A STUDY IN MOUDIL) AND NORMAL 1" JI V S I I, O G V. H 



not been continued so long us to permanently dunuige the tissues. In Experi- 

 ments 18, 19, and 20, it is remarkable tlnrt, altliough the injury wrought was suffi- 

 cient to cause death, yet the peculiar nervous symptoms allsuhsid.d upon the with- 

 drawal of the excessive heat. 



I have had two opportunities of performing upon men under very favorable con- 

 ditions experiments entirely parallel to those last detailed. 



The first of these was upon the person of a burly Scotchman, who was carried into 

 the Centennial Hospital on a hot July day in 187(). lie had fallen unconscious about 

 twenty minutes before. Upon entering the ward he was in a state of unconscious- 

 ness, muttering delirium, profoundly relaxed, with a pungcntly hot, dry skin, rapid, 

 feeble pulse, and greatly disturbed respiration. Death was apparently so iunninent 

 that no time was lost in making observations, but he was placed in a full bath 

 of ice-water, with ice in great chunks piled over his exposed shoulders, neck, and 

 head. After about five minutes his mouth temperature was 1()7°.5 F. From this 

 time it steadily fell, and after some fifteen minutes it had reached l()-i° F., when 

 very distinct signs of consciousness were developed, the man trying to get out of 

 the bath. By the time his temptu-ature had fallen to 1()'2° F. he was entirely con- 

 ecious, but the damage wrought was such that it was several days before he was 

 perfectly clear in his statements. In this case the cause of the high temperature 

 of the body was simply external heat. In the instance, detailed below, rheumatic 

 irritation was the materle>i mnrhi. 



This man was apparently doing fairly in a relapse of acute rheumatism, although 

 his temperature hatl shown a distinct tendency to be very high. At 10:30 A.M. 

 of the day in question he was seen by the Resident Physician of the Hospital, Dr. 

 Bruen, who states : " When I saw him at 10:30 A. M. there was much less inflanuna- 

 tion of the joints than on the preceding morning, and althougli his temperature was 

 as it had been, 104:° F., and, as I thought, a pericardial friction sound could be 

 heard, yet the man was doing fairly ; perfectly rational, with a good pulse." 



When I entered the ward about half-past twelve the patient Avas apparently 

 dying. The pulse was between KiO and 170, exceedingly feeble and thready; the 

 pupils strongly contracted, though not to pin-points ; the respirations fifteen jjcr 

 minute, exceedingly irregular, mostly deep, jerking, and interrupted ; the skin pale 

 and dry; the consciousness completely lost, violent shaking and shouting in the ear 

 only eliciting a fi'W grunts; the temperature in the axilla 1()8°.8F. ; the wrists pale, 

 and no signs of pain elicited by violently moving them. On anscultiug the heart 

 I could find no murmur ; the first sound was very feeble, somewhat jjrolonged, and 

 the second sharply accentuated. 



Orders were immediately given to put the patient in a cold bath. The follow- 

 ing is the record made at the time: — 



1:24 p. M.— Patient put in a full bath at ()0° P. 



1:25^. — Shows signs of consciousnes.s ; will put out the tongnn when londl}' asked to do so. 

 1:21. — Seems to recognize that the l)ath is very eold, and sti-u<rjrics to y-ct out. 

 1:30^. — Man lias a fair degree of rationality. He has been in si.v minutes and a half and is non- 

 ordered to be taken out at once. 



