r If A I'TF, 11 TIT. 

 Tin: TIIKUMIC I'll KN OMEN A OF FEVER. 



Is the present chapter the cliief olyect of research is tlio fletermination of wlicthcr 

 tlie rise of temperature in fever is due to an increased production of heat, or whetlier 

 it is owing simply to retention of heat? Of course, the problem is a very old one, 

 altliouijh not as vet settled. In the various attempts to work it out various methods 

 have been u.scd. These methods may all be classed as eithir diduetive or directly 

 experimental. The deductive attempts have consisted in calculating from the 

 amount of food and tissue-waste in health and fever, the amount of heat which is 

 generated. It is plain that this is more demonstrative than a priori reasoning, 

 but it is not as convincing as direct ex|)erimentation. Later on, the subject may be 

 considered from this point of view, but at present I shall exajninc solely the 

 experimental evidence at hand. 



The evidence hitherto brought forward consists of experiments made upon man 

 and upon animals. The two most important studies upon num arc those of I'rof. 

 Lii'bermeister (/^f</'f/'7(/»/(_7r/t tind Vt rsuclte iihtr die anm nihn><j <hn luillni WuMmrs 

 hti Fi>fitrha/li It h'raii/:/itifeii, Leipzig, 1868) and of E. Lcydcn (Btiitn/uH Archie, 

 Ud. HI.). 



Liebermeister's plan consisted in comparing the effects produced by normal and 

 feverish individuals in raising the temperature of cold balhs of known quantity 

 and temperature. Several diHiculties arc in the way of this method; some of these 

 I'rof. Liebermeister perceived and overcame more or less completely. It was found 

 that the body cools down very luiecpially in the bath, the limbs falling much more 

 rapidly than the trunk. This source of error was, to some extent, done away with 

 liy beginning the data for the subseqiuMit calculation, after the patient had already 

 been some time in the bath; i.e., after the extremities had already been, in great 

 part cooled. Prof. Liebermeister considers the specific heat of the body at 0.83, 

 which is perhaps a little high; but, in relative exi)crimeuts, error from such source 

 must in great part disappear. Allowance in all of the experiments was made for 

 the spontaneous cooling of the bath in a way which apjx'ars perfictly fair; the basis 

 of this allowance was obtained by permitting, after the removal of the body, the 

 bath to cool for a period of time equal to that during which the body had been in it 



Liebermeister made fourteen experiments upon fever cases, and compared the 

 results with those obtained by Konig upon healthy men. The conclusion arrived 

 at is, — that when baths of the same temperature are employed, "without exception, 

 the loss of heat in the fever patient is greater than in the well person." 



This evidence is very important, but there is one underlying possible fallacy 

 which prevents it from being considered conclusive. According to Liebermeister him- 

 self, heat i»r(Mluction, both in health and disease, is profoundly affected by the heat 

 ( K'O ) 



