BK media systems
Bennet's Book 1870
Winter and Spring
The Riviera, Mentone, Italy, Corsica, Sicily, Algeria, Spain and Biarritz,
By J. Henry Bennet, MD.
Whoever wishes to investigate medicine properly, should proceed thus: in the first plave to consider the seasons of the year, and what effects each of them produces; for they are not all alike, but differ much for themselves in regard to their changes. Hippocrates (on airs, waters, and places)
To appreciate the medical characteristics of the climate of Mentone, and of the Riviera in general, it is only necessary to weigh the meteorological facts enunciated.
A cool but sunny atmosphere, so dry that a fog is never seen at any period of the winter, either on sea or land, must be bracing, invigorating, stimulating. Such are the leading features of this region – the undercliff of central Europe.
Behind the mountains which skirt the Riviera and the Mentonian amphitheatre, in midwinter, as we have seen, frost and snow may and often do extend up to the north pole, more than two thousand miles. On the other hand, the wind blows from the northern quarters during the greater part of the winter season. The air must, therefore, be cool, and would be cold, were it not, also, for the summer heat stored up in the rocks, and given out by them. These causes keep Mentone free from frost when it reigns all around, but cannot make it a tropical climate.
I selected Mentone as my winter residence ten years ago, because I was suffering from advanced pulmonary consumption. Many of the invalids who have followed my example have laboured under the same dire disease. That the choice was a rational one, will, I think, be generally admitted, on consideration of the facts statet here.
When I first arrived, there were scarcely any strangers, but since I have drawn the attention of my fellow practitioners to the value of this climate as a health resort in chest affections, the foreign population has yearly increased, and numbered last winter (1868-9) fifteen hundred. It contains representatives of most European nations; the English and French, however, have hitherto been the most numerous. Since the translation of this work into German (in 1863) many Germans have made it their winter abode. Our American cousins are also finding their way to Mentone in yearly increasing numbers.
Phthisis is essential a disease of debility. It principally attacks those who have received organizations deficient in vitality from their partents, or who have injured the vitality of an originally good constitution by excess of any kind, or in whom such a constitution has been impaired by over work, or by hardship and privations independent of their own will. In such a disease a bracing, stimulating climate, such as I have described, must be beneficial, and has been most decidedly so, both in my own case and in those of the many whom I have attended. After ten winters passed at Mentone, I am surrounded by a phalanx of cured or arrested consumption cases. This curative result has only been attained, in every instance, by rousing and improving the organic powers, and principally those of nutrition. If a consumptive patient can be improved in health, and thus brought to eat and sleep well, thoroughly digesting and assimilating food, the battle is half won; and the principal benefit of the winter climate of the Riviera is the assistance it gives the physician in attaining this end.
Those who are in the last stage of the disease, on the contrary, appear to derive but little benefit from the change, although I have met with some exceptions to this rule. The malady generally seems to progress slowly but steadily. They suffer from the cold and the wind, and from the occasional outbreaks of wet, chilly weather. Moreover, some feel bitterly the absence of home comforts, and their separation from friends. Some each year drop off in the course of the winter, as they would have done at home. In their case, it appears to me that little is gained, as far as the disease itself is concerned, by the change of climate. They cannot avail themselves of its bracing capabilities for out-door life and enjoyment, and sometimes feel the variations, against which they cannot protect themselves as well as at home. Such patients, in the last stage of phthisis, emaciated, unequal to any exertion, evidently arrived at the concluding stage of their eartly pilgrimage, are, in my opinion, better at home, or in a warmer climate than that of Mentone, or of Italy generally - Madeira, for instance, where the temperature is said never to fall below 56 F.
In some instances, however, of advanced phthisis, in which there is, from the first, but little chance of recovery, the invalids, surrounded by dear friends, are so charmed with the sunshine, with the foreign scenery, and with the vegetation, that it compensated for all their fatigues and trials. Indeed, I have known them rejoice to be under the bright sky of the south, even in the midst of great physical trials. To such sufferers, admirers of the picturesque, mentally alive to the beauties of nature, to the glory of the sun daily careering in a blaze of light through the heavens, to the beauty of the "ever-changing" sea, to the shadows on the mountains, the quiet repose out of doors, all but daily enjoyed, amply compensates for the sacrifices of exile. They descend the valley of death rejoicing, nor can any one, in their case, regret the fatigue encountered in the journey from northern Europe.
Many persons who have always suffered from bronchitis in England are quite free from it at Mentone, owing probably to the dryness of the atmosphere. This remark applies to other similar climates. I have an old friend at Nice, a London physician, now above sixty, who abandoned London many years ago, owing to repeated attacks of winter bronchitis, which at least led to very serious complications. He made a winter settlement at Nice, and, ever since, has there passed the cold season, perfectly free from all bronchial mischief, and in flourishing health. In several instances of this description with which I am acquainted, the attempt to spend the winter in England has been attended with a return of the bronchial affection with its usual severity. It is easy to understand that a dry, bracing, cool, invigorating climate such as I have described, should have a beneficial influence on the respiratory mucous membrane of persons who have still some of the vital power of youth, or some constitutional stamina left. When we add to this, all but daily exercise in the open air throughout the winter, in the midst of magnificient scenery, removal from the cares, anxieties, and duties of ordinary life, pleasant social intercourse with fellow-sufferers and their families, all tuned to the same unison of cheerful and hopeful resignation, we certainly have, united, the hygenic influences calculated to renovate the general health, and thus to arrest the development of tubercular disease. Indeed, I am firmly convinced that a warmer and milder winter climate, only to be found in a tropical or semi-tropical region, is less favourable to the recovery of health in chronic chest disease; - always provided rigid attention be paid to the precautions necessary in a region where the temperature varies so constantly as it does on the shores of the Mediterranean.
The form of asthma which is connected with chronic bronchitis, the emphysematous form, also does well. As its gravitiy depends on the bronchitis, if the latter is improved so is the asthma. I believe, indeed, that many of the pitiable sufferers who present this complication, and who every winter get worse, with the vista before them at home of inevitable aggravation of their disease, might attain all but entire freedom from chest suffering by passing several successive winters on the Riviera. To them, in reality, the health question is as important as it is to the consumptive. This form of asthma gradually leads ot death in those who are advancing in life, and that through a stage of great suffering. I cannot say the same of the spasmodic form of asthma, the form that occurs in childhood, in middle age, at any period of life, apparently of nervous causes. I have known such cases do well, but the majority do not. I presume that the climate is too dry, too stimulating, and I am inclined to think that a moister climate, such as that of Pau, Ajaccio, Palermo, Algiers, or Madeira, would be more likely to suit. I would mention, that to some asthmatic persons the mere fact of living near the sea, or a few hundred yards from it, will make all the difference between severe suffering or perfect immunity, and conversely. At Mentone, therefore, both situations should be tried in case of need.
To live at Mentone, in a large proportion of the houses, is really like living on shipboard; for most of those first built, and nearly all the hotels, are situated on or near the beach. Within the last few years, however, a number of villas have been erected at some distance from the sea-shore, within the ampitheatre, as also two hotels, the Hôtel du Louvre, and the Hotel Beau Sejour. When the sea beats on the shore at Mentone, the spray is thrown inland in the shape of a fine dust-like vapour, which extends fifty or even a hundred feet from the beach, and must be inhaled by those who live in the houses that line the shore. The air coming from the sea is undoubtedly the purest and most wholesome we can possibly breathe.
The very aged, like the very young, seem to thrive in the mild winter climate of Mentone. They can get our constantly, either on foot, in Bath or donkey-chairs, or in carriages, instead of being confined to the house for months, as is often the case in the North. Moreover, they are never exposed to extreme cold, so fatal to old age. Instead of the cold east winds of the spring, which yearly fill the obituary of the Times, there is a truly genial, balmy spring, the spring of the poets.
One important reason why the climate of Mentone and the Riviera is beneficial in all these forms of disease is, that it is seldom, or never, at the same time, cold and wet. When the weather is cold, it is with north wind, and the air is dry. When the air is moist, south wind prevail, and the temperature is mild.
At Mentone the winter temperature in the shade is generally below 60° F, but the air is very dry, and this is no doubt the reason catarrhal affections are rare. Whenever the weather is both cold and damp, colds are caught at Mentone as elsewhere, but they generally die away as soon as the dry sunshine returns, even if the thermometer remains low. Those who enjoy the greatest immunity are those who keep their rooms cool and well ventilated day and night. I may instance the Germans and Swiss, who, accustomed at home to shut every crevice, and to treat the external air as an enemy, generally follow the same plan at Mentone, and suffer accordingly.
One of the most convincing proofs of the healthiness of Mentone is the general absence of severe accidental disease. During my ten winters‘ residence I have seen but very little of the deseases usually met with in the south of Europe – fever, malaria, dysentery, or of any serious malady attributable to external causes. To derive that benefit, however, from the climate of Mentone, it should never be forgotten that in winter the heat is sun-heat, and that the air, barring its influence, is usually cold. Warm clothes and woolen outer garments should be used. In dressing for out of doors, a thermometer, placed outside a north room, should be consulted.
Those who visit the south for the first time often think that summer clothing only is necessary, and that warm clothes and great-coats may be discarded. But summer clothes are useless from December to April. We may take a lesson from the native gentlemen, who, whenever it is not absolutely warm, cover themselves up to the chin with heavy cloaks.
If these rules are not observed, if warm woollen clothes are not constantly worn, and even warm flanel or merino vests next to the skin, rheumatic pains often attack the strong as well as the weak, and more especially those who are advancing in life. Attendance at church is a fruitful cause of rheumatism and colds. If the church is warm, people catch cold on going out. If it is cool, they nearly all come much too lightly dressed for sitting still a couple of hours "in their Sunday best", and often return home with sharp pains, which they try to account for by imaginary draughts. This tendancy to rheumatic pains is not peculiar to the Riviera. It exists, in winter, all over the south and the east, in Italy, in Spain, in Egypt, in Algeria, and even in the desert of Sahara.
A good plan for the invalid is to walk, ride, or drive to one of the many romantic regions in the neighbourhood - to Roccabruna, the Cabrole valley, the Cap Martin, the Pont St. Louis, the Nice, or Genoa Road, or, on calm days, to the picturesque rocky beach - to take the cushions out of the carriage, if driving, with a cloak or two, and to remain sitting or lying in the sunshine, in some spot sheltered from the wind, for two or three hours. The range of observation is thus increased without fatigue, the glorious scenery of the district is seen and enjoyed in its ever-varying phases, and the mind is refreshed by change.
On fine days, when the sea is calm, boats also can be had for a sail or a row, and air and exercise obtained without fatigue. Those who are equal to a sail and a drive the same day, can, according to the wind, sail east or west along the coast as far as Ventimiglia or Monaco, distant, the one seven, the other five miles. They can then land and return by means of a carriage sent on from Mentone to meet them. The view on the mountains thus obtained from the sea is truly magnificient.
The health of the native population is very good, according to my friend, Dr. Bottini. In his work, entitled "Menton et son Climat", Dr. Bottini, who has practiced a quarter of a century in the district, says that the average duration of life is forty-five years, an average far above that of the town population of the south of Europe in general. He also says that a large proportion of the older inhabitants of the districts attain to above seventy years of age. The sick poor are attended by Dr. Bottini and Dr. Farina, both men of ability and much esteemed. They are the medical and surgical attendants of the new hospital, recently errected in the angle of the eastern bay.