On Heat Regulation and Death Temperatures. 



361 



"A Eesearch into the Heat Begulation of the Body by an 

 Investigation of Death Temperatures." By Edeed M. Corner, 

 M.A., M.B., B.C. (Cantab.), F.K.C.S., B.Sc. (Bond.), Surgeon 

 to Out-patients, St. Thomas's Hospital, and Assistant-Surgeon 

 to the Hospital for Sick Children, Great Ormond Street, 

 Erasmus Wilson Lecturer, Boyal College of Surgeons, and 

 James E. H. Sawyer, M.A., M.D. (Oxon.), M.B.C.P., Honorary 

 Anaesthetist to the Ear and Throat Hospital, Birmingham, 

 lately House Physician to St. Thomas's Hospital. Communi- 

 cated by Professor J. K Langley, F.R.S. Beceived April 4, 

 —Bead May 5, 1904. 



The fact has long been known that, in many forms of disease, 

 variations of the bodily temperature occur as death approaches. Our 

 knowledge of such variations is limited to certain apparently sporadic 

 cases. - Hitherto, no attempt has been made to ascertain the special 

 class of disease in which such deviations occur most frequently, nor 

 has the subject been examined in a scientific light, so as to bring these 

 death temperatures in line with the present knowledge of the mode of 

 production of pyrexia. It is towards this latter object that this 

 inquiry has been directed. Further encouragement to bring forward 

 this new source of knowledge is given by Sir John Burdon Sanderson, 

 who says " the subject (of pyrexia) is one in respect of which results 

 as valuable can be obtained by clinical investigation as by experi- 

 ments on animals."* 



This communication has been divided into two parts. In the first 

 part, a general account is given of the bodily temperature immediately 

 preceding death, and of the variations which are seen in these thermo- 

 metric records. A series of problems are shown, in order to ascertain, 

 where possible, the different factors which may influence the variations 

 in the death temperatures. The figures quoted are, in all cases, the 

 absolute minimum, as numbers of these cases have to be rejected for 

 many reasons ; for example, those in which tepid sponging has been 

 employed, and others where the records are incomplete. In the 

 second part, an attempt is made to ascertain the possible influences 

 which may cause such variations in the bodily temperature, and to 

 explain, from a study of these changes, the mechanism by which the 

 temperature of the body is regulated in health, and the reasons for 

 which deviations from the normal occur in disease. 



Part I. 



As the fatal result approaches, the curve on the temperature chart 

 may exhibit several changes. In 49 per cent, of surgical, and in 

 * Clifford Allbutt, ' System of Medicine,' vol. 1, p. 152. 



