Climate and Health in Hot Countries and the Outlines of Tropical Climatology / A Popular Treatise on Personal Hygiene in the Hotter Parts of the World, and on the Climates That Will Be Met Within Them.

by George Michael James Giles

If the inhabitants of infected houses can be induced to migrate for a time into camp, so much the better, as in such cases the enormous additional disinfecting powers of air and light can be utilised by removing, for a time, portions of the tiling or thatch, and it must be remembered also that time alone is also an excellent disinfectant. The danger they run in immediately returning should be clearly pointed out, but if return they will, they must be let do so, as compulsion means opposition, and the benefit of the disinfection to the general community is only lessened by their return in so far that should they fall victims to their own rashness they form fresh foci of infection and the process has to be gone over again. In the case of small compact communities, such as gangs of coolies working under commercial corporations, a more autocratic course of action is, of course, practicable, but should never be carried to such an extent as to bring about organised opposition, and however stupid and prejudiced they may appear to the ordinary European mind, no effort should be spared to obtain the co-operation of the people themselves, and it is in securing this that the personal element of long association and mutual trust is especially valuable.

In spite of the great advances in our knowledge of the disease that have been made during the present recrudescence of the disease, we are still a great deal in the dark on many points, and especially as to the mechanism of infection in the majority of cases. Each year of the progress of the epidemic demolishes some one or other of the few standpoints of certainty that we had imagined as firmly established, and it is evident that some great discovery remains to be made before plague will cease to be, from many points of view, an almost complete mystery.

Small-pox.

Although in no sense a malady in any way peculiar to hot countries, Europeans are necessarily much more exposed to infection among semi-civilised communities, where vaccination is at best only partial, than in Europe; and hence it is well to impress the necessity of efficient re-vaccination on all who have to live among people by whom the blessings of vaccination are, as yet, imperfectly appreciated. Even a single vaccination affords so great a protection that it is rare to meet with fatal cases amongst those who are foolish enough to live in the midst of small-pox without being re-vaccinated, but it is hardly worth while to risk suffering from so revolting a disease, with the chances of disfigurement for life, for the sake of avoiding so trifling an inconvenience as that involved in the little operation. On this account it is very desirable for the intending emigrant to tropical parts to be re-vaccinated before starting, as an inflamed arm is much more troublesome when complicated with prickly heat than it is in temperate climates. In addition to this, it is always wise to submit to re-vaccination whenever an epidemic of small-pox is raging around one. If needless, the virus will not “take,” and you will suffer nothing worse than the trifling scratch involved in the operation. If, on the other hand, it “takes,” it shows that a grave risk would have been run in neglecting the precaution.

Sleeping Sickness.

This peculiar malady has only come into notice of late years, since the opening up of Central Africa, and though it was at first thought to be confined to the negro race, has recently been shown to occasionally attack Europeans. In its early stages, the disease presents many points of resemblance to ordinary malarial fever, and has usually been confused with it, both by patient and doctor; but following this, after an interval of a few weeks or months, certain peculiar nervous symptoms appear, from which the disease has taken its name, and which are mainly characterised by hebetude and somnolence. It would be superfluous, in a work like the present, to enter into any details as to its peculiarities, especially as our knowledge on the subject is at present in its infancy. It may, however, be fairly said that we are almost certain that the disease is caused by certain peculiar parasites (Trypanosomes) that are found in the early feverish stage of the disease in the blood, and subsequently, when the peculiar sleepiness appears, in the fluid that bathes the spinal canal. From the analogy of malaria, as well as from anatomical considerations, it is tolerably certain that the disease is conveyed from one human being to another by means of inoculation through the agency of biting insects.

Further, strong suspicion, approaching moral certainty, strongly points to certain flies, of the class known as horse and cattle flies, as the species that acts as the intermediary. These flies are much more common in tropical climates than they are at home, and are characterised by the peculiar persistency with which they attack an animal, in spite of all attempts to drive them off; and so much is this the case that nothing short of pursuing the insect until it is killed is of any use. They do not, as a rule, invade houses, and it is exceptional for them to attack man, but they will do so occasionally, and the stab they give is so sharp that it is hardly likely to be overlooked.

At present the disease appears confined to Africa, but species of the same flies are to be found in India, and the writer has more than once been bitten by them, though no danger attaches to the incident, as the specific germs of the disease do not occur in that country.

Fig. 14.—Drawing of the fly concerned in the Tsetse, or Trypanosome, disease of horses.