On the treatment of hyperpyrexia : as illustrated in acute articular rheumatism by means of the external application of cold / by Wilson Fox.

  • Fox, Wilson, 1831-1887.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of hyperpyrexia : as illustrated in acute articular rheumatism by means of the external application of cold / by Wilson Fox. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    21/94 (page 13)
    was no perspiration. During the two hours succeeding, the temperature gradually rose to 101*9° (2*2 degrees), and the ice- hag was then applied to the spine, but with very little effect on the temperature, which oscillated during nearly three hours, while the application was continued, between 101*2° and 102*2° —finally, however, falling to 100*9°—a reduction of one degree —when the ice-bag was removed. At 10 a.m. on the morning of the 13th (the seventh day after his admission, the eighteenth day of the disease), he had slept more or less continuously since 3 A.M.; the pulse was 82, jerking; respiration 36 ; tongue moist, vsdth a thin white fur; patient was a little deaf from the qui- nine given the afternoon before. From 10 to 11.40 a.m. the temperature rose from 100*9° to 102*5°, or 1*6 degrees. The ice-bag was then reapplied, but there was no reduction of tem- perature for more than six hours, when at 6.15 p.m. it had fallen to 100*9°. During the whole of this period it oscillated from 102° to 102*8°. The pulse-respiration ratio maintained an average frequency of 84: 32. The bowels acted naturally. The patient was conscious, comfortable, and composed, without pain, though very prostrate. (There is an omission here in the notes as to when the ice-bag was removed.) Within an hour of the last fall of temperature (or from 6.15 P.M. to 7.15 p.m.) it had again risen 1*3 degree (from 100*9° to 102*2°). The ice-bag was now applied continuously to the spine for fourteen hours, from 7 p.m. to 9 a.m. on the 14th. The tem- perature during the whole of this period oscillated between 101*8° and 102*8°, but only remained below 102° during the last three hours of the application, and it never fell below 101*8°. At 9 A.M. on June 14th, after thirty-two hours of this treat- ment (the nineteenth day of the disease and the eighth after admission), the heart’s apex was undiscoverable, and the dulness had risen to the first rib. There was intense friction at the base, and a loud double murmur at the apex, the nature of which, whether exo- or endo-cardial, was doubtful. The heart’s Bounds were exceedingly irregular, more so than the pulse. The patient coughed much, with distinctly rusty sputa. Both bases were dull, but the level of dulness was not further elevated. There was weak breathing at both bases, with pleui'al