essentially from observation of what the papers, taken together, appeared to him to agree upon.

Mr. Netten Radcliffe limited his observations to Dr. Gordon's paper, and to the reports on which that paper was founded. He observed that he felt some difficulty in entering upon their consideration, on account of the multiplication of details in them, which made it necessary to exclude from discussion numerous points which the author might deem necessary to a right understanding of the whole. The time at the disposal of the meeting left, however, no choice but to confine the attention to two or three points only, and he proposed to devote his attention to Dr. Gordon's conclusion, that " a form of fever like what in Europe is called typhoid, except in etiology, exists in India and other hot countries; that in them such a fever is due to climatic influences, not to filth or other specific causes; that all attempts made to trace any of 175 cases recorded to such causes have been unsuccessfully made." Mr. Radcliffe reviewed this conclusion from the point of view of the nature of the inquiry which had led to it, and the nature of the evidence on which it rested. Dr. Gordon had, according to his paper and reports, conducted the inquiry obviously from the point of view that it was doubtful whether the distinction of enteric fever as a separate and specific form of fever, as maintained in Europe, could be maintained; and implying that continued fever was a unity manifested in several varieties; and he had quoted approvingly the writings of several authorities in support of these views. Mr. Radcliffe animadverted upon the promiscuous character of these quotations, illustrating his remarks by taking the one most insisted upon, and showing that it was written by the most honoured physician in England some time before the great discrimination of Stewart, Jenner, and others had been made-a discrimination fully accepted by the distinguished writer at the present time—and referred to a growing habit among teachers who then believed in the unity of continued fevers, to multiply varieties. Mr. Radcliffe pointed out that the quotation particularly pointed to a habit conspicuous in Dr. Gordon's report, who, while writing of the continued fevers of India as a single disease, described not less than twelve varieties in 175 cases! Dr. Gordon's inquiry, such as it was, appeared to him not to be directed to the elucidation

of the fact whether "enteric fever," as understood by European physicians, existed in India, but to get together " views," "opinions," and certain data which tended to show that the continued fevers of India constituted one disease presenting several varieties to show reasons for reverting indeed to the doctrine of "continued fever," which was held before Stewart and Jenner wrote. He was concerned solely with pointing out the light in which that part of Dr. Gordon's work appeared to him, and had no purpose to discuss the question, whether it was a retrograde view or otherwise. And as to the form the inquiry took, it was carried out by a circular letter of queries, issued generally to the medical officers in the Madras command. The inquiry was carried out under the assumption that the years of labour which had been devoted to the personal investigation of the subject of enteric fever, by the great teachers in Europe and America, would be sufficiently represented in India by a series of formal returns filled up indiscriminately! Next, as to the value of the returns so made, in view of the inquiry, according to Dr. Gordon's estimate. The returns related to 175 cases which had occurred within a period of thirteen years among British troops scattered over the whole area of the Madras Presidency. Of these cases seren only, Dr. Gordon held, could be accepted as cases of true specific enteric fever, the remaining being examples of (1) endemic continued fever; (2) continued fever of adynamic type, non-specific; (3) febricula; (4) ardent fever; (5) endemic remittent; (6) fever of uncertain type; (7) continued fever; (8) typho-malarial fever; (9) remittent; and (10) malarial endemic. Nevertheless Dr. Gordon does not hesitate to use the whole of the 175 cases as furnishing evidence to decide the question of the relation of “enteric fever" in India to "filth or other specific causes." Mr. Radcliffe was not prepared to receive the evidence of persons upon questions touching the etiology of a disease who, according to Dr. Gordon's showing, were unable to diagnose the disease; neither was he prepared to set aside so summarily as Dr. Gordon had done such diagnosis as they had made. He would accept for the moment the diagnosis of the reporters and the information they had given upon it, as at least of the same value as the information which would have been given by a similar number of practitioners at home, taken indiscriminately

and addressed by circular. What followed? (raising no questions as to the value of the questions put for eliciting the information needed, and taking the answers as they are given,) Dr. Gordon's data show that the statements made as to twenty-five per cent. of the 175 cases recorded yield no information whatever. Deducting these cases from the total number, 53.5 per cent. show that the patients had been exposed to fæcal effluvium from latrines, to the filth in and about native dwellings, and to liabilities to infection; and 464 per cent. only are returned as affording no evidence as to exposure to emanations from filth, from infection, or from other sources likely to foster or produce the disease. Mr. Radcliffe observed that he was quite unable to reconcile these data with Dr. Gordon's statement, "that all attempts made to trace any of the 175 cases recorded to such causes (ie. filth or other specific causes), have been unsuccessfully made." Mr. Radcliffe took exception to Dr. Gordon's loose use of the words "causation," "filth," and "climate," and stated, illustrating the European use of the word "climate," that a definition which made that word, as Dr. Gordon makes it, synonymous with 'malaria," ("the expression malaria can only be accepted as a synonym of climatic influences;" "malaria is in these respects employed as synonymous with endemic and climatorial influences; ") passed his apprehension.

The scientific value of Dr. Gordon's report, so far as "enteric fever" in India is concerned, may be taken to be illustrated by the fact upon which Mr. Radcliffe dwelt, namely, that according to the author's own showing it rested upon seven cases occurring at intervals in the course of several years over the vast area of the Madras Presidency! We refrain from comment.

BY DAVID YOUNG, M.D., FLORENCE.

"A WINTER in Italy" would be an easy theme for a physician who had spent many of the best years of his life in this classic land, whether he sought to sketch for the traveller, in search of repose in healthful recreation, some of those histories which circle round almost every city in the peninsula; or whether he wrote more especially for those whose numbers increase from year to year, and who migrate southwards, as the autumn in the north sets in, seeking a refuge from the approaching winter, and to whom a sheltered sunny spot where they can enjoy life in the open air during all the winter months is of more importance than all the histories of bygone days, or the "treasures of art" which tempt so many to leave their homes. Winter in Italy has been described in all its aspects, and the many thousands who annually sojourn amongst us have nothing to desire in the way of information as to what they should see and where they ought to go. Winter stations are springing into notice everywhere—from Bordighera and Alassio in the north to Capri and Salerno in the south. It is otherwise, however, with summer quarters, and with the exception of the Baths of Lucca, lying between Pistoia and Pisa, there is scarcely a spot in Italy which has, until recently, been known to strangers as suitable for a summer residence. Of all the thousands who winter in

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Italy only a very few remain during the summer, and this not from unwillingness to do so, but from ignorance of the localities which are now found to be so admirably adapted for a summer sojourn. My friend Dr. Macpherson, in his excellent book on the Baths and Wells of Europe, says, "The Apennines scarcely afford any summer retreats cool enough for the English." This has certainly been the prevailing belief hitherto, and ever since taking up my residence in Florence the question as to where invalids and others should pass the summer has been one of the greatest difficulties I have met with in the discharge of my professional duties. The opinion of the physician on this matter is asked hundreds of times in the course of the spring and early summer, and as it is an absolute necessity that the majority, at least of invalids and visitors, should quit our large cities during the summer months, it becomes a subject of the greatest importance to our fellow-countrymen and others, who may happen to spend the winter in Italy and desire to return the following year, but who are at the same time anxious to avoid the fatigue of a long journey to Switzerland, for the intervening summer months. It would be an easy thing to find pleasant spots enough out of Italy if distance and expense were no items in the case, but when one or both must be taken into serious consideration, the deservedly popular summer resorts north of the Alps are too frequently out of reach. But apart from the question of economy, a summer residence in Italy for those who have spent one winter and wish to spend another, and especially for those affected with disease of the chest, is of greater value than is generally understood. When speaking of the climate of Abetone I will again refer to this subject.

As compared with Switzerland, Germany, and Austria, it has hitherto been believed that Italy had almost no cool summer resorts whatever. The reason why Italy is supposed to be so far behind other countries in the matter of summer Sanatoria is not that she is destitute of them, but that they are unknown or neglected. The more I see of the country parts of Italy, the more strange it seems to me that multitudes of foreigners, as well as of Italians, are obliged year after year to leave Italy, in search of summer quarters in Switzerland and elsewhere, when just as cool residences may be found, or might easily be developed, among the higher Apennines, and especially in the