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

Fig. 15.

Fig. 16.

Useful and Futile Forms of Ladies’ Pith Hats.

It is, of course, of the first importance to get a person stricken by the sun at once into the shade, and as the temperature of the body is rarely excessive in such cases, cold locally applied to the head is of more importance than a general bath, which, indeed, unless carefully watched, is apt to make matters worse, by driving the blood from the surface and so increasing the congestion of the brain and other internal organs. Hence it is better to apply ice to the head and to confine oneself to sponging the extremities as a measure for reducing the general temperature. In climates where insolation is common, there is little risk in getting wet, and hence if no proper ice bag be obtainable the ice, roughly crushed, may be applied to the head, simply tied up in a towel. Anyone who has suffered from even a mild attack of insolation remains for a long time specially sensitive to the effects of the sun, and therefore requires, for a long time, to be especially careful in avoiding exposure. When prolonged exposure to the sun at its fiercest must be braved, as in big game shooting, it is well to protect the spinal column by means of a pad worn outside the coat. Some persons are much more sensitive to the effects of the sun playing on the back than others, and though the precaution cannot be considered universally necessary, no one who feels himself inconvenienced by the effects of the sun on this part of the body should neglect the warning and fail to provide himself with a suitable protection. The usual plan is to have made a pad, cut to the shape of the back piece of the coat, of quilted cotton wool, covered with the same material as that of the coat and secured by buttons suitably placed.

The third form of “stroke” is that of heat, and appears to be due simply to the inability of the regulating powers of the system to keep down the temperature of the body to the normal level.

Unlike true sunstroke, it nearly always occurs at night, when the resisting powers of the organism are reduced to their minimum, and mostly under conditions in which the sleeper has inadequate air room, such, for example, as in crowded barracks and closely-packed railway compartments. Such cases may possibly occur, but personally I cannot recall an instance of this accident occurring to persons sleeping in the open air. Every year one reads in the Indian press of persons being taken dead out of railway carriages, and perhaps of a number of cases occurring simultaneously in a single barrack, but with adequate air space such an occurrence is, to say the least of it, exceptional.

At the same time, it is just in the hot “stuffy weather of a break in the rains,” when it is always on the cards that it may rain before morning, that such cases occur, and apart from the traditional danger of sleeping outside a room during the rains, one is naturally loth to risk a ducking. Given, however, adequate shelter from rain, there is no danger whatever from sleeping in the verandah at such times of the year, always provided, of course, that protection against infected mosquitoes is assured by a carefully tucked-in mosquito net, and when the atmospheric conditions are such as to involve risk of heat stroke, I personally prefer to sleep on the roof, under the shelter of the top of a tent, or of a special thatch shelter consisting of a roof without sides, or at most with one lateral wall to windward, when there is a probability of a driving rain falling during the night. As a matter of fact, under atmospheric conditions of this sort, one is unlikely to take much harm even if one does get damp, and the admittedly enhanced danger of malaria can be entirely obviated by means of mosquito curtains.

Till lately we heard nothing of the danger of anything worse than itching being connected with mosquito bites, and naturally those who were callous enough to popular notions of safety to sleep outside the house in the rains were about the last folks in the world to trouble themselves about the tickle of a mosquito bite, and became “moral examples” by contracting fever accordingly. During periods of great heat, especially if combined with dampness of the air, under which conditions heat stroke is likely to occur, severe muscular exertion should be avoided as far as possible; a light, mainly vegetable, diet adopted, and the amount of stimulants taken should be very limited, though it is a great mistake to limit fluids of other descriptions, and tea taken very hot is often useful and refreshing. Care should also be taken not to allow oneself to become constipated, and speaking generally it should be recognised that under the extreme climatic conditions that bring on heat stroke, the European must live cautiously if he wishes to come out of the ordeal unharmed.

In this form of the disease the temperature of the body is always high, 103° to 107° F., and the stupor deep and prolonged. Should you have to do with a case in the absence of medical assistance, every effort should be made to reduce the temperature of the body, the most efficient means being to place the patient in a full length bath. As a rule, under such conditions, the temperature of the water obtainable is too near that of the body to bring down the temperature sufficiently rapidly, and pieces of ice require to be added to obtain sufficient cooling power. The patient should be kept in the bath until the temperature (taken in the mouth) is restored to the normal level of 98°-99° F., after which he may be removed; but in serious cases the temperature shows an obstinate tendency to go up again, and it is generally necessary to keep it down by continuous sponging, applied especially to the extremities. If, in spite of these measures, it still continues to rise, the bath must be again resorted to. If ice be unobtainable wherewith to cool down the bath, the want of it should, as far as possible, be met by dipping out the water warmed by contact with the patient’s body, and replacing it with freshly-drawn water as cool as may be obtainable. It is well also to try to relieve the bowels by placing 5 grains of ordinary powdered calomel on the tongue, which will ensure its being gradually swallowed, even in the deepest coma, and every effort should be made to keep down the temperature of the air of the room, always provided that the freest possible ventilation be kept up.