Hints to Travellers, Scientific and General, Vol. 2 / Tenth edition, revised and corrected

by Royal Geographical Society

Treatment.—In the case of Heat prostration the patient should be laid in the shade on his back, his clothes should be loosened, his limbs massaged, and, if he is collapsed, stimulants in the form of ammonia or camphor should be administered. The asphyxial type of heat-stroke can only be treated by means of artificial respiration, which may have to be continued for as long as a couple of hours. The ordinary form, which has been called the paralytic type, must be treated promptly and vigorously. One must aim at reducing the temperature, getting rid of the toxic material in the body and preventing heart failure. Probably the best way of treating the condition as an emergency is to lay the patient naked on an inclined plane and drench him with cold water. When doing so it is well to take the rectal temperature, and to stop this chilling process when the thermometer registers 102° F. After the drenching wrap the patient in blankets and apply hot bottles to the trunk and limbs. An ice bag, if available, should be applied to the head, which in any case should be swathed in cold cloths. It should be noted that in the absence of ice, a sheet soaked in cold water or dilute alcohol, over which a draught of air plays, is a useful substitute. A fan may be used to create the air draught. Auxiliary methods of treatment can be efficiently carried out only under medical supervision. As soon as the patient has recovered somewhat, a dose of calomel should be given, followed by salines.

Syphilis.

Syphilis, or the Pox, is an infectious venereal disease, nearly always communicated by direct contagion. The course of the disease is marked by a primary sore, the chancre; early constitutional (secondary) symptoms, and late constitutional (tertiary) symptoms.

In primary syphilis the disease is limited to the part or organ originally infected, and the glands connected with that spot. After an incubation period of from three to six weeks a small painless pimple appears at the seat of infection; it breaks down, and forms a small ulcer from which oozes a little watery fluid. The base of the ulcer and the skin surrounding it are hard like gristle. The nearest glands, usually those of the groin, enlarge and occasionally become tender. Unless badly neglected, the original sore gradually heals and the glands resume their normal size. Secondary symptoms now make their appearance. These are fairly definite, and comprises (a) A skin rash, consisting of numerous irregularly shaped copper-coloured spots, spread over the face, upper part of the chest, the loins and the back of the arms. They do not itch. (b) Moist lumps and warts form in the crutch, around the scrotum (purse) and the outlet of the bowel. (c) Ulcerated sore throat. Large deep ulcers form on each tonsil, having ragged undermined edges. (d) Iritis or inflammation of the eye may also occur. These symptoms, even if untreated, tend to heal, but always leave more or less marked traces behind.

The discharge from either primary or secondary sores is infectious and may convey the disease, so that great care needs to be taken in handling such sores.

After an interval of apparent health, lasting perhaps only a few months, but often for a year or two, the tertiary symptoms or “reminders” make their appearance. These take the form of localised swellings, which soon break down, forming deep ulcers, and if untreated, produce extensive destruction of the part involved, with much deformity.

Prophylaxis.—The methods available are now so well known that they need not be discussed in a work of this kind. Mention need merely be made of the fact that in some foreign countries, owing to unhygienic conditions, there is a greater liability to contract the disease by what may be called unusual methods, and therefore every care should be taken to prevent such sources of infection, as, for example, the contaminated seats of closets, etc.

Treatment.—As soon as the disease is recognised, the treatment must be commenced.

Local treatment.—Keep the sore perfectly clean by washing it with an antiseptic solution such as chinosol (1 in 1000). Between the washings, dress it with a piece of lint soaked in “black wash,” or dust it with iodoform powder and cover it with a piece of lint smeared with boric ointment.