Volume 1

Text-book of the principles and practice of medicine / by the late Charles Hilton Fagge and Philip Henry Pye-Smith.

  • Charles Hilton Fagge
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Text-book of the principles and practice of medicine / by the late Charles Hilton Fagge and Philip Henry Pye-Smith. Source: Wellcome Collection.

    49/1212 (page 27)
    FEVER Febris : calor prnoter naturam.—Galrn. Pyre.ria—Thermometry—Clinical course of ivirexia—Hyperpyrexia—Theory of fever—Possibly beneficial effect of jjyrexia—Idiopiathic and symptomatic fever —Baised tenijyerature mihout fever—The pihysiologieal stages of fever— Conco7nitimt p)henomena of pyrexia : nutrition : pidse: respiration: muscles— Subnormal temp>erature. Among the varied effects of diseases there is, perhaps, none which is more commonly met with—and certainly there is none which is more important—than PYREXIA or FEVKR. It is not surprising, therefore, that the ancient writers recognised this condition. But it is strange that in modern times scarcely any attention was paid to it until recently. The specific fevers were studied ; but of the febrile state, common to them and to inflammatory disorders generally, little notice was taken. An increased action of the heart was considered as its chief characteristic. It would be difficult to overstate the value of an advance which was made early in the second half of the present century, by the introduction into medical practice of the clinical thermometer, as a direct and simple method of determining the presence or absence of pyrexia. This was not, indeed, a novelty. About a hundred years previously the instrument had been used by Boerhaave and by his pupils Van Swieten and De Haen ; and De Haen, who was a physician at Vienna, had discovered the striking facts that in ague, during the cold stage, the temperature of the blood is increased, and that the temperature of the body may sometimes rise after death. Hunter made many thermometric observations, and Dr John Davy ])ublished extensive tables of temperatures in animals and in man, under varied con- ditions of age and climate, in health and in disease. But when in 1850-51, Ti'aube and Biirensprung independently called attention to clinical thermo- metry, the practice was new. From that date Wunderlich, of Leipzig, devoted infinite pains to the study of temperature in all diseases. In this country the practice was soon adopted by Parkes, liinger, Aitken, and a host of others; and we may safely assert that it will never again be abandoned. Methods.—The use of the thermometer in clinical practice requires con- siderable care, if the results are to be relied on as being even tolerably accurate. The instrument is most commonly placed in the axilla, although there are other and often more suitable places, of which we shall speak presently. Now, the temperature which we want to ascertain is that not of any part of the surface, but of the deeper structures of the body, an inch or more below the level of the skin. To determine the surface temperature of any region is quite another, and a most difficult matter. Instruments called surface-thermometers have been constructed, with the receptacle for the mercury of such a shape that one side of it can lie Hat on the skin while