fanart asta of ites Sat Brey Sette ates SSG as rik Teaser * ta Btrirra S UpNagaren vate é bf rt? i> bo = ; i pean ee nt vate Pest Sti) A of M } ge’ ; 3 ih) res ge gagesye REPRE Ncs Hein cay ba ry ete pA aE Meat tata begs ey Vay anh ba WALA he Roy he AY ; ets ‘ rai ste EAE att A erat! pe ay bb parbee A} Mast eitata aay ai <5 EN Spied ar ataaeal Becta grike mA i tettes settee hale ead es 7h) 7 “ eee ange Ss mokdly & rey eet i; ii a ft } eae Pe aN i tia i | > on nt ay Go! THE EDINBURGH NEW we f PHILOSOPHICAL JOURNAL, EXHIBITING A VIEW OF THE ’ PROGRESSIVE DISCOVERIES AND IMPROVEMENTS IN THE SCIENCES AND THE ARTS. EDITORS. THOMAS ANDERSON, M.D., F.R.S.E,, REGIUS PROFESSOR OF CHEMISTRY, UNIVERSITY OF GLASGOW; Sm WILLIAM JARDINE, Barr, F.RS.E. ; JOHN HUTTON BALFOUR, A.M., M.D., F.RSS.L. & E, F.LS., REGIOS KEEPER OF THE ROYAL BOTANIC GARDEN, AND PROFESSOR OF MEDICINE AND BOTANY, UNIVERSITY OF EDINBURGH, FOR AMERICA, HENRY D. ROGERS, LLD., Hon. F.RS.E., F.GS., STATE GEOLOGIST, PENNSYLVANIA; PROFESSOR OF NATURAL HISTORY IN THE UNIVERSITY OF GLASGOW. (1 ae OCTOBER 1857. VOL. VI. NEW SERIES. EDINBURGH : ADAM AND CHARLES BLACK. LONGMAN, BROWN, GREEN, & LONGMANS, LONDON. MDCCCLVII. PRINTED BY d ND CO} } t oy Reh \ ‘ ¢ ws ery vay: ; ¥ THE EDINBURGH NEW PHILOSOPHICAL JOURNAL. Mountain Climates considered in a Medical Point of View. By Dr H. C. Lomparp.* Wuat is the effect of a mountain residence on the course of diseases ? Such is the question which has often presented it- self to me in the course of my medical practice, and on which it has been my wish to collect a few observations, very incom- plete it is true, but at the same time very little known. I have been unable, indeed, to find in medical literature any par- ticular work devoted to this subject, and it has appeared to me that some benefit would arise from supplying this want in the science. In speaking of a residence on elevated situations, the first question that presents itself is, what is a mountain climate, and what are its meteorological characteristics? In order to answer this question 1 examined works on Meteorology, but not finding there the desired information, I applied to Profes- sor Plantamour, who has had the kindness to furnish me with very valuable particulars. In the second place, I have availed myself of various sources, in order to study the physiological and pathological modifica- tions impressed on living bodies by a residence on heights. With regard to influences of a purely physiological nature, I have found all the materials requisite for answering the question in a recent work by Dr Meyer-Ahrens of Zurich * From the Bibliothéque Universelle de Genéve. NEW SERIES. —VOL. VI. NO. I.—JULY 1857. A 2 Dr Lombard on Mountain Climates The pathological influences of mountain climates, being a sub- ject greatly more complicated, I have found it necessary to un- dertake numerous researches in reference to them. On this point, the works of Dr von Tschudi on the diseases usually met with in the very elevated regions of our globe, have furnished me with very valuable information. In regard to countries of inferior elevation to Peru or Bolivia, I have obtained very complete documents, for which Iam indebted to the bibliographical researches kindly made for me by Dr Appia. But as there are, notwithstanding, many questions which can- not be answered by means of the works that have been pub- lished on this subject, I have availed myself of the knowledge of many of my colleagues, who have readily replied to my in- quiries as to the result of their observations on the diseases most extensively diffused among the mountaineers of different countries. Professor Bertrand of Grenoble, and Dr Albert of Briancon, have made me acquainted with the predominating character of the morbid affections which prevail among the Alps of Dauphiny. Professor Savoyen of Moutiers, and Dr Michon of Chamounix, have rendered mea like service in regard to Tarentaise and the valley of Chamounix. Many practitioners in our vicinity have conferred a similar favour with reference to the diseases most prevalent in the Jura and adjoining dis- tricts of Savoy. Lastly, my excellent friend, Dr Lebert, who practised for a long period in the neighbourhood of Bex and Saint Maurice, before being appointed Professor at Zurich, has communicated to me a work in manuscript from which I have derived most valuable information on the subject before us. With the advantage of all these documents, for the most part unpublished, I have been enabled to trace the outlines of the picture of Alpestrine Pathology. Proceeding, after this, to examine the effects produced by a residence among mountains, both in the case of invalids, and of healthy individuals, I have been led to draw some practical conclusions as to the maladies which may be combated by this means, and at the same time as to such as are aggravated by the bracing atmosphere of high lands. Lastly, after having reviewed the different alpine localities considered in a Medical Point of View. 3 which may be selected for the purpose in question, and ex- plained the hygienic precautions necessary for success in a mountain residence, I have come to some practical conclusions as to making the best choice between different localities, keep- ing in view the particular disorder which we wish to coun- teract. It is thus seen that the medical history of mountain cli- mates touches on many questions in Meteorology, Geography, Physiology, and Pathology. In order to discuss it with ad- vantage, therefore, a great number of facts must be brought under our observation, and even after this has been done, I can regard this work only as the commencement of an investi- gation, which others, with fuller information, may turn to better account, and render more useful to science than I have suc- ceeded in doing. 1—What are the Meteorological characters of Mountain Climates ? If we compare the great plains of Europe with the coun- tries in the vicinity of the high Alps, we may assign the name of mountain climate to that of the principal valleys of Switzerland, the Tyrol, or the Pyrenees. It is not, in fact, necessary that a country should be in the immediate vicinity of mountains in order to have its climate modified by the pre- sence of snow, the frequency of fogs, and the intensity of aerial currents, for we can recognise even in the climate of our valley some of the characters peculiar to the atmosphere of mountains. We can observe the frequent falls of rain in the districts adjoining the Jura, the accumulation of fogs formed on the heights, and which the north wind gathers in masses over our heads, as they are arrested by Mount Sion in front, the Saléve on the one side, andthe Jura on the other. Lastly, we may observe the sudden sinking of the temperature when the rains of the plain are converted into snow on the summits of the surrounding mountains. All these meteorological cir- cumstances may be considered as being, in some degree, cha- racteristic of alpestrine climates, if we compare them with the plains of France, Germany, or Lombardy. But it is our wish A2 4 Dr Lombard on Mountain Climates to confine the subject which now engages us to more elevated localities, and direct attention chiefly to such as are situated at a height more or less considerable above the neighbouring valleys. : Even with this limitation, the question of the meteorological characters of mountain climates is not sufficiently simplified. For, in examining each locality, we must take into account not only the absolute elevation above the sea-level, but also the exposure ; recollecting that no comparison can be insti- tuted between the northern and southern declivity of a moun- tain chain ; and that, owing to the disposition of the surround- ing hills, two localities situated at the same height may possess an entirely different climate. Such is the case, for example, with Montreux, compared with other villages in the neigh- bourhood, which have not the same advantage of being com- pletely sheltered from the north wind, and receiving the solar rays during great part of the day. Such, likewise, is the case with Mornex, which, from its position on the eastern and southern slope of the Little Saléve, enjoys a very different cli- mate from the surrounding villages, and in particular from Monnetier, whose temperature is much colder, to a degree al- together disproportionate to the difference of level between two localities so near each other.* With these preliminary reservations, we may now proceed to consider the subject of mountain climates, taking as points of comparison, Geneva and the Hospice of St Bernard, the height of which, according to the recent measurement of Professor Plantamour, is 8230 feet above the level of the sea. Various considerations operate in fayour of the choice of these two localities as terms of comparison. The first is, that at both of them numerous meteorological observations have been made according to the most approved method, and with the most trustworthy instruments, so that these two series of observations may be considered as admitting of the most rigorous comparison with each other. A second reason for the selection of the Hospice of St Bernard as a type of this kind of climate is, that it is the most elevated spot in * The height of Monnetier is 2335 feet; that of Mornex about 820 feet lower. . considered in a Medical Point of View. 5 Europe permanently inhabited, and as such can present us with the most correct observations, and at the same time the most conspicuous features of alpestrine climates. Lastly, a consideration of the utmost importance, in my estimation, is the opinion of Professor Plantamour, who regards the com- parison instituted between Geneva and the Hospice of St Bernard as admitting of being applied to all the mountains of the temperate zone, and as capable therefore of deciding the question with which we are occupied. This opinion M. Plan- tamour has confirmed by investigations, the result of which he has communicated to me in a manuscript note, from which I shall extract the principal conclusions. “ The difference between a mountain climate and that of a plain may be briefly stated as follows :— “1st, Temperature.—This diminishes with the height. The decrease between Geneva and St Bernard is one centigrade degree for 616 feet of height; but, as the mean tempera- ture of Geneva is lowered by the vicinity of the lake, this figure indicates a slower decrease than that generally ob- served in the temperate zone, that is, about one degree in 557 feet. The range of the diurnal variations is less at St Ber- nard than at Geneva. The maximum comes sooner, the mini- mum later. «The range of annual variations diminishes as we ascend. “2d, Atmospheric Pressure.—This diminishes with the height, which likewise tends to render the diurnal variations less extensive than in the plain, while the contrary is observed in the annual variations of the barometer. _ * 3d, Humidity of the Air —The absolute quantity of vapour contained in the air naturally diminishes with the tempera- ture. With regard to the relative humidity, or the degree of saturation, the annual mean does not present great differences in the two stations, while the monthly and diurnal variations are much smaller at St Bernard than at Geneva. “Ath, Rain or Snow.—Of these the annual quantity is one and a half, or twice greater at St Bernard than at Geneva, especially in winter. “5th, State of the Sky.—There is little difference with re- gard to the state of the sky, on comparing-it throughout the 6 Dr Lombard on Mountain Climates — year in the two stations, but while the summer is the most cloudy season at Geneva, it is winter that is clearest at St Bernard.” From the observations just given, and also from the infor- mation contained in the works of meteorologists, we obtain the means of characterizing mountain climates, on comparing them with the neighbouring plains and localities which have the same exposure. We may affirm that the air of mountains is colder the more elevated they are; but, at the same time, the temperature is more uniform, so that one is much less exposed than in the plain to those sudden variations which frequently take place in the course of a single day. The atmospheric pressure diminishes with the height, and this difference in the weight sustained by the human body, gives rise to various phenomena to which we shall again recur when treating of the modifications produced on our organs by a residence in an alpestrine climate. At present we may merely mention the rapidity of evaporation, which increases with the diminution of atmospheric pressure. The higher, therefore, a locality is above the sea, the drier will be the air, and the more speedily will it extract moisture from the bodies exposed to it. This last remark leads us to examine the question of the greater or less degree of dryness in the atmosphere of moun- tains. There is, in the first place, a great diversity of opinion among meteorologists, as to the relative humidity or precise degree of saturation. Some, such as De Luc and De Saussure, infer, from their observations on Mont Blanc, that the air of high mountains is much drier than that of the plains. Others, such as Kemtz and Bravais, have found the air on the Righi and Faulhorn sometimes drier and sometimes moister than in the plain.* Finally, Professor Plantamour has come to the conclusion, from a long series of observations made at Geneva and St Bernard, that if we consider the annual means, there is no very notable difference between the mountain and the * Cours complet de Meteorologie ; translated by Ch. Martins. Paris, 1843. considered in a Medical Point of View. 7 plain. But if we compare the diurnal or monthly variations, we shall find a much greater degree of uniformity in the ele- vated situation, We thus definitely ascertain that the inha- bitants of elevated regions are not subjected to those changes in the humidity of the atmosphere which are so frequent in lower countries. Three circumstances should contribute to render the air drier on heights; first, the facility of evaporation under di- minished atmospheric pressure ; secondly, the frequency and intensity of aerial currents on the summits and sides of our Alps ; thirdly, the power of the solar rays, which rapidly dry the earth and organized bodies. Exposure for a few minutes to the heat of the sun, in this rarefied air, is sufficient to dry the face, and cover the unprotected parts of the body with blisters, as we shall afterwards learn. At present we allude to these different phenomena only in as far as they are con- nected with the dryness of the air. It is true that the difference of temperature in the different atmospheric strata causes the condensation of the vapours in elevated places; hence, in the latter, there is a more clouded sky, and more abundant rain, as we have seen in regard to St Bernard, where the quantity of rain and snow is nearly double that which falls at Geneva. But, as has been seen, a greater degree of humidity in high districts is not produced by this ; and this is no doubt owing to the sloping position of most alpine localities, and the strength of the currents of air, which do not permit the moisture to obtain a lodgment in the soil. As the last property of the atmosphere of elevated regions, I may mention the absence of dew at sunset, a circumstance eminently favourable to invalids and such as are convalescent, as they may remain pretty late in the open air without appre- hension of that sensation of damp chillness which is so danger- ous in other places. To recapitulate briefly what has been said; it may be affirmed that we find in elevated situations an atmosphere colder and more steady, both in regard to temperature and humidity, and also more frequently renewed, than in the ad- joining plains. With.such properties, mountain climates ought to possess great value to such as dread the heats of 8 Dr Lombard on Mountain Climates summer, who are tried by sudden thermometrical or hygrome- trical changes, and who stand in need of a more vivifying air than that of the plains. We shall afterwards see where and in what manner the objects sought for may be best attained. Il.— What is the Physiological and Pathological Influence of Mountain Climates ? The differences of temperature and humidity which have been indicated between countries situated at different heights, present no character exclusively peculiar to them, and which may not likewise be found in other localities placed at the same level above the sea, although in different latitudes. Such, however, is not the case with atmospheric pressure, which can never have the same character at different heights. We may sometimes observe the barometer descend a certain number of millimetres, but we never notice differences like those which exist between Geneva and St Bernard, or between the sea-shore and the summit of the Righi or Mont Blane. There exists, therefore, in mountain climates a new element of great impor- tance, that is, a less degree of atmospheric pressure, and con- sequently air of less density, as well as a decrease in the quantity of oxygen necessary to sustain life by means of re- spiration. It is to these last two circumstances that we must ascribe, in a great measure, the phenomena observed on high mountains, and to which I wish for a short time to direct the attention of my readers. On applying to physical science, we shall be informed that the entire weight of the atmosphere represents as many times 300 kilogrammes as there are square decimeters on the sur- face of our bodies ; so that, according to the stature of different individuals, the total weight supported by our organs will vary between 15,000 and 20,000 kilogrammes. On leaving, there- fore, a country more or less nearly on a level with the sea, in order to repair to a higher locality, our bodies will be subjected to less degree of pressure in proportion to the elevation. It is easy to understand what degree of disturbance our organs must undergo when the enormous weight which they habitu- ally bore has been diminished by a sixth part, a quarter, or considered in a Medical Point of View. 9 even a third, as has been observed on the Righi, St Bernard, and the top of Mont Blanc. And if we add to this diminu- tion of pressure the no less important change which takes place in the density of the air, and consequently in the quan- tity of oxygen, we shall have little difficulty in accounting for the various disturbances which take place in the respiration, circulation, locomotion, and digestive functions, of those who have ascended the lofty peaks of our Alps, and made them for a time their place of abode. In the appearance of the symptoms just spoken of, it is not easy to say what portion we are to ascribe to the diminished pressure, and the insufficient supply of oxygen. ‘The respi- ration and circulation should be alike modified under these two influences, and ought to react on the muscular strength. On the other hand, as recent investigations have shown that it is owing to atmospheric pressure that the head of the thigh-bone is kept within the cotyloid cavity, it is evident that the dimi- nished weight of the air must render the movements more difficult. We thus come to the conclusion, that the appear- ances produced in living bodies, when transported to great heights, are the result of the two meteorological facts in ques- tion—a diminished pressure, and a smaller quantity of oxygen. After these preliminary remarks, bearing on certain theo- retical questions necessary for understanding our subject, let us now proceed to consider the modifications in our organs, whether physiological or pathological, occasioned by a more or less prolonged residence among mountains. With a view to facilitate the study of the phenomena ob- served in man and animals, we shall divide the localities which form the subject of our observation into two classes; those which are situated above 6560 feet, and which, for the sake of shortness, we shall call Alpestrine climates. We shallthen describe the effects produced by Alpine or sub-alpine cli- mates, that is, such as characterize localities situated below 6560 feet, and which contain the greater part of the villages or establishments to which patients are sent. The investigations which follow present themselves under two very distinct aspects. It is found that some of the changes which take place under the influence of mountain climates 10 Dr Lombard on Mountain Climates extend no farther than to modify the play of our organs, without inducing serious or prolonged derangement, and may consequently be termed Physiological. Others, which may be nothing else than a continuation or aggravation of the former, exercise an action sufficiently powerful to give origin to some disease, and consequently fall under the domain of Pathology. Let us consider these twofold consequences of an abode in alpestrine and alpine climates. § 1. Physiological and Pathological influence of Alpestrine Climates (above 6560 feet). The effects produced by the ascent of high mountains, or by a residence in the elevated regions of our globe, have been fre- quently studied, both among the Alps and Pyrenees, and also in the chain of the Andes, under circumstances which cannot be realized in Europe. Indeed, notwithstanding the important la- bours of De Saussure, Bravais, and Martins, on Mont Blane, at a height of 15,744 feet; those of Desor and Agassiz, on the glaciers of the Aar, at a height of about 13,120 feet ; it must be remembered that these observers could remain but a short time in regions so desolate and incapable of furnishing adequate shel- ter for a lengthened abode. But this is by no means the case in South America, where valleys and plateaux are to be met with in the chain of the Andes permanently inhabited, al- though their elevation is from 11,840 to 13,120 feet.* One of these, is particular, is the valley of Puna, where our country- man, Dr Tschudi,} resided for a long time, as well as in many other regions of the same nature. He informs us that, in Peru, they use the name mal de puna to indicate the effects produced by high situations on those who visit them, or live for a longer or shorter period upon them. The inhabitants of these elevated regions likewise call it sorroche or mareo. The last of these designations establishes a pretty correct comparison between sea-sickness and the influence of heights on the human body. * See the list of these various localities in the Annuaire du Bureau des Longi- tudes. ¢ Reiseskizzen in Perou. Sanct. Gallen, 1846. a FS SAAR EY MEMES ier = PEER ERS considered in a Medical Point of View. ll A perfect identity has been found to exist among the effects produced on living bodies in whatever part of the world they have been observed, insomuch that all these facts may be united in a single view, and distinguished by the same name, the mountain sickness (le mal de montagne). This has been done by Dr Meyer-Ahrens of Zurich, in a work lately pub- lished at Leipsic.* Considering, with this author, the princi- pal changes produced in our organs by the ascent of high mountains, or a residence in Alpestrine valleys, we shall pass successively in review those which arise in the functions of digestion, locomotion, circulation, respiration, and, finally, such as affect the nervous centres. The digestive organs undergo considerable modification, in- dicated by an ardent thirst, with a desire for water and other cooling liquids, and an aversion to wine and other strong liquors. De Saussure, who has often experienced this sensa- tion, has however remarked, that if this repugnance be over- come, the use of spirituous liquors, in moderate quantities, en- tails no disagreeable consequences, but on the contrary re- cruits the strength without causing intoxication; he has often observed that a draught which would inebriate in the plains no longer had that effect on the mountains. The appetite is sometimes increased, but for the most part it is destroyed al- together, and the distaste for food is so decided, that in try- ing to overcome it, nausea and even vomiting supervene. This I have myself experienced after having climbed, without stop- ping, from the foot to the summit of the Great Saléve, which formed an ascent of nearly 3280 feet. One of the effects of elevation is, that the muscular strength is weakened ; the least exertion is attended with great fa- tigue, even in men of the greatest vigour. Beasts of burden lose their strength even more speedily than men; they be- come short of breath, and are obliged to stand at every step, and, if forced to continue their journey, they soon sink, and their carcases may be seen lying in the elevated passes of the Andes. The circulation and respiration are obviously quicker than * Die Bergkrankheit oder der Einfluss des Ersteigens grosser Héhen auf den thierischen Organismus ; in 8vo, 1854. 12 Dr Lombard on Mountain Climates on the plain; the inspirations are deep and quick or gasping (saccadées) ; the heart beats forcibly, and often with quick- ness double that of its ordinary state. This was observed by Dr Meyer during his ascent of the Jungfrau. It must not, however, be supposed that this acceleration of the pulse is owing only to the muscular efforts occasioned by the ascent, since Dr Tschudi observed it in his own case, although he was on horseback. It was likewise remarked by Gay-Lussac and Biot, although they were motionless in a balloon, at the height of 8370 feet, the pulse of the one rising 22 beats, that of the other 32. The nervous system likewise presents some important symp- toms, such as vertigo, somnolency, pains in the head, some- times very severe ; frequently, also, a complete and sudden prostration of strength, so as to render all movement impossible; a condition for which even fatigue can in no degree account, and which must be ascribed to a particular state of the nervous system. Some travellers have experienced a feeling of light- ness, as if their bodies were no longer in immediate contact with the earth; others have felt a pressure from below up- wards under the soles of the feet ; often, also, hummings in the ear occur, and the motion of bubbles of air in the Eustachian tube. Lastly, various other symptoms are observed depending on the dryness and rarefaction of the air, both of which are re- markably promoted by the evaporation. It is under this in- fluence that the ardent thirst of which we have spoken is de- veloped, and which is no doubt caused by the desiccation of the walls of the mouth and the air passages; chaps also make their appearance on the lips and other parts of the skin ex- posed to the action of the air. Such is a view of the phenomena usually observed in man when transported to the higher regions of the globe. Animals also present various symptoms, which must not be passed over without notice. The inhabitants of the Andes, who are of Spanish origin, have been desirous to carry with them their favourite amuse- ment of bull fights into the high valleys of Bolivia, as, for ex- ample, to Paz, a town situate 12,234 feet above the level of considered in a Medical Point of View. 13 the sea. But they found themselves quite unable to rouse the combative energies of these animals, now become gentle and peaceable ; and, far from tearing each other, they became weak and breathless after a few frail efforts, and were seized with continual vomitings ; a grievous disappointment to the spec- tators who, instead of the sanguinary struggle they expected, found themselves assisting at what may be called a medico- veterinary case. Cats cannot live at an elevation above 13,000 feet; carried to this height, they invariably sink after being seized with very singular shocks of tetanus. At first they show only irregularity in their movements, as if affected with St Vitus’s dance; but these shocks afterwards become more and more severe, they make prodigious leaps, as if they wished to scale the rocks or the walls of the houses ; after these violent efforts, they fall exhausted with fatigue and die in convulsions. Dogs bear up longer than cats, especially if they have been whelped in the country. Conveyed to these regions, they may continue to live there for one or more years, although seized with convulsive movements very like those observed in young dogs, when attacked with the dog-malady. Rabbits can live at a great elevation, although it is as- serted that they then become barren. Gallinaceous birds soon perish. Horses and mules, although they suffer much, at length become acclimated. A great number of them die from the effects of fatigue disproportionate to their muscular strength, in an atmosphere so rarefied as that we are now con- sidering. After having noticed the different symptoms which charac- terize the mountain sickness, it remains for us, before con- cluding, to say a few words on the circumstances which favour its development, its duration, and appropriate treatment. The circumstances which appear to favour the development of this morbid affection in those who are seized with it, are, an unusual degree of fatness, a vigorous constitution predis- posed to congestions, and birth in a flat country, which renders residence in a different region greatly more difficult. With regard to meteorological considerations—the dryness of the air appears to contribute to its development, as those affected suffer 14 Dr Lombard on Mountain Climates much less in rainy weather, or when the air is charged with moisture. | The various symptoms of the malady in question are not o equal duration. If they are caused by the ascent of a moun- tain they usually disappear with rest and return to the plain. If the stay on the heights has been prolonged for some time, most of the disturbances in the nervous system and digestive organs commonly disappear at the end of ten or twelve days. But lassitude and dyspnoea last for a longer time; a space of many months, sometimes even of some years, is necessary to make them completely disappear, particularly in those who come from a flat country. Some travellers allege that a person is attacked by the mountain sickness only once; but this is not strictly cor- rect, although in every case the first attack is always the most severe. The most suitable treatment to counteract the symptoms in question consists, in the first place, of rest, and the use of some kind of spirits, when they have been occasioned merely by the fatigues of the ascent, as their influence, in that case, does not extend beyond a few hours or days. But when a prolonged visit has been made to the high regions, it is neces- sary to have recourse to a prophylactic treatment, and a rational use of medicine. Experience has shown that an aro- matic infusion is an excellent preservative against the dyspnoea and vomiting. Tea appears to answer this purpose pretty well ; but, among the Andes, great importance is attached to an in- fusion of the leaves of Erythrowylon Coca. The Indians always carry some of these with them, sometimes keeping them in their mouths, and sometimes making an infusion of them. Dr Tschudi found much advantage from them when he went to hunt in valleys between 10,000 and 13,000 feet above the sea. The inhabitants of the country likewise employ for the same purpose, and in the same manner, cloves of garlic, with which they rub their mouths and faces. By these means also they restore some degree of strength to the beasts of burden when they are short of breath and exhausted. With regard to the rational treatment, it must depend on the form the malady assumes. If it is accompanied with faint- considered in a Medical Point of View. 15 ing, paleness of countenance, and vomiting, it is necessary to have recourse to stimulants, which can then be taken in large doses without producing intoxication. But more frequently the disorder takes the form of inflammatory fever, with a ten- dency to cerebral or pulmonary congestions ; an antiphlogistic treatment is accordingly for the most part recommended. It consists in one or repeated bloodlettings, in the use of fruits, acidulated and purgative draughts, such as cream of tartar and the pulp of tamarinds. Absolute rest in a darkened chamber, kept at a proper temperature, contributes equally to the cure.' Besides the mountain sickness, such as it has been described, other morbid affections are likewise observed in the elevated districts of our globe, which we shall consider in succession, availing ourselves of the researches of various authors, and more especially of those of Dr Tschudi, who has published the result of his medical experience during his residence in Peru and Bolivia.* a" One of the most striking features in the pathology of the higher districts, is the frequency and severity of every kind of hemorrhage. Under the influence of diminished atmospheric pressure, and also in consequence of the dry and essentially tonic state of the air, we meet with frequent cases of heemopty- sis, epistaxis, hematemesis, and melzenas, so severe as to cause death. In certain regions of Peru there occurs also a kind of purple hemorrhage, characterized by pustules and boils, which sometimes terminate in suppuration, and sometimes permit the escape of a considerable quantity of blood; from one of these swellings Dr Tschudi has seen upwards of six pounds of pure blood issue. Along with these local symptoms fever supervenes, with cramps, pains in the joints, dysphagia, and great anxiety. This disease which has received the name of veruga, appears to be peculiar to Peru, and even. to be con- fined to certain valleys where it prevails as an endemic.t After hemorrhages, inflammatory diseases are those which occur most generally in the high regions of which we are speak- * (isterreichische Med. Wochenschrift, 1846. Communicated by Dr End- licher. t Le Veruga. Maladie endémique dans le Perou. Archives der Physiologis- chen Heilkunde, Von Rosas, 1845, 16 Dr Lombard on Mountain Climates ing. When they affect the nervous centres, they are as rapid in their progress as they are formidable in their consequences. The mountain sickness is often succeeded by an eruption very like urticaria, the phases of which ought to be watched with great care, for if the eruption become pale through cold or from any other want of caution, symptoms of cerebral excite- ment make their appearance, followed by stupor, coma, and death, in the course of a few hours. Dr Tschudi has often succeeded in arresting this formidable meningitis by means of copious bleedings, and the most energetic antiphlogistic treat- ment. There is another form of cerebral inflammation (men- ingitis) of very frequent occurrence among the Peruvian In- dians as a consequence of alcoholic intoxication. This disorder is of a very formidable character, since scarcely one out of ten survives it, and it is so frequent that Dr Tschudi assigns to it one-third of the acute diseases of Puna. Nothing equals the rapidity of its progress, for from any excess in drinking, death often follows in the space of six or eight hours. These facts indicate a connection with the meningitis which prevails as an epidemic in the north of Europe, chiefly among soldiers, and which likewise causes death in a few hours. With regard to pulmonary inflammations, they likewise partake of the acuteness and rapidity which have just been referred to, being almost always accompanied with pleuritic pains, so severe that even the apathetic Indian writhes like a worm under them, and betrays his suffering by the most signi- ficant gestures. But while the cerebral inflammations demand an active antiphlogistic treatment, this is not the case with the pleuro-pneumonia of Puna, which cannot be counteracted by bleeding. This method of treatment must indeed be avoided, not only as unavailing to effect a cure, but as even dangerous, for the patient not unfrequently sinks under the loss of blood. The stimulating treatment practised by the Indians ought therefore to be preferred, which consists in the use of strong doses of cayenne pepper (capsicum). Under this treatment copious transpirations take place, which are not long in re- moving the pulmonary symptoms. Inflammation of the inner parts of the mouth, of the larynx and bronchiz, are also fre- quently observed in Puna. —. ~* Oe Se ee ee ye el considered in a Medical Point of View. 17 The skin often becomes chapped, particularly in the parts ex- posed to the contact of the dry air of these regions; a prick- ling is felt in the face and hands, accompanied by a burning sensation ; they then become covered with small cracks, which are followed by a pretty thick scurf. This disorder, which seizes new-comers, is known in Puna by the name of choun. Tt is easily cured by confining oneself for a considerable time to a close apartment, kept at a moderate temperature. The other diseases of the skin met with in the same circum- stances are erysipelas and urticaria. Along with these, erysipelatous rednesses, and, under the in- fluence of the dried air of these lofty regions, as well as the reflection of the light from the snow, very severe cases of oph- thalmia make their appearance ; six out of eight of Dr Tschu- di’s guides were attacked on the same day, and he himself escaped only by great precaution. He compares this ophthal- mia with that of Egypt, and regards it as contagious by means of the purulent secretion which falls from the affected eyes. The Indians suffer much more from this disease than the Creoles, who are better acquainted with the means of guarding against it. If it be neglected, and the inflammation become very severe, it often ends in different kinds of chronic affec- tions of the eyes, such as pannus, hemophthalmia, hypopion, © chemosis, ectropion and staphyloma, which often occasion total blindness. : (To be continued.) Notes on the Food of some Fresh-Water Fishes, more parti- cularly the Vendace and Trout. By W. Bairp, M.D., F.L.S., &e. When we consider the immense value of the fisheries of Great Britain, foreign and domestic (calculated some years ago by Mr Barrow* to produce not less than eight millions sterling an- nually), the investigation into the nature of the food of fishes is * Encyclopedia Britannica, Art. Fisheries. NEW SERIES,—VOL. VI. No. I.—Juty 1857. B 18 Dr Baird on the evidently one of no small importance. The difficulties attending upon a complete knowledge of the subject are no doubt many and great, especially with regard to the marine species, arising chiefly from our want of information as to their feeding- grounds; still something has been done by such men as Mr Yarrell and others; and any new observations tending to fur- ther our acquaintance with the food of these useful animals cannot fail to be of some value. The peculiar delicacy of flavour which distinguishes some of our fresh-water fishes has been long known to depend upon the nature of their food, though it is only in a few instances that the exact kind has been ascertained. Mr Yarrell, for instance, in his valuable work upon “British Fishes,” informs us, upon the authority of the late Earl of Home, no ordinary observer, that the trout in Berwickshire differ very much, according to the locality in which they are found. The county of Berwick is divided into two districts, a hilly, mountainous region, and a flat, fertile plain. The two principal rivers rising in, and flowing through, the county, are the Blackadder and the Whitadder. This latter stream has its source at an elevation of 900 feet above the level of the sea, and flows over a very rocky and gravelly bed, whilst the former, the Blackadder, rises in deep mosses, and flows for one-half of its course through these mosses, and the other half through a rich and highly-cultivated district. The trout of the rapid, clear, and sparkling Whitadder are fine silvery fish, beautiful to look upon, but very inferior in taste to those of the dark, mossy Blackadder, abounding as it does in a greater variety and quantity of food, and which are of a dark colour, almost black, with bright orange fins. Two other smaller streams, the Eden and the Leet, traverse part of the same county, both flowing through a rich, loamy, and often marly soil, till they empty themselves into the Tweed. The trout of these little rivers, according to the late Lord Home, are of a good size, their bodies beautifully marked with bright red spots, and the sides and fins of an orange colour. The flesh is fully of a deeper red than that of the salmon, and almost as highly flavoured as that prince of fresh-water fishes. The trout of the Tweed, again, into which these two streams run, are very inferior, being in comparison both lean and ill- Food of some Fresh-Water Fishes. 19 flavoured; and it is worthy of remark, that as soon as the fine _ rich trout of the dull and sluggish Eden and Leet enter the ra- pid, clear waters of the Tweed, they begin to lose their beauty and gther good qualities; while, on the other hand, when the comparatively ill-flavoured trout of the Tweed ascend the Eden or the Leet, a change of colour is shortly observed to take place, and they soon assume the richer hues which distinguish those of the tributary streams. These differences in the quality of the trout arise, no doubt, from the nature of the food found in these various rivers. A direct experiment, to ascertain the value of different food upon the growth and development of trout was tried some years ago. For the details we are in- debted to Mr Stoddart, who mentions the result in his “« Art of Angling, as practised in Scotland.” Several fish were taken and placed in three separate tanks of water. The trout in one of these were supplied with worms; those in an- other were supplied with live minnows; and those in the third were fed upon small dark water-flies. The trout which subsisted upon worms grew slowly, and had a lean appearance; those which were supplied with live minnows became much larger ; whilst those which had flies alone given to them attained in a short time prodigious dimensions, weighing twice as much as both the others together. The great lake trout, Salmo feroz, is a coarse fish, and of an indif- ferent flavour. It is exceedingly voracious, and feeds princi- pally upon other fishes smaller than itself, the stomachs of such specimens as have been examined having always been found gorged with fish. The Lochleven trout, S. fario var. levenensis, on the contrary, is a delicious fish, and, as I have stated in my work on the “ British Entomostraca,” its food has been found to consist in great part of these minute and delicate little crus- taceans. ‘The charr too, Salmo salvelinus, is another excel- lent flavoured fish ; and we are informed by Sir W. Jardine, who has examined the stomachs of several, that their food consisted of minute entomostraca. To the kindness of this distinguished naturalist I was indebted last autumn for an opportunity of examining at leisure the nature of the food of another fresh- water fish, of exquisite delicacy and flavour. The Vendace, Coregonus Willughbii, Jardine, is a native of several of the BQ 20 Dr Baird on the small lochs that lie close to the town of Lochmaben in Dum- friesshire. The principal sheet of water is called the Castle Loch, as upon its bank is situated the old ruin known as Bruce’s Castle. These fish are more abundant in that loch than in any of the others, and, according to the tradition of the place, were brought thither from the continent by Queen Mary. The vendace is an elegant little fish, of from four to ten inches in length, and of a pale greenish-brown colour on the upper parts, shading gradually into a clear and silvery white. The flesh is white and rich, of a delicate flavour, and highly esteemed as an article of food. It is so delicate, indeed, that it cannot be transported to any distance ; and to be duly appre- ciated must be eaten on the spot. It is well known to sports- men that this little fish had never been caught with an angle,* and that it could not be taken with any bait, the only way in which it is captured being by means of a net. Some years ago Dr Knox of Edinburgh examined the stomachs of one or two specimens, and found the contents to consist of minute entomostraca. In a paper on the food of the salmon, her- ring, and vendace, published in the “Transactions of the Royal Society of Edinburgh,” in 1832, he mentioned this fact, and gave rough figures of two different species. Mr Yarrell also examined the contents of the stomachs of one or two speci- mens, and in his valuable work on “ British Fishes” has re- iterated Dr Knox’s statement, and likewise figured the spe- cies. Both these gentlemen, however, had only specimens of vendace to examine which had been preserved in spirit, and accordingly the animals found in the stomachs were so much de- composed that their figures are not to be relied upon. Those of Dr Knox (at least one of them) are too indistinct to enable the species to be determined with precision, while those of Mr Yarrell appear to me to be merely copies of specimens figured by Jurine. Having had the pleasure, however, last year, of accompanying Sir W. Jardine to the genial meeting of the Vendace Club, which takes place annually on the Ist day of August, at the Castle Loch at Lochmaben, I had an opportunity * An instance to the contrary has been mentioned by Dr Davy in the last number of this Journal, p. 348, where he states that he saw a specimen cap- tured in one of the Cumberland lakes—*“ an uncommon incident.” i { Food of some Fresh-Water Fishes. 21 of examining the stomachs of several specimens immediately upon their being taken from the water. The fish themselves were in excellent condition, fat, and evidently well fed ; and, as I had an opportunity afterwards of testing at the Club dinner, exceedingly well-flavoured. The stomachs of those examined I found to be quite full, and containing myriads of a minute Entomostracan new to Great Britain, and which, I believe, has hitherto never been described, though in all probability it is one of those roughly figured by Dr Knox, in his paper alluded to. It belongs to the family Daphniide, and genus Bosmina ; and I propose giving it the name of B. Coregoni. This genus was founded by me in 1845, in the “ Berwickshire Naturalists’ Club,” to contain those species of the old genus Daphnia, which are characterized by having the superior an- tenn long, and taking their origin from the extremity of the beak. Only one species has hitherto been described in Great Britain, B. longirostris, a minute creature, the anterior por- tion of the carapace of which terminates at the inferior angle in a sharp point or spine. The present species differs from it in being longer, having the superior antennze much longer, the carapace greatly more rounded, and the inferior angle not ter- minating in the sharp spine. As I have already mentioned, there were myriads of these little creatures in each stomach I opened ; and upon examining the mouth of the vendace, a curious and very interesting structure is observable, which appears to be well adapted for enabling this fish to catch its prey. The mouth is small, and is unprovided with teeth, except a few small ones on the tongue, but upon opening it, and looking down, we observe that the arches of the gills are furnished on the inner side with numerous long processes, each of which is barbed on both sides, and project into the cavity of the mouth. Mecting those of the gill-arch on the opposite side, these barbed processes form a complete strainer, arresting even such minute creatures as these entomostraca. The fish, swimming through the midst of a dense shoal of these little crustaceans, must take in thousands along with the water which it imbibes, but instead of being expelled along with this water, which flows over the surface of the gill and escapes from under the gill-covers, they 08 Dr Baird on the are arrested in their progress, and detained there till a quantity is collected sufficient to be swallowed.* It is not my intention to enter into the history of the ven- dace ; but a few remarks upon its geographical distribution may not be uninteresting. It was at one time believed to be exclusively confined to the Castle Loch of Lochmaben, but Sir William Jardine, in his paper in the “ Journal of Geographical and Physical Science,” has shown that this is not the case, as it is found in several of the other lochs in that neighbourhood. An allied species, locally known by the name of Schelly, has been long known, to inhabit some of the lakes of Cumber- land, and Dr Davy has recently proved that the Lochmaben fish is also found in Derwentwater.t This specimen was after- wards transmitted to Sir William Jardine, and in a letter received by me from him on the subject, he says, “1 can- not make out a specific difference. At the same time, the fish is of a stouter make, and the proportions of the parts a little stronger. When looked at together there és a difference, but if placed before you singly, you would at once say they are one species.” The same species, under the name of Gwy- niad, is well known to exist also in Bala Lake, North Wales. Sir W. Jardine writes to me in the end of November last (1856) that he had then before him a fish from that locality, and upon comparing it with his own specimens of the Loch- maben vendace, he “ durst not make it distinct, though very slight variations did exist in the outline of the opercula.” In the same letter he adds, “this is an important fact, breaking down the very restricted locality, which I never had much faith in.” ‘When the Lochmaben fish,”’ he continued, ‘‘ was shown to Agassiz, he said it was undoubtedly different from the Swiss species. I doubt this now, but have not been able to procure specimens.” Sir John Richardson, in his valuable article “Ichthyology,” in the last edition of the Encyclopedia Britannica, remarks that, according to M. Valenciennes, the * This curious structure was first pointed out to me by Sir W. Jardine. + See Dr Davy’s paper in last number of this Journal, p. 347. When the present paper was drawn up, and read before the Linnean Society, I was not aware that Dr Davy had communicated his notice to this Journal. Otherwise I should have been glad to have quoted more freely from his interesting notes upon this subject.—W. B. ‘ ———E Food of some Fresh-Water Fishes. 23 Coregonus Willughbii, or Lochmaben vendace, is identical with the Coregonus (salmo) albula, Linneus, of the Fauna Suecica; and that it occurs in Dalecarlia and Lake Mies, in Silesia, Brandenburg, Pomerania, and Mecklenbourg, and that an extremely similar, if not identical, species has been found even in Kamtschatka. Far from being restricted, there- fore, in its habitat, the vendace would appear, on the contrary, to have a wide geographical distribution; and, under what- ever name it may ultimately be described, it is now found in the lake district of England and in Wales, and (on the au- thority of Yarrell) the C. marenula, Jenyns, must now rank only as synonymous with the Coregonus albula, Linneus.* I am indebted to Sir W. Jardine for an opportunity of ex- amining the stomachs of the two fishes mentioned above, as taken in Bala Lake and Derwentwater, but the result has shown a considerable difference in the nature of the food from those of Lochmaben, arising probably from the season of the year in which they were caught, viz., winter. The stomach of the Derwentwater fish was completely empty, while that of the Bala Lake specimen contained the debris of numerous aquatic insects, such as the larve of tipule, the larve of small water-beetles, most probably a species of Hy- droporus, and the remains of some specimens of the perfect insect itself. The same friend has also kindly supplied me with the sto- machs of two specimens of the common trout from Galloway. Though the fact has long been known that great part of the food of these fish consists of entomostraca, I believe none of the species found in their stomachs have ever been properly ascertained. One of these trout was caught in a small loch in Galloway, and the water at the time was observed to be pecu- liarly prolific in small insects, &c. Upon examining the sto- mach, I found that it contained a mass of entomostraca in all states of decomposition. Many specimens, however, were quite perfect, and I was delighted to find that the species upon which this trout had been feasting was one hitherto unknown to naturalists. The specimens, as far as I could judge, were * See also, upon this subject, Sir W. Jardine’s note to Dr inti 8 paper, in last number of this Journal, p. 350." 24 Dr Baird on the Food of some Fresh-Water Fishes. all of the same species. This little entomostracan belongs to the family Daphniide, and forms a species of the genus Daphnia, or water-flea. I propose the name for it of Daphnia Jardinii. Its distinguishing characters, and which separate it from all other species known to me, are, 1st, The shape of the head, which in some respects resembles that of Daphnia mucronata, Miiller ; and, 2d, The lengthened form of the body and terminal spine of the carapace, which corresponds pretty nearly with the D. longispina of the same author. These two characters, united in the same species, separate it from all others belonging to the genus. The other trout was taken at Barn Hourie, and its stomach contained a mass of entomostraca of a totally different spe- cies. Unfortunately, however, the process of digestion had advanced farther in this trout than in the other, and I was unable to determine the species to which it could be referred. The specimens were numerous, and appeared to be confined to one species alone. It belongs to the family Cypridide, or those entomostraca in which the body of the animal is con- tained within a carapace of two valves, exactly resembling: a small bivalve shell. The carapace, however, from which the specific characters are chiefly taken, was so completely di- gested that no trace of it was left, the only parts remaining being the harder portions of the body of the animal, as its maxille, natatory organs, or antenne, and its feet. From these I was able merely to ascertain that the species belonged to the genus Cypris; but I hope some future time to have an opportunity of examining a trout from the same water before its dinner has been so far digested. Description of Species of Entomostraca. 1. Bosmina Coregont.—Carapax sphericus, valvule, in parte inferiore, rotundate; antenne superiores perlonge, longitudinis corporis toti. Long. $ linea. Hab. in ventriculo Coregoni Willughbii, in lacu “ Lochmaben.” 2. Daphnia Jardinii.—Caput triangulare, vertice mucronato; val- vule carapacis, in dorso, rotundatw, pars inferior mucrone longo termi- nata; pars anterior arcuata. Long. 4 linea. Hab. in ventriculo Sal- monis farionis in comitatu Kireudbright. — TS ee =