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can he tolerate their existence? Can he doubt their benumbing effects on weaker minds? Is it not time that he, and such as he, spoke out for liberty of thought and removal of disabilities in medical as in political life? Is it not time for withdrawing the unjust stigma which rests upon those whose only fault is their free carrying out of the very investigations which have raised the hopes here expressed?
Compulsory Vaccination: its Wickedness to the Poor. By J. J. Gabth Wilkinson. London: Pitman.
Sir James Paget on Changes produced by Vaccination.
Disasters from Vaccination. By Edward Ballabd, M.D.
On the Evil Consequences of Impure Vaccination. By Edwaed Hattghton, A.B., F.C.D., M.D., M.E.C.8.E., Ac.
The Danger and Injustice of Compulsory Vaccination.
Vaccination and the Vaccination Act. By Rev. Mundefobd Allen.
On the Best Method of Medicating Pilules. By Isaac C. Thompson.
Annual Record of Homoeopathic Literature for 1873. By C. G-. FiAtTE, M.D. Boericke and Tafel, New York.
Albany Weekly Times, Nov. 27, 1873.
The Dublin Journal of Medical Science.
The New Zealand Homoeopathic Gazette.
The Monthly Homoeopathic Review.
The Hahnemannian Monthly.
The American Homoeopathic Observer.
The Western Homoeopathic Observer.
The Chicago Medical Investigator.
The North American Journal of Homoeopathy.
United States Medical and Surgical Journal.
The Western Homoeopathic Observer.
The New England Medical Gazette.
The American Journal of Homoeopathic Materia Medica.
El Criterio Medico.
The Calcutta Journal of Medicine.
The Food Journal.
The Chemist and Druggist.
The New York Journal of Homoeopathy.
The Medical Union.
Compendia di Materia Medica Pura. Par Dr. B. Dadea.
THE CLIMATE OF MADEIRA, IN THE TREATMENT OF PHTHISIS AND OTHER AFFECTIONS OF THE RESPIRATORY ORGANS.
By W. B. A. Scott, M.D.
Little more than a quarter of a century ago the Island of Madeira was, unquestionably, the favourite winter resort of all phthisical invalids from this country whose resources and circumstances permitted them to visit so distant a shore. The writings of Sir James Clark, Dr. Gourlay, Sir Thomas Watson, Dr. Scott Alison, and many others, all described the climate of Madeira as that which was incomparably better suited than any other to consumptive patients. The sufferers themselves, in many cases, echoed the encomiums bestowed on that beautiful island by their medical advisers, and the prevailing opinion of the public, no less than that of the profession, rose so high in its favour that a visit of longer or shorter duration to that favoured spot was deemed an all but infallible cure for consumption in its earlier stages, a certain means of securing prolonged existence, or, at least, euthanasia, at a more advanced period, and an effectual prophylactic measure in cases where the disease indicated its approach
VOL. XXXII, NO. CXXVIII. APRIL, 1874. N
by premonitory symptoms, without having as yet established itself in the constitution.
A very different opinion on this subject prevails at the present day. The name of Madeira, indeed, is still found in works dealing with medical climatology, but it occurs merely as one among a host of others, and to which no special recommendation is accorded; while our more accurate knowledge of the topographic, thermometric, barometric, hygrometric, and other physical conditions of the various health resorts now in vogue has enabled us to institute comparisons between them with greater precision, and has led, in many cases, to very unexpected results. It will be an interesting task to endeavour to find out the causes of this former popularity, in which we shall readily perceive the reasons of its subsequent decline, while, at the same time, we shall be doing a good service both to the island itself and, what is of far greater consequence, to the interests of suffering humanity, if our investigation shall enable us to point out the nature of the cases to which the climate of Madeira is likely to prove of real benefit.
In order to understand the circumstances under which Madeira acquired the high reputation it formerly enjoyed as a resort for phthisical invalids, it is necessary to bear distinctly in mind the views entertained until a comparatively recent period upon the etiology, pathology, and treatment of phthisis. This formidable disease was supposed to be chiefly, if not entirely, confined to damp, cold, and variable climates, and its origin was mainly ascribed to these hygrometric and thermometric conditions. It was imagined to be a local disease affecting the lungs, at least primarily, and even in some cases to run its course without materially implicating any other organ. The former of these ideas derived some confirmation from the general pulmonary symptoms, as cough, dyspnoea, sanguineous and purulent expectoration, and so forth, while the latter seemed to be supported by the fact that in some cases death supervened without the previous occurrence of the profuse diaphoresis, troublesome sickness, and colliquative diarrhoea, 'which, singly or in combination, characterise in general the progress of consumption. In fact, these latter symptoms, as well as those of hectic, were accounted for as results of the "inflammatory" condition set up by the progress of the local disease, and, therefore, to be met by the disastrous antiphlogistic remedies then in fashion, which have more deaths to answer for than the most fiercelycontested tenets of political or religious persecution. Accordingly, when the disease had fully declared itself, "the quick pulse and high temperature were held to indicate "inflammation," and immediate recourse was had to the "regular" sanguinary, nauseating, and debilitating measures which, repeated sufficiently often, safely conducted the patient to the grave, leaving the survivors with the consoling assurance that every weapon of the therapeutic armoury had been employed strictly according to rule, in combating the foe; but in this particular case had failed to baulk the destroyer of his prey. Now, it is evident that under this mode of treatment every accidental and temporary aggravation, such as a trifling attack of intercurrent catarrh or bronchitis, which was supposed to call for medical interference, must, on account of the infatuated measures adopted, have been succeeded by marked loss of strength and increase of all the unfavourable symptoms. It was observed that catarrhal or bronchitic affections often took their rise from cold or variations of temperature, and as it was to the supervention of these affections themselves, and not to the inappropriate measures adopted for their relief, that the physicians of the day ascribed the aggravations of the primary disease, they argued, with much plausibility, that by transporting the patient to a warm and equable climate he would be placed in the most favourable circumstances for obtaining an arrest or suspension, if not a final cure, of his malady. Moreover, as in those days comparative sanitary statistics hardly existed, and as it was noticed that coughs and colds were more common amongst ourselves in winter than in summer, and frequently took their rise, even during mild weather, from rash transitions from a heated room to the open air, it was hastily and erroneously, but not altogether unreasonably, concluded, that phthisis was peculiarly a disease of cold and changeable climates, having its origin in these atmospheric conditions, and that therefore a temporary or permanent sojourn in more favoured regions might not only mitigate or heal the disease in those actually attacked, but even avert it altogether from others on whom it had not as yet laid its destroying hand. As might have been expected, no cases of consumption which fell under medical treatment in this country at the time we are considering ever by any chance recovered, and the not infrequent instances of spontaneous cure in such as had been so fortunate as to escape this ordeal were unhesitatingly declared to have been cases of bronchitis. The story goes that an Irishman once complained to a school committee of the undue favouritism shown by the master to one of the pupils at the expense of his (the complainant's) son. "Why," said Paddy, "sure an' the master asked how many commandments there were, an' my boy tould him there was a hundhred, and, bedad, the scoundhrel let t'other boy go above him who wouldn't own to more than ten!" And just as the indignant son of Erin thought that a schoolboy's deserts were in direct proportion to the number of moral obligations whose authority he acknowledged, so physicians of the old school were naturally persuaded that a patient's chances of recovery were directly proportional to the number and activity of the artificial methods employed in combating the disease. Armed with mercurial and antimonial draughts in the one hand, and with lancets, cauteries, and scarifiers in the other, like Queen Eleanor with the dagger and the bowl, they naturally felt that if they failed to destroy the interloper who had taken unlawful possession of their patient, and whose mazy windings they had so studiously tracked, it must be on account of her being invincible, and loudly denied the possibility of a spontaneous and gradual disappearance of their detested rival. Yet there is every reason to believe that fair Rosamond died in the course of nature, and it is still more certain that the formidable ailment, of which we have so ungallantly taken that objec