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made, the patient succumbed under excessive hæmoptysis, a termination which, according to Louis and Chomel, is rare in Europe. In no case could any erosion of a vessel be detected, and even when the bronchi, trachea, and stomach were filled with blood, the excavations in the lungs contained neither fuid or coagulated blood. In 55 fatal cases, hæmoptysis, in a greater or less degree, was noted 39 times, reproduced in the majority of cases at various stages of the malady. It did not seem to hasten the progress of the disease. The entire number of cases of hæmoptysis the author has met with in four years is 63, and of these 51 were evidently cases of phthisis.
Abdominal Lesions. Of nine cases examined after death, in only two were ulcerations of the intestinal canal discovered, and these were very slight. This would be expected from the fact, that diarrhæa, even in the last stage, is a very rare complication in Martinique. The fact is the more singular, as the gastro-intestinal functions are very susceptible of derangement in that island, constituting the great mass of cases of disease, while the treatment of phthisis by purgative medicines is a very popular practice.
Age.— The author gives this table-
9 The freedom of young children from phthisis is remarkable in Martinique, for Dr. Rufz, in all the autopsies he has made for various diseases in children, has never met with tubercles but twice ; although most of these cases had sank in consequence of prolonged diarrhæa, the most fatal complaint of children in that climate. He explains it thus :
“ Perhaps we may find the cause of this in the mild temperature of the climate, so favorable to the early years of life, and in the various habits consequent upon such a temperature. Children during the first months are only clothed in a linen shirt, and sometimes are allowed to go naked. They are not confined in cradles, or even within doors, but are placed upon a straw mat in the open air, and allowed to kick about as they please. About six or eight months after birth they crawl about on their hands and feet, and at ten months or a year old walk firmly. In the town of St. Peters, where running water is found in every house, they often bathe themselves two or three times a day. Nevertheless, such is the influence of warmth in infancy, than when these children are debilitated by diarrhæa or other cause, it is found best, notwithstanding the heat of the country, to clothe them in a flannel shirt.
“After the age of six or seven years, these children, so beautiful at first that an European, accustomed to the children of the North, always believes them six or eight months older than they are, undergo a change, become pale or yellow; and it is rare to find the same strong and healthy adolescence we meet with in the schools in France. It is at this period a voyage to Europe is so useful. The same difference exists even in the negro, although it is less sensible ; the negro infants being a much less fine race than those of the French peasants."
The author is disposed to believe that the climate of Martinique exerts a retarding effect occasionally upon the progress of consumption. He has met with eight cases which, notwithstanding marked signs of the disease at an early period of life, have reached old age.
Sex.–Forty-five men and fifty-six women were the proportions observed by Dr. Rufz; and in this case, stays exert no influence in giving the usual preponderance to females, since they are unknown in Martinique, where the garments are light and ample.
Constitution.-Among the women, 44 are noted as of feeble, and six of strong constitution; and among the men, 30 are of feeble, and 12 of strong constitution. The author observes, it is a great error to suppose that weak constitutions are those best adapted for a residence in warm climates. Persons of robust frame and temperate habits best resist the effects of the torrid zone.
Race.—These colonies have been peopled by Europeans and Africans. Children born of Europeans intermarrying, are white, and are termed white creoles. The children of Africans are termed black creoles. The union of Europeans with Africans has produced a population of various shades known as mixed-bloods. Of these last, the mulatto results from the union of the white and black, and the capre from that of the black and mulatto. The following is the proportion in which phthisis has manifested itself in each. European Whites
7 African Negros
2 Negro Creoles
19 Thus, the disease is rare among Europeans. The same fact is shewn by the experience of the military hospital of St. Peters, containing only European soldiers, from the age of 18 to 30; and from which it seems that, out of 400 patients admitted for various diseases, two or three only were affected with phthisis. The author contrasts this with what he had observed in the military hospitals of the South of France, where such cases abound. The proportion of the white creoles may seem unduly great in this table, as the practice of Dr. Rufz lies principally among that class. Phthisis proves especially fatal to the mulatto-women, who furnish the victims for public prostitution. The negro-creoles, considering that they are three times as numerous as the whites and mulattos united, offer a small proportion of cases of phthisis. As the slave-trade has been abolished since 1830, the number of African negros, of the age especially liable to phthisis, is but few.
Seeing that the disease is so rare among the two or three hundred soldiers who are sent annually from Europe to replenish the garrison, exposed as they are to various debilitating causes, as nostalgia, intermittent fever, dysentery, &c., and how few resident Europeans are attacked by it, one is tempted to believe the climate of these Colonies is favorable to
the disease. On the other hand, it is to be observed, that many Creoles who have remained during a long period in France for the purposes of their education, become the victims of phthisis very shortly after their arrival, which leads to the belief that the climate cannot be favorable to those already predisposed.
Hérédité.-Pursuing his enquiries into thirty families in which phthisis had prevailed, Dr. Rufz found that, in three instances, the fathers had died phthisical, in five the mothers, in two the uncle or aunt-eleven times a greater or less number of brothers or sisters, and three times the cousins. It would seem that phthisis is less a hereditary disease, transmissible from father to son, than a congenital defect peculiar to children issuing from the same blood.
Temperature. The suppression of perspiration by chills is the most powerful cause of disease in Martinique. The vicissitudes of temperature are by no means so considerable as in Europe. The thermometer is never raised at St. Peter's above 24° Reaumur, and, while thus high, seldom falls lower than 20o. But, although the greatest variation is not more than three or four degrees, bodies highly heated easily lose a large quantity of caloric, and slight breezes affect as much as thermometrical variations. It is not rare, upon the hottest days, to feel oneself as if frozen, while bathed in perspiration ; and a short sleep is often followed by this sense of chilliness. So that the use of the flannel-waistcoat, for the purpose of absorbing the superfluous sweat, and preventing the ill effects of clothing soaked with it being in contact with the skin, is more common in this colony than in any country in the world.
Treatment.—Dr. Rufz states, that a greater success attends this in Martinique than in Europe. He adopts the same plans of treatment that there prevail. Among hygienic procedures he especially recommends horse-exercise; and although he cannot go so far as Sydenham, in terming this the bark of phthisis, he has always derived good effects from its employment. One advantage of the climate of Martinique is, that the patient may take exercise out of doors during any part of the year; and the author has seen patients avail themselves of this solace until the last day of their existence.
It is interesting, in connexion with the recommendation of their employment by the high authority of Sir James Clark in our own country, to find the author a warm advocate for the more frequent use of emeties in the treatment of phthisis. In many cases in which he has had recourse to them, they have produced very beneficial effects in quieting the cough, calming the respiration, and improving the appetite. He has given them in all stages, and only on three occasions has found it necessary to suspend their use by reason of the fatigue they caused. In two cases they arrested hæmoptysis which had resisted other measures. He employs ipecacuanha or antimony indifferently.
“Ore trahit quodcunque potest, atque addit acervo."
Notices of some New Works. NARRATIVE OF A Voyage to Madeira, TENERIFFE, MEDITERRANEAN,
&c. By W. R. Wilde, M.R.I.A., &c. Octavo. Second Edition,
enlarged. Dublin, 1844. MR. Wilde, who is favourably known by his publication on Austria, and other works, was appointed medical attendant on a gentleman of fortune, voyaging in his own yacht, in pursuit of health and pleasure wherever their inclinations, wishes, or interests led them. A more delightful circuit could scarcely be made than our voyagers pursued. Although the Lexicographer never travelled farther himself than to Múll and Iona, he has stated it as his opinion that “he who wishes to see the world, must travel round the Shores of the Mediterranean.” We wish we could follow Mr. Wilde in his comfortable and spruce Yacht to Egypt, Palestine, and most of the great Lions of Antiquity; but we dare not travel beyond the prescribed circle of inedicine.
MADEIRA. The impression on the minds of professional men is now all but universal, that Madeira offers the best chance of recovery from pulmonary complaints-when not too far gone; for then, Madeira, like every other southern locality, will only accelerate the fatal catastrophe. There are, generally, from two to four hundred English invalids who winter in Madeira, and many of them, who arrive late, have some difficulty in procuring accommodations. These are of three descriptions—furnished houses in or near the town, (amounting to nearly thirty,) each capable of containing a moderate family, and varying in expense from 60 to 200 pounds for the season. These it is necessary to bespeak before-hand. One female servant is worth half a dozen of males. Abundance of extremely honest Portuguese servants can always be procured. The second mode of accommodation is in family hotels, where small families may have separate apartments at 45 or 50 dollars per month per head. There are half a dozen or more of these hotels. The third consists of boarding-houses, with a table-d’hóte, and conducted much the same as in England. There are six or seven of these-all kept by English. The following extract contains useful information.
* In connexion with the subject of invalids, I here beg leave to offer some information upon the different modes of transit, derived from the most authentic sources, and brought down to the present time. During the last two seasons, the Peninsular Steam Navigation Company sent out one of their vessels, the Royal Tar, direct to the island. The prospectus states, that she 'will leave Southampton on the 18th of October; and after landing her goods and passengers at Madeira and Teneriffe, will proceed to Gibraltar, from whence she will make two trips to Madeira, leaving Gibraltar, on the first trip, about the 2nd, and on the second trip, about the 12th of November, to convey to the island such passengers as may be desirous of visiting the Peninsular ports (Vigo, Oporto, Lisbon, Cadiz, and Gibraltar).' One of the same company's steamships will go out to Madeira in spring to bring home passengers. The latest and the amended prospectus of this company states, that passengers can be booked out in the fall and home in the spring of the year.
Outwards-passengers have the option of two ways of proceeding, viz. : either by way of the Peninsula, in the Peninsular and Oriental Steam Navigation Company's Peninsular steam-ships, which start from Southampton for Gibraltar, every Saturday, at four P.m., calling at Vigo, Oporto, Lisbon, and Cadiz; at any, or all of which places, passengers will have the privilege of making such stay as they require, being taken from port to port by following steamers, without additional charge, and finally embarking at Gibraltar for Madeira, on board the Royal Tar, which vessel will make one or more trips for that purpose, between Gibraltar and Madeira, starting from the former place on or about the 4th of November, on her first trip-or, passengers may proceed to Madeira direct, by the company's steam-ship, the · Royal Tar, Captain G. Brooks, starting for Madeira, from Southampton, on the 18th of October next.
“ Homewards—In the spring of next year, one of the Peninsular and Oriental Steam Navigation Company's steam-ships will make two, or as many more trips as may be necessary, between Madeira and Gibraltar, for the conveyance of passengers desirous of returning, via the Peninsula, and will return from Madeira direct for Southampton, the same as last spring.
“ Rates of passage-money, which include a liberal table, with wines, spirits, &c., and also bedding, linen, and cabin furniture of every description- From Southampton to Madeira, first class, £30; second class, £21; children under ten years, half price; children under five, one third; children in arms (with the parent), free. Steward's fees, 15s. each first class passenger.
“ Rates of passage out in the autumn, and home in the spring-Direct to and from Madeira, £55; by way of the Peninsula, £50. The Royal Tar carries an experienced surgeon. To secure passages, select berths, &c., apply at 44, Regent-street, Piccadilly; and the Peninsular and Oriental Steam Navigation Company's offices, 57, High-street, Southampton, and 51, St. Mary Axe, London.
“ The royal mail steamers for the West Indies proceed direct from Southampton to Madeira, leaving England the 2d and 17th of every month. This mode has only just commenced. All the steamers make the trip in from six to seven days.
“ The Brazil packets still continue to touch regularly at Funchal. The East and West India ships also call there generally; but will only take passengers to or from the island when their berths to their final destination are not occupied ; and this in England cannot be known till the last moment, so they are the least to be depended on.
“ Three regular traders, the Grace Darling, Florence, and Vernon, fitted up with very comfortable accommodation for passengers, sail regularly once a fortnight. Many persons prefer them to the steamers; the passage is about twelve days on the average; the expense about £20. Besides these, there are always small Portuguese vessels trading to Lisbon and Gibraltar.
Again, a steamer leaves Falmouth for Lisbon on Mondays, regularly. First cabin fare, £15; second cabin, £9. 10s., which includes table, &c. A steamer leaves Lisbon for Madeira every fortnight, and returns in a few days after she lands her passengers. Fares from Lisbon to Madeira (at present), first cabin, £10; second cabin, £7, including table; deck, £3. An English stewardess attends. The British mail contract-boats, which sail on Mondays from Falmouth, call at Vigo, Lisbon, Cadiz, and Gibraltar-touching at Oporto, and return by the same route, which is performed in eighteen or twenty days."
The heat of the Madeira Summer will be found too relaxing in general, and a return home in June will often be found useful.