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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    rises again to the former level, or sometimes this occurs very slowly ; sometimes also collapse may set in without the ])recetling tempera- ture having been very high, and towards the fatal close of a chronic disease it is very common to meet with repeated falls of temperature below the normal. §15. Those almost critical downfalls of temperature which some- times occur after a remittent or continuous course of chronic fever have many points of resemblance to collapse, especially w^hen the crisis is immediately preceded by a considerable rise of temperature (Per- turbatio critica). But the downfall does not happen so rapidly as in collapse, and does not go down so low as in that, only reaching the normal or a little below it. These defervescences are sometimes really favorable, and in such cases sometimes show that the effect of a comphcation has ceased. In the majority of cases they are, how- ever, deceptive pseudo-crises, and after remaining normal for a few days the temperature again rises rather slowly or suddenly. § 16. Very great irregularities are displayed by the course of the temperature during the course of many chronic diseases; rude and apparently objectless (unmotivirte) fluctuations occur; and although very considerable rise of temperature is always a symptom worthy of attention, no hopes must be based upon the occurrence of lower temperatures, partly because they are often transient, and partly because the disease may go on to a fatal termination with the dimi- nished temperature. The more abrupt the changes of temperature the less are they to be trusted. § 17. Towards the fatal close of chronic diseases, and in the death agony, the course of the temperature may be widely different in different cases, which need not surprise us, since death may be brought about in so many different ways in chronic diseases, and very often with only slight connection with the essential process.^ ^ As, for instance, death in cancer may happen (i) from haemorrhage; (2) nervous exhaustion (as when pain has become unbearable); (3) starvation, either immediate, from direct pressure on thoracic duet, or direct interference with organs essential to digestion ; or mediate by the enormous growth of the tumour diverting other supplies; (4) by asphyxia, when it presses upon or invades the air-passages; (5) by septic and pysemie processes being induced; (6) by invading organs whose integrity is essential to life, as the lungs, for example, or the nervous centres, and perhaps in other ways.—[Tkans.]