and cruel effects of an opinion so erroneously formed, can scarcely be imagined; and doubtless, by its despairing influences on the mind, has hurried many a one to the grave, who else might have lived in happiness many years.

Dr. Dujat says that he saw as many cases of Consumption in the Hospital at Rio Janeiro, as in those of Paris. Sir James Clark declares, "though the climate of Madeira may be very beneficial to the consumptives of other countries, there is no disease more frequent than Phthisis among the native inhabitants." A resident physician in Madeira says that "of nineteen cases of persons in the advanced stages of Consumption under his care, not a single one recovered, every one died."

And yet Madeira, by common consent on the part of those who advocate a milder climate for consumptives, is generally considered the most favorable in the world to those suffering from Phthisis. As for Italian skies and their health-giving influences, Louis says he has "seen entire wards of consumptives at Naples." And if the statement of Dr. Giovanni be true, that in the Military Hospital at Capua he cured two hundred and sixteen cases of Consumption in less than four years, it either must be a very curable disease, or of very common occurrence in that delightful clime.

The truth is, that the idea of benefiting consumptive persons by sending them to a milder climate, is becoming an obsolete idea, at least among medical men of learning and of wide and long experience; and the hope is, that the day is not far distant when it will be as to all classes, among the things that were. If it was simply not hurtful, neither beneficial nor injurious, the question might have remained undisturbed in these pages; but it

has been discussed for the sake of our common humanity, because the amount of pecuniary embarrassment, of social deprivations, of physical discomfort, of bodily pain, of mental sufferings and disquietudes, and of ceaseless unavailing longings to the last hour of life, to be permitted to see home once more, which it has entailed, is beyond calculation. They only can have any adequate conception of it who, like myself, have lived for so many years in the "sunny south," and for myself have seen of what I write. Sunny and beautiful indeed to those who have health, and time and money without stint, but not to the weak and worn and weary invalid. If a person is in the beginning of consumptive disease, he can get well without going to the south; if he is in the advanced stages-and it is not until in these advanced stages that there is any idea of going anywhere— why then going to the south will most certainly hasten a fatal termination, and of this southern physicians of distinction have, as a public warning, given wide and willing testimony.

It will not answer to form adverse opinions from isolated cases of persons appearing to be in a decline, who went south and returned improved. The first step to be taken is, to know certainly, of any particular case, that it was Consumption previous to the journey; to know it, not from an impression, but by all the means of careful medical examination. Let any reader, who is that much interested in the well being of humanity, take the trouble to inform me of a single case coming under his own observation, of the following character: A person having a night and morning cough, as steadily as the night and morning come; decided tiredness or shortness of breath on going up stairs, or walking a little fast up

a gently inclined road, who has been steadily declining in flesh for twelve months or more; who has during the whole day, from the time of his rising in the morning until he retires at night, a pulse always above ninety-one beats in a minute; if such a person has gone to the south, and returns with a pulse of seventy, with no night or morning cough, weighing as much as he did in ordinary health, and feels no special fatigue, or difficulty of breathing, viz. no shortness of breath in walking a little fast up a gently rising ground, then will I admit that such a person had Consumption, and by going to the south was cured.

All I desire is to get facts, whole facts, so as to arrive at a great practical truth; one which is to influence the health of millions living now, of millions yet unborn. And if the reader has such a fact in his possession, he may become a co-worker, in advancing the highest interest of his kind, by communicating it to my address. On the other hand, those who advise a Consumptive to go to a more southern clime than his own, for the purpose of regaining his health, without having investigated the subject critically, and without having numerous facts to ground that advice upon, such an one should pause a moment, and consider whether he is not possibly shortening the life, which he desires to prolong, whether he is not extinguishing the last hope of health. What I desire is, that every adviser, should advise knowingly, and feel ever, that a holy human life is at stake.

SPIROMETRICAL OBSERVATIONS.

Shortness of breath is a universal attendant on Consumptive disease. Spirometry is the measurement of the breath. Allusion has already been made to this

subject on page 83. Several difficulties will at once present themselves to the reflecting reader, viz.:

To know how much air a person's lungs should hold,or will expire, when in perfect health, and in full working order.

To know how to make an exact measurement.

To know some principle applicable to the fact, that different persons must hold different amounts of air.

It is sufficient to say that these things are known to the medical profession, and that they only are able to apply the principles involved, in a manner practicable, useful and reliable. I propose to offer some illustrations as to these points. The cases will be designated by numbers for convenience of reference hereafter; all of them have been measured by myself, and were recorded

at the time.

863. Had lost five-tenths of her lung measurement, and died in twelve days.

883. Had lost five-tenths, and died in eight months. 890. Had lost four-tenths, and died in two months. 908. Had lost two-tenths, and died in six months. 919. Had lost four-tenths, and died in two weeks. 923. Had lost four-tenths, and died in two weeks. 932. Had lost six-tenths, and died in two weeks. 938. Had lost four-tenths, and died in four months. 996. Had lost three-tenths, and died in three months. 997. Had lost three-tenths, and died in four months. 1013. Had lost three-tenths, and died in three months. 1014. Had lost three-tenths, and died in two months. I have thus given twelve consecutively fatal, measured cases, occuring during twelve consecutive months, known to have died from direct observation or information, by which it will be seen, that persons having Consumptive

symptoms, and who had lost the use of three-tenths of the lungs or more, died in four months; three only hav ing lived longer.

It will be seen that some, for example 883, with a loss of the use of five-tenths, which is one-half, lived eight months, while 908 with a loss of two-tenths, or one-fifth only, lived but six months, and 919, with a loss of four-tenths, or two-fifths, lived only two weeks; this difference arises from the fact, that the loss of measurement, in all cases, arises from two causes; 1st, the loss of lung substance; 2d, the loss of lung function only; the greater the loss from the loss of lung substance, the sooner the patient dies; but vice versa, when the greater portion of the loss is, not because the lungs have decayed away, but because they work imperfectly from being filled up with matter, or mucus, or tubercles, or from mere inaction. Auscultation must decide what proportions of the deficit is attributable to the respective causes, and from that, we must judge as to the probable time of termination. When the deficiency is small, the lungs cannot have decayed away to any critically hurtful extent.

When the deficiency is larger, much larger, and aus cultation shows no decay, no actual loss of lung substance, there is encouraging ground for restoration, if prompt and persevering attention is given to appropriate means. And it will be more satisfactory to the reader, for me to go back several years, and coupling this with the fact that the persons are still alive, in good health, and not needing medical advice, assurance may be felt that the restoration of the lungs to their full and perfect action, was a substantial, a real, a permanent restoration. 391. Nov. 24, '47. Deficiency from full measurement one-tenth.