METABOLISM IN FEVER AND CERTAIN INFECTIONS 151 



as due to puncture of the "heat center." She also obtained hyperthermia 

 whenever there was an increase in the intracranial pressure. 



Much of the earlier work on "salt fever," "water-fever" and the other 

 fevers which follow the injection of various substances dissolved in water 

 must be reviewed in the light of the more recent work which shows that 

 these reactions were due to some unknown fever producing substance which 

 is present in water unless it has been freshly distilled. Hort and Penfold 

 and many others have called attention to this experimental error. Stokes 

 and Busman have discovered another source of fever in certain impurities 

 in "pure gum" tubing. This toxic substance is dissolved by alkaline solu- 

 tions such as are used in the administration of salvarsan. 



We are indebted to Flury and Groll for some exceedingly interesting 

 studies on the metabolism in animals with trichinosis. They found that 

 the trichinae enter the muscles because they need carbohydrate for their 

 metabolism, and once established there abstract glycogen and live anoxy- 

 biotically. They secrete end products among which are free fatty acids 

 causing certain changes- in the muscles. There is a diminution in the 

 muscle fibers, total nitrogen, glycogen, purin bases and creatin. Extracts 

 of trichinous muscle are much more poisonous than normal extracts and 

 cause vomiting, diarrhea, fever and an edema which is probably due- to a 

 capillary poison. Flury was able to produce practically every sign and 

 symptom of trichinosis by using muscle extracts which contained no 

 living organisms. 



In conclusion we shall direct our attention to the stimulating work 

 of Balcar, Sansum and Woodyatt, who produced extraordinarily high 

 temperatures in dogs by giving concentrated solutions of salt, lactose or 

 glucose intravenously. As the strong glucose solution was continuously 

 pumped into the vein there were a diuresis and marked diminution of the 

 water content of the body. Later there was a severe chill with rise of 

 temperature, convulsions, anuria and death. Temperatures as high as 

 109-111 F. were frequently obtained and on one occasion the ther- 

 mometer recorded the unprecedented figure of 125.6 F. (52 C.). Wood- 

 yatt believes that this is due to a diminution of the free water in the body 

 caused by diuresis and by a combination of water with the glucose or salt 

 injected. With such a diminution of the water reserve it is impossible 

 for the body to transport to the surface and there dissipate by vaporization 

 the heat constantly generated in the tissues. This explanation is quite 

 applicable to the dehydration fevers of infants formerly spoken of as 

 "inanition fever" or "salt fever" or "sugar fever." At the present time 

 it seems doubtful if it can help us greatly in the explanation of the fever 

 of infectious diseases. 



