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Jacob Fine, MD
Stanford, Calif

JAMA. 1975;233(11):1164.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

An editorial by Knochel (231:496, 1975) comments on a case report of heat stroke in the same issue (231:480, 1975) that deals with the disseminated intravascular coagulation (DIC) that developed as a complication of the heat stroke. There is no reference in the editorial to a case report published earlier in THE JOURNAL (216:1195,1971) in which this hemorrhagic diathesis, as well as the other complications of heat stroke, were accounted for by an endotoxemia of intestinal origin that is the result of acute hepatic failure. Endotoxemia has since been documented in hepatic damage not only by heat stroke, but also in viral hepatitis, advanced cirrhosis, and drug poisoning.

The striking uniformity of the clinical picture in all these disorders (brain damage, congestion and edema of the lungs, and renal failure in addition to DIC), and their resemblance to those produced by endotoxemia in advanced Gram-negative sepsis, points . . . [Full Text PDF of this Article]

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