34 REVIEW — TROPICAL MEDICINE, ETC. 



Climate— It is not quite the case that no natives inhabit Erkowit. They are accustomed to graze 



continued their animals at these altitudes which they visit periodically, and indeed there is a native 



cemetury on the ground. At certain seasons Erkowit is wrapped in damp mists, but on the 



whole the description given is correct, and, though not ideal, the station is likely to prove 



valuable. 



In summing up, Sandwith points out the absurdity of sending a patient suffering from 

 the dire effects of malaria to a health resort where he can become re-infected, and speaks of 

 the necessity for maps showing the distribution of malaria-bearing mosquitoes. In their 

 absence, he says, we must be content to judge by altitude, and, in a country where malaria is 

 endemic, regard any height under 5000 feet as unsatisfactory. 



In 1906 the larvae of Pyretophorns costalis were brought me from a water-course at the 

 base of the Erkowit plateau. I reported the matter and mentioned its importance, but so 

 far as I know further action was not taken until I sent Mr. King specially to Erkowit for the 

 purpose of determining precisely the species of mosquito present and their distribution. 

 He did not find Anophelines at or near Erkowit, but discovered a new species of sand-fly 

 and certain mosquitoes which are described in his report. 



Sandwith points out that malarial patients are apt to get fever attacks when exposed to 

 cold altitudes, sea breezes, or even the damp cold of countries such as England. He believes 

 this to be largely due to an insufficient quinine treatment. Cantlie,' on the other hand, from 

 personal experience, records his belief that "it is not the cold but the hot weather in 

 Britain, especially in the south of England, that has to be dreaded by the old tropical 

 resident who is the subject of chronic malaria. As far as the British Isles go, he recommends 

 the climate of Morayshire and Nairn in the North of Scotland, while in the winter he 

 believes in the Swiss mountains at an altitude of not less than 4000 feet. 



Sandwith regards change to a temperate climate as essential in bad cases of sprue and 

 beri-beri, while for cases of dysentery and enteric the sea coast is recommended, but here 

 also insufficient or improper treatment previously may be the chief cause of a relapse. Such 

 cases sent to the hills in India are apt to contract hill-diarrhoea. 



Much interesting information regarding climate will be found in "Woodruff's book," which, 

 however, has to be read as a whole and cannot well be quoted here. A good deal that he brings 

 forward is not applicable to the Northern Sudan, for he deals chiefly with typical tropical 

 conditions where heat and moisture are combined to the greater detriment of those exposed 

 to them. 



Wolfe'^* has investigated the effects of climates on American soldiers stationed in the 

 Philippines. His paper is of a preliminary nature, but he notes that the kind of life led by 

 the individual has much to do with the change produced. A more or less active life 

 is necessary. The more indolent the life the sooner the stagnation and retrogression. Men, 

 however, break down under excessive marching in the Tropics quicker than in temperate 

 climates. The points observed were : (1) The pulse rate taken during sitting, standing and 

 exercise ; the maximum and minimum rates of the pulse ; (2) the respiration ; (3) the 

 haemoglobin ; (4) erythrocytes ; (5) leucocytes ; (6) differential leucocyte count. 



A remarkable paper is that by MacDonald,* who, dealing chiefly with tropical 

 Queensland, advocates an active out-door life, his motto apparently being " the more 

 sun the better," and this for man, woman and child. He advances proof to show that 

 under such conditions the white race thrives ; this even in a country where the rainfall 

 is heavy. His arguments certainly tend to upset all prevailing ideas on the subject, and 

 do not seem to have been taken very seriously by those who discussed a paper which, 

 whatever its value, is certainly interesting and perhaps suggestive. 



Haldane^' has discussed the influence of high air temperature and has conducted 

 experimental work on the subject. He quotes the old experiments carried out by Blagden, 



' Cantlie, .T. (June loth, 1907), " Clinical Observations on Tropical Ailments as they are met with in Britain." 

 British Medical Journaf, p. 1455. 



^ Woodruff, C. E., " The Effects of Tropical Light on White Men." Rebman, London, 1905. 



» Wolfe, E. P. (August 31st, 1907), "A Preliminary Report of Research Work on the Effects of Tropical 

 Climate on the White Race." Medical Record. 



* MacDonald, T. F. (May 1st and 15th, 1908), "Tropical Lands and White Races." Journal of Tropical 

 Medicine and Hygiene, Vol. XI., No. 10. 



' Haldane, J. 0. (October, 1905), "The Influence of High Air Temperature." Journal of Hygiene, 

 p. 494, Vol. V. 



• Article not consulted in the original. 



