37°C, limit between health and disease
- German physician Carl Reinhold August Wunderlich spent almost 20 years repeatedly measuring the body temperature of 25,000 patients.
Leipzig, Germany, 1850. Carl Reinhold August Wunderlich (1815-1877), a pioneer physician and psychiatrist, was appointed university professor and hospital director of the city. She worked in clinical pedagogy, rigorous diagnostic methodology and empirical observation of patients. He focused his attention on measuring the temperature of patients and claimed that fever was not a disease but a symptom. He promoted the use of temperature tables in hospitals and predicted with the example, repeatedly measuring the body temperature of almost 25,000 patients for almost 20 years, with about 1,000,000 data. It should be noted that temperature was taken with a thermometer of about 30 cm and that it took 20 minutes to obtain the data.
All this work concluded that it set the fever limit at an average of 37ºC. But he underlined that “mean.” Body temperature varies from one situation to another, from one person to another, and it's not a clear limit. It therefore acknowledged that the conclusion obtained had a margin of error of 1°C, i.e. the limit of fever was between 36.5°C and 37.5°C.
Some of the thermometers used by Wunderlich have been saved and researchers have observed that they were not properly calibrated
Some of the thermometers used by Wunderlich have been saved and researchers have observed that they were not properly calibrated. The doctor used to take the temperature under the arm of the patients and the result is usually lower than those taken in the mouth or anus. In addition to matching this interval, the clinical thermometers used by Wunderlich exceeded, and today we know that the mean limit of fever is slightly lower, at 36’8°C.
But the problem was not that 0.2 degree defect, but the disappearance of the margin of an established degree after so much tax work. When the work of Wunderlich was translated into English, the degrees Celsius passed to the degrees Farenheit, so the limit was set at 98.6°F. But that 1°C margin of error passed directly, a degree of Farenheit much lower than a degree of Celsius, so the translation lost about half the interval.
At the same time, Florence Nightingal (1820-1910) proclaimed the importance of statistics in medicine. Nightengland's contribution was fundamental in medicine and nursing, but the risk of generalizing statistics in the name of precision highlights the cases of body temperature. The translation resulted in the total disappearance of that reduced margin of error, and in some way the immense work of Wunderlich of 20 years.
Currently, 37°C marks the border between health and disease. And in the last two years, for many, too, the border between continuing with everyday life and having to isolate themselves for a few days.
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