1:88 SECTIONAL ADDRESSES. 



that resistance to authority which likewise appears to be a symptom of the 

 poisoning. 



These notes afford ample confirmation of the effect produced by carbonic 

 oxide poisoning of causing reiteration. I wrote the same words over and over 

 again unnecessarily. The condition I was in was rather curious. I had 

 absorbed enough of the poison to paralyse me to a certain extent and dull my 

 feelings, but at the same time my reason had not left me. 



The whole train of symptoms strongly suggests some form of 

 intoxication, and is not dissimilar to that produced by alcoholic excess. 

 Here it may be noted that, as far as isolated nerves are concerned, there 

 is pretty good evidence that alcohol and want of oxygen produce 

 exactly the same effects, i.e. they cause a decrement in the conducting 

 power of the nerve. And herein lies a part of its interest, for pharma- 

 cologists of one school at all events tell me that the corresponding 

 effects of alcohol are really due to an inhibition of the higher centres of 

 the mind ; you can therefore conceive of the mental mechanism of self- 

 control being knocked out either because it has not oxygen enough with 

 which to ' carry on,' or because it is drugged by some poison as a 

 secondary result of the anoxsemia. 



And now to pass to the results of more chronic anoxsemia. If I 

 were to try to summarise them in a sentence I should say that, just as 

 acute anoxaemia simulates drunkenness, chronic anoxeemia simulates 

 fatigue. 



The following slide shows you a photograph taken from a page in 

 my note-book written at the Alta Vista Hut, at an altitude of 12,000 

 feet. You will see that the page commences with a scrawl which is 

 crossed out, then '6 Sept.,' the word 'Sept.' is crossed out and 

 ' March ' is inserted, ' March ' shares the same fate as ' Sept.,' and 

 'April,' the correct month, is substituted, and so on, more crossings 

 out and corrections. All this you might say with justice is the action 

 of a tired man. The other pages written at lower altitudes do not, 

 however, bear out the idea that I was out of health at the time, and 

 there was no reason for tiredness on that particular day. Another 

 symptom frequently associated with mental fatigue is irritability. 

 Anyone who has experience of high altitudes knows to his cost that life 

 does not run smoothly at 10,000 feet. If the trouble is not with one's 

 own temper, it is with those of one's colleagues : and so it was in many 

 cases of gas-poisoning and in the case of aviators. In these subjects 

 the apparent fatigue sometimes passed into a definitely neurasthenic 

 condition. At this point an issue appeared to arise between the 

 partisans of two theories. One camp said that the symptoms were 

 definitely those of anoxsemia, the other that they were due to nerv<e 

 strain. As I have indicated later on, it is not clear that these two 

 views are mutually exclusive. It takes two substances to make an 

 oxidation, the oxygen and the oxidised material. If the oxidation does 

 not take place, the cause may lie in the absence of either or of both, in 

 each case with a similar effect. The subject really is not ripe for 

 controversy, but it is amply ripe for research, research In which both 

 the degree of anoxsemia and the symptoms of fatigue are clearly 

 defined. 



So much, then, for the injury to the machine wrought by Qhronio 

 anoxsemia 



