present in heat-stroke, must on no account be used as a cardiac stimulant. Convulsions are best controlled by cautious chloroform inhalations. As death in heat-stroke generally results from failure of respiration, Chandler strongly recommends artificial respiration when the breathing threatens to become suspended; he claims to have obtained some marvellous results from this expedient. It should be kept up for half an hour or longer.
During convalescence great care must be exercised to shield the patient from all influences calculated to provoke relapse.
SUN-TRAUMATISM
There is a large, ill-defined, and difficult-to-define class of heat-stroke cases which belong neither to the category of heat-exhaustion nor to the very definite and possibly specific disease just described. The morbid phenomena in this class of sun-induced disease are attributable, apparently, to a peculiar physical action of the direct rays of the sun on the tissues. To this category belong, it seems to me, those sudden deaths occurring without warning during, and manifestly in consequence of, exposure to the sun. Such may have been the sudden deaths described by Parkes, Maclean, Fayrer and others, in which soldiers in the excitement and stress of battle, while oppressed with thick clothing and heavy accoutrements and exposed to a blazing sun, suddenly fell forward on their faces and, after a few convulsive gasps, died. In these instantaneously fatal cases the paralysis of the heart or respiration seems to be of the nature of shock, as from a blow or other sudden and violent impression on the encephalon.
Doubtless, indeed it is a well-known fact, the strain undergone in these and similar circumstances may, in some instances, causa an apoplexy or rupture of some description in tissues prepared for such a cataclysm by morbid degenerations of long standing.
Besides the foregoing there is another type of case in which, after prolonged exposure to the sun, a febrile condition is established. This is sometimes of great
