ong the first symptoms.
The face is very pale, the skin is cool and moist, although the
trouble often starts with sudden arrest of sweating. There is great
prostration, with feeble, rapid pulse, frequent and shallow breathing,
and lowered temperature, ranging often from 95 deg. to 96 deg. F. The patient
usually retains consciousness, but rarely there is complete
insensibility. The pernicious practice of permitting children at
seaside resorts to wade about in cold water while their heads are
bared to the burning sun is peculiarly adapted to favor heat
prostration.

Heat stroke happens more frequently to persons working hard under the
direct rays of the sun, especially laborers in large cities who are in
the habit of drinking some form of alcohol. It often occurs in
unventilated tenements on stifling nights. Dizziness, violent
headache, seeing spots before the eyes, nausea, and attempts at
vomiting, usher in the attack. Compare it with heat prostration, and
note the marked differences. The patient becomes suddenly and
completely insensible, and falls to the ground, the face is flushed,
the breathing is noisy and difficult, the pulse is strong, and the
thermometer placed in the bowel registers 107 deg., 108 deg., or 110 deg. F., or
rarely higher. The muscles are usually relaxed, but sometimes there
are twitchings, or even convulsions. Death often occurs within
twenty-four or thirty-six hours, preceded by failing pulse, deep
unconsciousness, and rapid breathing, often labored or gasping,
alternating with long intermissions. Sometimes delirium and
unconsciousness last for days. Diminution of fever and returning
consciousness herald recovery, but it is a very fatal disorder,
statistics showing a death rate of from thirty to fifty per cent. Even
when the patient lives, bad after effects are common. Peculiar
sensibility to moderate heat is a frequent complaint. Loss of memory,
weakened mental capacity, headache, irritability, fits, other mental
disturbances, and impairment of sight and hearing are among the more
usual sequels, occurring in those who do not subsequently avoid the
direct rays of the sun, as well as an elevated temperature, and who
indulge in alcoholic stimulants. A high degree of moisture in the air
favors sunstrokes, but it is a curious fact that sunstroke is much
more frequent in certain localities, and in special years than at
other places and times with identical climatic conditions. This has
led observers