624 FEVER 



lymph and blood circulation. There is thus developed an 

 increase in the capacity of the cells for imbibition under 

 the influence of many of the infectious diseases. " This 

 feature seems at any rate to be more important than other 

 factors which have been held responsible for the retention 

 of water, as, for example, a decrease of output (or at least 

 a failure of increase of output) of water by the skin 40 

 (although it is recognized that at the subsidence of fever 

 the perspiratory secretion is usually increased in propor- 

 tion to the fall in temperature). 41 Neither the experiments 

 of Stahelin on febrile animals nor those of Carpenter and 

 Benedict on human beings favor the idea of a suppression 

 of the cutaneous output of water. 42 There is just as little 

 conviction in the attempt to explain the phenomenon by the 

 view that fever induces a retention of sodium chloride (vide 

 infra) because of renal inefficiency and that this in turn leads 

 to the water retention. 



Swelling of Cellular Protoplasm. It would seem that 

 the most important item which is to be considered here has 

 been heretofore overlooked, an increased acidification of 

 the tissues from the accumulation of -oxybutyric acid above 

 discussed (vide supra, p. 436). Perhaps, too, an accumula- 

 tion of lactic acid may be considered. From what we have 

 learned experimentally in regard to the relation of the 

 formation of acids in the tissues to the occurrence of swell- 

 ing of the latter (Vol. I of this series, pp. 255-257, Chem- 

 istry of the Tissues) it would appear quite probable that an 

 increased fixation of water in the tissues of febrile subjects 



40 Cf. G. Lang (Med. Clinic, Tiibingen), Deutsch. Arch. f. klin. Med., 19, 

 343, 1903. 



41 Schwenkenbecher and Inagaki (Krehl's Med. Clinic, Strassburg), Arch, 

 f. exper. Pathol., 53, 365, 1905. The output of moisture through the skin is 

 in general approximately in proportion to the temperature and to the incom- 

 pleteness of saturation of the atmosphere and is at once increased by moderate 

 muscular effort. Cf. A. J. Kalmann (Zoth's Lab., Gratz), Pfliiger's Arch., 112, 

 561, 1906; E. Heilner (Physiol. Instit., Munich), Zeitschr. f. Biol., 49, 373, 

 1907. 



Cf. Literature: F. Kraus, 1. c., pp. 635-638, and P. F. Richter, 1. c., 

 pp. 130-131. 



