On the loss of weight, blood-spitting, and lung disease / by Horace Dobell.

  • Dobell, Horace, 1828-1917.
Date:
1878
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Licence: Public Domain Mark

Credit: On the loss of weight, blood-spitting, and lung disease / by Horace Dobell. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    from those of Mr. Glaishor.—(See “Lond. Med. Rec.,” Oct. 14, 1874.) The maximum temperature observed by them at starting was 97°, and this continued at 1,300 feet. At 2,000 feet it was 96°, at 3,800 feet 85°. The fall went on until at the greatest altitude attained, viz., 8,743 feet, the temperature was 68°, or a loss of 17° in the last 4,943 feet of ascent. Supposing this rate to have continued during another 9,886 feet, there would have been a loss of 71° at 18,629 feet; whereas Mr. Glaisher, starting at a sea-level temperature of 59°, found a loss of only 61° at 30,000 feet; and supposing Mr. Webber to have made his observations on the Gurla Mandhata when the sea-level temperature was 97°, as in Professor Wahl’s and Wise’s experiments, he would have found the temperature at 20,000 feet of altitude-about the same as when reckoned by Mr. Glaisher’s standards; but the loss upon the sea-level temperature would have been about 78° in the one case, and only 40° in the other. This example well illustrates the difficulties and sources of fallacy, complicating our speculations on the influence of altitude on disease, to which I have referred. Another source of difficulty has been pointed out by M. A. Sanson (“ Comptes Rendus,” April, 1876). His experiments show that the ex- halation of carbonic acid by respiration increases with increase of tem- perature, and with decrease of barometric pressure. He concludes, therefore, that the greatest possible elimination of carbonic acid will result from the combination, a high temperature and a loio barometric pressure. But supposing this to be the case—as we have seen that low barometric pressure consequent upon altitude necessitates low temperature, it is evident that they may neutralise each other in their influence upon the elimination of carbonic acid. These results point to the great differences which may exist in physiological effects between such climates as are obtained by the altitudes of the Swiss Alps, the moun- tain plateaux of Mexico, or of the Bolivian Andes. Amidst all the difficulties of the subject, however, there is one prac- tical conclusion which we may safely draw, and which I wish most emphatically to impress, viz., that if we seek to save oxidation by the influence of altitude we must forbid exercise. Our patients should be carried in the quietest possible manner to their destination, and when there they should simply vegetate till they have become fat and well. (See p. 159.) Next in importance to the initial loss of flesh characteristic of con- stitutional tuberculosis is that Wasting of Children which contributes so largely to the Registrar’s records of deaths under the head of “Atrophy and Debility,” and which is commonly described as “Ma- rasmus;” and I venture to sum up what I wish to say on the treat- ment of this condition, by the following quotations from a paper “ On Fat and Starch in the Nutrition of Children,” which I contributed to