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December 15, 1945


JAMA. 1945;129(16):1123. doi:10.1001/jama.1945.02860500055026

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To the Editor:—  The article "Statistical Study of 265 Cases of Heat Disease" by Borden, Wadill and Grier (The Journal, August 25, p. 1200) was read with considerable interest. To those of us stationed in the southern part of Iran, where some of the highest known environmental temperatures have been recorded, the problem of heat disease has been of considerable importance. During this last summer we have encountered dry bulb shade temperatures up to 122 F. and humidity as high as 61 per cent.The general principles of treatment as outlined in the article are sound. In the management of heat stroke, however, there is, in my opinion, a considerable misdirection of emphasis. Much attention is devoted to the "rapid restoration of circulating fluid volume"; the urgency of rapidly reducing the hyperthermia is inadequately stressed.True heat stroke results from a breakdown of the central temperature regulating mechanism. In this

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