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.

    411/489 (page 395)
    morning remissions: whilst^ ho^rever^ pretty sensitive to external influences^ it appears strikingly little affected by the occurrence of inflammation of internal organs (unless they are of extreme severity). There is also very often a disproportion between the temperature and the frequency of the pulse, even when the heart itself is free from disease. Nothing like weekly cycles is to be observed. With good nursing (timely at hand) when the surroundings are also favorable, freedom from fever, or comparative freedom is already obtained in the course, or towards the end of the second week, or in severe cases during the third week.^ These general characteristics of the course must, however, be considered with more detail. The course naturally divides itself into three divisions; namely— (i) The ascent of the temperature or pyrogenetic stage ; (2) The Jieiglit of the fever, which sometimes rises to a solitary peak, or acme, and sometimes constitutes a fastigium of several days' duration; (3) Lastly, the period of descending temperature, which gradually loses itself in defervescence. {cl) The legmning of the fever seldom comes under observation in polyarticular rheumatism, because the patients hardly ever come under our notice till the course has lasted for several days. But their statements allow us very fairly to conclude, that the fever does not commence in the sudden manner common in croupous pneumonia, and in most cases of acute exanthematous affections, but takes a more gradual development, which is sometimes more tedious than that of abdominal typhus. Cases do occur, however, in which patients show a temperature of nearly 40° C. (104° T.) or even more, even as early as from the second to the fourth day; such cases are however exceptional. On the other hand, it is common enough to find that in the very middle, or ^ That our treatment, if not our medication of acute rlieumatisra is improved, is, I think, evident from this faet, which is also true of more than half our English cases. It is not so long since that it used to be publicly taught that at least six toeeks was required for rheumatic fever; and a little further back, six months was a rather common period. I myself believe that, with any treat- ment at all, and good nursing, no genuine case of this affection extends any- thing like so long as the latter date. Mistakes are of course easy between gouty, pyajmic, syphilitic, and albuminuric rheum«^ozc? cases, and true rheu- matism. As regards the absence of warning of serious complications, such as pericarditis, endocarditis, and pleurisy, sec the note appended to the previous section.—[Tbans.]