5:20 THE TREATMENT OF DISEASES. 



head-dress that was useless or worse than useless, succumb to the effects of heat in 

 large numbers. 



Exhaustion as the result of prolonged exercise is a powerful predisposing cause 

 of sunstroke. When severe muscular exertion is carried on for any length of time, 

 as in prolonged marching, under a continuously high temperature, perspiration 

 ceases, and not only is the cooling effect of its evaporation lost, but impurities are 

 retained in the blood. The result is that the sufferer soon becomes wretchedly 

 weak, and readily falls a victim to the excessive heat. 



Direct exposure to the rays of the sun is by no means necessary for the 

 production of sunstroke. It is not of unfrequent occurrence among men shut 

 up in the impure and heated air of close barracks in hot climates. It is often 

 observed on board ship when overcrowding and impure air are added to the 

 influence of excessive heat. It is not of frequent occurrence in ships in 

 mid-ocean, but it is common enough in the Red Sea during the months of 

 August and September. It is especially to be dreaded when excessive heat 

 is aggravated by prolonged calms. 



It is now well known that men will bear a high temperature in the open 

 air with comparative impunity, provided it is not too long continued, that the 

 dress is reasonably adapted to the temperature, that the free movements of 

 the chest are not interfere^ with by straps or baggage, and that alcoholic 

 liquors are not indulged in. 



The symptoms of sunstroke vary much in different cases. Often without the 

 slightest warning the patient falls, gasps, and expires before anything can be done 

 for him. Sometimes the attack is less sudden in its mode of onset, and there are 

 premonitory symptoms giving notice of the coming danger. The skin gets very dry 

 and hot, and the temperature rises to 107 or thereabouts. The patient complains 

 of giddiness, weakness, and nausea, and often of an inability to hold his water. 

 Soon he becomes hysterical or delirious, and rushes out roaring with laughter, or 

 perhaps screaming with terror in an attempt to escape from some imaginary enemy. 

 People in this state have endeavoured to take their lives or to injure those who have 

 tried to restrain them. After a time the patient becomes insensible, the heat and 

 dryness of the skin augment, and the closing scene is ushered in by an attack of 

 convulsions. In the former variety death ensues almost instantaneously, whilst in 

 the latter the symptoms may be protracted over a couple of days. 



Now as to the treatment of sunstroke. Throw some water over your patient, 

 and carry him as quickly as possible to the nearest shade. Strip off his clothes, 

 and douche his head, face, and chest with cold water. If this treatment be quickly 

 and energetically performed it may save his life. Should the skin remain hot, 

 repeat the douche at intervals. Apply ammonia, or sal volatile, or smelling-salts to 

 the nose occasionally. If sensibility be not restored by the douche, apply a blister 

 to the nape of the neck, or get the head shaved and put a blister on the scalp. Two 

 drops of croton oil placed at the back of the tongue will cause the boweLs to act, 

 and will do good. Get medical advice as soon as you possibly can. 



Bleeding should never be resorted to. When the patient is bled he nearly 

 always dies. In illustration of the pernicious effects of bleeding in sunstroke the 



