I30 



FITNESS FOR TROPICAL LIFE 



maintained unimpaired; and the same holds good, but perhaps with 

 more force, for women, who should be allowed leave to cooler tropical 

 regions and to the Temperate Zone as often as circumstances permit. 



When a woman returns to a temperate climate she should be 

 advised as to the necessity of an immediate medical examination, 

 as well as of the dangers of the change into cooler weather. 



INVALIDING. 



Two classes of cases require to be considered under this heading 

 —viz. , the tropical resident about to be invalided to cooler climates, 

 and the cool-climate resident about to be sent to the tropics for the 

 benefit of his health. 



With regard to the first, there are two quite different aspects of 

 the case, viz. ; — 



[a) Invaliding for the Good of the Employer and Employee Alike. 



■ — This is a matter of common sense, and is the kindest method of 

 dealing with many cases. 



{b) Invaliding because of Health.— Temporary invaliding or sick 

 leave should always be advised if the patient's health requires it, 

 but his financial status should also be taken into consideration before 

 too drastic recommendations are made. 



More difficult by far is the question of permanent invaliding from 

 service, and in coming to a decision the medical practitioner has 

 many points for consideration with reference to the present condition 

 of the patient and his future prospects. 



The nature of the illness, the physical and mental condition of the 

 patient, his age, his pension or gratuity, his possibilities of future 

 employment in cooler regions, his family, etc., have all to be con- 

 sidered. 



Among the many difficulties which present themselves under this 

 heading we venture to express the opinion that one attack of black- 

 water fever should not constitute per se a reason for permanent 

 invaliding. 



On the other hand, we are of the opinioij that mental symptoms 

 should constitute a reason for permanent invaliding, as the tropics 

 are climatologically unsuited for an unstable nervous system. 



As a general rule, if an endemic infection- — e.g., bilharziosis— is 

 playing havoc with a patient, he should be permanently invalided 

 from that particular area or areas, which may not mean that he 

 should be invalided from the tropics or from the service. 



NATIVES. 



Natives should never be accepted for employment unless they are 

 first-class lives. The eyes require careful attention, and colour- 

 blindness should be looked for, especially in certain employments 

 such as railways, steamers, ports, etc. 



Particular attention should be paid to the urine, and natives 

 know many tricks with regard to this part of a medical examination. 



Schistosomiasis of any part of the body should cause rejection. 



