MOUNTAIN SICKNESS. 89 



Common symptoms are palpitation of the heart with a 

 quickened pulse, severe headache, giddiness, singing in 

 the ears, diminished appetite, nausea with or without 

 vomiting, bleeding at the nose, and coldness of the ex- 

 tremities. Fairly common are indifference to danger, and 

 loss of interest in things generally, often with a tendency 

 to somnolence — although in some there is increased excita- 

 bility — spitting of blood due to haemorrhage from the lips, 

 gums, air passages, or lungs. Bleeding from the con- 

 junctivae is sometimes observed, as also blurring of the 

 sight, diarrhoea, and, in severe cases, muscular weakness so 

 great that standing or sitting up is no longer possible I 

 eventually the limbs may become completely paralysed, and 

 there may ensue loss of consciousness, and death. 



Curiously enough, lividity of the face, and especially of 

 the lips, which must be familiar to every Alpine climber at 

 heights of 12,000 to 15,000 feet, is apparently overlooked 

 by most writers or wrongly ascribed to cold. 



The first question I have to consider is whether these 

 symptoms are referable to one condition — viz., insufficient 

 supply of oxygen, or whether this may be complicated by 

 other conditions which require to be taken into account. 

 If they be all due to dyspnoea or asphyxia alone they 

 include phenomena which are not generally recognised by 

 pathologists as possible results of imperfect supply of air, 

 while if they be complicated with some other result of the 

 rarefaction of the air, it is desirable that these possible 

 complications should be clearly recognised. 



How far do the known results of dyspnoea on the animal 

 body correspond with the phenomena above referred to ? 



The gasping respiration we know well as the constant 

 result of imperfect supply of air to the lungs when the air 

 passages are unobstructed. We may equally safely put 

 down the muscular weakness to imperfect supply of oxygen 

 which we know is necessary for the contractions of the 

 muscles. 



The heart symptoms — viz., the palpitation and the 

 acceleration of the rhythm — may safely also be ascribed to 

 the dyspnoea. On arresting the respiration in the lower 



