A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt.

  • Oswald Vierordt
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A clinical text-book of medical diagnosis for physicians and students based on the most recent methods of examination / by Oswald Vierordt. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    {h) In the so-called collapse. In this condition there is generally a very rapid fall of the temperature, and at the same time a sudden failure of the heart, with (as is the contrary in crisis ) increase of the frequency of the pulse, with paleness and general failure of strength. The condition of collapse may pass over, when there generally is an immediate rise of temperature again to the former point; or it may pass on to a fatal termination. On the chart of the fever-curve the line of the falling temperature is crossed by the rising line of the pulse-curve in a characteristic way.^ Sometimes, in a case of collapse ending fatally, the pulse-line sinks parallel with the temperature-line.^ 2. It occurs sometimes temporarily in severe hemorrhages, also sometimes, for a short time, in all kinds of chronic diseases, especially in those of the heart and the lungs. If the temperature suddenly falls, accompanied by weakness of the heart and general prostration, then also we speak of collapse. 3. Continuing subnormal tenipei-attire, extending into a number of weeks, is very rare. It may exist in all severe wasting diseases and in diseases of the brain. 5. Diagnostic Value of the Temperature, especially of its General Course.—If we eliminate an elevation of temperature due to bodily exertion or to being in heated surroundings [as in a hot room or hot bath], an increased temperature of the body is otherwise a cer- tain proof that a morbid state is present, and that it is one of those which produce fever. In this lies the first diagnostic value of a meas- urement of the temperature. Of this a few examples may be given : 1. Frequently the elevated temperature, with some indistinctive complaints (or, in the case of children, abstinence from food with rest- lessness), is the only sign of a disease just commencing or of one that has been going on for some time. Ascertaining the temperature is, then, of deciding significance in that it leads to a more careful exami- nation and more extended observation and to directing suitable care of the patient. A high morning temperature generally points directly to an acute infectious disease. 2. In marked cachexia, without distinct organic disease, the exist- ence of temporary fever indicates tuberculosis with considerable prob- ability. 3. A single chill accompanied with a rise of the temperature to about 40° C. may, in a given case—say of a disease which from expe- rience sometimes causes suppuration—lead to the diagnosis of suppu- ration, as in gall-stones, renal calculi, after injuries to the skull, as brain-abscess; also here belongs puerperal fever, or, under certain circumstances, it may possibly be malaria. But the continued observation of the course of the temperature is of still greater importance. It advances medical knowledge in various ways : I. The course of the fever in a number of diseases is so typical that from the temperature alone the diagnosis may often be made with great probability, sometimes with certainty. At any rate, taken in asso- ciation with other symptoms, it is always an important aid in diagnosis. ^ See Pulse. ^ See Pulse.