- Email: [email protected]
MEDICAL ASPECTS OF THE MOUNT EVEREST EXPEDITION, 1933
1270
NOTES, COMMENTS, AND ABSTRACTS MEDICAL ASPECTS OF THE
MOUNT EVEREST EXPEDITION, 1933 BY RAYMOND GREENE, M.A., B.M., B.CH. OXF. SCHORSTEIN RESEARCH FELLOW, OXFORD UNIVERSITY; MEDICAL OFFICER, KAMET EXPEDITION, 1931 ; SENIOR MEDICAL OFFICER TO THE EXPEDITION AND
WILLIAM W. MCLEAN,
M.A., M.D. CAMB.
MEDICAL OFFICER TO THE EXPEDITION
I. INTRODUCTORY As medical officers to the Everest Expedition, was our duty to advise the selection committee on the choice of personnel and the equipment committee on the choice of food. The expedition having started, our function is the supervision of the health of its members on the march and on the
1933, it.
mountain. A thorough examination of each European member of the expedition was conducted at the central medical establishment of the Royal Air Force and afterwards by Dr. Claude Wilson, a former president of the Alpine Club. The results of each examination were discussed at meetings between the Air Force specialists and the senior medical officer of the expedition. Unfortunately, no tests have ever been devised whereby at sea-level it is possible to judge a high climber’s most important medical characteristic-his power of acclimatisation to great altitudes. It would, indeed, be possible to imprison a candidate in a decompression chamber for several weeks and to observe his reactions, the composition of his alveolar air, and the changes in his red cell count. But the cost would be prohibitive and the conditions too far removed from the natural. Moreover, few candidates could spae the time. Leaving aside perforce his most important
point, a party medically
almost
unexceptionable
was
chosen. The same care cannot be exercised in the examination of some’80 porters, but as far as possible the unfit were excluded. The prevailing ailments among the Sherpas and Bhutias of Darjeeling are due to intestinal parasites: the threadworm, tape-worm, round worm, and the common hook-worm. By the kindness of Major S. A. McSwiney, I.M.S., all the porters were admitted for one night, or longer when necessary, to the Victoria Hospital at Darjeeling. They were there examined by Dr. Yen Singh and the medical officers of the expedition, and cleared of parasites ; 34 per cent. were found to be infected. All porters were vaccinated against
small-pox. We were absolved from the more onerous work in connexion with the food of the expedition by the kindness of Mr. S. S. Zilva, D.Sc., of the Lister Institute, who inspected the ration lists from the point of view of calorific value and vitamin content. An almost recent tragedy drew the attention of explorers to the danger of scurvy after a comparatively short period of subsistence on preserved foods; but the careful examination of the reports of other expeditions and of troops in time of war have given rise to the opinion that much minor ill-health may result from a shortage of vitamin C far short of that required to produce scurvy. The high camp ration of a former Everest expedition was scorbutic. The present expedition is well supplied with highly concentrated lemon juice, a yeast preparation, and extract of halibut’s liver. Still more recent than the realisation of the importance of vitamins is the knowledge of that of palatability. De gustibus non disputandum is an aphorism
which may apply with truth to explorers at sealevel as in the arctic and antarctic regions. It emphatically does not apply at great altitudes, where a man can be persuaded to eat only what appeals to him. If the kitchen of a good London restaurant could be transferred to the North Col, the summit of Everest would be appreciably nearer. We feel that on this occasion we might from this point of view have watched with greater care the choice of foodstuffs. It is undoubtedly a mistake to hand over to a big firm the supply of food for an important expedition. Every item should be separately chosen and the personal likes of every climber most carefully considered. But one of us was already abroad, and the time of the other was fully occupied with still more important matters. The medical equipment of an expedition which will for many months be out of touch with instrument makers and chemists must always be difficult. The expense of transport severely limits the number and size of packages. But every expedition must be prepared for accidents and major operations as well as the ordinary minor ailments of a march under varied and smetimes arduous long
conditions. On the march across Tibet the medical officers apt to be unpopular with the kitchen staff. The Sherpa or Bhutia cook sees little sense in the cleansing of cooking utensils and dishcloths. Himself apparently immune to any but the most virulent forms of dysentery, he looks upon the boiling of water or milk as an insane and troublesome whim of the doctors. He will politely accept any order given to him, but only unceasing vigilance and frequent visits in rubber-soled shoes at unexpected times will ensure his cooperation. Dirty plates can so easily be cleaned with a little saliva or the tail of the shirt. Boiled water cannot after a while be distinguished from water gently warmed. Provided the amount of the sediment is small, it is less trouble to put water directly into the lower part of the filter ; the sahibs are so impatient when they are are
thirsty. One of the worst menaces to health on the march Tibet is dust. In every camping place the afternoon wind blows into mouth, nose, eyes, water, food, and cooking pots a fine yellow dust, which would be irritating and dangerous if it contained only the pure sand of the mountains. Coming from the soil of age-old camps in which sanitation is unknown it is doubly dangerous. There have on the present expedition been many cases of pharyngitis and conjunctivitis, though happily the trouble has been chiefly among the porters. Apart from very minor ailments, the European members of the expedition have arrived at base camp having suffered no severe illness of any kind. And the problems of climbing the mountain can now be faced with a team physically fit. across
Camp 1., 18,200 feet above sea-level, April 28th.
Dr. A. C. MAGIAN writes to say the statements in the lay press about him and his work were made without his consent and contained inaccuracies. A MEDICAL HISTORY OF LIVERPOOL.-Dr. H. R. Bickerton writes : A medical history of Liverpool, based upon material collected by Mr. Thomas H. Bickerton, is being compiled at the request of the family by Miss M. McKisack, lecturer in history in the University of Liverpool. If any of your readers have letters, papers, pictures, or personal recollections which they would care to submit for the purpose of this history, will they kindly send them to me at 88, Rodney-street, Liverpool ? All communications will be immediately acknowledged, and manuscripts will be returned with the least possible delay.
NOTES, COMMENTS, AND ABSTRACTS MEDICAL ASPECTS OF THE
MOUNT EVEREST EXPEDITION, 1933 BY RAYMOND GREENE, M.A., B.M., B.CH. OXF. SCHORSTEIN RESEARCH FELLOW, OXFORD UNIVERSITY; MEDICAL OFFICER, KAMET EXPEDITION, 1931 ; SENIOR MEDICAL OFFICER TO THE EXPEDITION AND
WILLIAM W. MCLEAN,
M.A., M.D. CAMB.
MEDICAL OFFICER TO THE EXPEDITION
I. INTRODUCTORY As medical officers to the Everest Expedition, was our duty to advise the selection committee on the choice of personnel and the equipment committee on the choice of food. The expedition having started, our function is the supervision of the health of its members on the march and on the
1933, it.
mountain. A thorough examination of each European member of the expedition was conducted at the central medical establishment of the Royal Air Force and afterwards by Dr. Claude Wilson, a former president of the Alpine Club. The results of each examination were discussed at meetings between the Air Force specialists and the senior medical officer of the expedition. Unfortunately, no tests have ever been devised whereby at sea-level it is possible to judge a high climber’s most important medical characteristic-his power of acclimatisation to great altitudes. It would, indeed, be possible to imprison a candidate in a decompression chamber for several weeks and to observe his reactions, the composition of his alveolar air, and the changes in his red cell count. But the cost would be prohibitive and the conditions too far removed from the natural. Moreover, few candidates could spae the time. Leaving aside perforce his most important
point, a party medically
almost
unexceptionable
was
chosen. The same care cannot be exercised in the examination of some’80 porters, but as far as possible the unfit were excluded. The prevailing ailments among the Sherpas and Bhutias of Darjeeling are due to intestinal parasites: the threadworm, tape-worm, round worm, and the common hook-worm. By the kindness of Major S. A. McSwiney, I.M.S., all the porters were admitted for one night, or longer when necessary, to the Victoria Hospital at Darjeeling. They were there examined by Dr. Yen Singh and the medical officers of the expedition, and cleared of parasites ; 34 per cent. were found to be infected. All porters were vaccinated against
small-pox. We were absolved from the more onerous work in connexion with the food of the expedition by the kindness of Mr. S. S. Zilva, D.Sc., of the Lister Institute, who inspected the ration lists from the point of view of calorific value and vitamin content. An almost recent tragedy drew the attention of explorers to the danger of scurvy after a comparatively short period of subsistence on preserved foods; but the careful examination of the reports of other expeditions and of troops in time of war have given rise to the opinion that much minor ill-health may result from a shortage of vitamin C far short of that required to produce scurvy. The high camp ration of a former Everest expedition was scorbutic. The present expedition is well supplied with highly concentrated lemon juice, a yeast preparation, and extract of halibut’s liver. Still more recent than the realisation of the importance of vitamins is the knowledge of that of palatability. De gustibus non disputandum is an aphorism
which may apply with truth to explorers at sealevel as in the arctic and antarctic regions. It emphatically does not apply at great altitudes, where a man can be persuaded to eat only what appeals to him. If the kitchen of a good London restaurant could be transferred to the North Col, the summit of Everest would be appreciably nearer. We feel that on this occasion we might from this point of view have watched with greater care the choice of foodstuffs. It is undoubtedly a mistake to hand over to a big firm the supply of food for an important expedition. Every item should be separately chosen and the personal likes of every climber most carefully considered. But one of us was already abroad, and the time of the other was fully occupied with still more important matters. The medical equipment of an expedition which will for many months be out of touch with instrument makers and chemists must always be difficult. The expense of transport severely limits the number and size of packages. But every expedition must be prepared for accidents and major operations as well as the ordinary minor ailments of a march under varied and smetimes arduous long
conditions. On the march across Tibet the medical officers apt to be unpopular with the kitchen staff. The Sherpa or Bhutia cook sees little sense in the cleansing of cooking utensils and dishcloths. Himself apparently immune to any but the most virulent forms of dysentery, he looks upon the boiling of water or milk as an insane and troublesome whim of the doctors. He will politely accept any order given to him, but only unceasing vigilance and frequent visits in rubber-soled shoes at unexpected times will ensure his cooperation. Dirty plates can so easily be cleaned with a little saliva or the tail of the shirt. Boiled water cannot after a while be distinguished from water gently warmed. Provided the amount of the sediment is small, it is less trouble to put water directly into the lower part of the filter ; the sahibs are so impatient when they are are
thirsty. One of the worst menaces to health on the march Tibet is dust. In every camping place the afternoon wind blows into mouth, nose, eyes, water, food, and cooking pots a fine yellow dust, which would be irritating and dangerous if it contained only the pure sand of the mountains. Coming from the soil of age-old camps in which sanitation is unknown it is doubly dangerous. There have on the present expedition been many cases of pharyngitis and conjunctivitis, though happily the trouble has been chiefly among the porters. Apart from very minor ailments, the European members of the expedition have arrived at base camp having suffered no severe illness of any kind. And the problems of climbing the mountain can now be faced with a team physically fit. across
Camp 1., 18,200 feet above sea-level, April 28th.
Dr. A. C. MAGIAN writes to say the statements in the lay press about him and his work were made without his consent and contained inaccuracies. A MEDICAL HISTORY OF LIVERPOOL.-Dr. H. R. Bickerton writes : A medical history of Liverpool, based upon material collected by Mr. Thomas H. Bickerton, is being compiled at the request of the family by Miss M. McKisack, lecturer in history in the University of Liverpool. If any of your readers have letters, papers, pictures, or personal recollections which they would care to submit for the purpose of this history, will they kindly send them to me at 88, Rodney-street, Liverpool ? All communications will be immediately acknowledged, and manuscripts will be returned with the least possible delay.