tionable young lady as a type in our allegory, frequently enough departed of itself, when not rendered fatal by "heroic measures. It was not strange, however, that the physicians of the day, finding the impotence of their art as a means of cure, should have laid the fatality of the disease to the account of nature rather than to that of their own malpractice, and, therefore, sought for prophylactic means when possible, or, when too late to apply these, prescribed such measures as might diminish the chances of the untoward complications they so much dreaded. Arguing on the insufficient premises we have above referred to, they supposed the requirements to be best met by a warm and equable climate, and this can assuredly nowhere be found in greater perfection than in the Island of Madeira. We need not be surprised, therefore, that they fondly deemed they had at last found the true Atlantis in this western isle.

During the latter years of the last century and the early part of the present, Madeira was so fortunate as to possess an eminently judicious British physician, in the person of the late Dr. William Gourlay, whose book upon the island is, in a medical point of view, very much the best which appeared previously to Dr. W. W. Ireland's articles in the MedicoChirurgical Journal of Edinburgh in the summer of 1869. Dr. Gourlay, indeed, remarked that no disease was of more common occurrence than phthisis among the Madeiranese themselves, and thus at once refuted the unfounded notion that this malady is, in any sense, exclusively or characteristically a denizen of cold or variable climates. He also observed that it ran a more rapid course among the natives in Madeira than among the English at home. In fact, Dr. Gourlay's is nearly the only medical work on this subject which can be described as having been written with a thoroughly honest intention,* as the publications of Dr.

even

* We do not, of course, extend this censure to the remarks of Sir James Clark (who, by the way, tells us he had never himself visited the island, but took his facts from information supplied him by others), but to the works named in the text, as well as to an ostentatious pamphlet by a Mr. Mackenzie Bloxam (who, however, was not a medical man), which contains an equal display of ignorance, presumption, and discourtesy; together with some others of like character.

Lund and others are little better than professional advertisements, and the foolish brochure given to the public two or three years ago by Dr. Grabham scarcely deserved even the contemptuous exposure it received from one of the Scottish medical journals. Notwithstanding his acknowledgment of the frequency and fatality of phthisis among the natives, however, Dr. Gourlay was of opinion that the climate of Madeira was eminently suitable for consumptive patients from other countries, especially England; and whether these two opinions are correct or not, we homœopaths are the very last people in the world to maintain that they are incompatible, as the allopaths are, of course, bound to do if they have the smallest regard to consistency. Dr. Gourlay found ample reason to be satisfied with the results of his own practice, and no wonder, for it seems to have been judicious in an eminent degree, and would do little discredit to one of his own school at the present day. He tells us that he found violent remedies of any kind badly borne, so that his measures were, as a rule, of the mildest character; he rarely, if ever, had recourse to bloodletting, substituting for this the administration of digitalis—a formidable drug, indeed, and one the action of which is even now imperfectly understood, but still, Hyperion to a Satyr as compared with the murderous operation it replaced. Under this enlightened treatment we are not surprised to find that many recoveries took place, and these, when contrasted with the uniform fatality of all cases of this disease which fell under the treatment of physicians in England at that time, naturally led the patients to endorse the favorable verdict of the profession, and to join loudly in the praises of an island which they had found so lovely a place of sojourn, and where many of them had received marked and permanent physical benefit.

The reputation thus acquired bond fide was (we fear, at times, disingenuously) defended in pamphlets and other publications by the various British physicians practising in the island. Of late years the dispute has assumed a specially acrimonious character, owing to the interests, not only of the doctors, but of the tradesmen and landlords,

having become seriously prejudiced both by the establishment of so many other sanatoria of equal or superior merit and easier access, and by the general migration of the previously resident English after the vine disease of 1852 having rendered all these persons dependent to a great extent upon the chance influx of winter visitors. Accordingly, as is the case in most valetudinarian resorts, we find that many of the English who, having originally visited the island for medical reasons, have since deemed it expedient to adopt it as their permanent abode, and whose interests have in consequence become associated with its prosperity, are loud in maintaining all its old claims as a sanatorium, in real or assumed ignorance of the fact that many of these claims have been utterly invalidated by the progress of science, and other results of the march of time. It now becomes our duty to lay before our readers as accurate and comprehensive a description of the island as is consistent with the limits of an article, and to consider this in connection with the altered views which our extended knowledge of pathology and therapeutics has introduced as to the causes, nature, and treatment of phthisis.

The island of Madeira is situated between the degrees of 32° 49′ and 32° 37′ north latitude, and 16° 39′ and 17° 17′ west longitude, its greatest length and breadth being about thirty and twelve miles respectively. It lies about 300 miles from the African coast, and a steamer performs the voyage from Funchal, its chief town, to Teneriffe in twentyfour hours.* Dr. Ireland remarks, "Like the Azores and Canaries, the whole island is obviously of volcanic origin,

* It ought to be mentioned in this place, that as Lisbon is the only town on the continent of Europe to which there is any direct communication, an invalid who shall select Madeira as his place of winter resort will find himself virtually compelled to remain in the island until he returns to England, whether the climate suits him or not; as the stormy passage to Lisbon, and subsequent fatiguing railway journey across Portugal, part of Spain and France in the depth of winter, ought certainly not to be hazarded by any one whose condition is such as to require change of climate at all. Lisbon itself has no claims whatever as a sanatorium, and now-a-days would never be thought of as such, except from its having been the death-place of Doddridge and Fielding, who resorted thither in vain pursuit of health.

formed partly by upheavals, but mainly by successive deposits of igneous rocks." This is shown by the existence of lava and trachytes, of recent date, together with trap and basalt, belonging to the secondary and tertiary strata. Dr. Ireland continues, "The backbone of the island, whose loftiest peaks are about 6000 feet high, slopes towards the sea both on the north and south aspect. Madeira is, indeed, one mountainous range surrounded by the ocean; nothing but hill, precipice, and ravine, scarcely any level ground, and no sea beach, save at one or two points where a powerful surf rolls about large pebbles which it has detached from the surrounding rocks." Owing to its mountainous structure the island presents a great variety of climates, snow being sometimes found on the summits during the winter time, while at Funchal the thermometer very rarely indeed falls below 53° or 54°, this mild temperature being due, in part, to the town having a southern aspect. It is with the town of Funchal itself we are principally concerned, as it is the sole residence of invalids, except for a few months during the spring and summer, when accommodation can be obtained at a village in the north of the island. This is much to be regretted, as the more bracing atmosphere of the northern shore would prove far more beneficial to a large class of consumptive patients than the warm, equable, and consequently debilitating climate of Funchal. At present, however, this can hardly be remedied, as their remoteness from medical aid, and even from the supply of the most ordinary conveniences and necessaries, renders the northern districts unsuitable for an invalid's residence. The rainfall at Funchal is about thirty inches, and the most frequent showers occur during October, December, January, and February, when the rain often descends in torrents; but as these, although violent, are rarely of long duration, and as, from the nature of the soil and pavement, the streets dry quickly, it is but seldom that an invalid needs to keep indoors for an

The rainfall at Malta is 15 in.; at Algiers, 36 in.; at Malaga, 16.5 in.; at Undercliff in the Isle of Wight 23:48 in.; at Nice, 36 in.; at Paris, 43 in.

entire day from this cause.* The number of days on which rain falls in the course of the year is said to be about eighty-eight, but this is thought by some to be increasing, owing to the reintroduction of the cultivation of the sugar-cane on the failure of the vines in 1852. Whether this event has really increased the rainfall may be a matter of doubt, but there can be no question that the constant irrigation the canes require must materially increase the vapour suspended in the atmosphere. This vapour, by in part condensing after sunset, combined with the insular situation, and the protection from northerly winds afforded by the range of hills behind Funchal, doubtless contributes to the equability of the temperature and the small thermometric variation between day and night (which in winter is often scarcely perceptible), but it also adds to the debilitating nature of the climate. This dampness was at one time overlooked, perhaps owing to the frequent absence of dew which results from the small nightly depression of temperature, but its existence no longer admits of question. Not only do clothes, books, &c., become mildewed and steel instruments rusty, but the hygrometer places the matter beyond controversy. The observations of Heineken and Barral with this instrument give us an average of 4-5 grains of aqueous vapour to the cubic foot, equivalent to saturation at 53°. Colonel Azevedo gives us 46 grains, or saturation at 53.5°. Mr. White gives us 5 grains, or saturation at 56°. Compared with this we have all over Scotland 3.2 grains, or saturation about 44.5°, and at Torquay 31 grains, or saturation at 44°. If we strike an average between the thermometric observations of Heineken, White, Barral, and Azevedo, we get the following mean temperatures for the seven months which chiefly concern invalids :-October, 69.89°; November, 65.40°; December, 61.88°; January, 60·82°;

* King Charles II used to say that in no country which he had ever visited was it possible to spend so many hours of so many days in the open air, throughout the entire year, as in England. He would certainly not have said this had he chanced to have ever resided in Madeira.