146 



EUGENE F. DU BOIS 



The temperature rises abruptly, remains high for a few hours and then 

 falls more slowly than it rose. The phenomena of this period of fever 

 have been studied in some detail by Jobling and Peterson, Miller and 

 Lusk, Scully and others. There is a primary leukopenia followed by a 

 marked leucocytosis, a primary lessening of the coagulability of the blood 

 followed by reduction of the coagulation time. The flow of lymph is in- 

 creased greatly and there is hyperperistalsis of the intestinal tract. Serum 

 protease and lipase are increased and there are changes in the antiferment 

 titer. A rise in nitrogen excretion has been found in animals after paren- 

 teral injection of foreign proteins by Friedmann and Isaac, Vaughan, 



39 



Fig. 28. Patient 27 years old with gonorrhea! arthritis given 50 million killed 

 typhoid bacilli intravenously at 9:05 P.M. Observation started at 9:28 P.M. and 

 continued throughout the night with one short interruption from 1 A.M. to 1:40 

 A.M. Note the sharp rise of the rectal temperature and the more gradual changes 

 in the average body temperature. The heat elimination rises above the heat produc- 

 tion at the time that the body temperature falls. Direct and indirect calorimetry 

 agree closely in all periods after the chill. 



Schittenhclm and Weichardt, Major and many others. Whipple and 

 Cooko found the greatest increase in 24-48 hours after injection and then a 

 gradual decline over 3-5 days. Hirsch(&) did not find a constant increase 

 in the heat production of rabbits during anaphylotoxin fever although she 

 did obtain it in the fever of trypanosomiasis and heat puncture. 



After the subcutaneous administration of large doses of vaccine the 

 clinical phenomena are similar though not so dramatic. In such conditions 

 Leathes(&) and later Sharpe and Simon have demonstrated a rise in the 

 excretion of nitrogen, uric acid and creatinin. 



The onset of the chill following the intravenous administration of 

 vaccine can be so accurately regulated and timed that it furnishes an ideal 

 opportunity to study the matter of the regulation of body temperature. 

 Barr, Cecil and Du Bois studied a number of patients in the calorimeter 

 during the various phases of the paroxysm. Figures 27 and 28 taken from 



