628 FEVER 



a number of foci in the brain. By far the most constant of 

 these is the so-called "heat puncture. " While penetration 

 of the anterior part of the brain does not produce any im- 

 portant effect upon temperature, after injury to the corpus 

 striatum intense and persistent rises in temperature are 

 met with. As electrical irritation of this part of the brain 

 is also capable of causing the same feature, we cannot be 

 mistaken in assuming that the change in heat regulation 

 ensuing from the heat puncture is to be regarded as an 

 irritation symptom. It is a matter of secondary impor- 

 tance with us whether we hold that there exists a special 

 "heat centre" or whether we adopt the view that (as for 

 example, Tiger stedt 51 believes) the nervous centres which 

 preside over the muscles and other heat-producing organs, 

 as well as those which innervate the cutaneous vessels, sweat 

 glands and dominate the respiratory movements, function- 

 ate in a manner which amounts to the same thing as heat 

 regulation. According to the works of Stefani and his 

 pupils the vagus may be said to take an important part in 

 heat regulation. 



Fixation of Heat Regulation at a Higher Level. P. F. 

 Eichter has attempted to frame a fundamental difference 

 between the hyperthermia of heat puncture and of infectious 

 fever, indicating that in the former but not in the latter 

 the body has lost its ability to regulate temperature. This 

 view has not, however, received confirmation from other 

 sources. It is manifest that up to a certain degree the power 

 of regulation of temperature is maintained in every form 

 of hyperthermia. Liebermeister has held the view that the 

 characteristic feature of heat regulation in fever is its 

 "establishment at a higher level," regulation being actu- 

 ally retained but set, not for 37 C., but for a higher tem- 

 perature. This suggestion has been taken up by many 

 authors, as Filehne, Stern, Krehl and Gottlieb. Friedrich 

 Kraus, too, refers fever to "a condition of irritation of the 



11 Tigerstedt, 1. c., p. 602. 



