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.

    24/94 (page 16)
    much cleaner. The pulse had, however, increased in rapidity from 84 to 120, and it was jerking and dichrotic; respiration 38 to 44. He was ordered to resume the quinine in doses of two grains every hour. On June 16th (the fourth day of treatment, the tenth day after admission, and the twenty-first day of the disease), at 10 a.m., when the temperature had risen, as before stated, to 104*2°, he was again placed in a bath at 95°, and retained there for forty- five minutes, while the temperature of the bath was gradually lowered to 86° Fahr. While in the bath the temperature in the rectum fell 2 degrees; audit fell 1*8 degree more in the half hour after his removal, viz., to 100*4° (mouth), when it slowly began to rise. A total reduction of 3*8 degrees was thus effected in less than an hour and a half, three-quarters of an hour only having been passed in the bath. Seeing that the temperatm*e threatened again to rise, and being desirous that this should be checked at once, and having on the last occasion found that the ice-bag to the spine had failed in doing this, I had the patient packed in the wet sheet wrung out of ordinary cold water (probable temperature about 60°); temperature of ward 72°. He was kept in this for two hours ; but in spite of it, the temperatmre had risen to 102*4°, or 1*6° degree, though a reduction of four-tenths of a degree was observed during the first half-hour. He had in the last eight horns taken ten grains of quinine. The tongue was more furred; the pulse was 120, dichrotous, and very irregular. In an hour and a half more after his removal from the pack, the temperature had further risen 2*1 degrees, viz., to 104*5°. The patient was now placed in a bath of 101°, and kept there during three hours and ten minutes, or from 3.20 to 6-30 p.M. In the first twenty minutes of this time the bath was gradually cooled to 86°—i.e., until the patient’s temperatme began to fall; it was then gradually warmed dm*ing the ensuing hour and a half to 98°. The temperature of the bath was 100° for a few minutes; but it was again cooled to 97°, when the patient was removed. The effect of this bath on the patient was as follows:— During the first fifteen minutes of his immersion the