142 



EUGENE F. DU BOIS 



duction was calculated from the oxygen consumption by the method of 

 indirect calorimetry, the heat lost by vaporization and by radiation and 

 conduction was measured by physical methods. Using Barr's method 

 already described under typhoid fever they calculated the changes in the 

 average body temperature and found that this curve was not always par- 



Fig. 26. Calorimeter observation made during the various stages of rising tem- 

 perature. The continuous curve shows the rectal temperature, the dash line shows 

 the changes in the average body temperature, starting arbitrarily at a point one-half 

 degree below the rectal temperature. The level of the respiratory quotient is shown 

 by the sign - -. The lines below give the direct calorimetry ( total heat production 

 calculated from the heat elimination and the rectal temperature change), the indirect 

 calorimetry (calculated from the oxygen consumption and respiratory quotient) and 

 total heat elimination (vaporization plus the heat of radiation and conduction). 



The patient was placed in the calorimeter about an hour and a half before the 

 anticipated chill. By careful management it was possible to start the third period 

 just before the rigor and end it about five minutes after the shivering ceased. Note 

 the almost level metabolism before the chill, the enormous increase caused by the 

 violent muscular action of the chill and the fall to a level higher than normal when 

 the body temperature was still 41 C. (From Barr and Du Bois, Patient, G. S. ) 



allel to the change in rectal temperature. This is shown in Fig. 25, which 

 is a composite of four different experiments. Fig. 26 shows the details 

 of the phenomena of the rise in temperature as observed in one typical 

 case. They summarize their results thus : 



"The periods of malarial paroxysms may be divided as follows : 



1. Preliminary. Temperature constant; no change in metabolism. 



2, Prodromal. Fifteen or twenty minutes before the chill there is a 

 slight rise in rectal temperature. 



