MECHANICAL COLD.
The third element in the action of cold is more purely mechanical, and this, though in a sense secondary, is of immense import. When any body, capable of expansion by heat, that is to say, by radiant motion of its own particles, is reduced in temperature, it loses volume, contracts, or shrinks. The animal body is no exception to this rule; a ring that will fit tightly to the warm finger will fall off the same finger after exposure to cold. The whole of the soft parts shrink, and the vessels contract and empty themselves of their blood. Cold applied to the skin in an extreme degree blanches the skin, and renders it insensible and bloodless, so that if you prick it it does not bleed, neither does it feel. In cases where the body altogether is exposed to extreme cold this shrinking of the external parts is universal; the whole surface becomes pale and insensible; the blood in the small vessels superficially placed is forced inward upon the heart and vessels of the interior organs; the brain is oppressed with blood; sleep, or coma, as it is technically called, follows, and at last life is suspended.
In exposure to the lowest wave of temperature in this country these extreme effects are not commonly developed; but minor effects are brought out which are most significant. In particular, the effect on the lungs is strongly marked. The capillary vessels of the lungs, making up that fine network which plays over the computed six hundred millions of air vesicles, undergo paralysis when the cold air enters, and in proportion as such obstruction from this cause is decisive, the blood that should be brought to the air vesicles is impeded, and the process of oxidation is mechanically as well as chemically suppressed. The same contraction is also exerted on the vessels of the skin, driving the blood into the interior and better protected organs. Hence the reason why on leaving a warm room to enter a cold frosty air there is an immediate action of the visceral organs from pressure of blood on them, and not unfrequently a tendency to diarrhoea from temporary congestion of the digestive tract. Three factors are at work, in fact, whenever the low wave of temperature affects the animal body; abstraction of heat from the body, beyond what is natural; arrest of chemical action and of combustion; paralysis of the minute vessels exposed to the cold.
COMBINED EFFECTS.
We cannot view the extent of change in the organic life induced by the low wave of heat without seeing at once the sweep of mischief which exposure to the wave may effect. It exerts an influence on healthy life in the middle-aged man, and I know of no disease which it does not influence disastrously. Is the healthy man exhausted, it favors internal congestion; has he a weak point in the vascular system of his brain, it renders that point liable to pressure and rupture, with apoplexy as the sequence; is he suffering from bronchial disease, and obstruction, already, in his air passages, here is a means by which the evils are doubled; has he a feeble, worn-out heart, it is unable to bear the pressure that is put upon it; has he partial obstruction of the kidney circulation, he is threatened with complete obstruction; is he indifferently fed, he is weakened generally. It is from this extent of action that the mortality of all diseases runs up so fast when the low wave of heat rolls over the population, affecting, as we have seen, the feeblest first.
Another danger sometimes follows which is remote, but may be fatal, even to persons who are in health. It is one of the best known facts in science that when a part of the surface of the body has been exposed long to cold, the greatest risk is run in trying suddenly to warm it. The vessels become rapidly dilated, their coats relax, and extreme congestion follows. But what is true of the skin is true equally, and with more practical force, of the lungs. A man, a little below par, goes out when the wave of temperature is low, and feels oppressed, cold, weak, and miserable; the circulation through his lungs has been suppressed, and he is not duly oxidizing; he returns to a warm place, he rushes to the fire, breathes eagerly and long the heated air, and adds to the warmth by taking perchance a cup of stimulant; then he goes to bed and wakes in a few hours with what is called pneumonia, or with bronchitis, or with both diseases. What has happened? The simple physical fact of reaction under too sudden an exposure to heat after exposure to cold. The capillaries of the lungs have become engorged, and the circulation static, so that there must be reaction of heat, inflammation, before recovery can occur. Nearly all bronchial affections are induced in this manner, not always nor necessarily in the acute form, but more frequently by slow degrees, by repetition and repetition of the evil. Colds are often taken in this same way, from the exposed mucous surfaces of the nose and throat being subjected first to a chill, then to heat.
The wave of low temperature affecting a mixed population finds inevitably a certain number of persons of all ages and conditions on whom to exert its power. It catches them too often when they least expect it. An aged man, with sluggish heart, goes to bed and reclines to sleep in a temperature, say, of 50° or 55°. In his sleep, were it quite uninfluenced from without, his heart and his breathing would naturally decline. Gradually, as the night advances, the low wave of heat steals over the sleeper, and the air he was breathing at 55° falls and falls to 40°, or it may be to 35° or 30°. What may naturally follow less than a deeper sleep? Is it not natural that the sleep so profound shall stop the laboring heart? Certainly. The great narcotic never travels without fastening on some victims in this wise, removing them, imperceptibly to themselves, into sleep ending in absolute death.
SOME SIMPLE RULES.
The study of the physiological influence of the wave of low temperature, and of its relation to the wave of mortality, suggests a few rules, simple, and easily remembered.
1. Clothing is the first thing to attend to. To have the body, during variable weather, such as now obtains, well enveloped from head to foot in non-conducting substance is essential. Who neglects this precaution is guilty of a grievous error, and who helps the poor to clothe effectively does more for them than can readily be conceived without careful attention to the subject we have discussed.