To avoid heat strokes
Dr William C Woodward’s views on a timely subject
The warming and cooling of the body by natural methods — Work should be moderate on hot days — Detecting symptoms of exhaustion
At the request of The Times, Dr William C Woodward, the District Health Officer, has contributed his views on the subject of the proper car of the body in hot weather. He shows how the body is naturally heated, and how the rigors of a warm climate may be withstood by proper attention to clothing, food, drink, and exercise. Dr. Woodward’s advice will be found particularly valuable in the extremes of heat by which Washington is occasionally visited in summer. He says:
“It is a matter of common knowledge that, in health, the temperature of the human body remains practically uniform, no matter what may be the temperature of the air or other medium surrounding it. This results from the nice adjustment of the amount of heat generated within the body, and the amount of heat given off by it. Every manifestation of life means practically the generation of heat. Muscular effort, the energy devoted to the digestion and absorption of food, and, in fact, even mental effort, contribute toward the generation of this heat. It is radiated from the surface of the body and given off, to a certain extent, in the process of warming such cold substances as are taken into the stomach, and, when the atmosphere is cold and dry, by the heating and moistening of the air before it enters the lungs.
“The great channel, however, through which heat leaves the body is the skin. In hot weather the surface is relaxed and the amount of blood circulating at the surface is larger. It carries to the surface the heat, generated largely in the interior, and there it is gotten rid of by radiation by conduction, and by the cooling which results from the evaporation of perspiration or sweat.
Maintaining health during hot weather
“These preliminary remarks are necessary to a proper understanding of the precautions to be taken to maintain health during hot weather. Such precautions may be classed under two heads: First, means to diminish the amount of heat generated, and, second, means to favor the dissipation of heat. The available means under the first head are comparatively few, and may all be summed up as simply avoidance of excessive activity; abstinence, as far as practicable, from muscular or mental work, and avoidance of undue tax on the digestive apparatus. As the dissipation of heat is a continuous process, work, if done slowly and continuously, may do no harm; the small quantity of heat generated is disposed of through the usual channels. A sudden effort, especially if continued, may, however, be sufficient to upset the balance and cause heat stroke or heat exhaustion, even with fatal results. The moral is, then, to work as little as is necessary, quietly and gradually, spreading it over as much time as is practicable.
“The precautions to be taken under the second head, that is, to promote the dissipation of heat, are equally important, but must be employed with caution. The loss of heat by conduction can be accomplished by means of cool baths, or cold baths if one is strong enough to stand them. These afford, however, but temporary relief. The drinking or eating of cold substances has a slight effect toward the same end, but is, as is well known, open to certain objections. It may disturb the circulation and interfere with the digestion. The amount of heat, too, which can be dissipated from the body in this way is small. The frequent drinking of cool water or acidulated drinks, especially between meals, tends somewhat to abstract heat from the system, although the amount so abstracted is not considerable, but has a more important function in encouraging the activity of the sweat glands and favoring the cooling of the surface by evaporation. The surface of the body is, after all, the place to which we must look for the dissipation of heat.
“It is needless to tell even the most ignorant that they cannot expect heat to be satisfactorily given off from the surface if all the time the surface is exposed to direct heat from the sun or other sources. Neither can they expect evaporation to take place rapidly if the greater part of the surface is covered with closely-fitting, almost air-tight fabrics. Avoiding direct exposure to heat, and favoring the free circulation of air about the entire body by wearing thin, porous, loose clothing accomplishes all we can hope to accomplish toward getting rid of heat from the surface.
Avoidance of heat stroke
“The whole subject of the avoidance of heat stroke may possibly be summed up in the avoidance of excessive activity of all kinds; the avoidance of direct exposure to heat, the free drinking of cool water, the use of easily digested food in moderate quantities, and the wearing of thin, porous, loose clothing.
“The ordinary signs of heat stroke have been gone over so often that they are by this time familiar to even the average layman. The difference between heat stroke and heat exhaustion are of vital importance, requiring, as the two conditions do, diametrically opposite treatment. It must be remembered that both of these conditions are more liable to come on when the air is still, and especially when it is moist, when the atmosphere is, in common language, ‘close.’ The explanation is simple. The absence of circulation of the air and the presence of moisture interfere with the cooling of the body. During weather of this character it is especially important that the precautions suggested above be observed.
“At any time during hot weather a hot, dry skin should be accepted as a warning of possible danger. If it is accompanied with faintness and dizziness and a sense of exhaustion, it is time to quit work altogether and, unless these conditions soon pass off, to see medical assistance. The application of cold water to the surface, the use of cool drinks, and the exposure of the surface of the body to currents of air are measures which can be safely adopted pending the arrival of the physician. The presence of a cold, clammy skin after exposure to undue heat may also, when accompanied with a feeling of vertigo and faintness, mean danger, being more or less suggestive of heat exhaustion.
“In this condition, pending the arrival of the physician, the use of warm drinks and the application of warmth to the surface of the body are helpful. Safety lies in the immediate removal of the patient from the conditions which have led to the attack and the institution and maintenance of proper treatment.”
Photo: Summer at the sea shore — Recreation Pier and bathers, Asbury Park, NJ (1901)