ii THE THEKMIC ECONOMY OF THE OEGANISM 85 



general. Considerable rises in temperature have also been 

 observed in medical cases of haemorrhage and softening of the 

 brain uncomplicated by convulsions. Hutin recorded a hyper- 

 thermia of 42'5 in a patient three days after haemorrhage into 

 the corpus striatum on one side. 



Puncture of the brain in animals always causes a certain 

 increase in pulmonary ventilation, although it does not always 

 take the form of polypnoea or tachypnoea. This explains the 

 fact noticed by Witrowski (1891), that after the brain of a rabbit 

 had been punctured, although the production and discharge of 

 carbon dioxide increased, there was a slight diminution in the 

 quantity of this gas found in the blood. 



Bichet, who ascertained calorimetrically the heat discharged 

 in the same unit of time by a normal rabbit, and by the same 

 rabbit after cerebral puncture, found in 24 cases that the 

 heat lost was increased on an average 25 per cent after the 

 puncture. Aronsohn and Sachs noticed an increase in the pro- 

 cesses of combustion after the puncture; they deduced this 

 increase from the direct determination of the quantity of carbon 

 dioxide discharged before and after the cerebral injury. 



When therefore puncture, or any other irritating lesion, does 

 not cause hyperthermia, it indicates that the increase in the pro- 

 duction of heat is compensated by the simultaneous increase in 

 the loss of heat, either by vasomotor paralysis or by increased 

 evaporation from the lungs. When, on the other hand, the 

 puncture causes hyperthermia, it follows that the production has 

 increased proportionately more than the loss of heat; this is 

 always the case in the hyperthermia which as a fundamental 

 symptom accompanies the process of fever. 



In fever there is always exaggerated production accompanied 

 by increased loss of heat ; the former process predominates over 

 the latter in proportion to the abnormal rise in the temperature. 

 The heat-regulating centres of a patient suffering from fever 

 regulate the temperature at a higher level than the normal a fact 

 first recognised by Liebermeister. Indeed the daily curve of 

 temperature usually pursues the same course in fever as the 

 normal curve (Jiirgensen). In the patient with fever there is 

 always a certain proportion between the production and the loss 

 of heat : an increase in the former corresponding to an increase 

 in the latter (Lovit). With a febrile temperature of 40 there is 

 a loss of heat 20-25 per cent greater than in a healthy person 

 whose temperature is regulated at 37 (Liebermeister). If this 

 increased loss of heat does not lower the patient's temperature, it 

 follows that the production of heat is 40-50 per cent greater 

 than in a normal person. The loss of heat may therefore be con- 

 sidered to have decreased in proportion to the increased thermo- 

 genesis; this confirms the old theory set up by Traube, who 



