Anomalies of Temperature

Anomalies and Curiosities of Medicine
by George M. Gould, M.D., Walter L. Pyle, M.D.

(Page 26 of 50)

In reviewing the reports of the highest recorded temperatures of the human body, it must be remembered that no matter how good the evidence or how authentic the reference there is always chance for malingering. It is possible to send the index of an ordinary thermometer up to the top in ten or fifteen seconds by rubbing it between the slightly moistened thumb and the finger, exerting considerable pressure at the time. There are several other means of artificially producing enormous temperatures with little risk of detection, and as the sensitiveness of the thermometer becomes greater the easier is the deception.

Mackenzie reports the temperature-range of a woman of forty-two who suffered with erysipelatous inflammation of a stump of the leg. Throughout a somewhat protracted illness, lasting from February 20 to April 22, 1879, the temperature many times registered between 108 degrees and 111 degrees F. About a year later she was again troubled with the stump, and this time the temperature reached as high as 114 degrees. Although under the circumstances, as any rational physician would, Mackenzie suspected fraud, he could not detect any method of deception. Finally the woman confessed that she had produced the temperature artificially by means of hot-water bottles, poultices, etc.

MacNab records a case of rheumatic fever in which the temperature was 111.4 degrees F. as indicated by two thermometers, one in the axilla and the other in the groin. This high degree of temperature was maintained after death. Before the Clinical Society of London, Teale reported a case in which, at different times, there were recorded temperatures from 110 degrees to 120 degrees F.in the mouth, rectum, and axilla. According to a comment in the Lancet, there was no way that the patient could have artificially produced this temperature, and during convalescence the thermometer used registered normal as well as subnormal temperatures. Caesar speaks of a girl of fifteen with enteric fever, whose temperature, on two occasions 110 degrees F., reached the limit of the mercury in the thermometer.

There have been instances mentioned in which, in order to escape duties, prisoners have artificially produced high temperatures, and the same has occasionally been observed among conscripts in the army or navy. There is an account of a habit of prisoners of introducing tobacco into the rectum, thereby reducing the pulse to an alarming degree and insuring their exemption from labor. In the Adelaide Hospital in Dublin there was a case in which the temperature in the vagina and groin registered from 120 degrees to 130 degrees, and one day it reached 130.8 degrees F.; the patient recovered. Ormerod mentions a nervous and hysteric woman of thirty-two, a sufferer with acute rheumatism, whose temperature rose to 115.8 degrees F. She insisted on leaving the hospital when her temperature was still 104 degrees.

Wunderlich mentions a case of tetanus in which the temperature rose to 46.40 degrees C. (115.5 degrees F.), and before death it was as high as 44.75 degrees C. Obernier mentions 108 degrees F. in typhoid fever. Kartulus speaks of a child of five, with typhoid fever, who at different times had temperatures of 107 degrees, 108 degrees, and 108.2 degrees F.; it finally recovered. He also quotes a case of pyemia in a boy of seven, whose temperature rose to 107.6 degrees F. He also speaks of Wunderlich's case of remittent fever, in which the temperature reached 107.8 degrees F. Wilson Fox, in mentioning a case of rheumatic fever, says the temperature reached 110 degrees F.

Philipson gives an account of a female servant of twenty-three who suffered from a neurosis which influenced the vasomotor nervous system, and caused hysteria associated with abnormal temperatures. On the evening of July 9th her temperature was 112 degrees F.; on the 16th, it was 111 degrees; on the 18th, 112 degrees; on the 24th, 117 degrees (axilla); on the 28th, in the left axilla it was 117 degrees, in the right axilla, 114 degrees, and in the mouth, 112 degrees; on the 29th, it was 115 degrees in the right axilla, 110 degrees in the left axilla, and 116 degrees in the mouth The patient was discharged the following September. Steel of Manchester speaks of a hysteric female of twenty, whose temperature was 116.4 degrees. Mahomed mentions a hysteric woman of twenty-two at Guy's Hospital, London, with phthisis of the left lung, associated with marked hectic fevers. Having registered the limit of the ordinary thermometers, the physicians procured one with a scale reaching to 130 degrees F. She objected to using the large thermometers, saying they were "horse thermometers." On October 15, 1879, however, they succeeded in obtaining a temperature of 128 degrees F. with the large thermometer. In March of the following year she died, and the necropsy revealed nothing indicative of a cause for these enormous temperatures. She was suspected of fraud, and was closely watched in Guy's Hospital, but never, in the slightest way, was she detected in using artificial means to elevate the temperature record.

In cases of insolation it is not at all unusual to see a patient whose temperature cannot be registered by an ordinary thermometer. Any one who has been resident at a hospital in which heat-cases are received in the summer will substantiate this. At the Emergency Hospital in Washington, during recent years, several cases have been brought in which the temperatures were above the ordinary registering point of the hospital thermometers, and one of the most extraordinary cases recovered.

At a meeting of the Association of American Physicians in 1895, Jacobi of New York reported a case of hyperthermy reaching 148 degrees F. This instance occurred in a profoundly hysteric fireman, who suffered a rather severe injury as the result of a fall between the revolving rods of some machinery, and was rendered unconscious for four days. Thereafter he complained of various pains, bloody expectoration, and had convulsions at varying intervals, with loss of consciousness, rapid respiration, unaccelerated pulse, and excessively high temperature, the last on one occasion reaching the height of 148 degrees F. The temperature was taken carefully in the presence of a number of persons, and all possible precautions were observed to prevent deception. The thermometer was variously placed in the mouth, anus, axilla, popliteal space, groin, urethra, and different instruments were from time to time employed. The behavior of the patient was much influenced by attention and by suggestion. For a period of five days the temperature averaged continuously between 120 degrees and 125 degrees F.

In the discussion of the foregoing case, Welch of Baltimore referred to a case that had been reported in which it was said that the temperature reached as high as 171 degrees F. These extraordinary elevations of temperature, he said, appear physically impossible when they are long continued, as they are fatal to the life of the animal cell.