PATHOLOGY. 
alleviation to the phthifical patient. Many places in hot 
climates are expofed to bleak winds: often the w inter is 
as bleak as our own. The mod: proper fituation is one 
in which equability of temperature throughout the year, 
protedlion from wind, and denfity of air, are continued. 
The occafional cold induced by blalls of wind renders the 
fituation of Rome, of Pifa, and even of Nice, objection¬ 
able. A place called Villa Franca, a fliort diftance from 
Nice, has been recommended as a fpot in which the 
temperature is uniform, the fite low, and the foil 
fertile. But, where pecuniary refources are wanting, 
or where the comforts of the native country are relin- 
quifned with regret, a fituation may be found at home, 
fcarcely if at all inferior to the boafled climes of Italy. 
The lower parts of the well-fheltered Devonfiiire have 
long been held in repute for the phthifical patient ; and 
Dr. Fofter, in a recent work on the “ Climate of Pen¬ 
zance and Land’s End,” has fbown that the latter places 
are fuperior even to that. The contrail of Penzance 
with the famous places of refort in Italy, is much in its 
favour, as will be feen by the following Table. 
Fahrenheit's Thermometer. 
Time of Ob¬ 
servation. 
Dec, 
Jan. 
Feb. 
Alar. 
Nice, 3 years, (1815-1817) 
fun -rife 
44 
44 
47 
45 
Pifa, 
(1814- l8l6) 
fun -rife 
42 
40 
43 
41 
Rome, 
(1815-1817) 
7 A.M. 
4 2 
41 
43 
42 
Penzance, 
(1815-1817) 
7&8A.M. 
42 
41 
44 
42 
The benefit confumptive patients derive from a fea- 
voyage has induced many to fuppofe that the fea-coafl 
mud be an advantageous fituation. This notion has 
been confuted, however, by recent obfervation. Mr. 
Mansford efpecially (fee Mansford on Pulmonary Con- 
fumption) is of opinion, that the vicinity of the fea 
fhould be feduloufly avoided. This author confiders 
that low inland fituations which enjoy a tolerably equa¬ 
ble and fomewhat warmer temperature, with a feclufion 
from the keen blads of the north and ead, are the fitu¬ 
ations to be felecled from thofe who are fufiering under 
pulmonary confumption. On reviewing various points 
in our own ifland, Mr. M. thinks no place prefents fo 
many requifites for the refidence of confumptive patients 
as the low ground which extends fouthward from the 
Mendip Hills ; of which he thus depidls the leading 
features : “ Its geographical pofitien is in the fouth- 
weftern part of the ifland. The fhelter ad'orded by the 
range of hills towards the north, and the lownefs.of its 
level, while fpots may be chofen jull fufficiently raifed 
above the mailhy lands to efcape the prejudicial and 
chilling influence of concentrated moifture, without 
being fo high as to defeat the object in view', point it 
out as one of the mod eligible. To thefe advantages of 
a phyfical nature may be added others of a more obvious 
and inviting charadter. The varied and romantic fce- 
nery of the neighbourhood does not fail to charm thofe 
who poflefs a relifli for the beauties of nature ; while the 
tades and habits of individuals may be gratified in the 
fociety of a city, or the feclufion of a village.” 
Now with regard to the drugs which have procured a 
name in the cure of confumption, we fhall pafs over the 
lichen, dramonium, tar-vapour, with a hod of others, 
becaufe the fliortnefs of their reputation has too clearly 
indicated their inutility; and pafs to the confideration of 
two medicines which are now much in vogue; viz. the di¬ 
gitalis and the pruflic acid. Thofe who give the former 
drug very properly confine its adminidration to cafes in 
which it has the effedl of abating the arterial adlion. 
This however is only to be found by its exhibition ; for 
we are not acquainted with the external appearances 
which defignate the conflitution in which digitalis acce¬ 
lerates rather than deprefles thepulfe; it fliould be given 
in very fmall dofes, and gradually increafed. Though 
unable to explain its modus operandi, we may remark, 
that a combination of very minute dofes of this drug, as 
Vol. XIX. No. 1303. 
287 
a quarter of a grain given every night with half a grain 
of calomel, has done much good, and this in cafes 
where no hepatic diforder w'as apparent. We make this 
remark becaufe it is well known, that, in phthifis accom¬ 
panied by difordered liver, a cure is often eftedled by the 
gradual ufe of mercury; and hence many pathologids 
confine its exhibition to liver-cafes. 
The utility of digitalis, when exhibited w'ith the 
above-mentioned reftridtions, in conjunction with other 
meafures, and not as a fpecific, no one will doubt. Of 
the pruflic acid we cannot fay fo much. Indeed, the 
diftinguifhed authors who have introduced it not having 
Hated the peculiar effedls of the drug, and having de- 
fcribed it as a fpecific capable of curing phthifis in an 
early flage, and alleviating it when advanced, we can 
only fay, that it appears to us very extraordinary, that 
the fame medicine ihould promote the removal of a tu¬ 
bercle and the cicatrization of an ulcer, fince thefe ope¬ 
rations appear efientially different. Moreover, in the 
cafes in which we have tried the pruflic acid, a few have 
been made worfe, and none have recovered. Neverthe- 
lefs it is very probable, that, if w’e knew more of the 
precife operation of this medicine, and the time at which 
it fhould be ufed, it might prove a ufeful auxiliary to 
the treatment of phthifis. 
Exercife, by various modes of geftation, has been fre¬ 
quently employed as a remedy for confumption. Syden¬ 
ham indeed afferted, that riding on horfeback is as effec¬ 
tual in the cure of phthifis pulmonalis, as the bark in 
agues, or mercury in the venereal difeafe, provided the 
journeys be long enough. An example is related in Dr. 
Darwin’s Zoonomia, vol. ii. (the cafe of the late inge¬ 
nious Dr. Currie of Liverpool,) in which an hereditary 
phthifis was removed, by perfevering in a daily journey; 
at firll in an eafy carriage, and fubfequently, as the 
ftrength increafed, alternately in the carriage and on 
horfeback. Some phyficians, however, are of opinion, 
that exercife on horfeback is rather pernicious, than 
otherwife, in phthifis. Sailing feems to be confidered at 
prefent as the mod efficacious mode of geftation, efpecially 
if a long voyage is taken, with the double recommenda¬ 
tion of removal to a warmer climate. As a fort of fub- 
flitute for this kind of gentle motion, Ringing has been 
recommended as a remedy for phthifis ; and Dr. Carmi¬ 
chael Smith has written a treatife in its favour. In the 
ufe of any or all thefe modes of gentle exercife, however, 
the fame precept muft be purfued ; they muft be reforted 
to early in the difeafe, and varied with the feelings of the 
patient. 
When the difeafe proceeds favourably, the fame treat¬ 
ment as to regular exercife, pure air, and nourifhing 
diet, is to be perfevered in ; and the digitalis and other 
powerful drugs difcontinued. When the ulceration of 
the tubercles is attended with bad fymptoms, we can 
only alleviate the fuffering of the patient. It will be too 
late to fend him to a foreign clime, or perhaps to allow 
exercife. The keeping-up of a regular degree of tempe¬ 
rature in fpacious apartments, the occafional ufe of nar¬ 
cotics, among which opium combined with fulphuric 
acid, poppies, and ladtucarium, hold the chief rank, 
comprifes all that can be done for the palliation of fymp¬ 
toms, and the prolongation of a wretched exiftence. 
Genus IV. Cyrtofis, [from xrplo;, curved.] Rickets, or 
curved fpine. Generic charadters—Head bulky, efpe¬ 
cially anteriorly ; ftature fliort and incurvated; flefli 
flabby, tabid, and wrinkled. There are two fpecies,. 
1. Cyrtofis cretinifmus, Cretinifm: chiefly affedting the 
head and neck : countenance vacant and ftupid : mental 
faculties feeble or idiotic; fenfibility obtufe; moftiy 
with enlargement of the thyroid gland : hereditary. 
The term Cretinifm is ufually applied to the idiotic 
and incurvated patients ; bronchocele to the fame dif¬ 
eafe connedted with enlargement of the thyroid gland. 
In this fyftem Cretinifmus embraces both. Cretins are 
4 E never 
