{"id":2525,"date":"2016-05-31T21:19:03","date_gmt":"2016-06-01T01:19:03","guid":{"rendered":"http:\/\/allphasepharma.com\/dir\/?p=2525"},"modified":"2016-05-31T21:20:04","modified_gmt":"2016-06-01T01:20:04","slug":"sesquicentennial-of-the-clinical-thermometer","status":"publish","type":"post","link":"https:\/\/allphasepharma.com\/dir\/2016\/05\/31\/2525\/sesquicentennial-of-the-clinical-thermometer\/","title":{"rendered":"Sesquicentennial of the Clinical Thermometer"},"content":{"rendered":"

\"Thermometer<\/a><\/p>\n

The history of the thermometer is studded with famous and familiar names. Galileo Galilei from Pisa, Santorio from Padua, and Huygens from The Hague developed temperature measuring devices, and Celsius from Uppsala, a Swede with a latinized name, Fahrenheit, from the Hanseatic city of Danzig, now in Poland, Ren\u00e9 Antoine Ferchault de R\u00e9aumur, a Frenchman, and Lord Kelvin, an Irish scientist from Belfast made improvement to the device, its composition, its usability, range and scale. This was a truly Pan-European scientific effort, it seems, long before there was anything like a European Union.<\/p>\n

\"Allbutt<\/a>
Sir TC Allbutt – source: Wikipedia<\/figcaption><\/figure>\n

As infectious diseases doctors we are – to a large degree – \u2018fever doctors\u2019, hence we would like to add Sir Thomas Clifford Allbutt to our honor list. He is the little known inventor of the first\u00a0clinically useful<\/u> thermometer, the predecessor of the now old-fashioned mercury thermometer. We want to celebrate the sesquicentennial of his 1866 improvement\u00a0of what used to be a very clumsy device.<\/p>\n

The Encyclopedia Britannica states that\u00a0Allbutt \u201cintroduced the modern clinical thermometer, a welcome alternative to the foot-long instrument that required 20 minutes to register a patient\u2019s temperature.<\/em>\u201d<\/span>[1]<\/a> Indeed, Allbutt\u2019s thermometer was a 6 inch portable instrument which gave reliable readings in 5 minutes, and which looks very familiar and modern (see below)\u00a0<\/span>[2]<\/a>.\u00a0\u00a0<\/span><\/p>\n

Before the advent of the Allbutt thermometer, instruments available to clinicians for temperature measurement were clumsy and unwieldy. Descriptions of foot-long thermometers were\u00a0common. Then came the Aitken thermometer, a mercury containing smaller device which was introduced in 1852. Despite an improved design it was still not convenient to use; Dr. Savage, a house officer in Edinburgh at the time, \u00a0tells us how he had to carry it around under his arm\u00a0in a case ‘like a gun’ and how much a difference the new Allbutt thermometer made.[3]<\/a><\/p>\n

As so often, advances in technology spearheaded medical progress.<\/p>\n

\"Wunderlich<\/a>
Prof. Carl Wunderlich – source: Wikipedia<\/figcaption><\/figure>\n

Nonetheless, the groundwork for measuring temperature was laid with the old foot-long instrument. It was Prof. Carl Wunderlich, a German doctor from Leipzig, who was asked by Traube, another famous name in the history of German medicine, to devote himself to temperature studies. Starting in 1851, he collected millions of\u00a0temperature recordings from\u00a0over\u00a025,000 patients.\u00a0His studies established the normal range for body temperature which we still use today and\u00a0the 98.6 o<\/sup>F cut-off for fever. He proudly reported that over 17 years there has been no patient on the ward of his hospital that did not have regular temperature measurements\u00a0[4]<\/a>.<\/p>\n

Wunderlich describes the periodic fever of malaria and the continuous fever of typhoid.<\/p>\n

Carl August Wunderlich\u2019s book is available online in its entirety [5]<\/a>. It is a remarkably complete publication addressing many aspects of body temperature generation, regulation, and fluctuations in health and disease. It contains a chapter on thermometry, the instruments available and preferred, their proper use, the sources of error, technological issues and calibration needs, internal controls, placement of the thermometer, the benefits of repeat monitoring and of documenting a temperature curve. He describes the amazing stability of body temperatures under various environmental conditions, the small diurnal variations (normally 0.5 o<\/sup>C higher in the afternoon than in the morning), the normal temperature range in pregnancy, newborns, elderly, the influence of race, sex, climactic factors.

Regarding the influence of activity, he mentions that physical exercise is affecting body temperature, but mental exercise is not. CARL A WUNDERLICH<\/p>\n<\/div> \u00a0The benefit of ice compresses to lower body temperature is described. It is impossible to describe the myriad of details he checked and considered.<\/p>\n

The importance of the topic is concisely summarized\u00a0in the book’s introduction which I am providing\u00a0here in abridged form:<\/p>\n

“Knowledge of patient body temperature is important and imperative for the physician because:<\/span><\/p>\n