A handbook of therapeutics / by Sydney Ringer and Harrington Sainsbury.

  • Sydney Ringer
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of therapeutics / by Sydney Ringer and Harrington Sainsbury. Source: Wellcome Collection.

    75/798 page 59
    COLD BATHS IN FEVERS The elaborate investigations regarding the action of cold applications in fevers, made in Germany especially, induce me to devote a separate chapter to this important subject. These investigations confirm the conclusions of Currie and Jackson, and give precision to our knowledge concerning the application of cold to the surface, and its effects. This treatment has been employed in typhus, typhoid, and scarlet fevers, measles, and other febrile diseases. More recently, Dr. Wilson Eox and others have by this means cured patients suffering from the hyperpyrexia occasionally observed in rheumatic fever, a condition, owing to its sudden onset and rapid course, hitherto regarded as almost necessarily fatal. Many of the symptoms, and dangers, of fevers, depend in great measure on the elevation of the temperature. The effects of fever, whether specific or inflammatory, are due either to elevation of the temperature, to the specific cause of the fever, or to the local inflam- mation. The symptoms common to all fevers are due simply to the elevated temperature of the body, whilst the characteristic, i.e. specific, symptoms are due either to the specific poison or to the local inflamma- tion. The increase of temperature affects the organs in a twofold manner: in the first place, it perverts, depresses, or, if the rise is very high, abolishes function; in the second place, it produces fatty, or, as it is termed, parenchymatous degeneration of all the tissues. That the common symptoms of fever, such as headache, delirium, quick pulse, dry skin, and general weakness are due to the height- ened temperature is well shown by the effects of a treatment which is able to reduce this abnormal temperature, for if by the aid of the cold bath or by quinine we lower the temperature to the normal standard, these pyrexial symptoms at once disappear. Fatty degeneration of the tissues sets in during the progress of a fever, especially when prolonged. This degeneration has been observed more particularly and fully in the liver, kidneys, heart, blood-vessels, and voluntary muscles. It is in all probability due to the pyrexia, for the degree and extent of the changes correspond to the degree and duration of the elevation of temperature; similar changes occur when the temperature of an animal is raised artificially by keeping it in a warm chamber. Under these circumstances the cells of the liver and kidneys become first cloudy, then granular, finally the nucleus becomes obscured, and the entire cell distended with granules, which appear to be the precursors of fat droplets, by the accumulation of which, ultimately, many cells burst and perish. The muscular tissue of the heart and of the voluntary muscles becomes granular, then fatty, and in severe cases their fibres undergo extensive de- struction. These effects of high temperature can obviously be combated only
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