Sunstroke.—In cases of simple exhaustion, ordinary treatment is all that is needed. Removal to a cooler locality, the cold douche (but not too much prolonged), or the administration of stimulants, may be beneficial. Tight or oppressive clothing should be removed, and the patient treated as in syncope from other causes. Rest and freedom from exposure to over-exertion, fatigue, or great heat, should be enjoined. In that form of sunstroke where the person is struck down suddenly by a hot sun, the patient should be removed into the shade, and the douche of cold water being allowed to fall in a stream on the head and body from a pump (or, as in India from the mussuck, or other similar contrivance), should be freely resorted to, the object being twofold—to reduce the temperature of the over-heated centres, and to rouse them into action. Mustard-plaisters and purgative enemata may be useful. If recovery be imperfect, and followed by any indication of injury to the nerve-centres, or by the supervention of meningitis, other treatment may be necessary according to the indications. Much exposure to the sun should be carefully guarded against; and, unless recovery be complete and rapid, the sufferer should be removed to a cooler climate, the most perfect rest and tranquillity of mind and body enjoined, and the greatest care be observed in regard to extreme moderation in the use of stimulants. (Dr. Fayrer.) For prevention, wear light head-gear with good protection to the nape of the neck; let the lining be double, one of green and the other of yellow material, and have ventilation holes at the sides and top.
Common Complaints
Common Complaints:—
Brain worries.—To the broad question, Are people suffering from overwork? Dr. Samuel Wilks, Physician to Guy’s Hospital, would have no hesitation in saying “No.” His remarks on the subject are worth repeating. He proceeds:—“On the contrary, if both sexes be taken, I should say the opposite is nearer the truth, and that more persons are suffering from idleness than from excessive work. Medically speaking, I see half a dozen persons suffering from want of occupation to one who is crippled by his labours. I have, therefore, very little sympathy with the prevalent notion that nervous and other diseases are due to overwork. As regards the community generally, or at least those of its number who come before the medical man on account of their ailments, my belief is that the explanation they offer arises from a delusion; and amongst girls, so far from any studies or other work being injurious, I could instance numerous cases of restoration to health on the discovery of an occupation. Very often, when a business man complains of being overdone, it may be found that his meals are very irregular and hurried, that he takes no exercise, is rather partial to brandy and soda, and thinks it not improper to half poison himself with nicotine every night and morning. The lady in the same way eats no breakfast, takes a glass of sherry at 11 o’clock, and drinks tea all the afternoon; when night arrives she has become ready to engage in any performance to which she may have been invited. When the man of business presents himself, with his nerves really overstrained, he is found to be a man of delicate or actually insane temperament. The rule, however, is that when a patient comes before me with his nerves unstrung, hypochondriacal, and goes through the whole machinery of his body to inform me of its working, previously committing all the facts to paper lest an important one should be forgotten, that man is getting rusty from having no occupation.... We forget sometimes what a formidable machine is the animal body, with its force-producing nervous system. The brain is an engine of many horse power; its energy must be accounted for in some way; if not used for good purposes, it will be for bad, and ‘mischief will be found for idle hands to do.’ It is fortunate that, with many girls, the frivolities of life keep them idly busy, and so, having a safety valve, they are harmless to others and themselves; but let a girl occupy herself neither with what is useful nor with amusement, she falls into bad health, she becomes a prey to her own internal fires or forces, and every function of her body is deranged, as well as her moral nature perverted. Cases of this kind appear to me of the commonest order, and at the same time very difficult of cure, because the mother’s aid can rarely be gained to assist the doctor; but, on the other hand, her sympathies too often only foster her daughter’s morbid proclivities by insisting on her delicacy and the necessity of various artificial methods for her restoration, as well as her resistance to the doctor’s advice for a more natural life, since she is sure it cannot be undertaken. Her daughter is too delicate for any of the occupations or modes of exercise proposed. What she requires is medical attendance, and to be alcoholised and physicked. It is remarkable, however, what a young lady can do under the power of a stimulus—as, for example, a gentleman lately expressed his surprise to me how his daughter, who could not walk many yards for a long time, owing to a pain in her back, was soon able to walk many miles a day when she procured the support of her lover’s arm. It is from considerations of this kind that, when the superfluity of women, amounting to half a million, doomed to be unmated, ask for employment, I cannot deny it to them. The human body is made for work, physical and mental. The amount it can do is of course proportionate to the power of the machine; but, unlike all other machines, its strength is only maintained by use, as assuredly it rusts and decays by disuse. Just as the muscles are better prepared for work by previous training, so the nervous system, whether it be the brain or spinal cord, becomes more energised by use. If healthy and vigorous persons be taken, there appears no absolute necessity for rest at all in the popular sense of the term. The rest required is gained during sleep, during meals, and necessary healthful exercise. It is only during sleep that the brain is actually inactive, although even then not absolutely, for at meals cheerful conversation keeps the mind employed, and even in our walks the attention is fixed on objects around. In times so occupied there are many persons whose minds are never idle, and who yet live to a good old age. Practically they have no rest, for when one object of study is complete, they commence to pursue another. It is by the happy faculty of diverting the powers into different channels that this is accomplished. Instances might easily be quoted of statesmen, judges, and members of our own profession who know no absolute rest, and who would smile at the suspicion of hard work injuring any man. I make it a custom to ask young men what their second occupation is—what pursuit have they besides their bread-earning employment. Those are happiest who possess some object of interest, but I am sorry to say there are few who find delight in any branch of science. The purely scientific man finds his best recreation in literature or art, but even in intellectual work so many different faculties are employed that a pleasant diversion is found in simply changing the kind of labour. For example, a judge after sitting all day, and giving his closest attention to the details of the cases before him, may yet find relief in his evenings by solving problems in mathematics. The subject of overwork, then, is one of the greatest importance to study, and has to be discussed daily by all of us. My own opinion has already been expressed, that the evils attending it on the community at large are vastly over-estimated; and, judging from my own experience, the persons with unstrung nerves who apply to the doctor are, not the Prime Minister, the bishops, judges, and hard-working professional men, but merchants and stock-brokers retired from business, Government clerks who work from 10 to 4, women whose domestic duties and bad servants are driving them to the grave, young ladies whose visits to the village school or Sunday performance on the organ is undermining their health, and so on. In short, and this is the object of my remarks, I see more ailments arise from want of occupation than from overwork, and, taking the various kinds of nervous and dyspeptic ailments which we are constantly treating, I find at least six due to idleness to one from overwork.”
For a long time it has been well known to the medical profession that in various critical states of the human system absolute silence, or the nearest possible approach to it, is not the least important condition to be secured. Accordingly muffled knockers, streets covered with straw or spent tan, and attendants moving about with noiseless step, are universally recognised as the signs and the requirements of severe disease. But the truth that noise is a contributor to the wear and tear of modern city life has scarcely yet been realised by the faculty, not to speak of the outside public. Consequently, while a zealous war is being urged against other anti-sanitary agencies, no general attempts for the abolition of superfluous noise have yet been made. We cannot, perhaps, give anything approaching to a scientific explanation why sound in excess should have an injurious effect upon our nervous system. We feel that noise is distressing, exhaustive. The strongest man after days spent amidst noise and clatter, longs for relief, though he may not know from what. It may even be suggested that the comparative silence of the sea-side, the country, or the mountains, is the main charm of our summer and autumn holidays, and contributes much more than does ozone to restore a healthy tone to the brains of our wearied men of business. Indeed, if we consider, we shall find that this is the most unnatural feature of modern life. In our cities and commercial towns the ear is never at rest, and is continually conveying to the brain impressions rarely pleasant, still more rarely useful or instructive, but always perturbing, always savouring of unrest. In addition to the indistinct but never-ceasing sea of sound made up of the rolling of vehicles, the hum of voices, and the clatter of feet, there are the more positively annoying and distracting elements, such as German bands, organ grinders, church bells, railway whistles, and the like. In simpler and more primitive times, and to some extent even yet in the country, the normal condition of things is silence, and the auditory nerves are only occasionally excited. It is scarcely to be expected that such a change can be undergone without unpleasant consequences.
The question has been raised, why should some noises interfere with brain work by day and disturb our rest at night so much more than other? A strange explanation has been proposed. We are told that sound made incidentally and unintentionally—such as the rolling of wheels, the clatter of machinery (except very close at hand), the sound of footsteps, and, in short, all noises not made for the sake of noise—distress us little. We may become as completely habituated to them as to the sound of the wind, the rustling of trees, or the murmur of a river. On the other hand, all sounds into which human or animal will enters as a necessary element are in the highest degree distressing. Thus it is, to any ordinary man, impossible to become habituated to the screaming of a child, the barking and yelping of dogs, the strains of a piano, a harmonium, or a fiddle on the other side of a thin party-wall, or the clangour of bells. These noises, the more frequently we hear them, seem to grow more irritating and thought-dispelling.
But while admitting a very wide distinction between these two classes of sounds, we must pause before ascribing these differences to the intervention or non-intervention of will. We shall find certain very obvious distinctions between the two kinds of sound. The promiscuous din of movement, voice, and traffic, even in the busiest city, has in it nothing sharp or accentuated; it forms a continuous whole, in which each individual variation is averaged and toned down. The distressing sounds, on the other hand, are often shrill, abrupt, distinctly accentuated and discrete rather than continuous. Take, for instance, the ringing of bells: it is monotonous in the extreme, but it recurs at regular intervals. Hence its action upon the brain is intensified, just as in the march of troops over a suspension bridge, each step increases the vibration. The pain to the listener is the greater because he knows that the shock will come, and awaits it. Very similar is the case with another gratuitous noise, the barking of dogs. Each bark, be it acute or grave, is in the highest degree abrupt, sharply marked, or staccato, as we believe a musician would term it. Though the intervals are less regularly marked than in the case of church bells, we still have a prolonged series of distinct shocks communicated to the brain. All the other more distressing kinds of noise possess the characters or shrillness, loudness, and of recurrent beats or blasts.
As an instance of an undesigned, unintentional noise being distressing to those within ear-shot, we may mention the dripping of water. A single drop, whether penetrating through a defective roof, falling from the arch of a cavern, or issuing from a leaky pipe, and repeated at regular intervals, is as annoying as the tolling of a bell, the barking of a dog, or the short, sharp screams of a fretful infant. The only difference is that the noise is not heard as far. We may hence dismiss the “will” theory, and refer the effects of noises of this class to regularity, accentuation, and sharpness.
It is particularly unfortunate that the multiplication of sound should accompany, almost hand in hand, that increase of nervous irritability and that tendency to cerebral disease which rank among the saddest features of modern life. A people worn out with overwork, worry, and competitive examinations might at least be spared all unnecessary noise. Many persons cannot or will not understand how necessary silence is to the thinker. A friend of the writer’s, engaged in investigating certain very abstruse questions in physics, is often compelled to throw aside his work when an organ grinder enters the street, and suffers with acute pain in the head if he attempts to go on with his researches.
We should therefore propose, as measures of sanitary reform, the absolute prohibition of street music, which is more rampant in London than in any other capital in Europe. The present law, which throws upon the sufferer the burden of moving in the matter, is a mere mockery. Another necessary point is the abolition of church bells. In these days of innumerable clocks and watches every one can tell when it is the time for divine service without an entire neighbourhood being disturbed for some 20 minutes at a time. Nonconformist places of worship collect their congregations without this nuisance. Further, all dogs convicted of persistent barking should be disestablished. And lastly, harmoniums, American organs, and wind instruments in general should be prohibited, except in detached houses. (Journal of Science.)