138 EFFECTS OF THE CLIMATE 



other words, a prolonged residence on the hills, to secure the 

 sujQferer from relapses, on returning to the low country. 



Dysentery, whether acute or chronic, is so seldom met 

 with, unconnected with derangement of the liver, as to fall 

 more properly under the next head. Under whatever form 

 it occurs, it is justly considered as one of the most formi- 

 dable and fatal of Indian diseases, occasioning a greater loss 

 of life among the lower ranks of Europeans in particular, 

 than any other complaint — Cholera not excepted. Upon 

 the whole, our practice in the less aggravated forms of the 

 disease has been tolerably satisfactory, but it always proves 

 extremely obstinate, from the tendency to relapse from com- 

 paratively trifling causes, such as slight atmospherical 

 changes, errors in diet, exposure, &c. and it is rarely over- 

 come without more or less injury to the constitution. It is 

 in this, and the next class of disease (hepatic), that I con- 

 ceive the precautionary measure of a sea-voyage most ur- 

 gently called for : with this advantage I apprehend that the 

 results would be completely reversed ; but without it, I am 

 disposed to think that none but the mildest forms of the 

 disease should be transferred to the Neilgherries, and that, 

 in all of them, the patient should be acclimatized by a pre- 

 vious residence at Kotergherry or Coonoor, until the disease 

 is fairly subdued, and nothing remains to be done, but to in- 

 vigorate the constitution, and restore the powers of digestion 

 and assimilation, by a transference to the bracing climate of 

 Ootacamund. 



The same observations apply, but with still greater force, to 

 the numerous and important class of hepatic diseases. The 

 liability to congestion, from the sudden change of temperature, 

 the mischief arising from the susceptibility of the skin, be- 

 tween which and the liver there exists the most intimate sym- 



