THERMIC FEVER OR HYPERPYREXIA.— This is an aggravated form of the pre ceding and is not infrequently witnessed. It is characterized by excessively high temperature—sometimes 115°, 116°, and even 117.S° F., as in the case observed by Lambert. This means death, preceded by intense dyspncea, asphyxia, and coma in the majority of cases, but by no means in all—under proper treatment.
In a considerable proportion of cases there are preliminary symptoms which, if accepted as warning, might prevent the development of the more dangerous features—nausea, cramps, progressively increasing weakness, vertigo, blurred vision, intense headache, and cessation of the perspiration. If these symptoms do not cause the patient to realize that he is in danger, and to repair to a cooler spot—the active symptoms of thermic fever appear. The skin, from dry, be comes flushed, red, and burning; it may finally assume a bluish tinge, while the mucous membranes become markedly cyanotic.
A thermometer left in situ would in dicate that the temperature is steadily rising, and though perhaps subnormal at first, reaching down as low as 93°, it may reach the temperature already men tioned. The pulse follows the tempera ture, and is at first full, bounding, and non-compressible, then becomes rapid; the number of respirations also follows suit, varying from 20 to 60 per minute. The eyes are watery and fixed, and the pupil is contracted.
Clonic spasms, alternating with rigid ity, are often observed. There is moan ing, delirium, and jactitation, uncon sciousness usually accompanying these symptoms. The urine and forces are passed involuntarily,—though the secre• Lions are sometimes totally suppressed, —and exacerbations of dyspncea, notice able from the start, gradually assume the state of asphyxia, followed by death.
A fatal issue does not always follow, however; and the use of appropriate means, especially the cold bath, often saves patients whose temperature has reached extraordinary limits.
Case of "electric sun-stroke" observed. The patient had been engaged some twenty minutes iu adjusting the screw which separates the carbon points of an arc-lamp, his face being held some 15 to 20 inches or more from the arc, and had neither covered his eyes with smoked glasses nor taken any precaution against radiation. The current was 12 to 14 am peres, with a potential of 44 volts, and the lamp had an illuminating power of about 200 Carcel burners. Two hours and a half later the man supped with good appetite, and three hours after this went to bcd and slept soundly, as usual. About midnight he was awakened by feelings of insupportable pain and burn ing in the face, and especially the eyes. He was unable to see, covered his eyes, and complained of great scorching, which was aggravated by the least access of light. The lids and conjunctivw were red and swelled, with muco-purulent dis charge. With pain lie distinguished be tween light and darkness, but could not distinguish objects. The entire face was reddened, especially around the eyes. Recovery took place under the following treatment: Belladonna ointment around the eyes and to the lids; cold compresses to the eyes; occlusion; hot foot-baths; saline washes, with, later, the addition of Van Swieten's solution. Prat (Ar chives de Med. Navale, Dec., 'SS).
Diagnosis.—The special conditions at tending these cases and the character of the symptoms render diagnosis easy in almost all cases.