THE TRUE CAUSE OF SEA-SICKNESS. 



By H. NORMAN BARNETT, F.R.C.S. 



The questions "To what is sea-sickness really due ? " 

 " Is there any cure ? " have often presented them- 

 selves to the minds of the general public. 



There is probably no ill which flesh is heir to that 

 has a more constant interest, especially in these days 

 of travel ; for it presents itself to the week-ender 

 crossing from Dover to Calais as well as the traveller 

 to the Far East or West. 



There is no minor ailment — minor so far as its 

 pathology is concerned — which causes so much 

 discomfort, none which gains so little sympathy 

 from those unaffected by it, and has had such 

 divergent prescribing with so little good result. 



There are many theories of the cause of sea- 

 sickness. I have had proof of the untrustworthi- 

 ness of most of them. What is known as the 

 " endolymph " theory is, however, scientificallv 

 accurate and supported by much practical evidence 

 of its truth. 



Having once found a cause which is a satisfactory 

 explanation of the various phenomena of sea-sickness, 

 its prevention and even cure become a comparatively 

 simple matter ; for we have in the bromides drugs 

 which, when properly handled, are capable of good 

 results in the treatment of this disorder. 



The sickness which occurs when crossing the 

 Channel or the Irish Sea, and vanishes when the boat 

 reaches its destination, is vastly different from that 

 arising in the Indian Ocean during the south-west 

 monsoon, when for a week the ship is violently 

 pitching, so that even seamen have difficulty in 

 remaining in their bunks at night. Supposing a 

 patient to be in delicate health, or suffering from 

 some concomitant ailment, the results may be most 

 serious. 



I have met many cases where great prostration 

 had to be faced ; others where haemorrhage 

 threatened a phthisical patient. Many patients who 

 are often thoughtlessly ordered abroad for their 

 relief or cure may be reduced to a very serious 

 condition. I am glad to note a change in this 

 respect, but many are still sent on long sea voyages 

 who could be much better treated in a sanatorium at 

 home. 



Sad cases are often seen of those in the second 

 and even third stages of phthisis who have been 

 enabled to take the voyage with much financial 

 difficulty, and have to make it as one of three 

 or four in a small third-class cabin. Such patients, 

 often unable to touch the food — good, but rather 

 coarse — are particularly bad subjects should the 

 ship encounter rough weather. They are usually 

 violently ill, and have to remain in lower-deck 

 cabins, with every porthole closed. The atmo- 

 sphere of such a cabin teems with tubercle bacilli 



and other forms of germ life inimical to health. 

 The result is that the unfortunate patient lands, if 

 he survive, on some distant shore a piteous wreck, 

 friendless, probably almost penniless, in every way 

 worse than when he left England, having on the 

 journey probably caused infection to more than one 

 cabin-mate. 



The only class of phthisical patient that should be 

 allowed to go for a long voyage on a passenger ship 

 is one in the first stage of the disease, who can afford 

 to have an entire first- or second-class cabin, with 

 plenty of air space, to himself. If bad weather be 

 met with, fair ventilation can then be secured. This 

 minimises the risk of sea-sickness for the patient, 

 and danger to others is avoided. A sea voyage is 

 very beneficial for those suffering from surgical 

 tuberculosis so long as the cases are not too 

 advanced. 



I would designate sickness at sea as that which is 

 produced in a person whose digestive organs are at 

 fault in one way or another, and which is often 

 confounded with true sea-sickness. I feel sure that 

 all who give any thought to the matter will find 

 an explanation in this of cases which are evidently 

 not explicable on the theory to which I shall presently 

 refer. They are, in fact, cases of severe sick 

 headache which might occur anywhere. 



The origin of sea-sickness is not so apparent as 

 many seem to think. That the exciting cause is the 

 motion produced by a ship on a rough sea is the 

 indefinite reason assigned, but it should be remem- 

 bered that there are many predisposing causes and 

 circumstances that modify the exciting one. 



Predisposing Causes may be divided into those 

 connected with the stomach, those connected with 

 liver, those connected with the nervous system, and 

 those connected with the ship. 



Those connected with the Stomach have had too 

 great stress laid upon them. In the healthy 

 individual symptoms referable to the stomach are 

 secondary, being the result, not the cause, of the 

 malady. In those who are suffering from gastric 

 disturbance, either chronic or acute, or who go on 

 board a ship with an overloaded organ, the condition 

 will prove a predisposing cause to " sickness at sea," 

 or even to the true ailment, by rendering them more 

 liable to react when any abnormal condition of 

 things is experienced, such as the motion of the ship 

 if rough weather be encountered. 



Those connected with the Liver we may dismiss 

 with a word, since what has been said above of the 

 stomach will apply equally to the liver. A sluggish 

 liver — one which is not secreting actively — is a very 

 bad companion for the sea-voyager, but it is not of 

 so much importance as a predisposing cause as one 



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