GENERAL THERAPEUTICS OF FEVER 85 



bring blood from the centre of the body to the periphery, where 

 it can more readily give off its heat to the surrounding atmosphere, 

 reduce the temperature of the body by increasing the dissipation 

 of heat through the skin. The same effect is obtained by other 

 drugs which act upon the cutaneous blood-vessels through the 

 vasomotors (paralysis of the vasomotor centre). The antipyretics 

 which operate by increasing blood-pressure include particularly 

 digitalis and strophanthus. Dilation of the cutaneous blood-vessels 

 is a part of the antipyretic action of alcohol, and also of the mod- 

 em antipyretics in so far as they depress the anterior portion of the 

 calorific centre (vasomotor ganglion cells for the cutaneous vessels). 



3. By decreasing metabolism, partly by retarding the giving 

 off of oxygen by the red blood-corpuscles to the tissues (internal 

 respiration) and partly by depressing the oxidation processes in 

 the cells of the tissues, alcohol, quinine and hydrocyanic acid cause 

 a reduction of body temperature. The acids act as antipyretics by 

 reducing the alkaUnity of the blood and thus decreasing its oxida- 

 tion capacity. 



4. By inhibiting and destroying the fever-producing micro- 

 organisms, camphor, salicylic acid, quinine, alcohol, arsenic, 

 salvarsan (organic arsenical compound), some of the modern anti- 

 pyretics and vigorous cutaneous irritation (increased formation of 

 antitoxins) bring about a fall of temperature. 



A peculiarity of many antipyretics is that they only reduce the 

 increased temperature of animals in a febrile condition and do 

 not lower the normal body temperature of animals in health. This 

 is readily explamed with regard to those antipyretics which reduce 

 temperature by destroying the fever-producing organisms, since 

 in the healthy body there are no such organisms to destroy. The 

 modem antipyretics, which operate as cerebral sedatives, exert a 

 more pronounced narcotic influence upon the heat centre or upon 

 the vasomotor centre irritated by fever than upon the normal heat 

 centre. Those antipyretics which act by decreasing metabolism 

 can lower the body temperature in normal as well as in febrile ani- 

 mals, as has been demonstrated by experiments with large doses of 

 alcohol and quinine. In individual cases, the modern antipyretics 



