614 FEVER 



Frugality of the Body in Chronic Febrile Conditions. 

 It would be altogether a mistake to assume, for the rest, 

 that the organism in a state of fever deals with its material 

 in any especially extravagant manner. In fact precisely the 

 opposite is apparently true. At least in the later part of 

 the course of very slowly declining cases of typhoid fever 

 and, too, in pulmonary phthisis, C. von Noorden repeatedly 

 observed that the body cells of human beings in protracted 

 fever are able to functionate very economically on a con- 

 sumption of 20 to 25 calories pro kilogram of body weight. 

 This may explain how chronic febrile subjects after having 

 at first lost rapidly in body weight, later, in spite of a 

 notably lower ingestion of food, are able to maintain for a 

 long period their body weight at almost constant level. 11 

 It may be added, too, that Montouri, 12 who transferred the 

 blood of an experimentally overheated dog into the jugular 

 vein of a second dog, thought that he observed that it con- 

 tained substances which inhibited heat production in the 

 normal organism. However, many objections are possible 

 against this type of experiments. 



Respiratory Quotient. Upon the bearing of the respira- 

 tory quotient in fever the views of authorities are some- 

 what contradictory, many being of the opinion that it is not 

 lower than in the normal state, 13 while others hold that a 

 reduction exists. 14 However, it seems scarcely likely to go 

 lower than 0.7. 15 We are clearly justified in ranking fever 

 metabolism along with inanition metabolism, in which (ac- 

 cording to Zuntz) the quotient likewise presents a lower 

 value; but in both cases the economy endeavors to carry 

 energy demands continuously put upon it principally at 

 the expense of its fat supply. 



11 Cf . Fr. Kraus, 1. c., p. 629. 



"A. Montouri, Bicherche biotermiche, Giannini, Naples, 1904; cited in 

 Centralbl. f. Physiol., 19, 285, 1905. 



"Cf. Roily, Deutsch. Arch. f. klin. Med., 103, 93, 1911, and earlier papera 



"P. F. Richter, 1. c., pp. 109-111. 



"E. Grafe (Med. Clinic, Heidelberg), Deutsch. Arch. f. klin. Med., 101, 

 209, 1910. 



