Volume 1

The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer.

  • William Aitken
Date:
1866
Catalogue details

Licence: Public Domain Mark

Credit: The science and practice of medicine / By William Aitken ... From the 4th London ed., with additions, by Meredith Clymer. Source: Wellcome Collection.

Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.

    81/972 page 71
    Single observations with other means of diagnosis will often de- termine whether the disease is one of danger or not. In typhoid fever a temperature which docs not exceed on any evening 1<>:5..)0 Fahr. indicates a probably mild course of the fever— and especially it' the increase of temperature takes place moderately, towards the beginning of the second week. A temperature of 105° Fahr. in the evening, or 1<>4° Fahr. in the morning, shows that the attack is a severe one, and forebodes danger during the third week ; en the ether hand, a temperature of 101.7° Fahr. and below, in the morning, indicates a very mild attack, or the commencement of con- valescence. In pneumonia a temperature of 104° and upwards in- dicates a severe attack. In acute rheumatism a temperature of 104° is always an alarming symptom, foreboding danger, or some com- plication such as pericardia] inflammation. In a case of jaundice otherwise mild, an increase of temperature indicates a pernicious turn, [n a puerperal female an increase of temperature indicates approaching pelvic inflammation. In tuberculosis an increase of temperature shews that the disease is advancing, or that untoward complications are setting in. In short, a fever temperature of 104° to 105° Fahr. in any disease indicates that its progress is not checked, and that complications may still occur. But it is by continuous daily observations that the most im- portant results have been arrived at, especially in the hands of Wunderlich, Greisinger, Traube, Billroth, Parkes, Jones of Au- gusta, Ringer, and others who are now working most actively in this field of labor. Certain febrile diseases have been found to have typical ranges or daily fluctuations of temperature throughout their course. In pure unmixed and uncomplicated cases this is found to be so con- stant that the differential diagnosis may be established by accurate observation of the temperature continuously from day to day. This has now been determined, especially in cases of malarious fever, typhus, typhoid fever, small-pox, scarlatina, measles, rheumatism, pyaemia, pneumonia, acute tuberculosis. In each of these dis- eases the temperature is one of the most certain (although not the only) means for determining the real state of the patient as re- gards morbid disturbances or complications, and a careful observa- tion of temperature from day to day is indispensable forjudging as to the prognosis. Frequently it affords the best and ultimate means of deciding in doubtful cases, and often it is the best corrective of a too hasty conclusion: for example, the characteristic variations of the temperature in a typical case of enteric, intestinal, or typhoid fever, are of such a kind that they are not found in any other disease. Intestinal catarrh, severe tonus of pneumonia, malarious
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