Re: Human Body Temperature

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In article <1991Aug12.163900.20…@philmtl.philips.ca> r…@philmtl.philips.ca (Ray Dunn) writes:
>In referenced article, cben…@gumby.Altos.COM (Christopher Benson) writes:
>>Growing up in Britain, I was taught (in more than one place) that
>>the normal human body temperature was 98.4 degrees Fahrenheit.

>>Now in the USA (Northern California), everybody here that I have
>>asked, was taught that the figure was 98.6 degrees Fahrenheit.

>Yes, this fascinated me too, and I still have no official explanation, even
>though it was discussed on sci.med.

>There is no absolute value for body temperature, it varies from individual
>to individual, so the "standard" is fairly arbitrary.  My guess is that
>98.6 is used because that is *exactly* 37 degrees C.  That is what is used
>here in Canada.

>I presume other Celsius countries use 37 degrees also.

Actually, growing up in Italy, I was taught that the normal human body
temperature is 36.5 C, that is, I believe, 97.7 F. I think that 98.4 F
is about 36.8 C.

Standard Italian wisdom is that temperature may vary during the day.
Oscillations between 36.5 C (in the morning) and 37 C (in the evening) are
considered acceptable for some people (i.e: individuals with high blood
pressure).

I have noticed that similar differences exist when discussing number of
heart beats, ideal body weight, max food intake, minimum elapsed time between
a meal and swimming, etc. For all of them, except the time elapsed between
a meal and swimming, the Italian suggested figure is rather smaller than the
American one.

During my last trip to Italy I had the opportunity to discuss the matter with
a couple of Italian physicians. Both of them told me that some differences
may depend on lifestyles and genetic make-up.

Recently a Canadian physician mentioned this issue during a TV show, here
in Toronto. According to this guy (I do not recall his name), immigrants
are particularly at risk, when visited by doctors who are not familiar
with specific characteristics of the specific ethnic group to which the
immigrants belong. According to him some things that are normal for people
with a certain genetic make-up are not normal for others.

Bruno Di Stefano
br…@bullet.ecf.toronto.edu

16 Responses to “Re: Human Body Temperature”

  1. admin says:

    >>On 12 Aug 91 21:39:12 GMT, br…@ecf.toronto.edu (Bruno DiStefano) said:

      another-person> There is no absolute value for body temperature, it
      another-person> varies from individual to individual, so the
      another-person> "standard" is fairly arbitrary.  My guess is that
      another-person> 98.6 is used because that is *exactly* 37 degrees C.
      another-person> That is what is used here in Canada.

      another-person> I presume other Celsius countries use 37 degrees also.

      Bruno> Actually, growing up in Italy, I was taught that the normal
      Bruno> human body temperature is 36.5 C, that is, I believe, 97.7 F.
      Bruno> I think that 98.4 F is about 36.8 C.

      Bruno> Standard Italian wisdom is that temperature may vary during
      Bruno> the day.  Oscillations between 36.5 C (in the morning) and 37
      Bruno> C (in the evening) are considered acceptable for some people
      Bruno> (i.e: individuals with high blood pressure).

    Body temperature is usually between 36.8 and 37.2. 36.5 is really too
    low.
    When it is hot it may rise during the day till 37.8.

    But maybe body temperature differs with ethnic background?
    Or do you measure with the thermometer in you mouth instead of in the
    rectum? Then you can expect 0.5C lower (i.e. 36.5)

    Peter Mutsaers                          email:    m…@fys.ruu.nl    
    Rijksuniversiteit Utrecht                         m…@fysap.fys.ruu.nl
    Princetonplein 5                          tel:    (+31)-(0)30-533880
    3584 CG Utrecht, Nederland

  2. admin says:

    [This thread started in soc.culture.british and has started to spread into
    several other newsgroups.  I have added sci.physics for reasons that will
    be clear by the end, but directed followups to soc.culture.europe which
    seems most appropriate to most of the article.]

    > > > Growing up in Britain, I was taught (in more than one place) that
    > > > the normal human body temperature was 98.4 [F, about 36.9 C]
    > > > Now in the USA (Northern California), everybody here that I have
    > > > asked, was taught that the figure was 98.6 [F, exactly 37.0 C].

    And indeed, fever thermometers in the two countries are sometimes
    marked with these respective temperatures.

    > > I presume other Celsius countries use 37 degrees also.
    > Actually, growing up in Italy, I was taught that the normal human body
    > temperature is 36.5 C, that is… 97.7 F.

    I expect that’s an axillary temperature.

    In some countries the usual place to measure an adult’s temperature is in
    the mouth, specifically under the back of the tongue.  (Oral temperature.)
    This is done in the UK, US, and Canada.  This area is relatively sheltered
    from the effects of the ambient temperature, but is subject to disturbance
    due to beverages recently consumed.

    In other countries the usual place is the armpit (axillary temperature).
    I understand that this is common in continental Europe, and that some
    doctors on this continent are adopting it, but I’ve never had it done myself.
    (So you see, this thread is relevant to soc.culture.europe.)

    People tend to be somewhat incredulous when they hear for the first time
    about whichever of these two methods they’re not used to.  I think there’s
    this image of the thermometer being taken from one person’s armpit to
    the net person’s mouth, but of course, that doesn’t happen.

    For completeness I should mention the rectal temperature, with the ther-
    mometer tip inserted in the rectum.  This is preferred for infants who
    might bite a glass thermometer inserted orally; I don’t know if it’s used
    in "axillary temperature" countries.  It’s actually subject to less
    disturbance from outside causes than the other two methods, and gives a
    temperature closer to the body core temperature than either.

    The instruction sheet with my digital thermometer was obviously translated
    from Fahrenheit to Celsius, since it gives F temperatures with one decimal
    place throughout the discussion and C temperatures with a spurious second
    place.  Be that as it may, after discussing normal variations, it gives
    the average normal temperature as:

            Axillary        36.44 C, 97.6 F
            Oral            37.00 C, 98.6 F
            Rectal          37.56 C, 99.6 F

    This is not to dispute that there might be differences due to genetics also.

    } } Herr Doktor Fahrenheit invented a temperature scale based
    } } on two fixed points …
    } } 0 being the coldest possible temperature obtained by
    } } mixing crushed ice and salt, and 100 being the standard
    } } fixed temperature of the human body in normal health.
    }
    } The story I heard said, when he invented the thermometer, he ran outside
    } and stuck it in the snow and called that point 0.  Then he returned
    } inside, stuck it under his arm and called that result 100.  We’ve been
    } stuck with the fact that it was a very cold night and he was running a
    } fever ever since.

    Well, I’ve actually read something about this (unfortunately I now have
    to reproduce from memory what I learned).  In the first place, Gabriel
    Fahrenheit (1686-1736) did not invent the thermometer; Galileo was using
    one around 1600.  I’m not sure if *he* invented it; one source says so.

    With the original thermometers or thermoscopes, there was no concept of
    a fixed scale.  Readings on a particular instrument could be compared
    only with others on the same instrument.  The original design used
    air as the expanding fluid, by the way, pushing some water up or
    down a spiral tube.

    Later the fixed scale was invented, but there was no universal agreement
    on scales — indeed, there used to be a lot more of them in use common
    use than the 3 or so seen today.  (Fahrenheit, Celsius, Kelvin; does
    anyone still use Reaumur or Rankine?)

    Gabriel Fahrenheit sold thermometers as a *business*, and he was the
    best in the business.  His thermometers were the most accurate, the most
    consistent from one instrument to the next.  But exactly how he achieved
    this was a *trade secret*.  The author of one book believes the following,
    and has convinced me…

       Fahrenheit’s thermometers were the best because he had chosen the best
       temperature scale.  The best in terms of reproducibility, that is.
       See, his real fixed points were at 32 and 96.  Notice that 32 and 96-32
       are both powers of 2.  This meant that he could prepare the scales
       easily *after* making each thermometer: first mark the two fixed points
       and then repeatedly bisect the distance between them to end up with
       single degrees.  Carrying the first bisected distance below the lower
       fixed point gave the zero point.

       When people *asked* Fahrenheit how he derived his zero point, he said
       it was the coldest temperature achievable with a mixture of water, ice,
       and salt.  But he also said that he used 32 as a fixed point, the
       temperature of freezing water, *and* 96, which was "blood heat" though
       he didn’t say how he measured this.  If it was axillary it was quite
       close to the modern value.   Since it doesn’t make sense to use three
       fixed points, the logical deduction is that he was deliberately being
       deceptive to protect his trade secrets and 0 was never a fixed point
       that he used in practice.

       Why choose a 0 lower than the fixed points?  Simple — to avoid the
       occurrence of negative values for temperatures ordinarily encountered!

    Be that as it may, the notion that 100 was ever a fixed point in the
    Fahrenheit scale is a later distortion — I suspect it comes from people
    deluded by the metric system into thinking that 100 is a convenient number
    for this sort of thing.  (It might be, if it was common to use centidegrees
    and hectodegrees, but that was hardly a consideration in Fahrenheit’s day.
    It still isn’t much of one now for temperatures, although I have seen
    millikelvins used in connection with cryogenics.)

    By the way, the lower fixed point used for the official definition today
    is absolute zero, which is defined as 0 K, -273.15 C, and -459.67 F.
    The upper fixed point is the freezing point of water *at the pressure
    where it is also the boiling point*; this is called the "triple point".
    It is defined as 273.16 K, 0.01 C, and 32.018 F; this makes the freezing
    point at 1 atmosphere very close to 0 C and 32 F.

    Remember, watch the newsgroups on any followups.

    Mark Brader                             "You are starlight; I’m Galileo"
    SoftQuad Inc., Toronto                                  – Amy Grant et al.
    utzoo!sq!msb, m…@sq.com           (Song heard while typing this article!)

  3. admin says:

    >>On 14 Aug 91 22:07:51 GMT, m…@sq.sq.com (Mark Brader) said:

      Mark> Followup-To: soc.culture.europe

      Mark> In other countries the usual place is the armpit (axillary
      Mark> temperature).  I understand that this is common in continental
      Mark> Europe, and that some doctors on this continent are adopting
      Mark> it, but I’ve never had it done myself.  (So you see, this
      Mark> thread is relevant to soc.culture.europe.)

      Mark> For completeness I should mention the rectal temperature, with
      Mark> the ther- mometer tip inserted in the rectum.  This is
      Mark> preferred for infants who might bite a glass thermometer
      Mark> inserted orally; I don’t know if it’s used in "axillary
      Mark> temperature" countries.  It’s actually subject to less

      Mark>      Axillary        36.44 C, 97.6 F
      Mark>      Oral            37.00 C, 98.6 F
      Mark>      Rectal          37.56 C, 99.6 F

    In Holland (I don’t know about other european countries) usually
    always rectal temperature is taken.
    As far as I’ve always known, and measured, rectal temperature should
    be between 36.8 and 37.2 (on hot days or with have labour may be
    higher up to 37.9).

    As this is also posted in sci.med, maybe someone can once and for all
    settle this question?

    Peter Mutsaers                          email:    m…@fys.ruu.nl    
    Rijksuniversiteit Utrecht                         m…@fysap.fys.ruu.nl
    Princetonplein 5                          tel:    (+31)-(0)30-533880
    3584 CG Utrecht, Nederland

  4. admin says:

    In sci.med, m…@fysap.fys.ruu.nl (Peter Mutsaers) writes:

    >Body temperature is usually between 36.8 and 37.2. 36.5 is really too
    >low.

     To low? That’s interesting. Everytime I have had my temperature taken
     in a doctors office (except on those occasions when I obviously had a
     fever), my temperature has been around 97.6 F or 36.5 C. In fact once
     when I had a rather severe infection in my hand, it was around <96 F.
     In each case it was measured by on of the electronic thermometers they
     stick in your ear. My mother also tends to have a low body temperature.
     Evidently its not *too* low. :-)

     - Kelvin

  5. admin says:

    Question:  How do you tell the difference betweem an oral and a rectal thermometer?

    Answer: By the taste!


    Gary Bisaga (gbis…@mitre.org)

  6. admin says:

    In article <MUTS.91Aug13140…@ruunfs.fys.ruu.nl> m…@fysap.fys.ruu.nl (Peter Mutsaers) writes:
    >Body temperature is usually between 36.8 and 37.2. 36.5 is really too
    >low.
    >When it is hot it may rise during the day till 37.8.

    >But maybe body temperature differs with ethnic background?

    Sorry, but my "normal" body temperature is 35.8; yes that is
    correct, not a mistake.  My father’s normal temperature was 36.1
    and has been a constant problem for both of us.  Visiting a new
    doctor, or donating blood, results in someone trying two or
    three instruments, calling in a supervisor, …, meanwhile I’m
    protesting that my normal temperature is always low.

    Interestingly, if my temperature reads 38, I have a serious
    fever, but everyone else thinks it is just a "high normal" or a
    "very low grade" fever, nothing to worry about.o

    So, there can be significant variations; after all, the "normal"
    number is simply the "mean" of a fairly narrow "normal"
    distribution, but there can be "outliers".  I suspect there is
    someone with an even lower "normal" temperature than mine.

    Michael Pilla

  7. admin says:

    In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

    >Sorry, but my "normal" body temperature is 35.8; yes that is
    >correct, not a mistake.  My father’s normal temperature was 36.1
    >and has been a constant problem for both of us.  Visiting a new
    >doctor, or donating blood, results in someone trying two or
    >three instruments, calling in a supervisor, …, meanwhile I’m
    >protesting that my normal temperature is always low.

    >Interestingly, if my temperature reads 38, I have a serious
    >fever, but everyone else thinks it is just a "high normal" or a
    >"very low grade" fever, nothing to worry about.o

    I was afraid this would come up in these discussions. In practicing
    medicine, it is common in outpatient settings to encounter patients
    who claim that their body temperature is lower than average, thus, a
    temp of 37 is a fever (i.e., they need antibiotics). I won’t go into
    a flame about the overuse of antibiotics in the U.S. (just mention
    that it is a  _huge_  problem), but it is important to address the
    issue of claims such as Michael makes above.

    There is no evidence for any systematic interindividual body temp
    variation of the  type Michael describes. Thermometer accuracy
    varies, site of body used for taking temps varies, and it is common
    to see temps of 35.5-36 degrees recorded in patient records, particularly
    if the room is on the cold side. Thus, one patient can have a whole
    string of low temperatures reported, just by chance.

    If I accepted the definition of fever as each patient such as Michael
    proposes, I would be significantly overcalling fevers.

    Brian

  8. admin says:

    In article <3110…@hpgrla.gr.hp.com>, kelv…@hpgrla.gr.hp.com (Kelvin Fedrick) writes…
    > stick in your ear. My mother also tends to have a low body temperature.
    > Evidently its not *too* low. :-)

    > – Kelvin

    Well, everything’s relative…

    -Celsius

  9. admin says:

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    pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:
    > Sorry, but my "normal" body temperature is 35.8; yes that is
    > correct, not a mistake.  My father’s normal temperature was 36.1
    > and has been a constant problem for both of us.  Visiting a new
    > doctor, or donating blood, results in someone trying two or
    > three instruments, calling in a supervisor, …, meanwhile I’m
    > protesting that my normal temperature is always low.

    > Interestingly, if my temperature reads 38, I have a serious
    > fever, but everyone else thinks it is just a "high normal" or a
    > "very low grade" fever, nothing to worry about.

    > So, there can be significant variations; after all, the "normal"
    > number is simply the "mean" of a fairly narrow "normal"
    > distribution, but there can be "outliers".  I suspect there is
    > someone with an even lower "normal" temperature than mine.

    This is an example of why the word "normal" should not be used to
    describe bodily measurements such as temperature, heart rate, respiration
    and blood pressure.  While grossly high or low readings may be described
    as abnormal, there are wide variations in what may be normal for a
    particular person.  For example, I’ve known someone who had a heart rate
    of ~30 beats per minute, which is normal for that person.  Similarly, my
    own normal heart rate used to be ~120 but has steadily dropped over the
    years and is now ~90.  It is acute deflections from the normal for a
    particular person that should be considered abnormal.  One question to
    ask a patient with a heart rate of, say, 120 is "Do you know what your
    usual pulse rate is?"  If they give you a value close to 120, that’s
    fine.  If they say "60", something’s wrong somewhere.


    Gerry Macridis, PO Box 3929, Wellington, New Zealand
    Phone +64 4 899444  Mail: xa…@tornado.welly.gen.nz

  10. admin says:

    In article <1991Aug16.141741.12…@ariel.unm.edu>, bhje…@vaxine.unm.edu (Brian Hjelle) writes:

     >In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:
     >>>
     >>Sorry, but my "normal" body temperature is 35.8; yes that is
     >>correct, not a mistake.  My father’s normal temperature was 36.1
     >>and has been a constant problem for both of us.  Visiting a new
     >>doctor, or donating blood, results in someone trying two or
     >>three instruments, calling in a supervisor, …, meanwhile I’m
     >>protesting that my normal temperature is always low.
     >>
     >>Interestingly, if my temperature reads 38, I have a serious
     >>fever, but everyone else thinks it is just a "high normal" or a
     >>"very low grade" fever, nothing to worry about.o
     >>
     >I was afraid this would come up in these discussions. In practicing
     >medicine, it is common in outpatient settings to encounter patients
     >who claim that their body temperature is lower than average, thus, a
     >temp of 37 is a fever (i.e., they need antibiotics). I won’t go into
     >a flame about the overuse of antibiotics in the U.S. (just mention
     >that it is a  _huge_  problem), but it is important to address the
     >issue of claims such as Michael makes above.
     >
     >There is no evidence for any systematic interindividual body temp
     >variation of the  type Michael describes. Thermometer accuracy
     >varies, site of body used for taking temps varies, and it is common
     >to see temps of 35.5-36 degrees recorded in patient records, particularly
     >if the room is on the cold side. Thus, one patient can have a whole
     >string of low temperatures reported, just by chance.
     >
     >If I accepted the definition of fever as each patient such as Michael
     >proposes, I would be significantly overcalling fevers.
     >
     >Brian

         Well, this is something that’s always annoyed me about doctors, they
    refuse to admit the possibility that the patient, having lived with his or
    her body for a lifetime, might just possibly be familiar with some of it’s
    quirks.

         I’ve got a relatively decent digital thermometer, and it almost always
    measures my body temperature low, around 97.7f (oral reading), it is especially
    low in the mornings (sometimes 96.9 or thereabouts), and the same thermometer
    gets normal readings for my wife and our kids.

         It’s been this way as long as I can remember so I don’t get overly
    concerned about it, but I have been given thyroid tests by doctors that
    thought it was odd (coming out normal), while others say, yes, individuals
    vary.

         My suspicion is that doctors would be a lot more effective both in terms
    of treating patients symptoms effectively and not wasting money on unnecessary
    tests if they would listen to their patients.

  11. admin says:

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    In article <1991Aug16.141741.12…@ariel.unm.edu> bhje…@vaxine.unm.edu (Brian Hjelle) writes:
    >In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

    >>Sorry, but my "normal" body temperature is 35.8; yes that is
    >>correct, not a mistake.  My father’s normal temperature was 36.1
    >>and has been a constant problem for both of us.  Visiting a new
    >>doctor, or donating blood, results in someone trying two or
    >>three instruments, calling in a supervisor, …, meanwhile I’m
    >>protesting that my normal temperature is always low.

    >>Interestingly, if my temperature reads 38, I have a serious
    >>fever, but everyone else thinks it is just a "high normal" or a
    >>"very low grade" fever, nothing to worry about.o

    >I was afraid this would come up in these discussions. In practicing
    >medicine, it is common in outpatient settings to encounter patients
    >who claim that their body temperature is lower than average, thus, a
    >temp of 37 is a fever (i.e., they need antibiotics). I won’t go into
    >a flame about the overuse of antibiotics in the U.S. (just mention
    >that it is a  _huge_  problem), but it is important to address the
    >issue of claims such as Michael makes above.

    >There is no evidence for any systematic interindividual body temp
    >variation of the  type Michael describes. Thermometer accuracy
    >varies, site of body used for taking temps varies, and it is common
    >to see temps of 35.5-36 degrees recorded in patient records, particularly
    >if the room is on the cold side. Thus, one patient can have a whole
    >string of low temperatures reported, just by chance.

    >If I accepted the definition of fever as each patient such as Michael
    >proposes, I would be significantly overcalling fevers.

    First, I do not take antibiotics for any fever.  I rarely get
    sick, fortunately, and I believe in Nature taking it’s course
    where possible.  I suspect that my rigorous exercise program
    keeps me healthy (as well as choosing my parents carefully ;-)

    Second, my temperature has consistently read within 0.1 degrees
    of the 35.8 for the past THIRTY years, at the very least.  I
    seriously doubt that I have always managed to be in a cold room,
    had the thermometer inserted whereever, had inaccurate
    thermometers always erring on the low side, …, that is just not
    possible for that period of time.  In that time period, I can
    count on the fingers of one hand how many times I have indicated
    around 38.  About one-half the time, I am sweating profusely,
    …, so I guess my body is reacting to the relative shift
    upwards.  I have the usual aches, …  Also, how do you explain
    that my father consistently read low for his entire adult life
    (over sixty years)?  Statistical abberration, too?

    My personal physician was the one who explained to me that the
    "standard" body temperature was simply a very narrow "normal"
    probability distribution and that there were outliers on either
    side who were "normal" and not to worry about it.

    The normal low temperature is interesting because of other
    people’s reactions to it.  Now it is interesting on an
    international scale. ;-)

    Michael Pilla

  12. admin says:

    In article <1991Aug20.143507.27…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

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    >In article <1991Aug16.141741.12…@ariel.unm.edu> bhje…@vaxine.unm.edu (Brian Hjelle) writes:
    >>In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

    >>>Sorry, but my "normal" body temperature is 35.8; yes that is
    >>>correct, not a mistake.  My father’s normal temperature was 36.1
    >>>Interestingly, if my temperature reads 38, I have a serious
    >>>fever, but everyone else thinks it is just a "high normal" or a
    >>>"very low grade" fever, nothing to worry about.o

    >>I was afraid this would come up in these discussions. In practicing
    >>medicine, it is common in outpatient settings to encounter patients
    >>who claim that their body temperature is lower than average, thus, a
    >>temp of 37 is a fever (i.e., they need antibiotics). I won’t go into

    >Second, my temperature has consistently read within 0.1 degrees
    >of the 35.8 for the past THIRTY years, at the very least.  I

    [stuff deleted]

    >possible for that period of time.  In that time period, I can
    >count on the fingers of one hand how many times I have indicated
    >around 38.  About one-half the time, I am sweating profusely,
    >My personal physician was the one who explained to me that the
    >"standard" body temperature was simply a very narrow "normal"
    >probability distribution and that there were outliers on either
    >side who were "normal" and not to worry about it.

    Of course there is some interindividual variation, its just a matter
    of degree :-) . 38 is a fever by most definitions. What is difficult is
    when 37.5 or even 37 becomes "fever" in a determined patient’s mind.
    Ask any doc who practices primary care about patients demanding
    antibiotics for colds and fevers- their overuse is an enormously costly
    and wasteful problem in the U.S. As a general rule, especially in
    pediatrics, the higher the fever, the more likely you are to have
    a serious (ie, bacterial) infection. I’ve practiced only a few years
    of primary care, but had many encounters with people asserting that
    37.5 is a fever for them.

    I’m glad to hear that you do not insist on antibiotics for every
    fever…

    Brian  >

  13. admin says:

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    In article <1…@eskimo.celestial.com> nan…@eskimo.celestial.com (Robert Dinse) writes:
    >In article <1991Aug16.141741.12…@ariel.unm.edu>, bhje…@vaxine.unm.edu (Brian Hjelle) writes:
    > >In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

    > >>Sorry, but my "normal" body temperature is 35.8; yes that is
    > >>correct, not a mistake.  My father’s normal temperature was 36.1
    > >I was afraid this would come up in these discussions. In practicing
    > >medicine, it is common in outpatient settings to encounter patients
    > >who claim that their body temperature is lower than average, thus, a
    > >temp of 37 is a fever (i.e., they need antibiotics). I won’t go into

    > >There is no evidence for any systematic interindividual body temp
    > >variation of the  type Michael describes. Thermometer accuracy
    > >varies, site of body used for taking temps varies, and it is common
    > >to see temps of 35.5-36 degrees recorded in patient records, particularly

    >     Well, this is something that’s always annoyed me about doctors, they
    >refuse to admit the possibility that the patient, having lived with his or
    >her body for a lifetime, might just possibly be familiar with some of it’s
    >quirks.

    Equally annoying is the patient who imagines s/he can throw out years of
    medical training and experience with hundreds and thousands of patients
    because s/he is "in touch with my body".

    >     I’ve got a relatively decent digital thermometer, and it almost always
    >measures my body temperature low, around 97.7f (oral reading), it is especially
    >low in the mornings (sometimes 96.9 or thereabouts), and the same thermometer
    >gets normal readings for my wife and our kids.

    So in what way are these numbers unusual? These are common temperature readings
    for normal people.

    >     My suspicion is that doctors would be a lot more effective both in terms
    >of treating patients symptoms effectively and not wasting money on unnecessary
    >tests if they would listen to their patients.

    This is a bad generalization. In many cases, patients do not come to the
    doctor’s office to be told that they are OK and sent home. They expect,
    even demand intervention. This is particularly true with fevers and colds.
    In the example discussed above, if I routinely "listened" to my patient I
    would be handing out at least 2X as much antibiotics as necessary.Brian  

  14. admin says:

    - Hide quoted text — Show quoted text -

    In article <0ymb…@lynx.unm.edu> bhje…@triton.unm.edu writes:
    >In article <1991Aug20.143507.27…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:
    >>In article <1991Aug16.141741.12…@ariel.unm.edu> bhje…@vaxine.unm.edu (Brian Hjelle) writes:
    >>>In article <1991Aug15.131928.2…@cbnewsi.cb.att.com> pi…@cbnewsi.cb.att.com (michael.a.pilla) writes:

    >>>>Sorry, but my "normal" body temperature is 35.8; yes that is
    >>>>correct, not a mistake.  My father’s normal temperature was 36.1

    >>>>Interestingly, if my temperature reads 38, I have a serious
    >>>>fever, but everyone else thinks it is just a "high normal" or a
    >>>>"very low grade" fever, nothing to worry about.o

    >>>I was afraid this would come up in these discussions. In practicing
    >>>medicine, it is common in outpatient settings to encounter patients
    >>>who claim that their body temperature is lower than average, thus, a
    >>>temp of 37 is a fever (i.e., they need antibiotics). I won’t go into

    >>Second, my temperature has consistently read within 0.1 degrees
    >>of the 35.8 for the past THIRTY years, at the very least.  I

    >[stuff deleted]

    >>possible for that period of time.  In that time period, I can
    >>count on the fingers of one hand how many times I have indicated
    >>around 38.  About one-half the time, I am sweating profusely,
    >>My personal physician was the one who explained to me that the
    >>"standard" body temperature was simply a very narrow "normal"
    >>probability distribution and that there were outliers on either
    >>side who were "normal" and not to worry about it.

    >Of course there is some interindividual variation, its just a matter
    >of degree :-) . 38 is a fever by most definitions. What is difficult is
    >when 37.5 or even 37 becomes "fever" in a determined patient’s mind.

    Well, it will surprise you, but in Italy a temperature of 37.5 C is
    routinely considered a fever….

    >Ask any doc who practices primary care about patients demanding
    >antibiotics for colds and fevers- their overuse is an enormously costly
    >and wasteful problem in the U.S. As a general rule, especially in

    Now, this is a totally different question : on the one side you have
    people like Michael who have a body temperature which is normally
    lower than the average, thus implying a lower temperature for a
    feverish state, on the other you have over-reacting patients who
    demand anti-biotics for colds.
    I don’t think that a significant part of the patients you are talking about
    actually assert that their normal temperature is below the average :
    certainly that might occur but, you will agree, that’s not a very
    typical case….

    >pediatrics, the higher the fever, the more likely you are to have
    >a serious (ie, bacterial) infection. I’ve practiced only a few years
    >of primary care, but had many encounters with people asserting that
    >37.5 is a fever for them.

    Yup, I can find about 57 million Italians who would assert that…

    >I’m glad to hear that you do not insist on antibiotics for every
    >fever…

    >Brian  >


    Fabio Marino                                    UCLA
    mar…@cs.ucla.edu                          Computer Science Department
    mar…@cognet.ucla.edu                              Brain Research Institute
    fa…@seas.ucla.edu                         Graduate Student

  15. admin says:

    In article <1991Aug20.193901.13…@cs.ucla.edu> mar…@baleen.cs.ucla.edu (Fabio Marino) writes:
    >In article <0ymb…@lynx.unm.edu> bhje…@triton.unm.edu writes:

    >>Of course there is some interindividual variation, its just a matter
    >>of degree :-) . 38 is a fever by most definitions. What is difficult is
    >>when 37.5 or even 37 becomes "fever" in a determined patient’s mind.

    >Well, it will surprise you, but in Italy a temperature of 37.5 C is
    >routinely considered a fever….

    So what? What do they then do about the fact that 1/3 of the population is
    having a fever on any given day in Rome? Give them all antibiotics?

    >>Ask any doc who practices primary care about patients demanding
    >>antibiotics for colds and fevers- their overuse is an enormously costly
    >>and wasteful problem in the U.S. As a general rule, especially in

    >Now, this is a totally different question : on the one side you have
    >people like Michael who have a body temperature which is normally
    >lower than the average, thus implying a lower temperature for a
    >feverish state, on the other you have over-reacting patients who
    >demand anti-biotics for colds.
    >I don’t think that a significant part of the patients you are talking about
    >actually assert that their normal temperature is below the average :
    >certainly that might occur but, you will agree, that’s not a very
    >typical case….

    These questions are inseperably intertwined, because there is no reason
    to label almost everyone as febrile. There is a practical reason for
    labeling someone febrile, and that is to decide to treat their presumed
    illness. If you choose to define fever as 37.5, you will have to deal
    with the fact that 95% of "febrile" people are not ill.

    Of course only a fraction of people wanting antibiotics are claiming
    a constitutively low body temperature. But I run into them frequently.

    >>of primary care, but had many encounters with people asserting that
    >>37.5 is a fever for them.

    >Yup, I can find about 57 million Italians who would assert that…

    And, by my reckoning about 15-20 million have a fever right now.

    Brian  

  16. admin says:

    >>On 20 Aug 91 19:39:01 GMT, mar…@baleen.cs.ucla.edu (Fabio Marino) said:

      other_person> Of course there is some interindividual variation, its
      other_person> just a matter of degree :-) . 38 is a fever by most
      other_person> definitions. What is difficult is when 37.5 or even 37
      other_person> becomes "fever" in a determined patient’s mind.

      Fabio> Well, it will surprise you, but in Italy a temperature of 37.5 C is
      Fabio> routinely considered a fever….

    I think we are still confusing the way of measurement here. Probably
    you mean 37.5C orally is fever, but not when measured rectally (is
    that en english word?) which is the normal way to denote body
    temperature I think.

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