METABOLISM IN FEVER AND CERTAIN INFECTIONS 133 



studied three tuberculous patients while investigating the action of anti- 

 pyretics and found the heat production only 3 to 4 per cent above the 

 average normal. McCann and Barr have recently made careful studies, 

 using the Sage respiration calorimeter. Their findings are shown in 

 Table 9. 



It will be seen that the total calories per day for the basal metabolism 

 ranged between 1,530 and 2,030, and that the lowest was 3 per cent 



c 



40 



39 





 38 



e 



37 



o 



36 



90 



100 



NO 



120 



130 



140 



Fig. 20. Results obtained by McCann and Barr in tuberculosis, showing relation- 

 ship of basal metabolism to temperature. The abscissae show level of metabolism in 

 terms of the average normal, 100. Most of the observations made when the tempera- 

 ture was above 39C. were 20-30 per cent above the normal basal average. 



below the average normal and the highest 35 per cent above. These authors 

 bring out the interesting point that the patients, after several weeks or 

 months of illness, were producing almost exactly the same amount of 

 heat as they did at the time of their best weight before the onset of 

 symptoms. The increase caused by the infection compensated for the de- 

 crease due to loss of weight and undeniutrition. Fig. 20, taken from 

 their work, shows that the metabolism tends to be proportional to the tem- 

 perature. This may be due to the temperature itself or to the toxic agent 

 which causes a rise in both. 



The figures for the direct and indirect calorimetry differed by 5 per 

 cent, the indirect method giving higher results. This difference, which is 



