—By Dr. Henry Thompson.
A case has lately occurred in the Middlesex Hospital, illustrating the beneficial effects of the bath in acute rheumatism, attended with head-symptoms and high temperature. Dr. Thompson, in his remarks on the case, observes that it is only now and then, in a few rare and scattered instances, that acute rheumatism proves fatal by an unexpected outbreak of overpowering nerve-symptoms, and such a result would have ensued in the instance recorded, according to Dr. Thompson's opinion, if the bath had not been used. The fatal issue in similar cases was formerly referred to the occurrence of metastasis, meningitis, and the like, but now it is said to be due to hyperpyrexia. To this last term, if used in a practical sense, Dr. Thompson makes no objection, as the importance of very high temperature can not be overrated as a symptom; but in a pathological point of view he thinks that its influence has been exaggerated, for the nerve-symptoms invariably precede the hyperpyrexia. Nevertheless, a high body-heat, ranging from 108.6 degrees to 112, is incompatible with life, and it is necessary to lower it by such means as are available, and Dr. Thompson thinks that the use of the bath is the best therapeutical agent. The temperature of the bath is 90 to 95 degrees in the first instance, and is gradually reduced by the addition of cold water to 70 degrees.
The clinical thermometer must be practically the best guide for the employment of the bath, for at a lower body-temperature than 102.5 degrees it would not be desirable to use it. It is important to observe that, in the case recorded by Dr. Thompson, the most severe and extensive chest-complications, such as pneumonia, pleurisy, bronchitis, and pericarditis, underwent no perceptible change for the worse in consequence of the bath. The case itself is recorded at length, with the thermometrical observations taken at frequent intervals from day to day, and the effects produced by the baths, which were eight in number, are accurately noted. The case, however, although terminating in recovery, was a tedious one, and the convalescence was exceedingly slow.—Medical Times.
The Eclectic Medical Journal, Vol. XXXIV, 1874, was edited by John M. Scudder, M.D.