Definition

This is a condition brought on by exposure to excessive heat of those who are enervated from sensual indulgence. Those who are brought down with so-called sunstroke are almost invariably sick beforehand. The inebriate is very liable to meet with this trouble in excessively hot weather. Those who are badly toxemic are also apt to come down with excessive heat. Real sunstroke is not a disease that will take hold of a normal and healthy person. Some authorities divide sunstroke into two classes: heat exhaustion and sunstroke. There is quite a difference. Heat exhaustion may come to those who are quite well, when exposed for a long time to very hot rooms. Stokers and men who feed furnaces are very liable to be brought down with heat exhaustion. But those who are brought down with sunstroke are sick, and often their resistance is so very low that they will go down under the effect of heat which the average person will not consider excessive. The large cities afford quite a number of examples of both heat exhaustion and sunstroke every year.

Symptoms

The victim falls into a state of prostration, and may die within an hour, the principal symptoms being those of heart failure, difficult breathing, and a comatose state. Some writers describe fatal cases that occur almost instantaneously. Victims fall as if shot down. The more common forms present pain in the forehead, dizziness, and a feeling of difficult breathing, with nausea and vomiting. In some cases there are diarrhea and frequent urination. If dyspepsia has helped the hot weather to bring on the condition, the breath will usually show it. There will be an alcoholic odor to the breath. Of course, sunstroke should not be mistaken for an alcoholic drunk; for patients will rally and get over the drunk, whereas, if they are neglected when the condition is that of heat exhaustion, they may die. The heat exhaustion must be differentiated from uremic coma and morphine narcotism.

Treatment

Get the patient to a comfortable place where he can rest and not be annoyed. The head should be bathed with hot water, while someone is fanning with a good strong fan. The rest of the body may be sponged with cool water. I would not use ice-water, because this leaves the patient very uncomfortable. If two or three people will volunteer to do the work of fanning, the patient will be benefited more by the hot sponge-baths given under the hand fanning; or an electric fan may be used. The sponging should be with hot water, and the entire body should be gone over as rapidly as possible--repeated and repeated. Evaporation will be so rapid that the excessive heat of the body will be carried away much faster and more safely than where patients are bathed in ice-water. When the patient rallies, he may take orange juice and water, half and half, or hot milk and hot water, half and half. If convulsions occur, they must be controlled with chloroform. Each case must be treated according to its requirements.