334 
G. A. BANHAM. 
perature of 41.7°, whilst after 41.8° or 42°,* they always termi¬ 
nated fatally. 
The temperature remains for a variable period at this height, 
but always shows a deviation of 0.5° to 0.8° from evening to 
morning. Sometimes this variation is still greater, and Brnsa- 
seo observed a sinking of 1.4°, and even 1.8°, from evening to 
morning. From energetic treatment, such as cold-bath , douche , 
and internal remedies, a quick decrease of the temperature is 
observed; also, the daily deviations are less noticeable. After 
some days, (which varies in different cases), the temperature slowly 
decreases by the so-called staircase-like (treppenartig) curve, until 
the normal temperature is attained. In the evening, however, an 
increase is always seen, which by the morning is improved again. 
In some cases the temperature decreases rapidly, and, if it does 
not show an increase in the evening, we observe a great improve¬ 
ment next morning. In such cases the curve suddenly changes, 
and we may even have a normal temperature in the morning, 
although it was a high temperature the previous evening. 
The temperature gradually cools, the differences disappear, 
and an apyretic condition is present. A diminution of about 1° 
daily, after a disease has attained its crisis, is a favorable sign, 
which symptom generally precedes others of improvement. A 
decrease of temperature without improvement of other signs, 
is generally indicative of evil, and often of internal hemorrhage. 
A violent diarrhoea can also cause a decrease of the internal tem¬ 
perature, especially if it suddenly appears. If the diminution is 
very striking, for instance 35°, we may look for septicsemia, necro¬ 
sis of lungs or intestines, and a quick end. It is also a bad sign 
if the temperature suddenly rises. This is particularly so in dis¬ 
eases of the typhus type, in which case a sudden rise either points 
out that a local part is worse or that a relapse has taken place. 
At the commencement of the death struggle, we often observe an 
increase even to 43°, in others a decrease—each may take place 
slowly or quickly. 
When the temperature remains at a high temperature for 
* A short duration of a temperature of 42° and 42.5° is not uncommon, and 
recovery often follows. 
