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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    bably spread in the superficial layers of the soil, like other pathogenic micro-organisms, and may be conveyed toman with dust blown by the wind or thrown up under the tread of a marching column. It is then inhaled into the lungs, or ingested into the alimentary canal, where it produces the deadly toxin which probably, as in cholera, becomes absorbed and sets up the symptoms of the disease. Diaonosis. Siriasis has marked characteristics, and now that we have a clear sketch of its symptoms it should not be confounded with syncope, alcoholic coma, cerebral hsemorrhage, and epilepsy. But there are two diseases with which it may be easily mistaken: cerebro-spinal fever and pernicious malaria. Cerebrospinal Fever. — Cerebro-spinal fever may closely simulate siriasis. In cerebro-spinal fever an early, frequent, and important symptom is the painful stiffness of the muscles of the neck; the patient lies with the body rigid and the head drawn back. The pupils may be contracted, but they are usually dilated or unequal. Strabismus is a fre- quent and important symptom. Herpes is very common. Cerebro-spinal fever begins with a chill which may recur several times in the course of the illness. In some cases the temperature may run as high as io6° or io8° F., but it usually averages from ioi° to 103°!?. ; its characteristic in this disease is irregularity. The respirations are often increased in fre- quency; in the graver conditions breathing becomes embar- rassed but not stertorous. Profound coma is exceptional, and delirium is always present at some stage of the disease. Constipation is the rule, and the urinary secretion is normal in quantity notwithstanding the fever. Foudroyant cases may end fatally in a few hours, but ordinary cases last from one to three weeks. Cerebro-spinal fever prevails mostly in temperate regions, and is more frequent during the colder months. Many of the cases put down to sunstroke in England and France were undoubtedly cases of cerebro-spinal fever; take, for example, the cases described by Donkin5 in 1888, some of those described by Bullar6 and Strange7 in 1868, by Armitage in 1881,8 those reported by Ducleaux in 1859.9 Pernicious Malaria— Manson and others have described a comatose form of malaria which greatly resembles siriasis. I am strongly inclined to believe that many of the cases reported as malaria in China and India were really cases of siriasis, but undoubtedly pernicious malaria may closely simulate this disease, and the diagnosis may be almost im- possible, especially when the two conditions are found con- comitant in the same patient, as not infrequently occurs. Pernicious malaria never occurs with the first attack, but shows itself in the second or third. Rigors usually precede the paroxysm. Conclusion. I know the title of this paper will startle many, but what I think most surprising is that siriasis should have remained so long in the domain of astrology. I have endeavoured to extricate it from the confusion in which it was enveloped, and I hope I have succeeded in giving a clear and correct sketch of the disease, and of the conditions under which it prevails. To have a correct notion of the etiology of any disease is un- doubtedly important, but in the case of siriasis it is especially