had made a descent of more than 4000 feet. * Poschiavo is not a good halting-place ; but three miles beyond, on the brink of the lovely little lake of the Poschia- vino, stands the very comfortable hotel and bathing esta- blishment of Le Prese, in the manager of which I was pleased to recognise an old acquaintance, M. Mella, for- merly the proprietor of the Grande-Bretagne at Bellagio, on Lake Como, who had made that delightful hotel so at- tractive to travellers. The mineral Avater is alkaline, sulphu- rous, and very slightly chalybeate. It is a cold spring ; but there is a steam apparatus for heating the water for the baths, which are newly constructed of Italian marble. The waters are said to be particularly efficacious in dyspepsia, skin-diseases, chronic rheumatism, and scrofula. ' The moderate height of Le Prese — about 3000 feet — and its situation in a narrow valley flanked on either side with lofty mountains, would prevent us from considering it a very bracing or invigorating place ; but it is much cooler than the Italian lakes generally, and presents a pleasant intermedium for spring and early summ.er, be- tween those and the higher stations, and may prove cool ASCENT OF THE VALTELLIXE. 153 enousrli in summer for many ■who have passed their winter in the Riviera or in South Italy. ' From Le Prese the road descends 1500 feet in ten miles to the opening of the Val di Poschiavino into the Valtelline at Tirano, a thoroughly Italian town. From this the road gradually ascends all the "way to Bormio; and the sooner travellers can get up the Valtelline, the better ; for, like all the low Italian valleys, it is as malarious and unhealthy to animal life as it is luxuriant and rich in vegetation. The tumtdtuous Adda, fed by a thousand mountain tor- rents, is continually depositing an alluvium of mud on all the flatter parts of its course, which, forming a rich swampy .soil, becomes, in the siunmer-heat, a hot-bed for vegetable growth, but a reeking source of miasmata to man. It is. in- deed, a sad and striking contrast to see under luxuriant vines, hansrina' in rich clusters amonsr the giorantic maize-stalks, all teeming with fertility, the sallow peasants, with haggard faces and goitrous necks, many stunted and deformed, and very 'few presenting the complexion or configuration of health. This remark applies more to the lower Valtelline, from Tirano to Colico, than to the upper portion ; and the improvement in the aspect of the inhabitants as we as- cended the valley was very remarkable. At Bolladore, the flat part of the valley, with its exuberant fertility, ceases ; and, after passing through a fine grove of Spanish chest- nuts, the road enters the narrow defile of La Serra, with its stupendous walls of perpendicular rock, separating the rich Valtelline from the paese freddo, as the upper or Bormiri end of this valley is termed. This, athough bounded on every side by lofty mountains or savage rocks, is not wanting in brightness or fertility. The valley, emerging from the gorge, is first narrow, with wooded knolls beneath the towering mountains, but above expands into an undu- lating plateau of green fields, beyond which, on the right front, stands the dilapidated little city of Bormio ; and to the left, on a rocky slope, the large establishment of the Bagni Nuovi, with the irregular buildings of the Bagni H 2 154 SUMMER QUARTERS FOR INVALIDS. Vecchi beyond, at a greater height ; niched at the foot of the great rocky barrier of the Stelvio mountains, -which here terminate in perpendicular cUfFs, as rugged and savage as weather- scarred limestone can make them. * It must be confessed that this first vieAv of tlie Baths of Bormio from below is too wild and desolate to be beautiful ; liut, as the Stelvio road emerges from the narrow streets of the ugly town, and ascends the gentle slope to the baths, the scene all brightens ; and, when we reached the terraced gardens of the building, and, turning our backs on the frowning Stelvio, looked in front over the green fields to the valley and gorge that we had left, now in the azure distance, with its varied mountains towering above it, some wooded, some barren, and most of them capped Avith snow — then another beautiful valley, with its vista of momitains lying to the left ; and withal, for a foreground, a garden glowing with grouped flowers of brilliant colours — we were constrained to admit that we had surveyed few scenes more lovely in the lands which we had left behind us. Thus were removed our fir.st misgivings as to the beauty of the place. * But next as to its salubrity. The establishment of the New Baths is a modern building, placed on a hill sloping up to the perpendicular cliffs before mentioned, Avhich are the terminal buttresses of Monte Cristallo, the highest of the two mountains between which the Stelvio road is carried. This hill is formed of the debris of the limestone rock fallen from the cliffs, and is consequently dry and stony, with large masses of rock scattered here and there over it. A thin soil, with mountain herbage and scattered shrubs, partially covers it; and this has been further im- proved by artificial planting and a variety of walks and seats for the benefit of the inmates of the establishment. The building faces the south, looking down the Val di Sotto or Upper Valtelline. Behind, the rocky cliffs of the Stelvio form a complete screen to the north and east. To the right is the valley of Pedenos, running Avestwards, and NEW BATHS OF BORMIO — TEMPERATURE, ETC. 155 leading to the Vals Viola and Livigno, through which it is possible to make short cuts to the Bernina road. To the left, beyond a pi-ojecting spur from the Stelvio mountain, lies the valley of Furva, which runs up to Santa Caterina, another watering-place, to be noticed hereafter, ' The new baths of Bormio are, therefore, favourably placed for dryness, sunny aspect, and shelter from the winds of the north and east; and yet derive coolness from the altitude, and from the breezes which frequently blow from the west and from the south. No doubt the heat of the sun is great in summer ; and there is a want of tree-shade near the establishment. But the detached rocks aiford shelter ; and there are always portions of the Stelvio road in the shade, as it winds through the ravine behind the old baths. On the opposite hill, also, are extensive pine-woods, in which shady walks may be found. ' The meteorological observations collected by Dr, C. G. Briigger give a favourable view of the temperature of the Bormio baths. The mean annual temperature is 44'51 deg. F., which is from two to four degrees warmer than any place of the same altitude in Switzerland. The moderate- ness of the temperature at different seasons is further proved by these figures : — ' Temperature of the Air at Bormio (New Baths). Summer Autumn Winter Max. . F, 80 deg. 732 Min. ... 41 deg. . ... 18-5 Mean. .. 61-7 deg, .. 43-16 ... 31-6 Spring 70 ... 21 ... 42 ' The mean humidity of the air at Bormio in the three summer months is 68 deg, (saturation being 100 deg,). By way of comparison, may be mentioned that of Berne (75-7 deg.), and those of Zurich (79"8 deg.), and Montreux (80 deg.) ' These figures correspond pretty well with the indications of our sensations during our sojourn. The air was nevejr 156 SUMMER QUARTEES FOR INVALIDS. either oppressive or too cold to be pleasant. The sun's rays, of covirse, had great power ; but there was almost always a cooling breeze, which was refreshing, without the extremes of scorch and chill from which wo had suffered in the Engadine. ' The airiness and dryness of the situation may be as- cribed partly to its absolute height (which I found 4560 feet above the sea ; Ball states, 4798), and partly to the declivity flilling from it — on the west, abruptly into the ravine down which dashes the torrent of the Adda ; and on the south, by a more undidating slope, into the Bormio valley ; while behind, to the north and east, it is protected from the colder winds by the Stelvio mountains. It may be said to stand in an amphitheatre of mountains ; but those in front are more distant, so that they shut out the morning and evening sun less than in the Engadine ; whilst those behind are so near and so high as effectually to shut out the cold blast from the north. Hence the thermometer, in the coldest months, falls only a few degrees below freezing ; whereas at St. Moritz it sometimes is down to —18 deg. F., or fifty degrees below freezing. The occurrence of frost at night during the summer months, which we had experienced in the Engadine, is never thought of at Bormio. In fact, the growth of gourds, and of several other tender plants, in the open gardens of the establishment, proves how much more genial is the climate than that of the upper Engadine, Avhere even potatoes and common garden-stuff cannot be raised. ' On comparing Bormio with other places, with regard to the amount of rain and the number of rainy days in the year, it appears from Dr. Briigger's tables to be much below the average; the number of rainy days in the summer (June, July, August), during five years, averaging twenty- three ; Avhilst at Zurich it was thirty-two ; at Berne, forty- five ; Zermatt, thirty-eight ; Eemiis (Unter Engadin), forty-two ; Gastein (Tyrol), forty-three ; Tegernsee (Ba- varia), fifty -two. In predominance of fine weather, there- NEW BATHS OF BORMIO. 157 fore, Bormio resembles Italy more than Switzerland. Possibly the paucity of trees in the immediate neighbour- hood may be a cause of this greater exemption from rain and cloud. I was struck with the difference betAveen this place and Switzerland generally, in the prevalent prognostic as to the weather. In Switzerland, it is commonly doubtful or gloomy. At Bormio, in spite of occasional gathering clouds and falling rain, the general assurance was, ' It will soon be fine again ; ' and so it proved. ' The establishment of the Bagni Nuovi is vmder the management of an intelligent Swiss, who speaks English, and is a most attentive host. It contains one hundred and forty bedrooms, plainly but comfortably furnished ; and there are the salles a manger, salon de societe, salle de lectu7-e, billiard-room, &c., usually found in large conti- nental hotels. There are forty bathing-rooms, with baths, some of marble, some of wood ; and appliances for douches of different kinds ; and a few are appropriated to collect the muddy deposit from the waters (fanghi) — a disgusting, looking slimy matter, redolent of sulphuretted hydrogen, supposed to be effectual as a discutient for tumours and rheumatic swellings. ' It is foreign to my purpose to describe the waters and their uses, and I must refer to the pamphlet of Dr. G. Fedeli, the intelligent physician residing in the establish- ment ; and to that of Drs. Meyer-Ahrens and Brligger, before mentioned. I may merely state that the thermal •waters gush in great abundance from several sources in the tufa deposits at the foot of the Stelvio mountain. These may be explored half a mile above the new baths, at the Bagni Vecchi, a smaller and still more economical esta- blishment. The temperature of the springs here is as high as 106 deg. F. At the Bagni Nuovi, to which it is con- veyed in pipes, I did not find it higher than 98 deg. F. The chief mineral ingredients in the waters are sulphates of lime, magnesia, and soda, with very httle iron and sulphur. The mud, however, which is deposited from the 158 SUMMER QUARTERS FOR INVALIDS. Archduchess Spring, is rich in filaments of sulphur, and in sulphuretted hydi'ogen, besides ochreous and saline matters. There is also a very drinkable cold chalybeate spring just below the old baths, not unlike that of St. INIoritz, but less brisk with carbonic acid. It is much recommended for the weaker patients who are using the baths. ' The establishment of the new baths is open from the middle of June to the end of September ; but, if the ad- vantages of the situation for purity and dryness of air — its sunny aspect, yet airiness — its coolness, without bleak- ness — were more known, its season would probably be lengthened, and part of the establishment kept open through the winter .■'•■ ' There are many delightful excursions in the neighbour- hood deserving of notice ; but the limits of this communi- cation will allow me to mention only that to Santa Caterina, another hotel or health-establishment, with accommodation for fifty inmates. There are only two or three baths ; but the attraction is a noted chalybeate spring. It seemed to me too strong to be taken without dilution ; but it is bottled to a great extent, and is much used as an addition to wine or to other waters. The distance is about ten miles from Bormio, np the beaiitifully-wooded glen, Val Furva. Although St. Caterina stands at a height of 6000 feet — as high as St. Moritz — there is in this glen leading to it a much greater variety of trees than in the upper Engadine. But, as at St. ^Moritz, the mineral spring rises out of a bog ; and, as you walk to it, the path yields with singular elas- ticity under your feet. This swampy ground forms the bottom of the valley, which is closely hemmed in by lofty mountains on all sides, except to the west, where it leads down the Val Furva towards Bormio ; and to the north- east, where it is open to the ice-bound Val Forno, sur- * In the present year (1870) the establishment was opened at the end of April, and it will probably be kept partially open during the next winter. ROADS TO BORMIO — OTHEE MOUNTAIN ABODES. 1 59 roxinded with the snow-peaks and glaciers of Monte C eve- dale, Zufall-Spitz, Monte Tresero, and others. However advantageous this situation may be for scenery and moun- tain-climbing, it is obviously not a suitable residence for invalids, or for any persons likely to suffer from cold and damp. ' Besides the route which we took to Bormio over the Bernina pass, there is another down the Engadine to Martinsbruck, and by the Etschthal over the Stelvio pass, the highest and grandest of all the carriage-passes over the Alps. Or the Stelvio may be reached from Innsbruck by the Brenner railway to Botzen,and up by Meran and the lower part of the picturesque Etschthal. From the Italian side it is possible to go from Varenna or Bellagio on the Lake Como to Bormio, in a long summer's day; but the journey is generally divided by sleeping at Sondrio, which is the least unhealthy of the towns in the beautiful but dangerous lower Valtelline, in which it is not expedient to linger even for a day. ' Although the new baths of Bormio appear to me to offer more advantages in point of dryness, shelter, and comfort than any of the other high mountain resorts in the Alps, yet several of these deserve mention, as affording good ac- commodation, and being entitled at least to compete with the Engadine as summer quarters. ' The Hotel Eigi Kaltbad (4727 feet) is on the south-west of the Eigi, and thus sheltered from the coldest Avinds. The Hotel Eigi Scheideck (5400) is on the south-east of the mountain, less sheltered, but is quiet, with more scope for promenade, and well supplied with milk and Avhey. The great objections to the Eigi hotels are, the frequent occur- rence of bad weather, and their inaccessibility by carriage. ' Leukerbad, under the Gemmi pass, stands at a height of 4042 feet, with a southern aspect, and by its great moun- tain-screen to the north and east, is fairly protected from extreme cold. It is accessible by a good carriage-road from the Ehone Valley, and has good hotel accommodation. 160 SUMMER QUARTERS FOR INVALIDS. ' Courmayeiir, on the Italian side of IMont BLinc, stands at a height of about 4000 feet, with two large hotels, but* it is too close to the Brenva glacier and the great snow- fields of the Geant to be safe from sudden chills. ' At Gressoney St. John, in the Val de Lys, is Dela- pierre's very comfortable hotel, at a height of nearly 5000 feet, in a beautiful Alpine valley, with the Lyskamm at its upper end ; but this splendid snow-mountain, Avhich is its pride, might send down its bleak blast at times, to the detriment of the delicate. The valley at present is not accessible to carriages. ' There is a good hotel on ]\Ionte Generoso, between the lakes of Como and Lugano, which may prove a good sum- mer residence. The summit is 5561 feet. This also is accessible only on foot or on horseback.' Comballaz, already mentioned as an accessible and comfortable station in the Diableret district, requires notice here also, as its height, 441 G feet, entitles it to rank among the highest class. Lauenen, at a height of 4134 feet, in the upper valley of the Sarina, can be reached from either Thun or Vevey, and lies in an amphitheatre of high peaks near the Gelten glacier, with a clean rustic inn. I have just visited Evolena (4700) in the Val d'Herens, out of the Rhone valley, near Sion, and found fair accom- modation at the Hotel de la Dent Blanche, with fine views of the snoAv mountains. A char-road to it will be open in August. Although a delightful change from the Rhone valley, the heat Avas rather overpowering even here ; and I may remark that the long days and greater height of the sun in the present month (June) reiider these places amid high mountains hotter than they are in the month of August, when, although from accumulation heat becomes greater, yet the heating operation of the sun is of shorter duration. Andermatt (4G42) and liospenthal (4787) on the St. SUCCESS OF WIWTEE IN THE SOUTH. 161 Gothard road, deserve mention as of the requisite height and of easy access ; but they are too much occupied by passing travellers to be suited for a sojourn for invalids. Tlie same remark applies to the inns of the Rhone glacier (5465), the Furca (7911), the Splugen (4757), and the Bernina (7G00). There are several well-known mountain inns accessible only by mule- path, and very attractive for the grandeur of their scenery, but not suitable for most invalids Such are the ^ggischhorn (7000), the Belalp, the Eiffel (8428) of Zermatt, the Rigikulm (5905), Pilatus (6282), and Miirren (5347). The more vigorous of valetudinarians may be able to accomplish a visit to them by way of excursion ; but for a sojourn they would prove too imcomfortable, and in bad weather dangerous. The Pyrenees have very few habitable abodes at a great height; Bareges and Qauterets only reaching to from oOOO to 4000 feet. Gavarnie and Panticosa rise to 4000 and 5000, but are wanting in accommodation suitable for pulmonary invalids. I have thus collected, in a somewhat desultory manner, notes derived from my own observation and that of others, which may, I trust, prove. iiseful to those who seek to im- prove their health by the aid of climate. The original and chief purpose of this little work was to give a perfectly m- partial view of the comparative qualities of the principal places in the south of Europe iu which the icinter is so much milder and drier than in England, that invalids, especially pulmonary invalids, may there pass through that trying season, without that deterioration which pretty surely awaits them at home. And with respect to the utility of this measure, which has been sanctioned by the practice of centuries, I have found in the records of a large experience to which I have access, abundant evidence of satisfactory results. On the other hand. Dr. PI. Weber quotes the opposite opinion of an eminent London phj-sician 1G2 SUMMER AND WINTER QUARTERS. to this effect : — ' My experience with regard to the warmer health resorts is great ; but it is unfortunately not favour- able.' In answer to this, I must refer my readers again to my first five chapters, and here merely add, that in so formidable a disease as phthisis, too much must not be ex- pected from climate alone. All the aids to be derived from medicine, diet, and regimen are required ; and when these are fully and fairly used, the results have been far from unfavourable in a large majority of cases. But when further good results are reported by Dr. H. Weber and others, as accruing likewise from the high mountain treat- ment of consumptive cases in icinter as ivell as in summery in common with all interested in the subject, I am most desirous that this plan should be fairly and favourably tried ; and to supply information which may aid in fulfilling this object, I have added this Appendix; indicating the several places in Switzerland and North Italy which offer the best summer quarters for invalids, and some of which may be available in winter also. 78, Park Street, Grosvenor Square, Jtdy 1870. 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Katharine Ashton 2-1 Laneton Parsonage J'* Margaret rercival 21 Passing Thoughts on Religion .. 21 Poems of Bygone Years 26 Preparations for Communion 21 Principles of Education 21 Readings for Confirmation 21 Readings for l>ent 21 Tales and Stories 21 Thoughts for the Age 21 Ursula " Thoughts for the Holy \\ eek ... . 21 Shipley's Four Cardinal Virtues 21 Invocation of Saints 22 Short's Church History 4 Sm *.rt's Walker's Dictionary 8 Smith's (V.') Bible and Porular Theology 19 1^ (J.-) Paul's Voyage and Shipwreck 20 (Sydney) Miscellaneous Works.. 9 Wit and Wisdom 9 Life and Letters 4 SOUTHEY's Doctor 7 Poetical Works 25 Stanley's History of British Birds 13 Statham's Eucharis Z*"' Stebbisg'8 Analysis of Mill's Logic G Stephes'8 Ecclesiastical Biography 5 Playground of Europe 22 Stirlisq'8 Secret of Hegel 9 Sir William Hamilton lo Stonehejjge on the Dog 27 on the Greyhound 27 Strickland's Queens of England 5 Sunday Afternoons at the Parish Church of a Scottish University City (St. Andrews). . 8 Taylor's History of India 3 (Jeremy) Works, edited by Eden 22 Thirlwall's History of Greece 2 Thompson s (Archbishop) Laws of Thought 6 —(A. T. ) Conspectus Ifi TODD (.4..) on Parliamentary Government 1 TODD and Bowman's Anatomy and Phy- siology of Man !■'> Trbkch's lerne.a Tale 2-1 Trench's Realities of Irish Life 3 Trollopb's Barchester Towers 24 Warden 24 Twiss's Law of Nations 2-i Tyhdall on Diamagnetism II Electricity 12 TYNDALLonHeat u Imagination in Science 12 Sound 11 's Faraday as a Discoverer i Fragments of Science 12 Hours of Exercise in the Alps.. 22 l^ctureson Light 12 Ueberweg's System of Logic 9 Uncle Peter's Fairy Tale 24 Urb's Arts, Manufactures, and Mines 17 Van Der Hoeven's Handbook of Zoology U Vereker'S Sunny South 22 Visit to my Discontented Cousin 25 Warburton'S Hunting Songs 26 Watson's Principles and Practice of Physic H Watts's Dictionarj- of Chemistry U Webb's Objects for Common Telescopes .. U Webster and Wilkinson's Greek Testa- ment 21 Wellington's Life, by Gleio 5 West on Children's Diseases U Nursing Sick Children 28 'S Lumleian Lectures 14 Whately'S English Sj-nonymes 6 Logic 6 Rhetoric 6 Whately on a Future State 21 Truth of Christianity 2 White's Latin-English Dictionaries 7 WiLCOCK'S Sea Fisherman 27 Williams's Aristotle's Ethics 6 Williams on Climate of South of France 15 Consumption 15 Willich'S Popular Tables 28 Willis's Principles of Mechanism 17 WiNSLOW on Light 12 Wood's Bible Animals 12 Homes without Hands 13 Insects at Home 13 Strange Dwellings 13 Woodward and Cates's Encyclopedia. . 4 Yardley's Poetical Works 26 YoNGB's English-Greek Lexicons 8 Two Editions of Horace 26 History of England 1 You ATT on the Dog 27 on the Horse 27 Zkller's Socrates 6 Stoics, Epicureans, and Sceptics. . 6 Zigzagging amongst Dolomites 23 Spottifwoodi