writings helped usher in a wave of experimentation that led to the

invention of the first crude �air thermometer,� possibly by Galileo

Galilei in 1592. Galileo referred to the device as a thermoscope. The
instrument consisted of an upright tube with a closed bulb at one
end, partially filled with air, and resting in a container of water at
the open end of the tube. Using temperature changes to expand or
contract the entrapped air in the bulb, the column of water moved
down or up the tube. Since both temperature and atmospheric pressure affected the
expansion and contraction of the air inside the
bulb, the device could have been named a barothermoscope; however, the slow and
relatively minor influence of barometric pressure
was not recognized until the invention of the barometer in 1643.7
The first thermoscopes were probably little more than playthings
or objects of curiosity. This perception would change abruptly
when the toy thermoscopes were fashioned with numerical scales,
reflecting the 17th-century trend toward quantification of natural
phenomena. In 1611, Galileo�s physician-engineer friend, Santorio
Santorio, placed the first such scale on a thermoscope, thus creating a very crude
clinical thermometer.8 The accuracy of the instrument must have been rather poor,
due to in part to the variability of
measurements arising from changing barometric pressures as well
as a lack of any standardized scales for quantification. Although
the bulb portion of the instrument could have been inserted into
a patient�s mouth for taking a temperature, it is not likely that the
reading would have meant anything of clinical significance.
By the 1650s, enclosed liquid-in-a-glass thermometers were
being fashioned by glassblowers in Italy. Ferdinand II, the Grand
Duke of Tuscany, is credited with inventing the first hermetically
sealed thermometer in 1654, using alcohol as the liquid. Having a
sealed tube improved the precision of temperature measurement
by eliminating the influence of barometric pressure on the thermometric readings.
The thermometers could be inserted into the
mouth without concern for fluid leaking out. These early clinical
thermometers were highly inaccurate, however, due to a lack of
standard calibration.
In 1665, Robert Boyle and Christian Huygens proposed independently that
thermometers could be calibrated effectively from a single fixed point.9 Their work
laid the foundation for the development
of the mercury thermometer with a standardized scale, invented by
Daniel Gabriel Fahrenheit in 1714. This was followed in 1742 by the
Celsius scale, conceived by Anders Celsius. The use of these scales
enabled the recording of temperature in an accurate and consistent
fashion. As the international standard, the Celsius scale presents
100 degrees between the freezing point (0�C, 32�F) and boiling
point (100�C, 212�F) of pure water at sea level air pressure.
Public health crises in 19th century Europe provided a strong
impetus for further developments in clinical thermometry. The most
prevalent diseases of the day were smallpox, typhus, enteric fever,
and tuberculosis, with cholera making its debut in the early 1800s.
The deadliest of these maladies was smallpox, killing an estimated
400,000 Europeans each year and afflicting commoners and royalty
alike.10 All of these diseases included fever as a primary symptom,
hence the umbrella term �fever diseases.� In 1802, the London Fever
Hospital was established to help accommodate Londoners who
were inflicted by infectious disease.