On the temperature in diseases : a manual of medical thermometry.

  • Carl Reinhold August Wunderlich
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: On the temperature in diseases : a manual of medical thermometry. Source: Wellcome Collection.

Provider: This material has been provided by the Gerstein Science Information Centre at the University of Toronto, through the Medical Heritage Library. The original may be consulted at the Gerstein Science Information Centre, University of Toronto.

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    uimsually severe aiul unusually jirolongcd, which hajjjx'ns in dijiihle pneumonias, or with acute pneumonia of the upper lobes, or Avhen a whole lung is attacked with inllammation. In such cases the t'astigium is generally prolonged into the second week, or even to its end. JJut then it is by no means stationary, but towards the end of the first week, or sometimes even earlier, there commences a stage of fluctuations, an amphibolic stage, with alternations of improvement and relapses. W e must not expect a rapid defervescence in such cases. In particular, the defervescence may be protracted and com- plicated, may occur less ra])idly, and may exhibit slight subsequent elevations of temperature. Such deviations from the normal fashion of the continuous course occur under very many different circumstances. On the one hand they occur in children, on the other in very old people, and espe- cially in sick persons, whose idiosyncrasies predispose to irregu- larities of the fever course. They occur in secondary croupous pneumonia, which, indeed, sometimes follows an identical course with that of primary, but in other cases exhibits more or less deviations from such a course. And occasionally such variations occur in all kinds of pneumonic attacks, just as in other typical affections there are some epidemics in which irregular cases greatly preponderate. Accidental complications of the case, sometimes with actual sepa- rate disease, sometimes only with isolated disturbances originating in other organs (severe delirium, obstinate constipation, or retention of urine, Src), may, indeed, easily induce more or less considerable modifications in the course of the temperature, and this especially occurs with previously existing emphysema of the lungs or coin- cident acute pleurisy, the occurrence of bilious symptoms, of albu- minuria during the course of the attack, and of severe diarrhoea or vomiting. In those cases, too, in which the fever supervenes on an already developed inflammation of the lung, which is most charac- teristically shown by traumatic pneumonia, deviations from the pure continuous type are almost constantly met with. Deviations from the regular course of pneumonia are very often brought about by the operation of energetic therapeutic measures, or by some favorable event occurring, in which case they may be advantageous to the patient.