It is unquestionable that in the parturient calorification is profoundly modified: even without resorting to the thermometer, it is only necessary to examine a woman during the stage of dilatation, and that of expulsion, to assure ourselves of the fact. During the stage of dilatation, unless there are pathological phenomena, the skin remains cool and the face only expresses fatigue. But in proportion as the stage of expulsion is prolonged, the face becomes flushed, sullen; the pulse becomes strong, tremulous; the skin covered with sweat; and these phenomena are inten sified as the expulsive efforts become more forcible, more vigorous, and frequent. Since the use of the thermometer has become a matter of routine, this elevation of temperature has been measured directly; but, strange to say, it is really much less than would be supposed—at least, that is the result of contemporaneous research.
We are indebted to Winckel for the most complete work on this subject.
In tracing this question to its source, Winckel shows that Sanctorius in 1638, afid Martin, in 1740, were the first to apply the thermometer to the study of human temperature; and to Granville, in 1825, we owe the first observations on the parturient. Home showed that in a normal de livery lasting three hours the temperature of the uterus was: Before labor 108° F.; after labor F. The pulse of the mother was 70, that of the cord 140.
In a delivery at the seventh month, the temperature of the uterus was: Before labor 100° F.; after labor F.
In a forceps delivery which lasted thirty-eight hours: Six hours before delivery, in the interval between pains F.; during strong pains 120° F.; after delivery F.; pulse of the mother, 110.
In a delivery lasting forty hours, the temperature was: Immediately after labor F.
Holil took the temperature in the hand, the mouth, and the axilla, and found 68° F. in the hand, F. in the axilla, and 91.6° F. in the mouth. He also showed that lowering of the temperature slowed the foetal' pulse, while its elevation accelerated it, but that the relation was not absolute.
Fricke measured the temperature of the vagina and uterus before and during menstruation, and that of the vagina during pregnancy; he con cluded from his observations that the vagina is always warmer, not only than the axilla, but even than the uterus.
Gierse denied any influence to menstruation, and declared that preg nancy produced but little change in the temperature.
Barensprung gave this average temperature of the vagina: Before labor 99.5° F.; during pains F.; after labor 101° F. He showed, besides,
that the temperature of the foetus, taken immediately after delivery, is about F. higher than that of the mother.
Hecker admitted that the normal pains do not elevate the temperature, which rises only when the pains are very strong, and, so to say, insufficient. Winckel, in 1862, declared that: 1st. In normal labor, the bodily temperature rises slightly from to r F.
2d. The rise of temperature during labor is not progressive; still, as labor proceeds, oscillations in the normal temperature can be clearly de monstrated.
3d. During labor, oscillations of F. are not rare.
4th. After all normal labors, the temperature rises during the first twelve hours on an average 1° F., and falls in the next twelve hours.
Lehmann, on the other hand, claimed a constant and rapid rise of tem perature during labor, proportionate to the intensity of the pains and especially the duration of the labor, to 104° F. and even higher; while it falls immediately after delivery, but still remains higher than during pregnancy.
Schroeder found that during pregnancy the vaginal temperature was on an average F. higher than that of the axilla (maximum 0.03, minimum 0.05); that at term the vaginal temperature was on an average 0.278°F. lower than that of the uterus, and he ascribed the greater heat or the latter to the foetus. During labor, the uterine temperature undergoes a mean rise of 0.165° F., but he was, unable to determine any difference due to the pains. Tarnier and Chantreuil, therefore, are in error when they state that Schroeder admits an elevation of one degree during pains.
The minimum temperature, therefore, corresponded to the time from 5.30 A.M. to 11.30 A.M. Moreover, the temperature of parturients presents many individual variations, independent of pathological states, it oscillates between F.
Gruber measured the temperature in the vagina, and arrived at the following conclusions: mean temperature during pregnancy, morning, 99.48° F.; evening, 99.2° F.; during labor 99.35° F.
Moreover, far from rising during labor, the temperature seems to fall, and he obtained the following figures, of mean temperature: Mean temperature during pregnancy, morning F.; evening 99.25° F.; almost immediately after delivery 99.71° F.; He concluded from these figures that the temperature rises very little during normal labor.