METABOLISM IN FEVER AND CERTAIN" INFECTIONS 123 



The results in all six conditions were next plotted on one chart (Fig. 

 16) and the average found by calculation. Lines were then drawn to show 

 the range of 10 per cent above and below this average, and it was found 

 that 82 per cent of the 137 determinations fell between these lines. Most 

 of the cases in which the metabolism was more than 10 per cent below the 

 average were tuberculosis patients with chronic undernutrition and an 

 unusually low nitrogen metabolism. Most of the cases with basal fig- 

 ures more than 10 per cent above the. average 'were typhoid patients with 

 high nitrogen metabolism. On the whole, there was almost as much uni- 

 formity among the fevers as in a group of normal controls if due allow- 

 ance were made for the increased metabolism in fever. 



90 



100^ 



110 120 130 140 150 160 I7O 



Fig. 16. Results in six different fevers grouped in one chart. The continued 

 line shows the average and the dotted lines are drawn to represent metabolism 10 

 per cent above and 10 per cent below the average. 



The average rise in heat production is about 13 per cent for each de- 

 gree centigrade (7.2 per cent for each degree Fahrenheit). This en- 

 ables us to calculate approximately the metabolism of a fever patient by 

 finding his normal basal and adding the average increase for his degree 

 of fever. In the case of toxic patients with great destruction of body pro- 

 tein there should be an additional ten per cent added and a similar addi- 

 tion in all other cases taking much food. If there is a high nitrogen elimi- 

 nation it is doubtful if food causes much specific dynamic action. Of 

 course a further allowance of 10-30 per cent may be necessary if the pa- 

 tient is restless. 



It is evident that the total oxidative processes in the body are in- 

 creased by the rise in temperature of the body cells. This at once reminds 

 us of the law regarding chemical reactions first enunciated by Van't Hoif, 



