Remarks on the etiology of sunstroke (siriasis) : not heat fever, but an infectious disease / by L. Westenra Sambon.

  • Sambon, Louis Westenra, 1865-1931.
Date:
1898
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Licence: Public Domain Mark

Credit: Remarks on the etiology of sunstroke (siriasis) : not heat fever, but an infectious disease / by L. Westenra Sambon. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tioned as causes o! siriasis “sun or heat and something more.” , .. , ., The symptoms of the disease, its relapses, its morbid anatomy, its peculiar geographical distribution, its epidemic outbursts, the conditions of climate and soil under which it prevails, the relative immunity to its attacks afforded by acclimatisation all clearly point to the specific infectious nature of the disease. I know not how I can better prove my statement as by taking these points in succession, and offering a sort of running commentary upon them. Symptoms. Onset.—The onset of siriasis is often sudden. Indeed, there are cases which are so sudden as to exemplify in a marked degree the characteristics of profound toxaemia. The patient falls as if shot, gives a few convulsive gasps, and dies. The same suddenness is witnessed in other infectious diseases, as, for example, cholera, plague, cerebro-spinal fever. This fulminant type occurs with variable frequency in epidemics. More commonly there are premonitory symptoms—headache, nausea, drowsiness, a general feeling of weakness, especially in the lower extremities, frequent desire to micturate. These symptoms may appear hours and days before the dangerous conditions set in. Attributing the disease to solar influence, we should expect it to occur in the hottest hours of the day, instead of which it happens mostly by night. It is a com- mon occurrence in India that the stertorous breathing or the retching of the patient, who is apparently asleep in bed, first attracts the attention of room mates, who arouse him with difficulty. Sometimes the patient starts up suddenly, and attempts to escape, staggering about, and struggling violently if laid hold of, but in a few minutes he drops down unconscious. Preliminary Stage.—Generally patients are seized with severe headache, an alarming sense of general oppression and exhaustion, a difficulty in breathing, and a distressing burning in the eyes associated with vertigo and chromat- opsia (surrounding objects appear of uniform colour, usually red, blue, or purple). The skin becomes dry and intensely hot, the patient is pale and excessively thirsty. The pulse is rapid, full, and bounding. The respiration is hurried and oppressed. The temperature rises suddenly to 107°, 1080, and sometimes no°F.; it may reach 1120 or 113°, and even above. Vomiting is very common, and may be a special feature at the outset; purging is, in bad cases, almost always present. The dejecta are watery, colourless, and resemble the “rice-water” stools of cholera. The skin and breath have a peculiar mousy odour which is as distinct and unmistakable as is the odour of typhus fever, small- pox, and other diseases. Very often cramps occur in the calves of the legs or in the muscles of the back. A maculo-papular eruption has been described as occurring occasionally, but there is nothing characteristic about it. Comatose Stage.—When the disease has fairly set in, in- sensibility follows. At first the patient may be partially roused, but he soon passes into a condition of profound coma. The muscles of the face and upper extremities show convulsive twitchings ; sometimes there are general convul- sions of the most violent description. Authors have de- scribed cases in which muscular rigidity amounted to