12 THE TONER LECTURES. 



septicemic fever by the injection of putrid matters into the 

 blood. Let us pause a moment to understand clearl}-, how- 

 ever, what we mean by fever being hseinic or neurotic. If the 

 poison carried by the blood into all parts of the body acts 

 upon the various tissues everywhere in such a way as to in- 

 crease 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, then that fever may be 

 called, with scientific strictness, heemic. Suppose, however, we 

 have a fever-centre in the nervous system, and that irritation 

 of a peripheral nerve is capable of causing fever b}' affecting 

 that centre, such fever would certainly be a neurosis. Granting 

 the existence of a "fever-centre" of this kind the laws of life 

 teach us that there must be poisons capable of acting upon it 

 directly so as to produce fever. Such a fever would certainly 

 be neurotic, although produced through the blood, the vital fluid 

 acting simply as a " common carrier." With this understanding 

 of the terms, certainly clinical proof is at present wanting that 

 the fever of pj'fflmia, of the exanthemata, or of any so-called 

 blood poisoning is strictly hsemic. It may be due to an action 

 of the poison upon the central nervous system. 



There are, however, numerous febrile reactions in regard to 

 whose origin there can be no doubt. Take one of the most com- 

 mon conditions, that due to the irritation of a local inflammation. 

 It is scarcely possible that the inflammation develops anj^ sub- 

 stance which acts as a general irritant to the tissue; it is much 

 more probable that the fever is produced through the agenc}' 

 of the nervous system. Irritative fever cOmes and goes so 

 quickly, is accompanied by so little perceptible general de- 

 .rangement of the system or of the blood, that it seems as 

 though it were as distinctly the result of irritation of peripheral 

 nerves as is tetanus, with its intense fever. 



The intense fever which is sometimes excited by the passage 

 of a catheter, as asserted by Bilroth (Archiv fur KJin, Chi- 



