HEATING AND VENTILATION. Gyo HEAT-STROKE. inlets are very numerous the inrush of air will be unpleasant to those near by. BiBLiocR.vrHY. Consult Billings, Ventilation and llvaliiiij (cv York. 189;j), which is par- ticularly full in its discussion of ventilation, and includes descriptions of the ventilation of a num- ber of hospitals and other public liuildings; Car- penter. Heating and Vrntildtin/i Jiidldinns (New York. 1S!)5). which goes more fully into licating and develops the mechanical pliases of both sub- jects; Baldwin. Hot Water Uaitimj and Fitting (Xew York, 1890) ; Richards and Woodman, Air, Water, and Food (New Y'ork, 1900), which sets fortli the pliysiological side of venlilation briefly and clearly, and has a valuable chapter on methods of air analysis, and the determination of carbonic acid; Putnam. Ttte Open Fireplace in All Age.t (Boston. 18S1) ; Dwyer. on "Stoves and Ueating Apparatus." in One Hnndred Years cf American Voinmerce (Xew Y'ork. 1895) : Pro- ceedings American tiociett/ of Heating and Venti- lating' Engineers (New York, 1894-1900). HEA'TON, Augustus George (1844—). An American painter, born in Philadelphia, Pa. He was the first United States student admitted to the Ecole des Beaux-Arts in Paris (1863). He studied under Cabanel there, and afterwards be- came a pupil of Bonnat, and exhibited several times at the Salon. Among his works are: "Washington at Fort Duquesne;" "'The Recall of Columbus." which was bought by the United States Government and engraved for the 50-cent stamp of 1893; "Hardship's of Emigration," en- graved on the 10-cent stamp, celebrating the Trans-JIississippi and International Fair: and "The Promoters of the New Congressional Li- brary" (1888). He also painted portraits of Mrs. .JefTerson Davis and Amelie Rives. HEATON, IUry Hakg.ret (183G-83). An English art critic, the daughter of a silk-printer, James Keymer, who was a friend of Douglas Jerrold. She wrote: Masterpieces of Flemish Art (1869) ; Life of Albrecht Diirer (1870) : and a valuable Concise Historg of Painting (1873; and in Bohn's Artist's Library, 1888) ; as well as con- tributions to Bryan's Dictionary of Painters and Engrarers. HEAT-STKOKE, Sunstroke, or Thermic Fever, also called Ixsol.tiox, Heat Apoplexy, Sun Fe'ER. and Siriasis. The effect produced upon the body by exposure to intense heat, whether from the sun, from furnaces, or from the atmosphere. Another form of affection resulting from exposure to heat is Heat Exhaustion, or Heat Prostration, in which there is a very dif- ferent set of symptoms. In the commoner, mild form of heat prostration, the patient exhibits exhaustion, weakness, faintness, and occasionally nausea ; in the severe form, pallor, great depres- sion, collapse, and loss of consciousness, with a subnormal temperature dropping sometimes as low as 95° F. All cases recover in a few hours. Heat-stroke, on the contrary, usually comes on abruptly, or is preceded by some weak- ness and anxiety. Unconsciousness supervenes early, with flushing of the whole body and pro- fuse sweating, delirium or even mania, vomiting and diarrhnpa. and a temperature of 108° to 11.5° F. Death may ensxie speedily, from cessation of respiration or from cerebral anaemia : the sweat- ing ceasing, the full rapid pulse becoming imper- ceptible, and asphyxia, coma, or convulsions fol- VOL. IX.— i5. lowing. Laborers in the open, laundresses in an overheated Ivitchen, bakers, antl firemen in engine- rooms, present most of the cases. Alany cases occur at night among those exposed to indoor heat wlo have not been in the sun at all ; others wlio liavc been in the sini during the day arc stridden at night in the vitiated atniospliere of crowded tenement-house rooms, after drinking alcoholic beverages and eating hearty meals. Two and six-tenths per cent, of the heat pro- duced by the chemical metabolism within the body is lost from the body in wanning substances taken in as food and drink, 2.0 per cent, in warm- ing the inspired air. 14.7 by evaporation, and 80.1 per cent, by radiation and conduction from the skin. With the inspired air hotter than the body, radiation and conduction abolished, and evaporation rendered impossible in an atmos- piicre nearly saturated with vapor, the constant production of heat by muscular action must re- sult in a great strain upon the inhibitory cerebral centres that preside over heat regulation. Any previous ill health, alcoholic indulgences, or other excess is followed by a f.ailure of these centres under such strain, and heat-strolie is the result. The combined influence of lieat and auto-intoxi- cation constitute the combined cause of heat- stroke, with the possibility of a germ poison. Sambon, of Rome, in a paper on heat-stroke published in 1898, asserted the infectious char- acter of the disease as produced by a specific germ. He classes it with j-ellow fever, dengue, and other tropical affections, all germ diseases requiring high atmospheric temperature for their develop- ment. Tliis view has yet to be substajitiated. Van Gieson. of New York, however, during an extensive examination of brains of victims of heat-stroke, fovind clianges in the chromophilic pla(pies of the ganglion-cells. These plaques were changed in shaiie, fewer in number, replaced by fine dust, or entirely absent. The nucleus of the brain-cell stained very deeply, and within the nucleus membrane were found minute spherical granules not normally present. Van Gieson says: "There seems to be no other interpreta- tion open as to the significance of this degenera- tion than the operation of a toxic substance upon the ganglion-cells. . . . There is in insolation a toxic cytolysis or cell resolution of the neurons." He considers the morphologic changes in the ganglion-cells similar to those produced by alco- hol, lead, and the qjicrobe poisons ; and that heat-stroke is "a species of auto-intoxication, the neural symptoms finding a clear and definite explanation in the acute parenchymatous de- generation induced by an autogenous poison." The treatment of heat prostration, the mild form of thermic exhaustion, consists in securing elevation of the temperature of the body by the use of external heat and in supporting the heart by the use of alcoholic stimulants, strychnine, and similar drugs. In heat-stroke, on the other h.and, rapid reduction of temperature must be secured at the earliest possible moment. Sprink- ling ice-water over chest and body or rubbing with ice is imperative. It has been urged that ambulances carry ice and a sprinkler, that treat- ment may begin as soon as the p.atient is reached, and continued during his trip to the hospital. Here the patient is placed on a Kibb*: pot or a Walton bed. and the cold nfTusion is continued till the temperature falls to 102..5° F. He is then rubbed dry. removed to a bed and wrapped
