A handbook of therapeutics / by Sydney Ringer.

  • Ringer, Sydney, 1835-1910.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of therapeutics / by Sydney Ringer. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    51/596 (page 37)
    cases of rheumatic hyperpyrexia, adds precision to our know- ledge of the effects of cold baths. He has shown that the fall of temperature continues even six or more degrees, 40 or 50 minutes after the discontinuance of the bath. It is important therefore to observe the temperature in the rectum while the patient is in the bath and to remove him before the tempera- ture is too far reduced, lest too great a reduction might lead to collapse. This indeed appears sometimes to occur for we read of cases becoming- cyanotic, although German ob- servers aver that this is not important and advise the application of warm bottles to the extremities. Still the author is convinced that it is important to avoid so depressing- an effect as he has seen a child suffering- from scarlet fever, killed by an over energetic employment of cold. German observers have shown conclusively that this treat- ment greatly reduces the mortality of typhus and typhoid fever. Thus Brand treated 170 cases of typhus without a single death, and Bartels treated 30 cases of typhoid fever without a single death. The mortality of Hagenbach’s typhus patients was 5 per cent, provided the cases were treated early, and Dr. Stohr reduces the mortality of his patients from 30 to 6 per cent, and the results he thinks would have been still more favourable could he have treated some of his cases earlier. Dr. Wilson Fox, and more recently Dr. H. Weber, have shown that we may reasonably expect to cure those very grave cases of rheumatic hyperpyrexia, to which no doubt most of the fatal cases of rheumatism are attributable—an invaluable addition to our knowledge. Not only does this treatment reduce the excessive heat of fever but it allays the nervous symptoms and limits the wast- ing, and Brand says it also prevents meteorism, bleeding, and lessens diarrhoea in typhoid. On the other hand, Hagenbach and Jurgensen assert that this treatment does not lessen the meteorism and diarrhoea in typhoid fever, nor reduces the size of the spleen, nor the decrotism of the pulse. All observ- ers agree that cold baths do not shorten the course of