SUNSTROKE AND SOME OF ITS SEQUELyE. 175 



body. In some cases rousing by flagellation with the sweeper's broom 

 was added with great effect, especially in the case of Brigadier-Gen- 

 eral W , who I thought must have died. All, or nearly all, recov- 

 ered, 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 injec- 

 tions, 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 need- 

 ed, according to the conditions. 



Future exposure to the sun should be carefully guarded against, 

 dnd, 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 applica- 

 tion too far, as danger would attend continued depression of the tem- 

 perature 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 eflicacy. 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 princi- 

 ples ; the diet must be carefully regulated. As improvement pro- 

 gresses, 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 sequelse 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- 



