It is also known as Heat stroke or Heat hyperpyrexia. Very often in summers there are news in daily papers about the deaths occuring because of heat stroke. But rarely people think about this cause of death and that what it is? Why it affects and how it affects?And what measures can be taken to prevent it, and what should be done after sun stroke. This all I would like to discuss here. So that all the cases of sun stroke should not prove fatal.
     Homoeopathy offers few very good remedies to tackle this yearly problem. Sun stroke is quite common in India's tropics, though white race is more susceptible. In places like Calcutta, Rajasthan, Bihar and Delhi this problem seen quite often.
     Sun stroke is most common in elderly people with pre-existing chronic diseases like Arteriosclerosis, Congestive heart failure. It is also more common in pateints those who are taking diuretics. Predisposing factors can include Diabetes Melitus, Alcoholism, use of drugs like Atropine and skin disorders in which it may be difficult to loose heat such as Ectodermal Dysplesia, Congenital absence of Sweat glands, or severe Scleroderma.
Direct exposure to sun is not a neccessary prerequisite. Heat hyperpyrexia may develop during any period of hot weather, but the incidence in temperate climate increases during prolonged heat waves and at temperature of 90 F(32.2 C) or higher. High humidity in the range of 60-75% is a prerequisite to heat stroke .
     Sweat fatigue is the major pathogenic mechanism of heat stroke and patients stop sweating before the onset of acute symptoms.The cessasion of sweating is due to an intrinsic breakdown of the heat regulatory mechanism for reason not known.As manifestations there may be few premonitory symptoms of heat stroke and loss of the counsciosness may be the first sign.Few patients may complain of headache, vertigo, faintnaess, abdominal distress, confusion, hyperaemia, delirium develop in more severe cases .
     Fever and prostration are the significant findings on physical examination. Rectal temperature greater than 106F (41.1 C) is common and agrave prognostic sign. Maximum internal body temperature as high 112-113 F(44.4 C) have been recorded. The skin is hot and dry and sweating is absent .The pulse rate is increased and the respiration or breathing is rapid and weak.Systolic lood pressure may be elevated, muscles are flaccid and tendon reflexes may be diminished. Lethargy, stupor or coma depending on the severity ,is present.Shock is common in fartal cases.
     Urine and blood examination show few abnormalities. Increase in W.B.C. count ia characteristic as are Proteinuria, and elevation in BUN. Respiratory Alkalosis Hypokalaemia, Hypophosphataemia may be seen.In additon to tachycardia or fast pulse rate E.C.G. may shiow sinus Arrythmia , flattening and subsequent inversion of T wave and depression of the ST segment ,diffuse myocardial nacrosis with E.C.G. evidence of Myocardiial Infarction has been reported.Other major laboratory abnormalities include Thrombocytopenia and prolonged bleeding ,clotting and prothronmbin times, Afibrinogenemia and Fibrinlysis and consumptive coagulopathy.All these may be responsible for diffused bleeding. Liver damage is common, it appears within 24-36 hours, and is characterised by clinically apperant Jaundice and often by abnormalities in Hepatocellular enzymes. Renal failure is a very common complication of Sun stroke.
     Person with sun stroke may die within few hours after being discovered ,or may die of the complications such as Acute renal failure. However number of patients may die several weeks after the acute episode, usually of Myocardial Infarction,Heat failure, Renal failure, Bronchopneumonia or complicated Bacteraemia. Death may rapidluy ensue complications include dilatation of the Right heart and Oedema of the lungs. If the patient recovers from the coma there may be mental confusion,Aphasia ,Incontinence , and signs of Pyramidal or cerebellar lesion. Complete recovery may ensue , or the patient may show the sign of Demantia. The prophylaxis would be, the bowels should be kept open daily. Plenty of fluids taken, but Alcohol should not be consumed in excess. The head ,neck and spinal cord should be adequately protected from the sun .
     Stimulants such as narcotics are ontraindicated.Interavenous fluids should be given with the monitoring of central venous pressure and urinary output. Both dehydration and heart failure be avoided . Fresh blood may be given in cases of bleeding. Persistant oliguria is an indication of early Dialysis.
     Blood film must be taken to exclude Malaria.Homoeopathically most important remedies are Glonoine, Aco, Bell, Camphor, Verat V, Stram,and Nat Mur etc.withdefinite indications of the remedy.
     In young children convulsions are common at temperature higher than 106 F, and irreversible brain damage due to proteinenduration is common in temperature of 108 F . Fortunately when fever reaches the dangerous level the mechanism of heat loss is suddenly activated, consequently oral temperature above 106 F are not very commonly seen.
     The systemic symptoms accompnying deviation in temperature are not understood very rightly. For example at temperature of 102 F many patients have malaise and drowsiness, weakness and generalised aches and pains, many other however feel entirely well. Though homoeopathically it individualises a patient from the other and we have certain remedies working beautifully in these cases also e.g. Opium, Bell, Arnica, Bapt, R.T, Ars Alb, Aco, and Gels etc.