1st. In eclampsia, the temperature rises from the beginning to the end of the attack.
2d. In the interval, the temperature remains high, and, at the time of a convulsion, there is a slight rise.
3d. If the eclampsia is going to prove fatal, the temperature continues to increase and may be very high. If, on the contrary, the attacks dis appear, and if the coma lessens or ceases altogether, the temperature falls gradually, and may become normal.
4th. Finally, Bourneville, concerning the diagnosis between puerperal ecla,mpsia and urfflmia, adds: " Most authors class under the term ummia. both eclampsia and various forms of urtemia. Now of 31 cases of true urremia which we have observed in men and in women, whether caused by an affection of the kidneys, or an obliteration of the ureters, (calculi, cancer, etc.), whether it be in the form of coma or convulsions, the tem perature gradually falls, and at times below 93° F." Hence a very striking contrast between the thermometric curve of puer peral eclampaia and that of urEentia, which we will sum up in the follow ing statement: In the beginning, a lowering of the temperature in ursemia is noticed, and an elevation of the temperature in puerperal eclampsia. In the course of urEemia, the temperature falls gradually, while in that of eclampsia it rises more and more, from the beginning of the attack, usually very suddenly. These differences are greater at the approach of and even at death. In urfemia the temperature falls very much below the normal; in puerperal eclampsia, on the contrary, it rises very high above the normal.
Pinard and Budin have published a great many thermometric observa tions of eclampsia. Also Dieud6 and Herbart have written on the subject (1875), also Buffet (1877), Lorain (1877), Deubel (Nancy, 1879) and lastly Hypolitte (1880.) In 1879 only, does Winckel report four cases of eclampsia, and reach the following conclusions: " The most striking thing is the un usual course of the temperature, which, during sixteen hours without attacks, rose from normal to 102.4°, which, a little before the third attack, had fallen to 100.4°, and rose again at the beginning of the sixth attack to 102.3°, but fell, finally, from 1° to 5° until death, although during this short space of time the patient had still attacks of eclampsia."
Dieud6, from his observations, concludes that: " The first statement of Bourneville is too absolute, and that in eclampsia, not only does the temperature not rise continually, from the beginning to the end, but it may, rarely it is true, remain stationary or fall in spite of the attacks; but he is in accord with him in this, that, whenever the temperature, after having followed the ordinary course peculiar to puerperal eclampsia, falls gradually, a favorable termination can be prognosticated." Deubel similarly considers the statements of Bourneville as too abso lute.
Finally, Hypolitte, who bases his researches on thirty observations. has arrived at the following conclusions, which are those of Dieudi. slightly modified.
"1st. In the great majority of cases, the temperature rises from the be ginning to the end. of the attack, but it may, though rarely, remain sta tionary or fall in spite of the attack. The temperature rises most often to the highest point during the tonic convulsion, to fall slightly—two tenths to three-tenths of a degree, during the clothe .convulsion. 2d. Between the attacks, the temperature remains high, and, on the return of a spasm, the temperature rises. After several attacks. the temperature may remain normal or subnormal or over 1°, but the temperature does not remain there with subsequent attacks, or in the interval between the attacks. the temperature reaches the high point which is usually observed. 3d. If the eclampsia is to end in death, the temperature continues to in crease, and rises very high; if, on the contrary, the attacks disappear, and if the coma diminishes, or ceases altogether, the temperature falls gradually and becomes normal. It may happen, also, that the tempera ture begins to fall before the end of the attack. 4th. In eclampsia, the temperature remains usually between 100.4° and 104°, and may go above 105.4° after death, and even reach 106° to 107° and over. The pulse follovrs the course of the temperature exactly, 100 to 140, and at times 160." As we will see, these thermometric researches have a great importance from a diagnostic and prognostic standpoint.