I450 



HEAT STROKE AND HEAT SYNCOPE 



History, — In the section entitled High Atmospheric Temperatures 

 contained in Chapter VII. we have set forth the views of a number 

 of authors with regard to heat stroke, sunstroke, and heat syncope 

 from early times down to 1908, and it seems to us to be inexpedient 

 to repeat that which we have already written. We will, therefore, 

 merely continue that history in the following paragraphs. ^ In 

 191 2 and 19 13 Hiller made a number of investigations on this subject 

 in the German Army, and Fiske in that of the United States, while _ 

 Segale published remarks upon thermo-calorimetry. 



In 1913 and 1914 Pembrey, and separately Simpson and Woolley, 

 wrote an important series of papers dealing with heat strokes. 



It is to be noted that, like ourselves, Simpson and Ogilvie hold 

 that there is no difference between heat stroke and sunstroke from 

 a clinical point of view, while Rogers, and later Bram, consider 

 that there is a difference. 



Thus Rogers says that the syncopal form is due to the sun and the 

 hyperpyrexial to the heat, whereas Bram maintains inter alia that 

 sunstroke is associated with a very high temperature and heat stroke 

 with either a normal temperature or a low fever ruiming from 

 100° to 102° F. 



Simpson's experiments, as well as our own described in Chap- 

 ter VII. (p. 137), show that Haldane's researches detailed in 

 Chapter III. (p. 62) apply to tropical climates. 



In 1915 Puntoni, in studying sunstroke, made a number of 

 experiments, by means of a photographic camera, with regard to 

 the penetrating powers of various kinds of rays, in which the place 

 ot the camera was taken by a piece of the cranium obtained from a 

 post-mortem and containing blood. He concluded that the human 

 cranium was diathermal for violet ultra-violet rays, which he con- 

 sidered to be the causal agents of sunstroke, and to avoid which he 

 advised the use of clothing composed of white externally and green 

 internally, and also of green glasses for the eyes. With reference to 

 this, we may perhaps draw attention to Sir William Crookes' non- 

 actinic glasses, with which we have performed some few experiments 

 in the Sudan, and which, tested therein, are capable of protecting 

 photographic plates. 



k In 1916 Koizumi, as the result of experiments upon animals, 

 bilieved that during severe manual labour in high atmospheric 

 temperatures the products of metabolism are produced in such 

 abnormal amount that they cannot be removed, properly and effi- 

 ciently, from the blood, and so act as causal agents in the production 

 of heat stroke. This may perhaps help to explain the importance 

 of diet in the prevention of heat stroke. 



In 1917 Gauss and Meyer gave an excellent clinical account of an 

 outbreak of heat stroke in Chicago, and Amar investigated the effects 

 of muscular exertion in high atmospheric temperatures and drew 

 attention to the use of deep breathing in these conditions. 



In 1918 McKenzie and Le Count concluded that the chief cause 

 of heat stroke was the inability of hot air in the vicinity of the body 



