The predisposing causes of sun-stroke are (1), an unusually elevated degree of tem perature, accompanied by great dryness of the air; (2) The electrical condition of the atmosphere that precedes a thunderstorm; (3) A contaminated atmosphere from over crowding; (4) All debilitating causes, such as prolonged marches, previous disease, intemperate habits, etc. Death sometimes occurs so suddenly that there is little oppor tunity for treatment, but the feet, indications in these cases are—the cold douche, from a height of three or four feet, keeping the surface wet and exposed to a current of air, the exclusion of light as far as possible, and the free employment of stimulants. In less rapidly fatal cases the outer clothing should be removed, and the douche applied, as before, over the head and along the spine. Relaxation of the pupil is the first favor able sign. If the pulse flags the douche must be replaced by the mere application of cold to the head. The hair must be cut as short as possible, and the nape of the neck blistered as speedily as possible. If insensibility recurs after an interval of ten or twelve
hours, a blister should be applied to the crown of the head. The extremities and chest should be stimulated with mustard poultices. Immediately after the employment of the douche, a strong purgative injection should be thrown up the lower bowel by means of a long stomach-pump tube (as, for example, a mixture of an ounce and a half each of castor oil and oil of turpentine, and two drams of tincture of asafoetida in about half a pint of barley-water). Under no circumstances should there be any abstraction of blood. The preventive measures are of more importance than the treatment; but this is a subject into which we have not space to enter. The advice of the regimental sur geon is too often disregarded by the commanding officer; and the lines which are itali cized in Mr. Russell's account of the cases—quoted at the beginning of this article—would seem to contain a well-devised prescription for the induction rather than the prevention of sun-stroke.