Altitude sickness

“ Nausea and vomiting; headaches of most severe character; feverishness; hemorrhages; lassitude, depression and weakness, and an indescribable feeling of illness, have been repeatedly mentioned as occurring at great elevations, and have only been cured by descending into lower zones. To these maladies the term Mountain-sickness is now commonly applied.
It is very generally admitted that mountain-sickness should be attributed to the diminished atmospheric pressure (or, as it is termed, to the rarefaction of the air) which is experienced as one goes upward. ”

“ For myself, I know that after several nights at very high altitudes my mind is dull and my courage reduced to vanishing-point. In all cases, so far as I know, there is considerable loss of weight. To actual mountain sickness we can acclimatize ourselves by going as frequently as possible above 20,000 feet. But we cannot stay for long at very high altitudes and preserve all our strength. ”

“ A high altitude, from the purity and stimulating properties of the air, is of value to many mild or very early cases, but where the disease is extensive, where the heart is irritable, or where there is any tendency to insomnia, high altitudes are contra-indicated, and no such patient should be sent higher than some 1500 ft. Where the disease is of long standing, with much expectoration, or accompanied by albuminuria, the patient appears to do best in a humid atmosphere but little above the sea-level. ”

“ But if he stirs about, if he tries to lift the weight of his body by climbing, then he has need of more oxygen than is contained in the blood; and, as this is not to be had, the symptoms of mountain-sickness make their appearance, and the only hope of relief is in repose. This is the reason why aeronauts, who perform no work, experience "balloon-sickness" at a far greater elevation than mountain-climbers experience the symptoms to which they are liable. ”

“ In mountain-climbing faintness and nausea may be caused at great altitudes. At the opposite extreme, in pier-driving and laying the foundations of bridges, men have to work in air-chambers at a pressure of from three to four atmospheres. ”

“ In the Himalayas, the traveller does not begin to suffer from the attacks of this ailment until he has reached a height of 16,500 feet; while on the Andes a large number of persons are affected by it at an altitude of 10,700 feet. In the South American mountains, the symptoms are much more serious: to the fatigue, head-ache, and want of breath are added giddiness, sometimes fainting-fits, and bleeding from lips, gums, and eyelids. The aeronaut, however, who is spared all the fatigue of climbing, rarely suffers any inconvenience except from cold, at such elevations. ”

“ The ill effects of altitude are mostly imaginary. True, climbing high into a brighter, finer atmosphere diminishes the elastic clasp—the pressure of the air—and causes physiological changes. These usually are beneficial. Climbers who become ill through mountain-climbing would also become ill in hill-climbing. In the overwhelming number of cases the lowland visitor is permanently benefited by a visit to the mountains and especially by a climb in the heights. ”

“ In short, it would seem that any consumptive in an early stage of his disease who does not thrive at a moderate altitude would do well to come here and to stay—that is, if he will remember that all the climate is out-of-doors. ”

“ Dyspepsia and Chronic Gastro-intestinal Disorders.—In these conditions it is especially imperative that we take a broad view, particularly in respect of climate and altitude. Inland spas at moderate or high altitudes are generally preferable. Doubtless the beneficial result is in part due to the influence that change to a mountainous region, with abundant open-air exercise, exerts on the nervous system. ”

“ The mountaineer himself is rarely aware of his weakness; he probably explains it to himself as a touch of passing mountain sickness. It is only when he, or more probably his leader, notices that it recurs at the same height and that the symptoms are not physical or mental, but affect the mysterious half-way region that we must call ‘nervous,’ that the true cause suggests itself. ”

“ I was always struck with the resemblance of the earliest symptoms of this disorder with those of the sea-sickness. The anxiety, nausea, weariness, dejection, head-ach, are in both cases the same, and only differ in point of duration. It even happens sometimes, when a person is long and violently sick at sea, that some small degree of fever will appear at times, and the pulse shall be heavy and intermittent, as in the first period of the small-pox. ”

“ But while the adaptive changes take place readily and regularly under ordinary conditions in healthy persons, many observations at health resorts of high altitude have shown that in a few cases (old age, certain organic diseases of the heart) they do not take place at all, while in the case of anæmic and neurotic patients they take place only at a moderate altitude and when a cool and bracing atmosphere allows of much outdoor exercise without perspiration. A natural inference to be drawn from those facts is that the climates of all tropical plateaus are not equally conducive to health. ”

“ All the foreigners here have nerves. What would be peaceful, dove-like households at sea-level, become scenes of breakage of all description at this altitude, and all sorts of studies might be made on the subject of “air pressure” on the life of man and woman. There is not the accustomed amount of oxygen in the air and, with all the burning-up processes of the body lessened, there is an appalling strain on the nerves. ”

“ If the air passenger suffers from gout, rheumatism, or is susceptible to sea-sickness, he will experience no inconvenience, because there is no jogging, no rumbling over cobble-stones or broken rails, or riding on a heavy sea; he will feel no motion at whatever hight he may be, but will glide voluptuously—without perception almost—like a summer cloud through the vast ocean of the ærial fluid. ”

“ Various experimental researches, and especially the latest and very careful investigation by Haldane, Douglas, Henderson and Schneider on Pike's Peak, have proved beyond a doubt that that formerly mysterious disease, mountain sickness, is due solely to the greatly diminished pressure of oxygen existing at all considerable heights. ”

“ A spoonful of crushed ice, in a wine-glassful of cold water, or weak brandy-and-water, will often afford relief when all other means fail. Smoking at sea is very apt to induce sickness. M. F. Curie, in the ‘Comptes Rendus,’ asserts that drawing in the breath as the vessel descends, and exhaling it as it ascends, on the billows, by preventing the movements of the diaphragm acting abnormally on the phrenetic nerves, prevents sea sickness. ”

“ New-comers suffer from difficulty of breathing; often after sudden and severe exercise, climbing, or running, the effect is like the nausea, sickness, and fainting experienced upon Mont Blanc and in Tibet ”

“ Such are a few of the varied conditions to which man has become accustomed since he emerged from his tropical and arboreal relatives.
The question finally comes down to the effect of the rarefaction of air on life. An inquiry as to how far man can stand changes of atmospheric pressure is of interest in this connection, for we know that sudden changes are accompanied by151 mountain sickness, at great elevations, and caisson disease under great pressure. Large birds soar among the high peaks of the Andes and drop at once to sea-level. ”

“ Their investigations explode the theory that altitude is a strain upon the heart, or injurious to the system. These men concluded that the heart is subjected to no greater strain in high altitudes than at sea-level, except under the strain of physical exertion. The blood is richer in high altitudes. For every hundred red corpuscles found at sea-level there are in Colorado Springs, at six thousand feet, one hundred and ten; and on the summit of Pike's Peak, from one hundred and forty to one hundred and fifty-four. ”

“ The truth is that of the thousands who each month go over the road, the majority suffer from soroche, mountain sickness, not at all, or with little and temporary discomfort. A slight headache is common ”

“ Clinton Dent in the lix Badminton volume bestows a chapter on the subject of ‘Mountaineering and Health.’ Here we have an authoritative summary of the physical qualifications required by the mountaineer, and of the bodily ailments he may possibly incur. A perusal of the chapter will convince the reader of the suitability of a mountainous region such as our own country can offer for preliminary training before the high Alps are approached. There is much less likelihood of over-strain; snow-blindness, frost-bite, and mountain sickness are rarely met with here. ”

“ The sunshine of a high region is beneficial to those ill with coughs, colds, bronchitis, tuberculosis, anæmia, or other wasting diseases, because the upper altitudes are rich in many rays [249] that are beneficial, some of which are absorbed by the higher air and do not penetrate to the earth, or only reach the earth in minute quantities. There on the mountain the sun’s rays are unpolluted by the dust and the bacteria of lower levels and the cities. But one does not need extreme altitudes. ”

“ One of the young men was seriously alarmed by bleeding from the lungs, and the intense dryness of the day and the rarefication of the air, at a height of nearly 15,000 feet, made respiration very painful. There is always water on the Peak, but it was frozen as hard as a rock, and the sucking of ice and snow increases thirst. ”

“ Persons suffering from rheumatism, neuralgia, advanced pulmonary consumption, organic heart disease and all disorders of the brain and nerves should avoid a high altitude. Patients that are afflicted with any of the above-mentioned diseases are more comfortable in a low altitude and should choose between the coast of California and the low, dry lands of the lower Gila and Colorado rivers, according to the season of the year and the quality of climate desired.
The diseases which are especially benefited by the climate of Arizona are consumption, bronchitis, catarrh and hay fever. ”

“ But in our brief and general survey of Etiology this topic must be left without discussion, since no disorder appears to be traceable to elevation alone, beyond the temporary prostration on exertion, with hemorrhages from the nose, lungs, etc., often produced in those who climb to great mountain-heights or ascend rapidly in balloons. It has been shown by ample experience that considerable populations may live in ordinary health through long periods at altitudes more than 10,000 feet above the level of the ocean. ”

“ After making a change from a low to a high altitude sleep may be sound for a time, but it soon becomes fitful and unrefreshing.
It has been discovered that altitude increases the amount of hemoglobulin and thus enriches the blood and is particularly beneficial to pale, thin people. It also sharpens the appetite and promotes digestion and assimilation. ”

“ I have waked in the morning with the snow drifting across the back of my neck, been wet to the skin all day, and gone to bed in my wet clothes, and slept myself dry; and have lain out all day in a November gale, in a hollow scooped in the half-frozen ground of the duck-marsh, and felt never a hair the worse. Scores of similar experiences will rise up in the minds of every camper, hunter, or fisherman. You may catch cold during the first day or two out, before you have got the foul city air, with its dust and bacteria, out of your lungs and throat, but even this rarely happens. ”

“ Proximity to large bodies of water, river valleys, and damp plateaus are undesirable as places of residence for invalids with lung troubles. There are exceptions to this rule. Localities near the sea with a climate [Pg 202] subject to slight variations in temperature, a dry atmosphere, little rainfall, much sunshine, not so cold in winter as to prevent much out-door life and not so hot in summer as to make out-door exercise exhausting, are well adapted not only to troubles of the nervous and circulatory systems, but also to those of the respiratory organs. ”

“ Another method of inducing sickness, and pulmonary absorption in consequence, is by sailing on the sea; by which many consumptive patients have been said to have received their cure; which has been erroneously ascribed to sea-air, instead of sea-sickness; whence many have been sent to breathe the sea-air on the coasts, who might have done better in higher situations, where the air probably contains less oxygen gas, which is the heaviest part of it. ”

“ SEA-SICKNESS, the symptoms experienced by many persons when subjected to the pitching and rolling motion of a vessel at sea, of which depression, giddiness, nausea and vomiting are the most prominent. They generally show themselves soon after the vessel has begun to roll by the onset of giddiness and discomfort in the head, together with a sense of nausea and sinking at the stomach, which soon develops into intense sickness and vomiting. ”

“ With regard to mountain-sickness, the only matter for surprise, as it seems to me, is that it is not more82 frequently felt at lower elevations, and that the human economy is able so readily to adapt itself to the altered conditions when transferred to an atmosphere of say two-thirds of the ordinary density, where the diminished supply to the lungs is aggravated by the increased mechanical effort requisite to move the limbs, and raise the weight of the body in an attenuated medium. ”