A STUDY OP FEVER. 11 



seem scarcely worth while to prove that the chemical move- 

 ments of the fever patient are vastly above normal. The elabo- 

 rate experiments of Liebermeister {Beobachtimgen und Ver- 

 suche uber die Anwendung des Kalten Wassers hei Fieher- 

 haften Krankheiten^ Leipzig, 1868), of Kernig {ReicherV s Ar- 

 chiv, 18G0), upon the effects of cold baths in fever and in health, 

 have abundantly proven that fever patients yield a vastly greater 

 amount of heat to the water in which they ax'e immersed from 

 hour to hour than do healthy men, and yet their temperature 

 remains above normal. The proven excessive elimination of 

 carbonic acid in the breath and of solid matters in the urine in 

 fevei", the well-known emaciation that fever causes, all bear 

 similar witness to the experiments just quoted, so that it must 

 be received as an axiom, that the essential part of fever is 

 increased chemical movements throughout the system. 



Having arrived at a clear idea as to what fever is, we are 

 prepared to investigate its mechanism — to determine, if possi- 

 ble, in what way the rise of bodily temperature is produced. 



In fever all portions of the body usually are in unison ; the 

 increased tissue-change which is at the basis of the eleva- 

 tion of temperature, apparently occurs everywhere throughout 

 the system. It is plain that there are only two bonds of 

 union between all portions of the body, two organs or tissues 

 which fuse, as it were, all parts of the system into one ; and 

 that any physiological or pathological process which is equally 

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

 nervous system. 



Is fever, then, a hreraic disorder, or is it a neurosis? Very 

 possibly many of you, especially those whose military expe- 

 rience causes pyaemia to be ever present in the thoughts, will 

 reply at once, it is hoemic. In many exanthemata there is 

 undoubtedly, either as a cause or as a result of the disease, an 

 altered state of the blood. In pj^jemia a blood-dyscrasia is 



certainly a primary phenomenon; and in animals we develop 

 38 



