SUN STROKE OR HEAT STROKE AND HOMEOPATHIC MANAGEMENT

                                                     SUN STROKE OR HEAT STROKE

Other names:- sun stroke, heat stroke and  heat hyperpyrexia.

DEFINITION:-

                Heat stroke or sun stroke is a state of hyperpyrexia, convulsions, delirium or coma following exposure to excessive atmospheric temperature (shade temperature above 110 F). the body temperature suddenly shoots to 42 – 43 C (107 – 110 F).

AETIOLOGY OR CAUSES:-

-          Heat stroke or sun stroke is caused by a derangement of the heat controlling mechanism.

-          It’s a commonest condition in India and other tropical countries.

-          In this country, it occurs during hot summer months (especially during spells of hot wave) due to direct exposure to the sun while working outdoors.

-          White peoples or persons unaccustomed to such a situation are specially prone to have such an attack.

-          Debilitating conditions, alcoholism, febril conditions and factors that interfere with sweating (e.g improper clothing) are pre disposing factors.

-          Some cases of heat exhaustion may develop heat stroke (secondary heat hyperpyrexia).

-          The brain is primarily affected. There is congestion and increased in intracranial tension. Degenerative changes occurs in brain cells, particularly in the hypothalamic region and base of the brain (including the cerebellum).

-          Due to renal shutdown, glomerular and tubular degeneration occurs in the kidneys. Necrosis also occurs in the liver. There is haemmorrhagic tendency due to intravascular coagulation.

      SYMPTOMS:-

-          The onset is sudden.

-          There is a history of exposure to the sun for some time.

-          Headache.

-          Vomiting.

-          Dizziness.

-          Mental confusion and in-coordination.

-          Convulsions may occur in children.

-          The patient soon becomes delirious and finally, unconscious.

-          On examination, the face is flushed and the skin is hot and dry.

-          The temperature is raised to 42C (107F) or above. There is complete absence of sweating.

-          The pulse is rapid and the respiration is hurried. The pupils are dilated.

-          Towards the terminal stage, convulsions occur, breathing is irregular and pupils are constricted.

-          There is either Oliguria or complete anuria, transient cardiac arrhythmias may occur.

-          Right sided cardiac failure or peripheral circulatory failure may occur.

DIAGNOSIS:-

The diagnosis can be made on the basis of the following.

-          History of long exposure to heat.

-          Hyperpyrexia (temperature shooting above 106F).

-          Absence of sweating.

-          Exclusion from other causes of hyperpyrexia such as malaria, pontine haemorrhage, meningitis, over whelming sepsis and terminal stage of liver failure.

TREATMENT:-

-          The aim of therapy is to bring down the elevated or raised temperature to a safe level or normal level as rapidly as possible.

-          This may be achieved by continuous sponging with ice-cold water or ice bath together with ice water enema. Evaporation should be encouraged by means of fans.

-          The patient usually regains consciousness and the body temperature falls unless brain is irreparably damaged.

-          If coma persists lumbar puncture is indicated to relive the raised intracranial pressure.

-          Chlorpromazine is indicated and repeated after ½ hour if the patient is delirious and restless.

-          Lytic cocktail (chlorpromazine phenargan and pethidine 50 mg each) may be given for reducing raised temperature.

-          When heat stroke is secondary to heat exhaustion, adequate water and salt replacement is essential. Danger of pulmonary oedema due to administration of intravenous fluids must be remembered.

HOMEOPATHIC TREATMENT:-

                Some of the medicines for sun stroke or heat stroke are given below.

1.       ACONITE.

2.       AMYLAMINUM.

3.       ANTIMONIUM CRUDUM.

4.       ARNICA MONTONA.

5.       ARSENICUM ALBUM.

6.       BELLADONNA.

7.       CACTUS.

8.       CAMPHORA.

9.       CARBO VEG.

10.   GELSEMIUM.

11.   GLONINE.

12.   NATRUM CARB.

13.   NATRUM MUR.

14.   OPIUM.

15.   THERIDION.

16.   VERATRUM ALBUM.

17.   VERATRUM VIRIDAE.

18.   ARGENTUM METALICUM.

19.   LACHESIS.

20.   THUJA.