according to our constant experience, a bruit de soufflet in the course of the artery.

If the pain be connected with the upper or thoracic dorsal vertebræ, and be owing to aneurism, it seldom occurs that there is not some difficulty in deglutition, or some obstruction in the respiratory apparatus, either affecting the trachea, and so weakening the respiration in both lungs, or exercised upon either one bronchus or upon one lung, and so producing a difference in the relative form of the respiration in the two lungs. In the absence of the bruit de soufflet (which we have almost always found absent in thoracic aneurism, except where the valves of the aorta were involved in the disease), some one of these symptoms will generally be present to confirm the value of the pains.

The character of the pain consists in a constant, aching, boring sensation, and a sharp, lancinating pain.

To relieve the agonizing pain of aneurism, there is scarcely a limit to the amount to which we may exhibit opium, without producing narcotism.

In the treatment of aneurism, low diet should be avoided, as lessening the prospect of a radical cure of the disease, and as increasing a nervous irritability,-the constant accompaniment of it.

The interval between the fatal termination and the bursting of an aneurism is various, and is much influenced by the importance of the organs which the hæmorrhage may affect. If it burst into the pericardium, and compress the heart, such interval will, of course, be shorter than if it compress a less vital organ. If there have been an adhesion between the laminæ of the pericardium the effusion will be more gradual, and therefore the interval will be longer than if no such adhesion existed, as we have proved by experience. The suddenness of the fatal termination would seem to be in proportion to the extent and suddenness of the hæmorrhage, and the importance of the organ or organs, whose function may be mechanically interfered with by the effused blood.

ART. XI.-Observations on a peculiar nervous Affection incidental to Travellers in Sicily and Southern Italy. By J. HUNGERFORD SEALY, ESQ., M.D., A.B., late Resident Physician at Florence, Messina, &c.

THE peculiar disease which I am about to describe I had frequent opportunities of witnessing during my residence in Sicily and Southern Italy.

the

It is characterized by an excessive irritability, attended with extraordinary mental and muscular activity, and seldom attacks new comer, but more frequently those who have been resident between two and three years, and not yet acclimatized, and just beginning to suffer from nostalgia. In it, a consciousness of disease exists, which is incapable of being expressed, and the mind is disturbed by visions, which the sufferer is almost ashamed to avow; the imagination is morbidly awakened, yet the mind of the patient is still under the control of judgment, yet with scarce a capability of obeying its dictates.

Having suffered much from it myself, and witnessed it in all its stages in others, varying, indeed, from the sublime of fearful, as I saw it in the case of an English clergyman at Messina, to the ridiculous of absurd nervous fancies, in those not previously subject to such hallucinations, I consider myself peculiarly qualified to offer a few remarks on it, which I hope may prove serviceable to travellers in the countries of which I shall treat.

That it is a disease of climate I am well convinced, and that all are more or less liable to it in visiting those countries, my experience has assured me. The modifications of it are, however, great, and the grades various, from slight excitability to serious and formidable disease, affecting the mind and body; it consequently behoves every traveller to be particularly cautious of his diet and general health, and to observe carefully his impressions and sensations, to guard against this insidious and formidable enemy, and, by attacking it at the commencement, overcome it effectually.

To the travellers in Rome, Naples, and Sicily these obser vations will peculiarly apply.

That it has not hitherto been sufficiently noticed and described, my acquaintance with the literature referring to Italy and Sicily assures me. In fact, little or no notice is taken of it by any of the writers on climate with which I am acquainted, such as Clarke, Johnson, &c.

It seems a hyper-elimination of the nervous principle, a peculiar elastic evaporation, if I may so express it, of a spiritual consciousness and capability, aroused by electrical agency or invisible atmospheric influence.

The imaginative and the sanguineo-nervous temperaments are peculiarly liable to it, and suffer much during the prevalence of the Scirocco wind, particularly at Rome and Palermo, and at Naples and Sicily, when the atmosphere is charged with electricity, or when thunder is brewing, as the vulgar phrase is, and particularly during earthquakes in Sicily.

That all should experience excitement in that elastic atmosphere is little to be wondered at. It forms a considerable part of the charm of travel and climate; it is, however, when that excitement becomes excessive and permanent that it requires consideration and control. No one, I believe, has ever crossed the Alps without finding in himself a sense of elasticity on the Italian side different from the more cloudy atmosphere of the Swiss mountains; and how much more is that experienced on first landing in Naples or Sicily, supposing that the traveller has come by sea. He must be indeed a dull clod of unimpassioned clay who would not feel excited beside the tombs of Tasso or of Virgil, or seated on the rock of Scilla contemplating Sicily. In fact, the impression of vigour is so great, as a plain, unimaginative London gentleman expressed himself to me, as we strolled in the Marina, at Messina, together, that he felt as if " he wished to knock down every one he met," and although a man of a sobered time of life, and, I have reason to believe, quiet habits in England, he became so excited to mirth, as to

be almost unbearable, and this without the smallest assistance from internal stimulants. The extraordinary rarity of the atmosphere contributes much to this, the force with which impressions are conveyed to the senses; in fact, in Sicily the air is so attenuated and transparent that distance seems almost annihilated, and sounds come on the ear with appalling force; the perpetual ringing of their church bells, and the firing of their gioco di fuoco on fete days, is enough to startle the best strung nerves; and the perpetual roaring of their criers about the fish-stalls is truly horrifying. The noises both at Naples and Messina, where the slightest sound is audible, from the tenuity of the atmosphere, is appalling; and yet, curious to say, the natives do not appear to mind it, although they all seem much alive to nervous impressions, which the restlessness of their motions indicates: you never see a Neapolitan or a Sicilian at perfect rest, he is always either twisting his cane or shaking his leg, or contorting himself in some way or other, but absolute rest seems incompatible with his existence. This same excitability the English traveller feels more or less, according to the character of his nervous system.

Some portions of Italy, however, possess this influence much more than others. The difference between Rome and Naples, in that respect, is very striking, and the locality it is, doubtless, which so influences the appearance and habits of the inhabitants. The difference between the two cities may be thus summed up, as regards the stranger. At Rome you are pleased, at Naples you are amused; the hypochondriac is rendered worse at Rome, at Naples he is debarred from gloomy thoughts by the multititude of animated objects around him: the Toledo at Naples is a perpetual Roman Carnival. At Rome you derive your gratification from inanimate objects, and from your own reflections. At Naples you have no time to reflect, your mind is amused and engaged by others; it is a varied and amusing panorama; the gait of the Roman differs from that of the Neapolitan, it is VOL. XXV. No. 74. 2 P

more slow and solemn. The Corso at Rome and the Toledo at Naples, may be compared to St. James and the Strand, in London.

While resident in Florence several cases of this nervous affection presented themselves to me, affording curious, and some of them most amusing traits; but the severest form I ever witnessed of it was in Messina in Sicily, which I shall here relate, omitting merely the name, as the exceeding peculiarity of the mental symptoms of the patient, a talented and most respected clergyman, may render it painful to him to have revived those recollections of the awful times in which I attended him, should this ever meet his eye.

Having arrived at Messina, by steam packet, from Naples, and aware that there was no resident English physician in the island, I was shortly after my arrival waited on by a gentleman, saying, that their resident clergyman was dangerously ill, and requested my immediate attendance, that they had written to Malta for one, the English merchants of the town being in the greatest state of alarm about him, and that they had been most anxiously expecting the arrival of some ship containing one; that the town was quite in a ferment about him, the Church of England Service having been suspended for some weeks. In as short a time as possible I made my call. I found the gentleman in bed, his countenance was haggard and wretched, his eyes glaring out of his head, and deeply suffused and bilious; his skin was dry and parched, and almost verging on the icteroid tint; his tongue was dry, and red at the edges, and covered with a brown fur in the centre and back portion; his pulse was small and quick; and his general expression denoted the deepest misery and suffering, although his mind was perfectly clear. On inquiry, I found he had been ill three weeks, during which time he was under the care of a Sicilian physician, and was gradually getting worse. On inquiring what medicine he had taken, he said very little, and that not of a purgative character, although