PROTEIN DESTRUCTION 617 



that the febrile affection may induce some degenerative 

 change in organic structures (as may be recognized morpho- 

 logically in the parenchymatous degeneration of glandular 

 tissues and the hyaline coagulation of muscles), and that a 

 gradual elimination of tissue constituents which have been 

 rendered useless is responsible for the epicritical urea ex- 

 cretion. The destruction of protein may sometimes attain 

 an extremely high grade in febrile affections. Thus, for 

 example, according to Friedrich Kraus, 22 it is not a very 

 rare occurrence in pneumonia to encounter an increase of 

 nitrogen elimination corresponding to as much as half a 

 kilogram of muscle tissue per diem. Friedrich Miiller has 

 recorded a case of typhoid fever in which the patient lost in 

 the course of a single week an amount of nitrogen which 

 would correspond with a daily destruction of 360 grams of 

 muscle. 



The question next arises how this increased protein de- 

 composition is to be interpreted. The first thought that the 

 hyperthermia itself is the immediate cause of this destruc- 

 tion must be rejected. Naunyn succeeded in superheating 

 rabbits experimentally for periods of two weeks so that 

 their body temperature exceeded 41 C. as an average, and 

 yet there was not the least trace of parenchymatous or 

 fatty degeneration appreciable in their organs. In man, 

 according to Linser and Schmidt the status of experimental 

 heating seems to be that as long as the temperature remains 

 below 39 C. no increase of nitrogen elimination is to be 

 noted, but that it becomes apparent as soon as the temper- 

 ature exceeds 40 C. But the protein decomposition does 

 not bear any fixed relation with the height of the fever. 

 Senator long since made observation of the fact that in 

 malaria if the temperature be artificially kept low by qui- 

 nine, there is not necessarily any diminution of the protein 

 destruction. Deucher saw the reverse, that in typhoid fever 

 various antipyretics may lower the loss of nitrogen inde- 



~~L. c., p. 596.~~ 



