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proving the existence or non-existence of typhoid fever some time in advance of the appearance of the characteristic rash, between the sixth and twelfth days.

In typhoid fever the fluctuations between the morning and evening temperatures becomes greater near the end of the second week. At this time, if the morning temperature is below 102°, even if the evening range is high, the prognosis is favorable.

A gradual decrease of the morning temperature is especially favorable. A continuous range as high as 104° represents a disease unfavorable in its prognosis. A daily rise to 105° denotes a disease of marked severity. A daily rise to 106° denotes great danger; while a morning temperature of 104°, and an evening rise of 105° or 106°, should lead us to give a very doubtful prognosis.

Mild attacks should generally end from the fifteenth to the twenty-first day. Severe ones may last from twenty-eight days indefinitely. A sudden decrease in the temperature generally precedes intestinal hemorrhage and diarrhoea; while a sudden rise from the current rate of the disease portends the establishment of some intercurrent complication. A temperature of from 106° - 108° in the morning is given by Wunderlich as the precursor of certain death.

Passing to those diseases of childhood which we more commonly meet, we shall find in scarlet fever facts worthy of consideration. The temperature in this disease is very much elevated, and this elevation is long continued.

A case of not unusual severity may present a range of from 104° to 106° on the second or third day. The fifth day generally determines the acme of the febrile symptoms, thereafter the temperature being subject to but slight variation. One of the best developed cases of this disease, which I have seen this year (1867), was in a boy of twelve years. The record was as follows:

§ III. - 13*

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In comparison with scarlet fever, tonsilitis may well be studied. In tonsilitis the pulse may be about 100, and the average rise of the temperature will be to about 100.5°. The normal heat will be regained about the sixth or seventh day of the disease.

During the initial fever of measles, the temperature may rise to 103° or 105°, and may remain so for twenty-four hours after the eruption has appeared. But it falls rapidly, so that, on the seventh day, the disease presents an almost normal temper ture. If, after this fall, it should again rise, or if, after the appearance of the rash, it should continue as high as 104° or 106°, complications of some kind are probably in progress.

Between measles and typhus a marked distinction is observed upon the sixth day. In the former disease, the pulse and temperature are falling; in the latter, both are rising.

In small-pox, we meet with the high and peculiar fever, with

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intense pains in the back, and a temperature of 106°. continues until the close of the third day, when the eruption appears. Defervescence takes place speedily, and by the close of the fifth day the temperature is generally about 100°.

When the secondary fever ensues, there is a rise to 103° or 106°, which is followed by the gradual and often protracted convalescence. In varioloid the temperature on the fifth day is nearly normal, and there is no rise thereafter, unless caused by complications.

While speaking of typhoid fever, I might very properly have given the thermometrical indications of that disease which so much resembles it-tuberculosis pulmonalis. The observations upon this subject are yet so imperfect that I can but briefly and unsatisfactorily refer to it. We find the heat of the body continuously elevated, and generally it may be observed some weeks prior to our being able to discover tuberculous deposits. The usual evening temperature is from 102° to 103°, rising at times to 106°.

As regards prognosis in phthisis pulmonalis, we find that a continuous high temperature indicates acute disease. A low morning range, and considerable evening rise, indicate much less. activity. If the animal heat becomes normal, the deposition has probably ceased. In a case now under treatment, the thermometer rose from 98° to 101.5° in two weeks, during the first development of the disease.

In acute articular rheumatism, we find a very high temperature, frequently ranging from 104° to 110°.

In tubercular meningitis, the temperature is largely increased; while, in that condition of the stomach and nervous system which so much resembles it, constituting the hydrocephaloid disease of Marshall Hall, we have a normal heat of the body.

In traumatic erysipelas, the thermometer frequently rises very high; in slight cases often marking 104° during the first twentyfour hours, and, in the latter part of the disease, rising to 107°

or 108°. In a case of facial erysipelas lately under my charge, involving the whole face except the upper margin of the forehead, I was enabled to announce the beginning of convalescence on the third day, with a pulse of 113; the temperature having suddenly fallen from about 102° to 98°. The following day proved the prognosis correct.

Dr. Gibson, of the Somerset Hospital, relates a series of cases illustrating the practical application of the thermometer in cases of pneumonia, and those discases which similate it:

"A man 45 years of age, with signs of pneumonic consolidation extending as far upward as the sixth rib, had a respiratory rate of 32 per minute, yet his temperature was normal. A woman, aged 29, having similar signs, with a pulse of 100 and respiration 32, had a perfectly normal temperature. A boy, aged 14, in whom the physical signs consisted of slight dullness, with feeble bronchial respiration at the base of the lung, was found to have a temperature of 107°." The doctor very pertinently adds, "How, in the first-named cases, could the absence of pyrexia have been diagnosed; how, in the last case, could the impending severity of the attack (for severe it became) have been prognosticated, without the aid of the thermometer?"

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The usual course of temperature in pneumonia is high on the second day, reaching its maximum on the third or fourth, and beginning to decline on the seventh or eighth day. If the temperature is higher than 1049, a very severe attack is indicated.

In cerebro-spinal meningitis, there is often a temperature of 106° to 108°, without a proportionate increase in the frequency of the cardiac pulsations; thus furnishing a very important diagnostic from those forms of hysteria with spinal irritation (so called), which are often perplexing to the practitioner.

In yellow fever the thermometer in the axilla often indicates 108°; while, in the collapse of epidemic cholera, it falls to 90°, or even 80°, after death, however, frequently rising to 104 degrees.

In cases of sunstroke, it has been observed to rise as high as 1129.

In Bright's disease of the kidneys, the temperature, during the acute stage, ranges from 103° to 105°, and continues so for from three to six days. When the inflammation ceases, the temperature becomes normal, though hæmaturia may be observed afterwards.

In cancerous affections, the thermometer is slightly raised, marking 99 to 100°. The third day before death of a woman with encephaloma uteri, the temperature was 98.8°, with a pulse of 130°.

A few general remarks in regard to prognosis must bring this paper to a close.

Generally, we may observe, a temperature of 101° to 103° is favorable. A rise to 105 or 106° is unfavorable. A temperature of 108 to 109° is usually a token of approaching dissolution. Wunderlich has observed a higher temperature than this, prior to death in a case of traumatic tetanus, where the thermometer rose to 112.5°, and, after death, reached 113.8°. An equable temperature morning and evening is unfavorable. A greater temperature in the morning than in the evening is very unfavorable.

In the course of any disease, an abnormal or irregular temperature is more to be feared than an unusually high one. The temperature and pulse, taken together, are of greater weight in the prognosis of the disease than the other symptoms alone. The temperature falling notably, without a corresponding improvement of the other symptoms, is generally of grave import. In most diseases, if the morning temperature continues, our prognosis may be favorable; while, if the evening temperature is continued, the reverse is the case.

In conclusion, allow me to suggest that while, by our personal observations, we should endeavor to assist our allopathic colaborers in the great work of investigating the thermometrical

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