Coma and Allied Disturbances of Consciousness in Hypopituitarism

BRmsHJ is discounted, and the overalls absorb approximately their own weight of sweat.The very real protection which overalls provide against steam leaks, burns from very hot metal parts, dirt or oil, and flash burns in wartime cannot be denied; but they should be made of the lightest and most ventile and durable fabrics which will meet these other requirements.Since Bedford (1946) proposed that the effective tempera- ture scales should be used in the Navy for describing warm environments, no better alternative has appeaied.The venti- lated dry-and wet-bulb thermometers, of either the " sling " or Assmann design, still provide the medical observer with the most accurate and convenient method for measuring the air temperature and humidity.The silvered katathermometer has not been replaced by any more simple and equally accu- rate alternative for measuring turbulent air currents of low velocity.The globe thermometer has emerged successfully from a series of comparisons, with other available methods for determining the mean radiant temperature, made by Newling in a " radiant-heat tunnel " at Singapore.The " corrected effective temperature " also gained support from physiological investigations by Macpherson and others of the team in the same radiant-heat tunnel (Macpherson, 1952).But it is wise to remember that the effective temperature scales were constructed primarily to deal with the thermal environment to which persons engaged in light work are exposed indoors during the summer in homes and offices in North America.They are most useful when used for this type of environment, and are beset with pitfalls when used for situations which they were not designed to meet. ConclusionsApart from information about the various factors which limit work at high temperatures, probably the most useful facts which have been derived from these studies so far are, first, that the effects on men in the Tropics are very similar to the effects observed on men doing the same kind of work in temperate climates, provided the workers are trained to work in the heat and are able to recuperate between exposures in an atmosphere which is not so warm that it induces perceptible sweating; secondly, that the upper tolerable levels of warmth for men in a similar state of training for work in warm atmospheres are much the same whether they are living in the Tropics or in England; and, thirdly, that the variations between ifidividuals, and even in the same individual from day to day, are very great at times.Observations made on small numbers, or on only a few occasions, may be misleading if they are used as a basis for general conclusions.Finally, with regard to men who are not specially trained to work at high temperatures, Weiner and Macpherson (1953) have produced evidence, from experiments carried out under otherwise identical conditions in Singapore and at Oxford, which indicates that untrained men in England are less heat-tolerant than untrained men in Singapore.I have referred to only a few aspects of the many