326 Historical 



Guides have frequently become ill at a fairly low level, because 

 they had been drunk the night before; peons who have bad 

 habits suffer more from the puna than the others, says Caldcleugh 

 (page 35). 



The following are the principal circumstances, variable and 

 accidental, which may affect the intensity of mountain sickness: 

 lack of acclimatization, lack of training, fatigue, insomnia, poor 

 food, and temporary ill health. Different constitutions seem un- 

 evenly affected. According to most of the travellers, according to 

 A. Smith (page 44) , Tschudi (page 46) , Burmeister (page 52) , and 

 Pissis (page 56), the plethoric and also the aged or very weak 

 persons are especially affected. It is not rare to see persons appar- 

 ently frail, but bilious or nervous, make with impunity ascents on 

 which corpulent people fail. We may say that they have less 

 weight to carry, which is important, especially when they are 

 walking in the snow, into which they sink less; besides, their 

 pulmonary surface is, like that of children, greater in proportion 

 to their weight, but whatever the explanation is, the fact is com- 

 monly observed. 



The state of ill health, for whatever cause, likewise predisposes 

 one to be sick sooner. "When I was not well", said Al. Gerard, 

 "I was sick at 13,000 feet, but in good health I felt no effects at 

 16,000 feet" (page 138). 



An effect of general nature is that of cold, which predisposes 

 to mountain sickness. As we have seen, it usually appears in the 

 region of perpetual snow, and in intertropical lands it recedes with 

 the snow line to enormous heights. All travellers agree in declar- 

 ing that when the icy wind of high places rises, it makes the 

 symptoms unendurable, and may bring on death; this fact was 

 first noted in the Andes by Acosta (page 25) . 



If then to the fatigue of walking and of burdens borne we add 

 insufficient food, the privations of poverty, and clothing insuffi- 

 cient to keep out the cold, we find united all the causes which may 

 increase the intensity of mountain sickness. These causes, not to 

 mention bad habits, combine to attack the unfortunate Indian 

 coolies and also, though to a less degree, the peons of the Andes; 

 that is enough to explain the violence with which they ordinarily 

 suffer from the puna or the bies, to use their expressions. 



If now we refer to the differences mentioned at the beginning 

 of this section among the different mountains in regard to the 

 height at which the symptoms usually appear, we can explain 

 them in part by the observations which have just been abstracted. 



If in' the tropics mountain sickness hardly ever appears below 



