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.

    422/489 (page 406)
    •lOC; THE TEMPERATUHK TN S-JPIIILIS. By this I avoidj on the one hand, tlie ambiguons expression syphiHs/' and, on the other hand, their doubtful relation to the local chancre is not either assumed or denied. The luetic (syphilitic) symptoms may certainly occur without any fever, and there is, perhaps, no form of luetic manifestations which may not develop itself, and run its course perfectly free from fever. On the other hand, with certain symptoms of lues, fever is far more common than is generally believed ; and this fever is somewhat peculiar; and indeed so characteristic that it is by no means difli- cult to at least suspect the nature of the disease by a glance at the course of the temperature. [See fig. 39 opposite.] § 2. In luetic (syphilitic) cases, elevated temperatures are most commonly met with at the time when the first extensive hyper?emic papular or pustular skin eruptions are developed. The fever which accompanies the luetic (syphilitic) eruptions of the early periods may be very severe, and the maximal temperatures may reach nearly 41° C. (= io58 E.). The course of the temperature is markedly remittent (pseudo- intermittent), with a daily downfall which descends quite to normal, or very nearly so. The alternation of these deep morning remissions with the high evening exacerbations is tolerably regular, but in spite of the rapid rise of the evening temperature rigors only accom- pany it in exceptional cases. It is also equally exceptional for a day quite free from fever to intervene between the days of fever, or for the fever subsequently to display a tertian type, or for greater and more moderate exacerbations to prevail alternately from day to day. The duration of the fastigium is indefinite, sometimes it is short, occupying a few days only, but it may last over a fortnight [and even longer than this.—Trans.], The fever subsides by the evening exacerbations gradually becoming less severe, in a manner which corresponds pretty closely with the behaviour of the tempera- ture in advanced periods of convalescence from abdominal typhus. § 3. In many of the acute internal luetic affections of the liver and Israin, and also in those of the bones which occur from time to time, we sometimes meet with an analogous though less regular course of the temperature, which is marked by the alternation of considerable morning remissions, with more or less severe evening exacerbations. In that malignant form of lues which is marked by