The temperature in the early days of both hemorrhage and embolism has been described. At a later period of the hemiplegia it remains in the neighborhood of normal. The temperature of the affected side is often higher than that of the sound one for an indefinite period, but in many cases sinks below if atrophy takes place. The time at which the change occurs is extremely variable. Out of ten cases reported by Folet,45 in two of them for three years and one year after the attack the paralyzed side was eight-tenths and six-tenths of a degree respectively the warmer. In three others, of twenty months, four and six years, it was the same on both sides, and in the remaining five the paralyzed limb was a little the cooler. In the last eight there was more or less atrophy.
45 Gaz. hébd., 1867.
The coincidence of rise of temperature with vascular relaxation has already been noted under the head of Cerebral Hemorrhage. It is not difficult to explain why a vascular paralysis in a comparatively well-nourished limb, especially when the heart is vigorous, may, by allowing a larger amount of warm blood to circulate, raise the temperature, when the same paralysis with atrophied muscles, weak heart, and impaired general health, merely furnishes a larger reservoir in which the slowly-moving blood may be cooled. The accompanying charts represent the difference of temperature between the two sides in two cases of hemiplegia, the first, O. G. T. (Fig. 41), from embolism, and the second, J. B. (Fig. 42), from hemorrhage, the observation being made within two or three weeks of the attack. The dotted line is from the paralyzed side. A subjective feeling of coldness is not uncommon in paralyzed limbs.
FIG. 41.
FIG. 42.
The modifications undergone by the urine in a case of cerebral hemorrhage are increase of quantity amounting to polyuria, the urine becoming limpid and afterward returning to the usual color; a diminution in the quantity of urea coinciding with the fall of temperature, and afterward a return to the normal or even above it. When this augmentation is considerable, it constitutes at the same time with a marked elevation of temperature an unfavorable prognostic sign.46 In a case under the observation of the writer, probably of thrombosis, the acid urine has been remarkable for the amount of mucus contained in it, so that it pours from one vessel to another like white of egg. There is a small amount of pus, but no vesical irritation whatever.