Symptomatology. Sem.eiology. 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" 

 indicates fever. A sudden additional rise of several degrees in 

 the progress of fever is grave. A persistence of the high even- 

 ing 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 usually attended with other 

 symptoms of extreme prostration and sinking. A sudden con- 

 siderable fall to near the normal, without untoward attendant 

 symptoms, may indicate a crisis and a more or less speedy im- 

 provement may be hoped for. This sudden fall often attends 

 the period of eruption of certain exanthemata, as cowpox, horse- 

 pox, sheeppox, aphthous epizootic, etc. A sudden extensive 

 fall of temperature may result from some transient accidental 

 cause, as a prolonged deep sleep, a haemorrhage, the relief of 

 constipation, or of enuresis. A sudden rise 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 cessation 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 

 highest value. Though largely superseded by the usually more 

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

 ployed as symptoms corroborative of the thermometric indica- 

 tions. 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, of the large 

 blood vessels, and of the nervous system, and in cases of poison- 

 ing. For special indications furnished by the pulse, see diseases 

 of the heart. 



