A STUDY IX MORBID AND X T. M A L PHYSIOLOGY. 13 



and depress tlie heart, and thereby lower tlie freqnency of tlie cardiac beat, and 

 reduce th<; force of the circulation although distinctly causing fever. It is notorious 

 that in disease, fever coexists with ahuost every conceivable condition of the circu- 

 lation, and indeed, if we can believe clinical records at all, nuiy occur or continne 

 after the cessation of circulation, /. e. in the post-mortem rise of teuiix-rature. Tliis 

 clinical fact abundantly confiruis the conclusion readied in our propositions, and 

 at the same time reveals the effect of modifying circumstances upon the typical 

 phenomena of fever. Peculiarities of symptoms found in continued fevers, there- 

 fore, do not militate against the theory here inculcated. Every clinician who has 

 employed the cold water treatment of typlioid and other fevers must have noted 

 the subsidence of the nervous and circulatory disturbance under the use of cold ; 

 results which are the counterpart of those wliich occurred in the more acute cases 

 heretofore reported in this paper. The elaborate researches of Zenker (Ueher die 

 Ver Under ungeii der loiWcilrUvli. Mush, in Tijphus AbdontinaIis,l.c{\-)z\s;, 1SG4) have 



demonstrated the profound nutritive disturbances whicli occur in febrile diseases 



apparently the direct result of continued heat of a mild f}pe. These researches 

 have been confirmed by the experiments of Dr. M. Litien ( Yirclion-'s Archiv, INIay, 

 1876). This observer found tliat, when guinea pigs are kept for some days in air 

 heated steadily to from 96^8 to 98'^. 6 F., fatty degeneration of most of the tissues 

 is produced. The liver is usually affected first, the heart next, then the kidneys, 

 the striated muscles, and fiually the cellular tissue and to some extent tlie mucous 

 membranes become involved. 



It would appear therefore that after these many centuries we must acknowledge, 

 as now demonstrated, the aphorism evolved from shadowy premises by the genius 

 of Galen, nain essentia qiiidem fehrium est in ealvris pradcrnaturcm (^De Di.ff. Fehr., 

 Liv. i., chap. i.). 



Having reached the conclusion just announced, two questions naturally offer 

 themselves as requiring answer before it will be possible to determine the true 

 nature and mechanism of the fever process. 



First. What is the mechanism by which the production and dissipation of animal 

 heat is regulated in the animal organism \ 



Second. Is the rise of temperature in fever due to the excessive retention or to 

 the abnormal production of heat, or to both of these conjointly \ 



To the consideration of these questions the next two chapters of this memoir 

 are devoted. 



