The principal causes of disease in tropical countries / by Alexander William Mitchinson.

  • Mitchinson, Alexander William.
Date:
1880
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Licence: Public Domain Mark

Credit: The principal causes of disease in tropical countries / by Alexander William Mitchinson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    West Coast, with visits to the interior, up most of the rivers, reaching Cape Town, and going thence to Delagoa Bay, and so to the East Coast. He wished it to he understood that his friend, Mr. Guest, had assisted him in preparing the paper, and, for the reason he had given, Dr. Mann wonld be kind enough to A'u' The paper read was- THE PRINCIPAL CAUSES OF DIS TROPICAL COUNTRIES. w \ By Alexander William Mitchinson The greatest impediment in the way of the development of some of the most favoured portions of the earth is the unwillingness to settle perma- nently within the tropics that characterises certain nations, otherwise remarkable for their colonising energy. This disinclination to colonise tropical 'Countries doubtless arises from mistrust of what is called the climate. It is on all hands allowed that climate exercises a great influence on health und disease, and it is usual to speak of a climate as if it were an element, like the wind or the rain, and to attribute to it either virtues or evil proper- ties, according to our conception of its character. Put what is climate F What constitutes a bad, and what a good climate ? Is a climate to be called bad in which a black man can happily and con- tentedly live the full term of his life, because in it the white man can only count upon a diminished term of existence ? Is our temperate climate to be stigmatised as bad because it rapidly kills off natives of the tropics who do not adopt a different manner of clothing and feeding themselves here from that which has kept them in contented health at home ? If a native of tropical Africa, residing in Europe, were to limit his food in quantity, nature, and quality to that which .is sufficient to maintain life in his own climate, his bodily and mental condition would rapidly deteriorate, and. he might, with equal reason, allege that he was being poisoned by the climate of Europe. If the views put forward in this paper are held to be true, it will be admitted that health in the tropics, as everywhere else, is much more dependent upon diet and habit of body and mind—and, in towns and villages, upon •good sanitary regulations—than upon what is known as the “ medical climate ” of a given place, or upon the barometrical, thermometrical, and uuun u / hygrometrical variations peculiar to a given •district. It will be admitted, in short, that accli- ■UiOl/XAVUi M , matisation is more of an educational than a physical process, and that when a European has learnt correctly to apply the principles of hygiene, he may live his life in the tropics with equal or greater certainty than in temperate climates. It may be said, indeed, that though there are good and bad situations, swamps, and malarious localities, there is, in the common sense of the term, no such thing as a bad climate. All climates are good for man to live in if he applies intelligently the principles of sanitary science to the regulation of his life. But the same cannot be said of all localities. There are towns in Africa which, like Bathurst, on the Gambia River, Delagoa Bay, in South Africa, and a large number of others, are pitched on sites the worst possible, sites that could hardly have been deliberately selected on any intelligible principle, but must have been pitched upon almost haphazard by the earliest European settlers. Many of these sites are scarcely raised above the level of the sea, and some are even, in part, below it; so that drain- age is practically impossible, filth cannot be removed, and, in short, all the worst sanitary conditions of the worst periods of the most neglected spots of Europe are intensified and aggravated in the badly-situated towns of Africa. How, then, can the death-rate be otherwise than high? That man can exist at all under such horrible infractions of every sanitary law is itself a proof that the general climate is excel- lent and favourable to health. It is just as absurd to charge on “the climate” the high mortality of a pestilential African town site, as it would have been to call the climate of London bad when the Fleet Ditch was an open sewer. Climate, if it is capable of definition as a dis- tinct conception, may be said to be the sum of the meteorological influences that affect a given region of the earth, including in the term meteorological influences, not only the influence of elevation and of latitude, but that of the internal heat of the globe, the geological structure of the earth’s crust, the topographical condition of its surface, the quantitv and quality of water, the currents of water and of the air, and the distribution of vegetable and animal life, including human popula- tion. Except in so far as it may affect a region generally, it is illogical to speak of the climate of swamps and malarious places, just as it would be absurd to say that the atmosphere of Barking Reach, at ebb tide in summer, represented the climate of Kent. The conditions in both cases are quite exceptional, and the risks are exceptional also. ^ The distinction is important, because it constantly happens that whole regions are condemned as having a bad climate, simply because careless settlers have built upon a malarious swamp, and equally careless traders have followed upon their foundations, when a little search would have enabled both to find, and generally within a short distance, a much more, eligible situation. _ There are within the topics but few variations of temperature, the greatest range of variation being in the parts most distant froin the equator. The thermometer generally rises higher on the plains than in the mountains, but this will be idfluenced to some extent by geographical position or geological formation. The variations are greater in summer than in winter, and, as we might expect, the range of variation is less on the coast than m the inland districts. The study of the meteoric causes of disease has engaged, and is still engaging, the attention of many scientific men, and careful meteorological observations are very properly recorded by travellers in tropical climates ; but those who have attempted to apply the data of meteorological science to the healing art have, as yet, had but a small modicum of success. Without denying the importance of the study of that science, or questioning the value of many of its facts, it is open to great doubt whether a too great reliance on meteorology by a physician does not frequently blind him to the real causes of disease and lead him far astray in his efforts to prescribe remedies. I have no hesitation in affirm- ing that, if we could establish a system of registra- tion in these tropical climates, which would fumisn us with reliable statistics as to the variations of the death-rate from month to month, and from season