THE CLIMATE OF ST. MORITZ, UPPER ENGADINE, SWITZERLAND. BY WALTER B. PIATT, M.D., F.R.C.S. (Eng.), OF BALTIMORE. REPRINTED FROM THE TRANSACTIONS OF THE AMERICAN CLIMATOLOGICAL ASSOCIATION, MAY 31, 1887. PHILADELPHIA: WM. J. DORNAN, PRINTER. 1 888. THE CLIMATE OF ST. MORITZ, UPPER ENGADINE, SWITZERLAND. BY WALTER B. PLATT, M.D., F.R.C.S. (Eng.), OF BALTIMORE. REPRINTED FROM THE • TRANSACTIONS OF THE AMERICAN CLIMATOLOGICAL ASSOCIATION, may 31, 1887. PHILADELPHIA: WM. J. DORNAN, PRINTER. 1888. THE CLIMATE OF ST. MORITZ, UPPER ENGADINE, SWITZERLAND. By WALTER B. PLATT, M.D., F.R.C.S. (Eng. ), OF BALTIMORE. In bringing St. Moritz, a Swiss village in the Upper Engadine Valley, to your notice as a health resort, the writer is aware that it is well known in a general way to be a " good place for consumptives," as it is termed. How good, what other patients and diseases are likely to receive benefit, and in what way, are questions we shall attempt to answer. Where there are a number of places at which a certain class of invalids improve or recover, an intelligent choice of one locality rather than another, often depends upon the distance, or the total relative expense of getting and living there. To discuss the climate of St. Moritz with- out regard to the other conditions necessary to make it habitable, not to say endurable, would be as much out of place before this Association, as a relation of the climate of the planet Mars. If one cannot eat, sleep, and be reasonably diverted, time were worse than wasted to speak of the rain-fall, the temperature, and the dry atmosphere. The Engadine is a narrow valley, fifty-seven miles long, which varies from one to two miles in width, and runs northeast and south- west. It is situated in the southeastern corner of Switzerland, close to the Italian frontier. The valley is bounded by two parallel mountain ridges, and nearly twenty shorter valleys open into it. The Upper Engadine interests us chiefly, as in the lower part of this, is St. Moritz. The extreme Upper Engadine has a climate which has been compared to that of Finland in its very short summer, and long, very cold winter. The mean height of the upper valley is 5500 feet above the sea, while St. Moritz itself has an elevation of about 6000 feet. We say about, because the upper village, the most desirable part of the town. 4 PLATT, is 6100 feet above the sea level, while the " baths," half a mile distant, lie in the plain, 300 feet below. The Inn river flows along the valley, widening in three places into as many beautiful lakes half a mile to two miles long, and two to three miles apart. Many visitors row or are rowed on the one at St. Moritz. This Upper Engadine Valley is one of the three highest valleys in civilized Europe. The two mountain ridges, as well as the many peaks which shut in the Engadine, are covered even in summer with snow almost to their bases, while eight or ten miles distant are two of the finest glaciers in Switzerland easy to visit, and one of them quite safe to follow without a guide. These little matters of topography have a double interest, as affecting the temperature, and affording a great variety of interesting excursions, long or short, difficult or easy. The writer has visited the Adirondacks, and Southern Georgia, Montana, the Yellowstone region, and Colorado, besides other parts of Switzerland, and believes the climate of Engadine to have peculiar advantages. Everyone who has been there can agree with Dr. Burney Yeo, of London, who says: " The air is perfectly pure, clear, dry, and bracing," and one feels what is usual at high elevations, the desire and ability to walk considerable distances without fatigue. Caution is especially necessary at first, not to overdo this matter of exercise. In summer more or less rain may be looked for in one day out of three. Yet fog is very unusual, although far from uncommon in many other Swiss valleys. The season begins June 15th and lasts two and a half months. Phthisical patients who have considerable natural vigor, and who have taken fair care of their health, may arrive June 1st, and remain until November. October is a delightful but cool month, and September is, on the whole, pleasanter than August if not as warm. Heavy snows begin about November 10th, and the ground is, after this, never free from snow until the end of April. A record of the temperature kept for eight years, and quoted by Gen. George B. McClellan (who spent some time at St. Moritz), taken at 7 A. m. and 1 and 9 p. M, for the four months of June to September inclusive, showed a mean of 50.72° F.s and a daily mean variation of 12° F. For a period of seven years the lowest temperature observed in the same months was 32.5° F., and the highest 77.9° F. Toward the end CLIMATE OF ST. MORITZ 5 of October the weather begins to be quite cold, and on one occasion skating began October 25th. We may look at St. Moritz as a summer resort, as a place for winter residence, or in regard to its waters and baths. It is chiefly as a summer resort that it is desirable for tuberculous patients, although numbers do remain, with decided benefit, through the winter. The advantage of the summer climate is a pure, cool, dry air; there is little or no dust, and the Alpine quiet is very grateful to the patient from town. The disadvantage is, that the daily variation of the ther- mometer may be considerable. The early morning is cold, the noon- day often more than warm, but the early evening is very agreeable. Changes which would be unpleasant in another, damper climate, are of far less consequence in this dry air; in fact, people do not readily "take cold," although acute pulmonary disease, pneumonia, and pleurisy, as well as chronic rheumatism do occur in the acclimatized. Whether this region can suit people with delicate lungs, is answered by the fact that a large number do well physically, and enjoy them- selves at the same time. During the winter of 1882-83 over fifty guests remained at the Kulm Hotel, and some of them spoke to me enthusiastically of the pleasure of the past cold weather, which was spent in skating, sleigh-riding, and coasting. Two to three feet of snow, and several feet of ice on the lakes is the rule in winter. One agreeable feature of St. Moritz is the fact that, relatively to the well people, but few sick are concentrated in one hotel. This is an advantage appreciated by those who have seen in other places rows of consumptives looking at each other's tongues, feeling one another's pulses, counting coughs, and taking their stimulant in concert. There are few other trees than pines and larches in the vicinity of St. Moritz, but the flowering plants are marvellous in their variety and color. I have never seen a valley where the meadows and moun- tain slopes seemed so completely covered with flowers as in the Upper Engadine. Many of them are species peculiar to these altitudes, and quite new to the stranger looking for health or pleasure. • As to the food and hotel accommodations, the best is excellent, and the good very fair. Most of the provisions consumed are brought over the mountain passes from Chur, and, strange to say, it does not make the cost of living excessive, since this is less than in many other places in Switzerland. The Kulm Hotel is undoubtedly the best place to go (1883). Here one finds the table, the rooms, and the service good. Moreover, the 6 PLATT, house has a glass-covered corridor where one may breakfast or walk, when it is too cool or too wet to go out of doors. There are, of course, smaller hotels and some excellent pensions in the upper town (for this is the only part of St. Moritz desirable as a residence). Near the baths, 300 feet below, are also a number of hotels frequented mostly by conti- nental visitors, who attach great importance to the waters. The drain- age of the upper town could hardly fail to be good, if given a chance, since the handful of houses making up the village is placed on a steep hillside, which has been made habitable by terracing. The natives are thrifty, peaceable Swiss, who speak a Romance dialect called Ladin, which is believed to resemble closely the ancient spoken Latin. The country is entirely safe for ladies to walk about alone, indeed, one rarely meets or sees anyone off the highway except the summer visitors. There are several resident physicians, both Swiss and English, as well as one or two good apothecaries, so that patients need have no fears about medical attendance. The chief diversions in summer are walking, dining, rowing, or tennis. The Italian boundary is but a few hours distant, an easy walk for a well man, over a fine road and through a beautiful country. Parties are made up almost daily to visit the glaciers or lakes. A word or two about the waters. There are two springs at St. Moritz, very similar in character, both are cold, having a temperature of 40° F. Both contain comparatively large amounts of calcic car- bonates, small quantities of iron, and considerable carbonic acid gas. Their actual value will never be settled until the old dispute is ended about the comparative virtues of the air and water. I believe the waters may do serious damage when drunk cold, and in large quantity indiscriminately. They are doubtless of benefit in suitable quantities in anaemia, chlorosis, and neurasthenia, but of doubtful use, or else injurious in chronic pulmonary disease. As far as the waters go, patients would do better to visit some other European chalybeate, since there are many, such as Schwalbach and Pyrmont, richer in iron and yet well borne. One of the springs at St. Moritz to which public attention was first directed by Paracelsus, was subsequently named after him, and its virtues have been exaggerated ever since. For suitable cases Dr. Burney Yeo suggests the probable advantage of a course of the waters at Tarasp in the Lower Engadine, or at Homburg, where the waters CLIMATE OF ST. MORITZ. 7 are aperient as well as chalybeate, and later to take the water for a few weeks at St. Moritz, where it has the latter quality only. Women at about climateric period are apt to do well at St. Moritz. How much the water by itself accomplishes is problematical. The baths, which are taken industriously by the Germans, are cer- tainly refreshing. The tubs are of wood, narrow, and coffin-shaped. The patient being fairly in the tub the lid is put on, leaving only his head out. The water has been previously warmed, and the carbonic acid gas now accumulates in myriads of minute bubbles on the cooler skin of the patient. These finally escape, causing a reddening of the body-surface, and an agreeable prickling sensation, decidedly sedative in its effect upon nervous cases. The kind of patients most likely to receive benefit by a residence of some months at St. Moritz are cases of early, slowly progressing tuber- culosis, where the cough is moderate, range of temperature low, and the strength tolerably well preserved. Particularly are young men apt to do well who have a good frame and physique, and who seem to develop tuberculosis by accident, as it were, and whom nature did not seem to build for the especial purpose of destroying by phthisis. Plucky girls, who are fond of out-of-door life, full of resources, and who have but recently begun to fail in appetite, and cough, are likely to receive benefit also. Cases of fibroid phthisis do exceedingly well. The general effect of the air is that of a tonic. Patients eat or sleep better; the cough is less, as a rule, and some recover. It is absolutely impossible to make general recommendations apply with certainty to individual cases. Whether the bacilli in the sputa are less I do not know. The dimi- nution of bacilli in the sputum of a given patient, after a reasonable time, will doubtless be the ultimate test of the curative value of a health resort. It is now well known that altitudes above 1500 feet are not neces- sarily useful in proportion to their height above the sea-level. Davos Platz, for instance, an excellent place for some cases, as far as climate is concerned, is considerably lower than the Engadine. It is said to have certain disadvantages in other respects not to be underrated. As before stated, patients who have led a sedentary life, dyspeptics, neurasthenic cases, and pale, fat, catarrhal women, are almost sure to improve. Those who ought not to come to St. Moritz are elderly people, who are not strong and tough. Moreover, patients with insufficient hearts, 8 PLATT, CLIMATE OF ST. MORITZ. whether they are dilated or fatty or have valvular lesions. These car- diac cases ought not, of course, reside at high elevations anywhere. Some insomnia is often caused in neurotic individuals for the first few nights of their stay, which may be occasioned by the low atmospheric pressure, the cool rooms, the perfect silence, or all three combined. The cost must be counted in the pursuit of health as well as of pleasure. $160 will transport one person with comfort from New York to St. Moritz, allowing five to six stops of a day each on the way after leaving Liverpool, and taking sixteen days for the entire journey. Before June 15th the rates for board and room at the best hotel (the Kuhn) are (or were) about $10 per week for room with board. During the season room and board are separate, and will amount to $15 to $20 or more. September 1st the old terms are resumed, or special rates can be made. One ought to take many things into consideration before sending a patient alone to the Engadine. His strength, his purse, his courage, and social position. As to the latter quality, we may say, in passing, that the visitors at the best places in Upper St. Moritz are very com- panionable, as a rule, and are made up of the so-called better classes from England and America. For a beginning case of consumption in a young man, we might expect that a long sea voyage, followed by a spring at Aiken, S. C., and a summer at St. Moritz, would be of the greatest benefit. Some others would do better to winter at Nassau (W. I.), and summer at St. Moritz. We believe that for certain patients the best European health resorts are far more likely to be beneficial than are the best in America. I refer, as a difference, to more agreeable ways of mental occupation and diversion. And this for some is a matter of no small moment.