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Page:Popular Science Monthly Volume 19.djvu/187

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175
SUNSTROKE AND SOME OF ITS SEQUELÆ.

body. In some cases rousing by flagellation with the sweeper's broom was added with great effect, especially in the case of Brigadier-General W——, who I thought must have died. All, or nearly all, recovered, except two, both of whom had been bled on the spot before I saw them.

In addition to the douche, stimulants, such as mustard-plasters, to various parts of the body, legs, abdomen, etc., and stimulating injections, which relieve the loaded bowels and at the same time rouse, may be useful.

When I say such cases recovered, I refer to the reaction at the time. In some there were consecutive symptoms of fever, headache, etc.; and, were we able to trace their subsequent history, we should probably find that complete recovery never occurred. If recovery is incomplete, and followed by indications of disordered nerve-centers or of meningitis, other treatment of a more active character will be needed, according to the conditions.

Future exposure to the sun should be carefully guarded against, and, unless recovery has been rapid and complete, the sufferer, if in India or the tropics, should be removed to a cooler climate, where he should be protected from all excitement of mind or body, and the greatest care be taken not only to avoid all errors or excesses of diet, but also of stimulants.

In the graver cases of thermic fever, or heat-asphyxia, heat being the primary cause of the disease, the object is to reduce temperature as speedily as possible and before tissue-changes have been caused. Remedies adapted to fevers may be used sometimes with advantage. Bleeding has now happily been abandoned except in rare and peculiar cases. The treatment, generally, consists in the judicious application of cold by affusion, or by ice, taking care not to reduce temperature too low. Great care should be taken not to prolong the cold application too far, as danger would attend continued depression of the temperature below the normal standard of blood-heat. The bowels should be relieved, and blisters may be applied to the scalp and neck, though I can not but say I have not much faith in their efficacy. In the epileptiform convulsions that so frequently occur, the inhalation of chloroform may be useful, but its administration must be carefully watched. The earliest and most severe symptoms having subsided, the febrile condition that follows is to be treated on ordinary principles; the diet must be carefully regulated. As improvement progresses, symptoms of intra-cranial mischief may begin to supervene; where the indications are of meningitis, iodide of potash and counter irritation may be of service; removal to a cooler climate is essential.

The sequelæ of sunstroke are often very distressing, and render the patient a source of anxiety and suffering to himself and to his friends.

Among them are, in various degrees of intensity, irritability, im-