14 THE TONER LECTURES. 



tracted, would not respond to light. Temperature had risen 

 to 110|^°. Other thermometers were procured, and in fifteen 

 minutes after the temperature taken again in the axilla, month, 

 and rectum. In the latter place it was 111^°, in the axilla 

 111° F. The man was ordered to be laid in the bath-tub, but 

 there was no water at hand, and when some was procured in 

 half an hour from the time the resident first saw the patient, 

 he was dead. His urine, when drawn by catheter, was scalding 

 hot, but no albumen was found in it, nor any pus. 



Fost-mortem examination sixteen hours after death revealed 

 only intense congestion of kidneys, and of all the genitalia and 

 jDelvic viscera. There was no apparent inflammation of any 

 part of the genital passages. The brain was very much con- 

 gested, as were also the sinuses of the dura mater, and the 

 vessels of the brain. The brain substance appeared healthy ; 

 there was some effusion into the ventricles. There was also 

 congestion of the lungs. 



A very curious phenomenon, which is in itself sufficient to 

 prove that fever is not due to a diseased condition of the 

 blood, irritating, or in some way acting locally upon tlie tis- 

 sues, is in the confinement, in some cases, of the fever to a 

 part. This is more especially seen in malarial disorders, but 

 is occasionally witnessed in other affections. I have never 

 myself seen such a case, but it is said that sometimes a por- 

 tion of the body not larger than the finger will pass through 

 all the stages of an ague paroxysm, chill, fever, and sweating. 

 In acute apoplexy I have known of an intense paroxysm of 

 fever confined to the affected side. 



It is unnecessary, I think, to dwell upon this point more in 

 detail. The conclusions to be drawn from the clinical con- 

 sideration of the subject are: in some cases fever is undoubt- 

 edly a neurosis; whilst in other cases clinical medicine is 

 unable to decide with certainty whether the elevation of tem- 

 perature is neurotic or hremic. 



