Freeland tribune. (Freeland, Pa.) 1888-1921, 1901-10-07
SUNSTROKE PATHOLOGY
INTENSE HEAT AND HUMIDITY PRE-.
VENT EVAPORATION.

The Lungs Become Deeply Congested and
: the venous System Engorged The
Heart Contracted-Cold Douches Otter
Give Wonderful Relief.
| There Is no argument necessary to
prove that heat in itself Is the prime
! causative factor of sunstroke, declares
the Medical Record. Most commonly,
it is true, the phenomena variously
grouped under the designations Of In
ISOLATION. coup de soliel and sonnen-
stitch are due to the intensity Of direct
solar rays; they are also induced by
artificial heat in shady quarters, and
even during the night when high
temperature and extra humidity pre-
vent the proper cooling Of the body
by natural evaporation.
Although different grades of heat
exhaustion are given with their cor
responding varieties Of pathological
LESSONS, 1t is fair to assume that
they depend essentially upon different
degrees Of action of the primary fac
tor.
The study of autopsical LESSONS in
given caSes is not always satisfactory
in reconciling relations Of cause and
effect. When death is sudden no dis
/ tinctive tissue changes are manifest
Under such circumstances the condi-
tion appears to be either that of syn
cope from simple failure of heart ac-
ton, or from direct shock to the we're
bral and respiratory centres. The lat
ter, termed the asphyxial form. is the
most common and most rapidly fatal.
In the hyperpyrexial variety, in which
the temperature may range from 10S
degrees F. to ITO degrees F., the
cerebral LESSONS are usually quite pro-
nounced.
There are often evidences of menIn-
gifts, serious effusions in the ventricles
and occasionally hemorrhages into the
brain substance. In spite of these
/ pathological appearances. mostly
focused, as they seem to be, in the
cerebral centres, the cause Of death
Is asphyXia and not apoplexy. AS
evidences of this fact the lungs are
| deeply congested, the entire venous
system is engorged, the heart is firmly
contracted, and the blood is dark. i'm
paired in coagulability and has in
| creased fiuidity. In general way we
may, perhaps, explain the existence
of the various LESSONS by the assump-
| tion that in all cases the brain and
nervous centres, especially the respira-
| tory, are overwhelmed by the sudden
| elevation Of temperature, and respira-
| tion and circulation eventually fail,
the latter being probably to the in
| hibitory influence of the vagus. 1t is
simply over-stimulation by heat, fol-
lowed by eventual exhaustion.
In the hyperpyreXial form, in which
the symptoms come on more gradu-
ally and continue proportionately long
er than in the other varieties, there ap-
! pears to be more time and more op-
portunities for permanent LESSONS in
brain structure. Thus in those who
recover from the immediate attack.
| there may be marked and permanent
impairment of intellect, frequent
headaches, due to subacute meningitis;
also loss Of memory, eyesight and
hearing, muscular paralysis and other
evidences of permanent absence of
nerve force. There can be no question
that these changes thus induced are
distinctly and diffusively organic in
| character, although, as yet, such are
not absolutely explained by any mani
fest degeneration in nerve cell struc-
ture, or in any uniform retrograde
metamorphosis Of nerve fiber. The
gross LESSONS are, however, plainly
enough seen to enable us to hope that
the discovery of the finer ones may be
OILY questions Of time, opportunity
and study.
| We only glance cursorily at the gen.
eral pathology of coup de soleil, in
order to appreciate such practical
matters for treatment as may be
thereby suggested. Everything in the
way of q promise of absolute recovery
depends upon the prompt treatment
of the initiatory symptoms. 1t is only
in this way that permanent LESSONS
can be anticipated or prevented. Once
the organic changes are fixed, the vic
tim beDmes hopeless invalid, with
impairment of his most valuable
faculties. The main therapeutical in
dications are in the direction of modi
flying immediate shock, and of reduc
ing more or less rapidly excessive TEN
perature. In this connection, it is wei
to recollect the numbers of important
centres involved, and the intimate as
sociations of some of these with the
respiratory and cardiac functions.
While it is somewhat doubtful tha
local cold douches to head, neck ant
spine can do much more than lower
surface temperature they certainly
even in this indirect way. often ac
complish wonderful results. 1t woul(
seem almost like blowing hot and colo
with the same breath to advise hear
stimulation in connection with the
Foregoing measures, but IN reality b.
SO doing. we effectually counterbalanc
the effects of the ultimate exhaustion
which always follows the primar.
overstimulation. I'm fact, we ma,
work them side by side as indications