SUNSTROKE (otherwise called HEAT STROKE, HEAT APOPLEXY, HEAT AS PHYXIA, COUP DE SOLIEL) , a very fatal affection of the nervous system, which is very common in India and tropical countries, and also in more favored regions in extremely hot weather. The symptoms of the disease are liable to be greatly modified in different cases. Two contrasted forms are recognized. In the cardiac the heart is chiefly affected, and the symptoms are weakness, faintness, dimness of sight, giddiness, etc. Death may take place either suddenly or more gradually from failure of the circulation. If recovery occur it is complete. This form is said to occur only from direct ex posure to the sun's rays. In the cerebro spinal form, the commoner of the two, the symptoms usually come on more gradually; nausea and giddiness may be present at first; but the most striking feature of the disease is either wild de lirium or coma, with a pungently hot skin and extremely high temperature 106° F. or upward. Even those who re cover from this form of the disease are apt to suffer for a long period, or it may be permanently, from severe headache, epilepsy, enfeebled mental power, or other nervous disorders. Intermediate
varieties are also met with, forming links between these two extremes.
The predisposing causes of sunstroke are (1) an unusually elevated degree of temperature; (2) heavy or unduly tight clothing, particularly if it interfere with the free expansion of the chest; (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 opportunity for treatment, but the general 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 rap idly fatal cases the outer clothing should be removed, and the douche applied, as before, over the head and along the spine.