J.Jpn. Surg. Soc.. 55(8): 859-878, 1954

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Original article

THERMOLOGICAL STUDIES ON THE CHILL AND FEVER IN THE FIELD OF SURGERY

The author made various observations of the changes in body temperature in the field of surgery; the consumed amount of oxygen, internal temperature of the body (axillary, rectal and liver tempe atures), surface temperature (subcutaneous temperature of various portions), muscle temperature and blood temperature of the median vein were measured in succession with a thermoelectric meter, and the following results were obtained:
1) Although Basedow's disease shows marked metabolic elevation, a rise in body temperature was generally not observed, and the subcutaneous temperature of the extremities and internal temperature of the body showed an approaching value.
After thyroidectomy the general symptoms improved and the basic metabolic rate became low, but the body temperature hardly showed any difference from that before operation. The difference between the temperatures inside the body and subcutis of the extremities became large, and showed a gradient of temperature about two times that as compared to preoperative average.
2) In time of flexible movement of the upper body, the metabolism was remarkably accelerated and owing to the activating of the regulation of body temperature, the subcutaneous temperature of the non-exercising portions suddenly rose and no changes in body temperature was noticed.
3) Observing the capillaries in the basal portion of the nails, it was found that the changes during chill and fever consisted of both a decrease in diameter of capillaries and slowing of blood stream velocity. This capillary changes were found to occur before the onset of chill.
4) The subcutaneous temperature of the extremities already begans to fall at the predromal stage of fever and the gradient of temperature in the central portion of the body and peripheral portion gradually increased with the lapse of time. By this change one was able to predict the appearance of shaking chill. The degree of decrease of subcutaneous temperature was most remarkable in the periphery of the extremities, and the temperature of the trunk was similar to that inside the body.
5) With the recovery of fever, the subcutaneous temperature of the extremities began to rise at first and the internal temperature of the body gradually decreased. Furthermore, it was noticed that the peripheral surface temperature of the extremities reacted most sensitively and promptly.
6) Anesthesia presents in general an antipyretic action; the degree is most prominant in general anesthesia followed by lumbar anesthesia although influenced by the character and amount of basal anesthesia. Furthermore, since high temperature and high humidity in an operation room cause stasis of heat and low temperature loss of heat or shaking chill, the author pointed out the necessity of air conditioning in an operation room.
(author's abstract)

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