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Clinical Temperature: Title and subTitle BreakNew Physiological Basis FREE

Theodor H. Benzinger, MD, ScD
[+] Author Affiliations

Reprint requests to Naval Medical Research Institute, National Naval Medical Center, Bethesda, Md 20014.


JAMA. 1969;209(8):1200-1206. doi:10.1001/jama.1969.03160210032008
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Quantitative mechanisms that regulate normal temperature and determine its clinical aberrations have been found with the methods of gradient calorimetry and tympanic thermometry. Homeostasis is achieved by warm-sensitive neurons of a "human thermostat" or "temperature-eye" in the anterior portion of the hypothalamus. These fire and excite sweating and vasodilatation for heat loss when their temperature exceeds a sharply determined set point near 37 C (98.6 F). Similar warm-sensitive neurons inhibit, through a synaptic station in the posterior portion of the hypothalamus, the metabolic response to cold which is excited by cold-receptors of the skin firing from thresholds at 33 to 35 C (91.4 to 95 F). Pyrogens depress or extinguish firing of central thermoreceptors. The set point is shifted. Fever develops. These findings provide a basis for the understanding of clinical temperature, and the tool for its reliable measurement—tympanic, not rectal thermometry.

REFERENCES

Pickering, G.:  Regulation of Body Temperature in Health and Disease , Lancet 1:1-9 ( (Jan 4) ) 1958;.
Aronsohn, E., and Sachs, J.:  Die Beziehungen des Gehirns zur Körperwärme und zum Fieber , Pfluegers Arch Ges Physiol 37:232-301 ( (Oct 29) ) 1885;.
Isenschmid, R., and Krehl, L.:  Über den Einfluss des Gehirns auf die Wärmeregulation , Arch Exp Path Pharmakol 70:109-134 ( (Oct 25) ) 1912;.
Barbour, H.G.:  Die Wirkung unmittelbarer Erwärmung und Abkühlung der Wärmezentra auf die Körpertemperatur , Arch Exp Path Pharmakol 70:1-26 ( (Oct 18) ) 1912;.
Benzinger. T.H., et al:  Human Calorimetry by Means of the Gradient Principle , J Appl Physiol 12:S1-S24 ( (March) ) 1958;.
Benzinger, T.H., and Taylor, G.W.: " Cranial Measurements of Internal Temperature in Man ," in Temperature: Its Measurement and Control in Science and Industry , New York: Reinhold Publishing Corporation, 1962;, vol 3, pp 111-120.
Benzinger, T.H.: " The Thermal Homeostasis of Man ," in Heim. R., et al: Les Concepts de Claude Bernard sur le Milieu Intérieur , Paris: Masson & Cie 1967;, pp 325-379.
Benzinger, T.H.:  Heat Regulation: The Homeostasis of Central Temperature in Man , Physiol Rev , to be published.
Hellon, R.F.:  Thermal Stimulation of Hypothalamic Neurones in Unanesthetized Rabbits , J Physiol 193:381-395 ( (Nov) ) 1967;.
Hensel, H., and Zotterman, Y.:  Quantitative Beziehungen zwischen der Entladung einzelner Kältefasern und der Temperatur , Acta Physiol Scand 23:291-319 ( (Sept 21) ) 1951;.
Hemingway, A., et al:  Effect of Heating Hypothalamus of Dogs by Diathermy , J Neurophysiol 3:329-338 ( (July) ) 1940;.
Hardy, J.D.; Hellon, R.F.; and Sutherland, K.:  Temperature Sensitive Neurones in the Dog's Hypothalamus , J Physiol 175:242-253, 1964;.
Downey, J.A.; Chiodi, H.P.; and Darling, R.C.:  Central Temperature Regulation in the Spinal Man , J Appl Physiol 22:91-94 ( (Jan) ) 1967;.
Thauer, R.:  Der nervöse Mechanismus der chemischen Temperaturregulation des Warmblüters , Naturwissenschaften 51:73-80, 1964;.
Bullard, R.W.; van Beaumont, W.; and Banerjee, M.:  The Role of Skin Temperature in the Regulation of Sweating , abstracted, XXIII International Congress of Physiological Sciences, September 1-9, 1965, Tokyo, p 292 .
Robinson, S., et al:  Relations Between Sweating, Cutaneous Blood Flow, and Body Temperature in Work , J Appl Physiol 20:575-582 ( (July) ) 1965;.
Stephen, C.R.:  Fulminant Hyperthermia During Anesthesia and Surgery , JAMA 202:178-182 ( (Oct 16) ) 1967;.
Wilson, R.D., et al:  Anesthetic Management of the Poor Risk Pediatric Patient , read before the Southern Medical Association, New Orleans, Nov 19, 1968 .
Dickey, T., and Stephen, C.R.:  Body Temperature Monitoring Via the Tympanic Membrane , read before the annual meeting of the Southern Society of Anesthesiologists, Atlanta, March 28, 1969 .

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Pickering, G.:  Regulation of Body Temperature in Health and Disease , Lancet 1:1-9 ( (Jan 4) ) 1958;.
Aronsohn, E., and Sachs, J.:  Die Beziehungen des Gehirns zur Körperwärme und zum Fieber , Pfluegers Arch Ges Physiol 37:232-301 ( (Oct 29) ) 1885;.
Isenschmid, R., and Krehl, L.:  Über den Einfluss des Gehirns auf die Wärmeregulation , Arch Exp Path Pharmakol 70:109-134 ( (Oct 25) ) 1912;.
Barbour, H.G.:  Die Wirkung unmittelbarer Erwärmung und Abkühlung der Wärmezentra auf die Körpertemperatur , Arch Exp Path Pharmakol 70:1-26 ( (Oct 18) ) 1912;.
Benzinger. T.H., et al:  Human Calorimetry by Means of the Gradient Principle , J Appl Physiol 12:S1-S24 ( (March) ) 1958;.
Benzinger, T.H., and Taylor, G.W.: " Cranial Measurements of Internal Temperature in Man ," in Temperature: Its Measurement and Control in Science and Industry , New York: Reinhold Publishing Corporation, 1962;, vol 3, pp 111-120.
Benzinger, T.H.: " The Thermal Homeostasis of Man ," in Heim. R., et al: Les Concepts de Claude Bernard sur le Milieu Intérieur , Paris: Masson & Cie 1967;, pp 325-379.
Benzinger, T.H.:  Heat Regulation: The Homeostasis of Central Temperature in Man , Physiol Rev , to be published.
Hellon, R.F.:  Thermal Stimulation of Hypothalamic Neurones in Unanesthetized Rabbits , J Physiol 193:381-395 ( (Nov) ) 1967;.
Hensel, H., and Zotterman, Y.:  Quantitative Beziehungen zwischen der Entladung einzelner Kältefasern und der Temperatur , Acta Physiol Scand 23:291-319 ( (Sept 21) ) 1951;.
Hemingway, A., et al:  Effect of Heating Hypothalamus of Dogs by Diathermy , J Neurophysiol 3:329-338 ( (July) ) 1940;.
Hardy, J.D.; Hellon, R.F.; and Sutherland, K.:  Temperature Sensitive Neurones in the Dog's Hypothalamus , J Physiol 175:242-253, 1964;.
Downey, J.A.; Chiodi, H.P.; and Darling, R.C.:  Central Temperature Regulation in the Spinal Man , J Appl Physiol 22:91-94 ( (Jan) ) 1967;.
Thauer, R.:  Der nervöse Mechanismus der chemischen Temperaturregulation des Warmblüters , Naturwissenschaften 51:73-80, 1964;.
Bullard, R.W.; van Beaumont, W.; and Banerjee, M.:  The Role of Skin Temperature in the Regulation of Sweating , abstracted, XXIII International Congress of Physiological Sciences, September 1-9, 1965, Tokyo, p 292 .
Robinson, S., et al:  Relations Between Sweating, Cutaneous Blood Flow, and Body Temperature in Work , J Appl Physiol 20:575-582 ( (July) ) 1965;.
Stephen, C.R.:  Fulminant Hyperthermia During Anesthesia and Surgery , JAMA 202:178-182 ( (Oct 16) ) 1967;.
Wilson, R.D., et al:  Anesthetic Management of the Poor Risk Pediatric Patient , read before the Southern Medical Association, New Orleans, Nov 19, 1968 .
Dickey, T., and Stephen, C.R.:  Body Temperature Monitoring Via the Tympanic Membrane , read before the annual meeting of the Southern Society of Anesthesiologists, Atlanta, March 28, 1969 .
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