TEMPERATURE AND PULSE

We follow Mr. Curran again in his clear statement of the importance of temperature in disease. Every household should have a clinical thermometer to use in taking the temperature of the patient in the event of sickness. The average normal temperature in adults is from 98.4 to 98.6 degrees. There is a daily variation of sometimes 1.5 degrees, the highest point being reached in the evening. Exercise, diet, climate and sleep cause deviation from the standard. Almost every disease, however, carries with it an abnormal variation in temperature. If the rising temperature does not always show what the disease is, it does show what it probably is not. For instance, a rapid rise of three of four degrees above the healthy standard does not mean typhoid fever, but may mean measles or scarlet fever, and in whooping-cough and smallpox, the highest temperature precedes those diseases from two to four days. In diphtheria there is this rise before anyone thinks of looking at the throat. Increase of temperature calls for cooling remedies, external and internal, and degrees of temperature below the standard require warming and sustaining treatment.

An increase of temperature beginning each day a little earlier is a bad sign; one beginning later promises well. A decrease of fever beginning each day earlier is a good sign, but if later each day, is a bad one. A very high temperature, say 105 degrees, is dangerous in itself, but more so if it has come on gradually as the last of a series. A fall of temperature below normal is far more dangerous than a much greater corresponding rise. One degree below normal is more an indication of a bad condition than two and one-half above normal. In convalescence if there is no rise of temperature after eating there is no nourishment secured from the food; if there is a sudden or high rise of more than one degree the food was too stimulating or bulky. To be beneficial in convalescence food must increase the temperature a quarter to half a degree and this must almost subside when digestion is over, though leaving a gradual improvement in the average daily temperature.

Temperature from 106 degrees upward and from 95 degrees downward is extremely dangerous and virtually a sign of fatal ending. As the temperature increases or decreases from normal toward these extremes, it consequently becomes more threatening. Temperature should be taken by placing the bulb of the clinical thermometer in the rectum or under the tongue.

There is a close connection between the temperature and the pulse, both of which guide the judgment in matters of health. The pulse is most rapid at birth, and becomes constantly slower until old age, ranging from a maximum at the beginning of 130 to 150 pulsations a minute to a minimum at the end of life of 50 to 65 pulsations. The average pulse through the period of adult life is from 70 to 75 beats per minute. It is considered that every rise of temperature of one degree above normal corresponds with an increase of ten beats of the pulse per minute.

We have already spoken of the importance of the bath in health. Baths have their equal importance in sickness, and their direct effect upon many diseases. All the vital organs are affected through the skin, and by keeping it in a healthy condition the circulation of the blood, the action of the kidneys and bowels and all the digestive processes are promoted, many diseases warded off, and the assimilation of food aided. In many fevers, for instance, a sponge bath with water a few degrees cooler than the normal temperature of the body will give great comfort and relieve and reduce the temperature materially. A warm bath with water about at the temperature of the body, or a degree or two less, produces no shock to the system but makes the pulse beat a little faster and causes a little more activity of circulation.

Put bran enough in the water to make it milky, and the bath will assist in softening the skin, when it is dried and flaky. Put in a pound of rock salt to every four gallons of water and you will find the bath useful in invigorating feeble constitutions.

Thirst is Nature’s Signal that the system needs an increased supply of water just as truly as appetite shows need for food. It is relieved not only by water but by barley water, toast water and similar drinks, by small pieces of ice held in the mouth, and by drinks made from the juices of fruit. Care must be used, however, in the employment of these apparently harmless things, or injury may follow from taking them to excess.

Bed Sores are the inflamed spots which occur on the body, often as a result of carelessness during a long illness. They are not likely to occur if the bedding is kept smooth and free from wrinkles and the patient kept dry, his position varied as frequently as possible, and the proper bathing not neglected. If such sores threaten there are several remedies which will help to prevent them. Alcohol, brandy or glycerine rubbed over the parts exposed to pressure, after washing in the morning and evening, will serve to harden the place where applied. A solution of nitrate of silver, painted on threatened but unbroken skin as soon as it becomes red, will prevent sores. In the early stages of bed sores apply a mixture of equal parts of rectified spirits and white of egg. Put it on with a feather and renew as it dries till an albuminous coating is formed. For bed sores occurring in typhoid and other fevers an excellent prescription is composed of two parts of castor oil and one of balsam of Peru, which are spread on pieces of lint, laid on the sore and covered with a linseed poultice to be changed three or four times a day.

The Characteristics of Fever are a rising of the temperature, and, as a rule, increased rapidly of the circulation as shown by the pulse, and alterations in the secretions of the body, which are usually diminished. Fever diet consists in giving the patient plenty of milk, arrowroot or broth, composing a light, easily-digested fluid diet, every three hours, day and night. If milk alone is used the patient can take from three to five pints in twenty-four hours. The general treatment recommended for fevers consists in sponging off the body of the patient under the bed clothes with cool water three or four times a day, keeping him lightly covered, the room well ventilated, and its temperature from sixty-eighty to seventy degrees. He should be given plenty of cooling drinks in small quantities from fear of overloading his stomach, but frequently repeated even if he has to be coaxed to take them. The secretions of the kidneys and bowels must be kept up by such medicines as are prescribed by the physician in charge.