Heat stroke: report on 18 cases.

Eighteen hyperpyrexial patients with a mean rectal temperature of 42.3 degrees (range 41.2-43.1 degrees C) were rapidly cooled in a unit producing evaporative cooling from a warm skin. Sixteen patients recovered, and two, who were diabetic, died. The time taken for the core temperature to drop to 38 degrees C varied from 26 min to 5 h. The success of a treatment which maintained vasodilatation by warming the skin accords with the hypothesis that peripheral vasoconstriction combined with a high metabolic heat output is a major factor in the pathogenesis of heat stroke.