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.

    426/489 (page 410)
    In tlic second form a diagnosis between that and typhoid fever is often for a long while, and perhaps even up to the time of death, impossible. However, the course of the temperature is more irregular in acute tuberculosis than is ordinarily the case in abdominal ty])hus; the remissions are generally somewhat greater than in the latter disease, and do not sink down to normal. Those cases of acute tuberculosis which simulate typhoid fever are generally those which are most rapidly fatal. Should life, how- ever, be prolonged, which^ is exceptional, the fever later on assumes another character, it may be either the hectic or the intermittent type. Undoubtedly the intermittent fever type is the rarest form in acute tuberculosis. The course of the temperature of each fever- abscess (or local suppuration) may perfectly resemble that of an intermittent fever, and repeat itself with the same regularity, sometimes, indeed, with a tertian or duplicated quotidian rhythm. Yet the occurrence of the attacks, especially in the afternoon, and the fact that the heights reached by the temperature are somewhat less, or become so in time, than those met with in intermittent fever ; whilst, on the other hand, the temperature of the intermission (or apyrexia) generally falls deeper below the normal than in that, may raise our suspicions of the j^resence of acute tuberculosis. In the further course of acute tuberculosis the intermittent type is generally lost, and the succession of an invariably less severe remittent fever renders the diagnosis certam, if that has not already been settled upon other data. [See notes at end of the next section.] XXVI.—Acute Phthisis. § I. Acute phthisis may take its origm from a condition per- fectly free from fever, upon which elevations of temperature supervene in a zig-zag fashion, with remissions and exacerbations of increasing severity ; less regularly and more tediously, however, than is usual in abdominal typhus. Or acute phthisis may closely follow the fever of an attack of bronchitis, pneumonia, or some other acute affection; in which case, ^ So that, as has been well said, The incautious practitioner pooh-poohs the attack at first as only a trifling cold, and in a week or two has to sign tlie death certificate.—[Tra^s.]