(• II A I' r i: u IV. 



TIIK TIIKOKY OF FKVKIl. 



TiiK preliminary problems wliirh offered tliemselves nt tlie outset of this study 

 of fever liaviiig been solved, tlie nature and mechanism of the ])roce8s naturally 

 jirescnts itself for disrussion. The first jjortion of this last prolilcm seems to me 

 sufficiently elucidated by the ])roposition which has been already formulated in 

 the third chapter of the present memoir, but is here repeated. 



"Fever is a complex nutritive disturbance in which there is an excessive pro- 

 duction of such portion of the animal heat as is derived from chemical movements 

 in the accunudated material of tiie ori,'anisni, the overplus beiuf^ sometimes less, 

 sonu'times more than tlie loss of heat production resulting from abstinence from 

 food. The degree of bodily temperature in fever depends, in greater or less measure, 

 upon a disturbance in the natural play between the functions of heat production 

 and heat dissipation, and is not an accurate measure of the intensity of the increased 

 chemical movements of the tissues." 



Sucii being the nature of fever, the mechanism of its production is next in order 

 of study. 



It is plain that rise of bodily temperature may be local, or it may be general. 

 A local tissue may from some local cause suffer this rise, but where all parts of the 

 body are simultaneously affected there must be some general l)ond uniting thera 

 together through wliich is brought about the simultaneous action. There are only 

 two tissues or systems which, uniting together all parts of the body, fuse them, as it 

 were, into one. These are the blood and the nervous system. Any acute pliysio- 

 logical or patliological process, not dependent upon original vice of constitution, 

 affecting the whole protoplasm of the body simultaneously and which is equally 

 shared by all tissues, must have its origin therefore either in the blood or in the 

 nervous system. 



Is then fever ha?niic or neurotic in its origin 1 



In many febrile diseases there is apparently a poison circulating in the blood, 

 as the tons et origo mali. ^^■h(•n we ])roduce fever — by injecting a putrid sub- 

 stance in the lower animal or by allowing its entrance from a wound in man — 

 we know that the first step is the presence of a definite poison in the blood. It 

 is perhaps mitural to say, under these circumstances, that the fever is hivmic in 

 origin. IJut what is meant by this term? If the poison, carried by tl>c blood into 

 all parts of the brnly, acts upon the various tissues everywhere in such a way as to 

 increase in them tissue change; or if, upon entering the blood, it excites such 

 changes in that fluid as to cause the blood to incite the tissues everywhere to fever, 



