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.

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    indications of pericardial effusion were then also discovered, in indistinctness of the apex beat and slight elevation of the cardiac dulness. These were found on the 3rd to be more evident. The apex beat was in the fonrth interspace; the dulness had extended to the second costal cartilage, and friction-sound of grazing character was heard at the base. It was subsequently ascertained that menstruation had appeared on the night of June 1st, and ceased abruptly on the night of the 2nd, without any discoverable cause. During June 3rd the temperature continued to rise throughout the whole day, without any fresh joint affection, but with a gradually increasing degree of restlessness. Sweating, which had been slight through the whole disease, continued throughout the early part of this day. The subsequent condition of the patient in this respect was not noted. The rise of the temperature was, however, sudden and abrupt in the later hoius of the evening of this day. At 10 A.M. it was 102° in the axilla; pulse 112 ; resp. 28. At 8.30 P.M. „ 104-8° „ At 11.30 P.M. „ 106° „ At 12 „ 107-8° Dm-ingthe evening delirium had commenced, and at 11.30 I was summoned, and found the patient with a hot skin, and violently delirious, requiring at times two people to restrain her in bed, uttering loud cries and talking incessantly. The state of the heart was unchanged. The exact frequency of the pulse was not recorded. I determined to try the effect of a full bleeding. This was practised at 12.25 a.m. on the morning of June 4th, to the extent of between twenty and thirty ounces. The blood was unfortunately thrown away without examination. The immediate effect of the bleeding on the delirium was remarkable. It ceased abruptly, and the patient was quiet for a short time, but passed into a state of perfect unconsciousness. Then succeeded a peculiar series of irregular muscular movements of the hands and arms, with chattering and grinding of the teeth, and convulsive movements of the jaws, which continued for some time, during which, however, a further elevation of the temperature ensued. At 1 A.M. on the 4th, or within half an hour after the