Bad Medicine, Part 1: The Story of 98.6 (Rebroadcast)

[0] Hey there, Freakonomics Radio listeners, we are taking advantage of August to replay you a special three -part series we did last year called Bad Medicine.

[1] Today, part one, the story of 98 .6.

[2] And it starts right now.

[3] We begin with the story of 98 .6.

[4] You know the number, right?

[5] It is one of the most famous numbers there is because the body temperature of a healthy human being is 98 .6 degrees Fahrenheit.

[6] Isn't it?

[7] So now I'm going to take your temperature, if you don't mind, just open your mouth and I'll insert the thermometer.

[8] Perfect.

[9] The story of 98 .6 dates back to a physician by the name of Carl Wunderlich.

[10] This was in the mid -1800s.

[11] Wunderlich was medical director of the hospital at Leipzig University.

[12] In that capacity, he oversaw the care and the taking a vital sign.

[13] on some 25 ,000 patients.

[14] Pretty big data set, yes?

[15] 25 ,000 patients.

[16] And what did Wonderlick determine?

[17] He determined that the average temperature of the normal human being was 98 .6 degrees Fahrenheit or 37 degrees centigrade.

[18] This is Philip McCoviac, a professor of medicine and a medical historian at the University of Maryland.

[19] Well, I am an intern.

[20] by trade and an infectious disease specialist by subspecialty.

[21] So my bread and butter is fever.

[22] There's one more thing, McCoviac is?

[23] I am by nature a skeptic, and it occurred to me very early in my career that this idea that 98 .6 was normal, and that if you didn't have a temperature of 98 .6, you were somehow abnormal, just didn't sit right.

[24] Philip McCoviac, you have to understand, cares a lot about what is called clinical thermometry.

[25] And if you care a lot about clinical thermometer, you care a lot about the thermometer that Carl Wunderlich used to establish 98 .6.

[26] His thermometer is an amazing key to this story of 98 .6.

[27] So you can imagine how excited McCoviac was when on a tour of the weird and wonderful Mooter Museum in Philadelphia, the curator told him they had one of Wonderlick's original thermometers.

[28] I said, good heavens, may I see it?

[29] And she said, sure, would you like to borrow it?

[30] And I said, of course.

[31] And so I was able to take this thermometer back to Baltimore and do a number of experiments.

[32] The Wonderlich thermometer, McCoviac realized, was not at all a typical thermometer, First of all, it was about a foot long, fairly thick stem, and registered almost two degrees centigrade higher than current thermometers or thermometers of that era.

[33] Two degrees higher?

[34] Centigrade?

[35] Uh -oh.

[36] In addition to that, it is a non -registering thermometer, which means that it has to be read while it's in place.

[37] So it would have been awkward, use.

[38] McCoviac noticed something else about the original Wunderlich research.

[39] Investigating further, it became apparent that he was not measuring temperatures either in the mouth or the rectum.

[40] He was measuring axillary or armpit temperatures, and so that in many, many ways, his results are not applicable to temperatures that are taken using current thermometers and current techniques.

[41] As it turns out, The esteemed Dr. Carl Wunderlich...