TE'MPEBATURE OF TILE BODY IN HEALTH AND DISEASE. It is universally admitted as a result of the observations of numerous physiologists, among whom our own countryman, Dr. John Davy, stands pre-eminent, that although the range of tempera ture varies in different parts of the human body, the normal temperature at completely sheltered parts of the surface amounts to 98°.4, or a few tenths more or less in temper ate climates; and that if there is a persistent elevation above 99°.5, or a depression be low 97°.3, some form of disease is certainly indicated. (In warm-blooded animals, gen erally, the temperature is one degree lower at completely sheltered parts of the surface than in the back of the mouth, or other accessible internal parts.) Some of the circumstances which cause a deviation from the normal temperature are mentioned in the article on AximAL HEAT. It may be further noticed, that exposure to cold without exercise, and sustained mental exertion, reduce the temperature, and that the amount of heat is at first reduced after a full meal, although, as stated in the above-named article, it subsequently rises. Moreover, in the tropics, the average tem perature is nearly 1° higher than in temperate regions.
When the temperature rises in cases of disease, the following relation to its augmen tation and that of the pulse has been established: an, increase of temperature of 1° above 98° corresponds with an increase of 10 beats of the pulse in the minute. Thus, if the pulse is GO at 98°, it is 70 at 99°, 80 at 100°, and so on. It is now established beyond all doubt, by the observations of Wunderlich, Virchow, and many other foreign physicians, and by Parkes, Jenner, Aitken, and Ringer in this country, that the preternatural heat which in certain cases can be detected by the thermometer, and may exist to the extent of 4', 6°, or even 8° above the healthy -average, and which varies in amount iu different dis eases, in different persons, and at different times of the same day, is the essential symp tom of fever. Dr. Davy, in his Physiological and Anatoinwal Researches, vol. i. p. 206, describes the case of a lunatic soldier, in whom the accidental discovery that his tem perature was 6° above the normal standard, led to the detection of tubercular disease of the lungs and intestines. Wunderlich, whose experience embraces at least half-a-million exact thermometric observations, bears unqualified testimony to the value of this mode of investigation in the early detection of disease, and as often furnishing an important guide to treatment. Some of these instances are quoted by Dr. Aitken in his Science and Practice of Medicine, 3d ed. vol. i, pp.41 46.
We give in a condensed form a few of the more important of these observations. Irt ague, the temperature of the body begins to rise several hours before the beginning of the paroxysm, and after the disease seems to have disappeared, a periodic increase of the temperature may still be detected, and as long as this continues, the patient is not really cured. In typhoid fever, the rise of temperature, or its abnormal fall, will indicate what
is about to happen three or even four days before any change in the pulse or other sign of mischief has been observed, A sudden fall of temperature has thus denoted intestinal hemorrhage several days before it appeared in the stools. A fall as low as 93° was noticed by Parkes in a case of this kind. When a person, who yesterday was healthy, exhibits this morning a temperature above 104°, it is almost certain that an attack of ephemeral fever or ague is coming on, and should the temperature rise up to or beyond 106°.3, the case will certainly turn out one of ague or of some other form of malarious fever. If, during the first day of illness, the temperature rises to 106°, it is certain that the patient does not suffer from typhus or typhoid fever; and if the temperature of a. patient, who exhibits the general signs of pneumonia, never reaches 101°.7, it is certain that there is no soft infiltration in the lungs. "In typhoid fever, a temperature which does not exceed on any evening 103°.5, indicates a probable mild course of fever. A temperature of 105° in the evening, or 104° in the morning, shows that the attack is a severe one, and forebodes danger during the third week. On the other hand, a temper ature of and below, in the morning, indicates a very mild attack, or the com mencement of convalescence. In pneumonia, a temperature of 104° and upward indi cates a severe attack. In acute rheumatism a temperature of 104° is always an alarming symptom. In a case of jaundice otherwise mild, an increase of temperature indicatei a pernicious turn. In tubei.culosis, an increase of temperature shows that the disease is advancing, and that uutoward complications are setting in. In short, a fever tempera ture of 104° to 105° in any disease indicates that its progress is not checked, and that complications may still occur."—Op. p. 21. We may further observe that, from the observations of Dr. Sidney Ringer, a persistent elevation of temperature exists as an in variable precursor of the growth of tubercle in any organ. As a general rule, when ithe temperature rises continuously to 106°.2, the prognosis is unfavorable; and when it rises to 110°, a fatal issue is almost certain. The diseases in which the highest temperatures have been observed are scarlatina, in which it has been noted at 112°, and tetanus, in which, at the period of death, it was 112°.5, and an hour afterward was 113°.8. In Dr. Aitken's work, the reader will find a series of diagrams illustrating the range of tem perature in ague, erysipelas, measles, pneumonia, simple continued fever, scarlatina, amall-pox, typhoid and typhus fevers, etc., together with a full description of the in struments to be used, the method of using them, and practical rules for recording obser vations.