CALIFORNIA AS A WINTER RESORT FOR 
INVALIDS. 
A. C. W. BEECHER, M.D., 
THE season is approaching when the physician 
is asked where certain ot his patients shall go 
to avoid the inclemency of a Northern climate, or, 
the physician himself is constrained to recommend, 
advise, and even urge the departure of his patient, 
often without serious consideration of the conven- 
ience, comfort, or the expense. 
Few questions are more important to decide, or 
require more discrimination, than that of advising 
patients to go away and the indication of where they 
should go. This is particularly applicable in the 
case of the sufferer with confirmed pulmonary dis- 
ease, notably phthisis. 
I believe few physicians (comparatively speaking) 
are personally familiar with the localities or regions 
to which they send their patients. There is, perhaps, 
a reasonable excuse for this condition—lack of means, 
time, or disposition, or all of these, and so are de- 
pendent upon the reports of others for whatever of 
information they may have of them. 
It is the fate of the physicians—and particularly 
those in large cities—to receive from time to time 
circulars, pamphlets, and books upon various places, 
lauding their advantages as health resorts, giving 
barometric, thermometric, and hygrometric tables, 
which are generally meaningless, so far as anything 
can be derived for practical use. 
I believe that nothing but a personal visit can give 
the desired knowledge. Not of a day only, but suf- 
ficient to observe the climate and surroundings, and 
preferably during the season which it is most desira- 
ble for the patient to avoid at home. 
The many places recommended for invalids of the 
same class are apparently so diametrically opposite 
in what would naturally be regarded as desirable, as 
to appear incongruous; the extreme cold of the Dakota 
winter being regarded as health-procuring as the more 
moderate temperature of Southern California, and is, 
perhaps, in some respects, more advantageous. For the 
patient, sick with whatever disease, who is able to 
travel, stop a longer or -shorter time at a place, and 
then move on at will, a trip is perhaps better than a 
prolonged sojourn in one locality; but the patient who 
is far advanced in an incurable disease should never 
be sent away from home ; and I hold that a physician 
is censurable, if not more, who would advise the 
contrary, unless the patient’s family decide to make 
a home in a recommended locality. For in that way, 
and only in that way, will the invalid have home 
comforts ; and it is the deprivation of these comforts 
that shortens the life. 
A personal friend, who had spent some winters in 
the Bermudas, once wrote to me, saying: “In the 
name of humanity, keep your consumptives at 
home ! ” This expression was made from observa- 
tions of invalids who had, by recommendation, sought 
the climate of those islands, “who, either in their 
rooms or in the damp and chilling corridors of the 
hotel, shivered and coughed their lives away, suffer- 
inggreatly ere death relieved them.” 
PHILADELPHIA, PA. It is nrot sufficient to recommend or regard a place 
as suitable for invalids because the temperature does 
not reach the extremes of heat or cold as they are 
found in the Eastern and Northern parts of our coun- 
try, nor that tropical plants grow and the trees are 
ever green. It is a noted fact that cold winds of the 
Southwest are more penetrating and unbearable than 
to be found in the North, even in the most inclement 
.period of a Northern winter, and that because the 
bouses are not built to resist, and no provisions for 
heating the rooms. 
Southern California ! Oh, how delusive ! The 
land of perpetual sunshine, flowers, orange groves, 
vines. Elysian fields; no storms, no sweeping, chill- 
ing winds, no need for stoves or furnaces. 
The poor invalid, filled full of hope, leaves home 
to seek this great natural sanitarium, a journey of 
perhaps 4,000 miles, arrives weary and exhausted, 
but with brightened eyes looking out upon the luxu- 
riant green grass, orange blossoms, and fruit on acres 
upon acres of trees, feels thrilled with the idea that 
here there is no snow and ice, here the warm and 
genial temperature will enable the eye to feed on 
beauty, the lungs to breathe a softened atmosphere ; 
but woe to the unfortunate who is not provided with 
good, warm clothing, for the temperature (because it 
does not reach the extremes, because the tropical 
plants remain out during the entire year) does not 
admit of indulgences in summer garments. 
Sleeping may be done at most any time under 
comfortables and blankets. The houses or hotels 
are not generally heated, nor is there any general 
provision made for the heating of apartments to 
combat an emergent cold snap or the chilly evenings 
which are frequent; it becomes a case of “go to bed 
to keep warm.” 
In the last of May, 1890, in the city of Los Ange- 
les, Cal., I saw ladies wearing fur shoulder capes, 
and I personally experienced the comfort of my win- 
ter clothes, which I had not discarded, excepting a 
light overcoat instead of my heavy one. A beauti- 
ful, charming, and attractive place, palm-trees and 
century plants planted in the ground along the curbs 
in some parts, towering and luxuriant eucalyptus, 
orange orchards and evergreens at almost every 
hand, and flowers everywhere, pleasing to the eye, 
making a picture hardly to be seen elsewhere in the 
United States. Smaller adjacent places are said to 
be even more beautiful, and the temperature delight- 
ful to those who are merely run down from close 
application to business, or those who are completely 
convalescent from prolonged sickness ; but to the 
invalid afflicted with incurable disease or organic 
disease of the lungs, I can readily understand he 
will be worsed instead of bettered, and is fortunate 
if he have strength enough to get home to die among 
his friends. 
In a conversation with a lady long a resident of Los 
Angeles, and whose posi tion brought her somewhat into 
relation with the traveling public, I expressed my sur- 
prise that this place had such a great reputation as a 
winter resort for invalids from the North and East, 
when she stated that the inhabitants regarded Los 
Angeles as a summer resort rather than as a winter 
resort; in other words, that summer was the proper 
season to visit this place. She also gave me some of 
her observations of some of the cases which come for 
health borne from the cars on a litter; borne to the 
cars in a coffin. Hopeless from the first; hopeful to 
the last; chilled, dying, dead ; away from home and 
the comforts only to be gotten there ; among strangers 
who are mercenary even though humane. The region 
of perpetual fruits, flowers, and evergreen trees,means 
to the invalid, no ice, no snow, no shiver from cold 
and chilling winds, siveet and balmy atmosphere, gen- 
tle repose—often a complete delusion. Warm, woolen 
clothing always advisable, and outside wraps should 
be at hand. I would earnestly recommend to the members of 
the medical profession, as far as possible to familiarize 
themselves with the health resorts ; their advantages 
and disadvantages ; their fitness or unfitness for par- 
ticular classes of cases ; and, under the most favor- 
able considerations, to weighiwell the advisability of 
sending any confirmed invalid of the class contem- 
plated in this paper, i. e., pulmonary disease, away 
from his home. 
California is a marvel in what it contains of varie- 
ties of climate ; from the torrid temperature of the 
Colorado deslert to the snow peak of Shasta. To the 
person in health, or recovering from disease, there is, 
perhaps, no State in which so much variety can be 
obtained, invigorating and health producing. 
P. S.—Since writing the above it has been my plea- 
sure to receive from Dr. T. D. Myers, of Philadel- 
phia, his valuablelpaper entitled, “Some of the Pecu- 
liaritiesof the Climate of California, and their Relation 
to the Treatment of Consumption of the Rungs,” in 
which I find complete confirmation of the opinions I 
have expressed, only that his conclusions are the re- 
sults of several years of personal observation, and, 
therefore, much more extended and valuable, and 
take the liberty of quoting from it the following : 
“The difference between thesun-hineand the shade 
is very striking during the winter months. The sun- 
shine is that of the semi-tropics, while the tone and 
coolness of the air corresponds pretty nearly with that 
in the White Mountains in New Hampshire in early 
autumn. This wide difference between sunshine and 
shade is one of the strongest factors in limiting the 
class of consumptives who may go to Southern Cali- 
fornia during the winter with a reasonable hope of 
benefit.” 
1S16 Diamond street.