Dr. J. Burdon Sanderson on the process of fever.

  • Burdon-Sanderson, John Scott, 1828-1905.
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. J. Burdon Sanderson on the process of fever. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/38 (page 18)
    Apr. No.l. On tho Process of Fever, by Dr. Bunion Sanderson. 3- Case observed by Huppert Pneumonia in a male, aged 18, who during the four days following the third of his illness had febrile temperature varying up to 40°*75 C. (105°*3 F.) and took no solid nourishment. The observation was interrupted before the crisis. In the four days he excreted 138*2 grammes of urea; i.e., 34'5 grammes per diem. 4. Case observed by Huppert and ltiesell* Pneumonia in a male, aged 25. During six days of “ high fever,” from the third to the eighth day of his attack, both included, the total weight of nitrogen in the nourishment consumed by him amounted to 2*97 grammes, while nearly twice as much was discharged by the alvine evacuations and sputa. In the six days he excreted a quantity of nitrogen by the urine, corresponding to 223'6 grammes of urea; i.e., 37-2 grammes of urea per diem. Mean daily discharge of urea in the four cases, 40’3 grammes. Here, again, the mean of the results gives about 124 per cent, as the fever increment, showing that the exclusion of the first day or two had no great influence. But in the third category, comprising cases in which the illness was of longer duration, and the observations related to a more advanced period, the mean urea discharge was only 34*5 grammes, and the increment was therefore 98 per cent. 1. Case observed by Unruh (loc. cit. p. 242):—Pneumonia in a male aged 2D weighing 122 lbs., whose temperature rose during his attack to40°*5. (104°'9F.) During the seven days of his illness, beginning with the third and including the crisis, 278*47 grammes of urea were excreted; i.e., 39*8 grammes per diem. 2. Case observed by Huppert (loc. cit. p. 25):—Acute rheumatism with heart complication, in a male aged 21, weighing 130 lbs. Temperature during the first 10 days from 38° to 40°. During this period the patient’s diet consisted of a variable quantity of milk, with the addition during the first two days of a little soup and bread. On two of the following days no food was taken. The excretion of urea during the 10 days amounted to 394*67 grammes; i.e., 39*4 grammes daily. 3. Case observed by Wachsmuth (repoifled by Huppert, loc, cit.):—Pneumonia in a male, whose highest temperature during the attack was 40°*5. C. (104°*9 F.) Between the second and the eleventh day, during which period the patient took nourishment, he excreted 231*9 grammes of urea; i.e., 23'2 grammes per diem. 4. Case observed by Salkowskif. Erysipelas in a youth of 18, in whom the highest temperature was 40°*2. (104°*4 F.) He was on fever diet from the 3rd to the 12th day. In eight days he excreted 319*44 grammes of urea, i.e., 39*9 grammes per diem. 5. Case observed by Pribram and Robitscliek (loe. cit.):—Relapsing fever in a young man of 22. Highest temperature recorded 40°*4. (104°*7 F.) In the eight days, from the 3rd to the 10th day of the illness, during which the daily diet consisted of soup and a gill of milk, he excreted 218*67 grammes of urea; i.e., 27*3 grammes per diem. 6. Case observed by Senator :—Pneumonia of the right upper lobe in a very robust and well-nourished journeyman slaughterer, aged 24. The patient, who had shivered on the 2nd of March, was admitted into hospital on the 4th. On the 5th and 6tli his temperature reached 40°*5. (104°*9. F) On the 8th defer- vescence took place. During the seven days, from the 3rd to the 9tli, inclusive, his diet consisted of soup, coffee, and 600 cubic centims. of milk daily; and he excreted 225*10 grammes of urea, i.e., 37*5 per diem. It is to bo noticed that the cases selected were of very various diseases, diseases, in short, which have nothing in common, except the febrile St&tG. Tho general conclusion to bo derived from the whole series is that in the early stage of fever a patient excretes about three times as much urea as lie would do on the same diet if lie were in health, the difference * Huppert und Riesell, Ueber den Stiokstoffumsatz bcim Fieber. Heilkunde, vol. x. 1869, p. 329. j Salkow.ski, Untersuchuugeu ilber dio Ausscheiduug der Alkaksalze. Archiv, vol. Liii. p. 209. Arch, der Virchow’s