Symptomatology . Semeiology . 23 



be taken at the same hours on successive days, bearing in mind 

 that the morning temperature is usually slightly lower and the 

 evening one slightly higher. Where possible both morning and 

 evening temperature should be taken. With elevated tempera- 

 ture, repeat sooner to see that it is not transient. A transient 

 rise of 1° to 2° is unimportant. A permanent rise of 2° or 3° in- 

 dicates fever. A sudden additional ris^ of several degrees in the 

 progress of fever is grave. A persistence of the high evening 

 temperature to morning shows aggravation. A persistence of 

 the low morning temperature to the evening bespeaks improve- 

 ment. A sudden extreme fall to much below the normal (4° or 

 5°) indicates collapse. This is usuall}' attended with other symp- 

 toms of extreme prostration and sinking. A sudden considerable 

 fall to near the normal, without untoward attendant symptoms, 

 may indicate a crisis and a more or less speedy improvement may 

 be hoped for. This sudden fall often attends the period of erup- 

 tion of certain exanthemata, as cowpox, horsepox, sheeppox, 

 aphthous epizootic, etc. A sudden extensive fall of temperature 

 may result from some transient accidental cause, as a prolonged 

 deep sleep, a hemorrhage, the relief of constipation, or of enuresis. 

 A sudden ri.se may supervene on such suppressed function or 

 other cause of nervous irritation or on toxin poisoning, but it does 

 not persist more than twelve or twenty-four hours after the cessa- 

 tion of the morbific cause. 



A rise of 10° or 12° above the normal standard is usually 

 promptly fatal. 



A continued high temperature indicates persistent disease, and 

 a considerable rise during defervescence implies a relapse and in 

 the absence of any error in diet or nursing is grave. 



Pulse. Before the introduction of the clinical thermometer, 

 the indications furnished by the pulse were held to be of the high- 

 est value. Though largely superseded by the usually more re- 

 liable thermometer, yet they should not be discarded, but em- 

 ployed as symptoms corroborative of the thermometric indications. 

 In many cases the pulse will furnish criteria, when in the absence 

 of fever, the heat of the body will tell of nothing amiss. This is 

 especially true of diseases of the heart, the large blood vessels, 

 and of the nervous sj-stem, and in cases of poisoning. For special 

 indications furnished bv the pulse, see disea.ses of the heart. 



