Ague. Chills recurring regularly for a few days indicate the intermittent nature of a disease. But during the first chill if the thermometer is applied, we may know that a case is one of fever and ague, if while the skin is yet cold the thermometer rises to 105°, and later to 107°, and during the stage of sweating the instrument shows a decline of 2° every fifteen minutes till it has reached 98½°. This rapid rise and decline is due only to malaria, and quinine is indicated. (F. 182.)
Tubercular Phthisis. If a patient has been losing flesh of late and been troubled with a short, dry cough, take his temperature at about six P. M. for a few evenings. If the thermometer records 99° to 100°, and no other cause exists for this regular nightly increase of temperature, the case can be put down as one of incipient consumption, especially if tuberculosis has been in the family. Endeavor to improve the general nutrition by attention to the quantity and quality of the food (as generous diet as can be taken without disturbing the stomach or increasing the feverish symptoms); by enjoining a residence in a healthy climate; by exercise in the open air; by warm clothing; by daily tepid sponging, with friction of the skin; and by cod-liver oil or petroleum emulsion with hypophosphites. An animal diet is generally necessary. If digestion fails and there is acidity of the stomach, give pepsin. (F. 72.) Add a teaspoonful of sweetened lime water to a tumbler full of milk, and if this agrees with his stomach, he can take that amount four times a day.
In TYPHOID FEVER the patient may complain of lassitude, headache, pain in the back, etc., for several days before he is feverish. Then his temperature is 99°, and it may be one degree higher each night, until on the sixth and seventh evening it is 104°; it being each morning one degree less than at night. Even if there is no diarrhœa, tympanitis, or eruption, we may by observing the temperature, feel sure that we have a case of typhoid fever. If it is a moderate case the temperature will be 104° at night, and 103½° in the morning, till the fourteenth day, when it may decline one degree in the morning, and half a degree or one degree in the evening. After that it may decline regularly till on the 21st day it may be 98½°. Relapse or chest difficulty may modify this regular decline, and the nurse must carefully note and report to the physician the temperature each morning and night.
In TYPHUS FEVER the temperature reaches its height, 104° or 105°, within thirty-six hours. It continues at that height, with morning remissions of one-half degree, till the eleventh or thirteenth day, when it rapidly falls to the normal; a sweat or a long sleep ushering in the favorable termination.
Scarlet Fever. If a child is suddenly taken ill with a chill, vomitings, very rapid pulse, and the thermometer records 105° or more, very early in the disease, it denotes scarlet fever; and from this sign alone, even without any sore throat or eruption, a diagnosis may be made. This disease may very frequently go on well without any danger till the eruption subsides, but danger arises from exposure of the child to cold any time during the subsequent four weeks.
Hysteria. There may be pain perhaps in the bowels, abdominal tenderness, and vomiting; or there may be symptoms of inflammation in some other part; if the thermometer does not register more than 98½° it is probably hysteria. Assafœtida, valerian, and such remedies will probably cure.
Apoplexy. In this disease the thermometer soon after the attack shows a temperature of only 97°, and lower still if there should be a second effusion to still more compress the brain. On the contrary, in a fully developed case of sunstroke, the thermometer will not record less than 107°.
It would be a good thing if every nurse and every mother kept a clinical thermometer.
CHAPTER II.
EMERGENCIES, ACCIDENTS, SUDDEN SICKNESS.
The diseases last named were there mentioned because their distinctive character could be determined by the thermometer. They are, however, examples of the kind of cases that I design now to speak of particularly; where there is apparent cause for alarm, and where there is apparent necessity that something should be done immediately.