Differential diagnosis : a manual of the comparative semeiology of the more important diseases / by F. de Havilland Hall ; edited by Frank Woodbury.

  • Hall, F. de Havilland (Francis de Havilland), 1847-1929.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Differential diagnosis : a manual of the comparative semeiology of the more important diseases / by F. de Havilland Hall ; edited by Frank Woodbury. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    2d. That the patient be in bed at least one hour before the observations are made, since that time is necessary for the surface of the body to regain tlic heal ln.-t by previous exposure. 3d. The position of the person examined should be such that the anterior and posterior edges of the axilla are relaxed, for otherwise a cup-shaped cavity is formed, in which the thermometer moves freely* without being in contact with its walls. This occurs especially in emaciated persons. 4th. The temperature should be taken twice daily, say at eight in the morning and eight in the evening. If but one observation is possible, then the evening should be preferred, since the morning temperature, abnormal though it may be, rises in the evening. 5th. The thermometer should remain in the axilla at least five minutes. As regards the peripheral parts, such as the hands and feet, accord- to Dr. H. Wegscheider,* the following propositions should be received in reference to the distribution of temperature in febrile diseases:— 1st. There is no constant relation between the internal temperature, as measured in the axilla, and the general temperature of the surface. 2d. Two completely symmetrical parts of the skin, as between the toes, show no proportionate course in their temperature; not only do they differ by not rising or falling to the same level, but one may rise while the other remains stationary or falls, or vice versd. 3d. There is greater variation in the temperature curves in the same part of the skin in the same person in fever than in health; but in fever there is a striking fall of temperature, notably lower than in the healthy state. However, in those people who suffer from cold feet the tempera- ture is often as low, or somewhat lower. 4th. It follows, from the last, that there is a greater difference, in fever, between the temperature of the axilla and that of the periphery than any changes of local temperature which may occur in health. Although the axilla is generally selected, on account of convenience, the temperature is often taken with the thermometer in the mouth, rectum or vagina, and it is believed that such observations give more correct indications of the heat of the body than those taken on the surface. The temperature fluctuations in the various zymotic diseases have now * Archiv. filr Pathologie, Feb. 1877.