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, 268 (12), 1578-80

A Critical Appraisal of 98.6 Degrees F, the Upper Limit of the Normal Body Temperature, and Other Legacies of Carl Reinhold August Wunderlich

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  • PMID: 1302471

A Critical Appraisal of 98.6 Degrees F, the Upper Limit of the Normal Body Temperature, and Other Legacies of Carl Reinhold August Wunderlich

P A Mackowiak et al. JAMA.

Abstract

Objective: To evaluate critically Carl Wunderlich's axioms on clinical thermometry.

Design: Descriptive analysis of baseline oral temperature data from volunteers participating in Shigella vaccine trials conducted at the University of Maryland Center for Vaccine Development, Baltimore.

Setting: Inpatient clinical research unit.

Participants: One hundred forty-eight healthy men and women aged 18 through 40 years.

Main measurements: Oral temperatures were measured one to four times daily for 3 consecutive days using an electronic digital thermometer.

Results: Our findings conflicted with Wunderlich's in that 36.8 degrees C (98.2 degrees F) rather than 37.0 degrees C (98.6 degrees F) was the mean oral temperature of our subjects; 37.7 degrees C (99.9 degrees F) rather than 38.0 degrees C (100.4 degrees F) was the upper limit of the normal temperature range; maximum temperatures, like mean temperatures, varied with time of day; and men and women exhibited comparable thermal variability. Our data corroborated Wunderlich's in that mean temperature varied diurnally, with a 6 AM nadir, a 4 to 6 PM zenith, and a mean amplitude of variability of 0.5 degrees C (0.9 degrees F); women had slightly higher normal temperatures than men; and there was a trend toward higher temperatures among black than among white subjects.

Conclusions: Thirty-seven degrees centigrade (98.6 degrees F) should be abandoned as a concept relevant to clinical thermometry; 37.2 degrees C (98.9 degrees F) in the early morning and 37.7 degrees C (99.9 degrees F) overall should be regarded as the upper limit of the normal oral temperature range in healthy adults aged 40 years or younger, and several of Wunderlich's other cherished dictums should be revised.

Comment in

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    Weiger WA. Weiger WA. JAMA. 1993 Mar 10;269(10):1249; author reply 1252. doi: 10.1001/jama.269.10.1249b. JAMA. 1993. PMID: 8437293 No abstract available.
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    Edelsberg JS. Edelsberg JS. JAMA. 1993 Mar 10;269(10):1250; author reply 1252. doi: 10.1001/jama.269.10.1250b. JAMA. 1993. PMID: 8437294 No abstract available.
  • 98.6 degrees F.
    Chamberlain JM, Terndrup TE, Alexander D. Chamberlain JM, et al. JAMA. 1993 Mar 10;269(10):1250-1; author reply 1252. doi: 10.1001/jama.1993.03500100047014. JAMA. 1993. PMID: 8437295 No abstract available.
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    Walworth DH. Walworth DH. JAMA. 1993 Mar 10;269(10):1251-2. doi: 10.1001/jama.269.10.1251b. JAMA. 1993. PMID: 8437297 No abstract available.
  • 98.6 degrees F.
    Shaw ME. Shaw ME. JAMA. 1993 Mar 10;269(10):1249-50; author reply 1252. doi: 10.1001/jama.1993.03500100047013. JAMA. 1993. PMID: 8489619 No abstract available.
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    Marion GS, McGann KP. Marion GS, et al. JAMA. 1993 Mar 10;269(10):1251; author reply 1252. doi: 10.1001/jama.1993.03500100047017. JAMA. 1993. PMID: 8489620 No abstract available.

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