CARBOHYDRATE METABOLISM IN FEVER 621 



acidity ; but it must be remembered that the body has avail- 

 able means to keep its juices neutral as long as the excess 

 of acid does not reach too high a degree. According to the 

 present status of our knowledge we may refer the increased 

 production of acetone bodies (^-oxy butyric acid, diacetic 

 acid, acetone) in fever to a heightened fat destruction, which 

 becomes so manifest from the wasting occasioned by pro- 

 longed fever that any further proof seems superfluous. 

 Blumenthal noted in streptococcus infections a higher grade 

 acetonuria than in other febrile affections, and Bottazzi saw 

 in diphtheria the curve of the acetone bodies fall under the 

 influence of the curative serum; which facts will probably, 

 in the writer 's opinion, be brought into relation with varia- 

 tions in the intensity of fat destruction. 



Relation of Carbohydrate Metabolism to Fever. A great 

 number of investigations have been directed to the relations 

 of carbohydrate metabolism to fever. Although the studies 

 in relation to the amount of sugar in the blood of animals 

 exposed to cold, to heat and of febrile animals do not admit 

 of any simple interpretation as far as the author sees, 32 there 

 is not the least reason to doubt that destruction of carbo- 

 hydrates in the tissues, and especially in the liver, is in- 

 volved to a very important degree in the processes of heat 

 production in the body, and (as inter alia is indicated from 

 observations by Cavazzani) is subject to regulatory influ- 

 ences from the nervous system. This is illustrated in a very 

 suggestive manner by observations by Dubois and also by 

 E. Weinland, 33 showing that in the marmot as it wakes from 

 its hibernation the glycogen supply falls within a few hours 

 to half its quantity, and that the temperature coincidently 

 rises. Hirsch and Roily have suggested that glycogen-free 



u G. Embden, H. Liithje and E. Liefmann, Hofmeister's Beitr., 10, 265, 

 1907; H. Senator, Zeitschr. f. klin. Med., 67, 253, 1908; R. Lupine and Bouhid, 

 C. R. Soc. de Biol., 69, 379, 1910; A. Hollinger (Liithje's Clinic, Frankfurt 

 a. M.), Deutsch. Arch. f. klin. Med., 92, 217, 1908. 



E. Weinland and M. Riehl (Physiol. Instit., Munich), Zeitschr. f. Biol., 

 50, 75, 1908. 



