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.

    398/489 (page 382)
    Tlic temperature continues fully normal, or it may be sub-febrile, for eighteen, twenty-four, and sometimes thirty-six hours or more, and it seems as if recovery would follow, yet there is uo actual retro- cessiou, generally speaking, in the local symptoms. All at once the temperature rises again rapidly, although it does not usually reach quite its former height, remains generally only a few days at the fastigium, and then tends towards a definitive defer- vescence, or the fever may thus renew itself a second or even a third time. By imperceptible gradations these relapsing cases are allied to the one just described above (§ 9), in which there occur remissions or pseudo-crises, with an extended apyrexia. During the febrile relapse the local chaiiges either remain sta- tionary, or they become intensified in certain spots (the duluess becomes intensified, the bronchial breathing more perfect), or they extend further. Sometimes, although nut invariably, erratic pneumonias exhibit a relapsing form; by erratic, I mean those pecuhar forms of the disease in which (like erratic erysipelas or many cases of polyarticular rheu- matism) the lung affection jumps from one spot to another, the places first attacked heal again, whilst new spots are invaded, and so infiltration and resolution succeed with extraordinary rapidity, as in- dicated by auscultation and percussion. § II. The i?ifermiUen( course is closely allied to the relapsing, and only differs by the fact that the apyrexise and the paroxysms alternate in tolerably regular rhythm, and are more sharply defined, one from the other, than is the case in the relapsing form. The fever paroxysms themselves resemble the pneumonic ephemera with acutely pointed peaks. The local anatomical symptoms may also diminish during the apyrexia or interval. This form is only ob- served in its most perfect development during epidemics of intermit- tent fever.^ An intermittent type may also be observed in embolic pneumonias with a tendency to repetition (self-repeating). Intermittent pneumonias may lead to erroneous opinions in a two- ' This iulermitteut form of pueuinouia is occasionally found in maiuiiuus dis- tricts in England, I have myself observed it in patients from Barking lload, and I remember Dr. Tsicholas Parker, late Physician to the London Hospital, pointing my attention to the same fact.—[Tkans.]