CHLORINE RETENTION 625 



might be referred primarily to this as a cause. Although 

 Max Herz 43 has proposed in this connection the hypothesis 

 that a swelling of the cellular protoplasm may be the source 

 of the heat of fever, the author is disposed to regard this 

 view as a reversal of cause and effect; and in accordance 

 with this belief it may be suggested, therefore, not that 

 fever is occasioned by a protoplasmic swelling, but that on 

 the contrary, fever, by occasioning an accumulation of acids 

 in the tissues, may sometimes lead to an increased swelling 

 of the latter. 



Chlorine Retention. In connection with the retention of 

 water in the economy of febrile subjects it is necessary to 

 consider also the retention of chlorine. It is a fact well 

 known for a very long time that at the height of many 

 febrile diseases (especially pneumonia, typhoid fever and 

 scarlet fever, but not malaria) that the urine is strikingly 

 deficient in chlorides. 44 In febrile tuberculous cases, too, 

 as a rule there may be noted with temperature accession a 

 fall in the elimination of sodium chloride, without necessary 

 manifestation of change in the concentration of the urine. 45 

 So, too, the same phenomenon has been observed in the 

 fever induced experimentally by hay infusion and by 

 trypanosomes. 46 Efforts have been made to explain this 

 symptom in a variety of ways ; for example, as a result of 

 salt hunger caused by under-nutrition, as a result of reten- 

 tion of chlorine in degenerated tissue or in the protein in 

 circulation as a compensation for a lowered osmotic pres- 

 sure of the blood due to a markedly increased elimination 

 of phosphoric acid, etc. Personally the author is of the 

 opinion (in agreement with v. Hosslin) that all such ex- 

 planations are aside from the mark, and that we are really 



48 M. Herz, Wanne und Fieber, Wien, 1893, p. 91. 



44 Literature on Chlorine Retention in Fever : F. Kraus, 1. c., pp. 662-663 ; 

 P. F. Richter, 1. c., pp. 128-130. 



48 N. Meyerowitsch, Inaug. Dissert., Zurich, 1911; cited in Centralbl. f. d. 

 ges. Biol., 1911, No. 1918. 



49 v. Hosslin: Zeitschr. f. Biol., 55, 25, 1909. 



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