Joseph Fayrer

“ 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. ”

“ Soldiers, laborers, artificers, and people in factories, heated rooms, hospitals, barracks, tents, and even ships, may suffer from heat-exhaustion, which may pass into the same dangerous condition of heat-asphyxia. People in the hay-field, or otherwise exposed to great heat, especially if they have indulged in excess of alcoholic stimulants and food, may suffer. ”

“ Weak persons with defective hearts may die in this state of syncope. Soldiers or others, when exposed to great heat, may drop out of the ranks, fall in a state of syncope and die on the spot, or pass into a state of coma and die later; or they may recover, after being in great danger, with damaged nerve-centers, and are rendered quite unfit for further service, or even residence in a hot climate. ”

“ No remarkable morbid change is observed in cases where death has occurred suddenly. The heart may be firmly contracted, and the lungs and brain and its membranes congested, but not invariably, for sometimes the reverse conditions exist ”

“ The pulse varies; in some it is full and laboring, in others quick and jerking; the head, face, and neck are livid and congested; the carotid pulsation is very perceptible; the pupils, at first contracted, dilate widely before death. ”

“ Vigorous, healthy persons of moderately spare frame, with sound viscera, and who are of temperate habits, if the atmosphere be pure and moderately dry, can sustain a great amount of heat. Acclimatization has also some influence in conferring toleration. ”

“ 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. ”