DEGENERATIONS AND INFILTRATIONS. 271 



food taken into the system, it is evident that any condition inter- 

 fering with digestion and absorption must influence the general 

 nutrient supply. In fevers the glands of the alimentary tract, as 

 well as the cells of other organs, are affected with albuminoid 

 degeneration. Their secretions are diminished or altered, the diges- 

 tion arrested in greater or less degree, and the appetite lost or per- 

 verted. For these reasons the diet must be adjusted, not only to the 

 needs of the patient, but also to his powers of digestion. But this 

 state is established only after the degenerative changes have been 

 inaugurated, and does not explain the way in which they start. 



If we bear in mind that the febrile condition is the result of a 

 toxic state of the blood and nutrient fluids, and that the poisons 

 present are probably obnoxious to the cells, we shail find no dif- 

 ficulty in understanding that the cells might reject a nutrient supply 

 so vitiated. Where we can observe the action of cells, we know 

 that they are repelled by certain substances, and it appears reason- 

 able to suppose that cells which we cannot directly study during 

 life possess similar powers of rejection. If this view be correct, 

 the very condition which induces fever would also interfere with 

 the proper nutrition of the cells. 



The causation of fever, according to this argument, is to be 

 sought in the toxic condition of the blood and other nutrient fluids, 

 the poisons disturbing the action of the thermo-regulating mechan- 

 ism of the nervous system and also interfering with the nutrition 

 of the cells of the body. As soon as fever begins, its influence 

 upon the cells is to stimulate their activities, for we know that a 

 moderate elevation of temperature causes an increased metabolism 

 in those cells that we can study while alive. It is, consequently,, 

 not necessary that a direct functional demand should bear upon 

 the cells in order that the chemical changes within them be aug- 

 mented. The rise of temperature is sufficient to account for 

 increased metabolism, which, in turn, implies a liberation of heat, 

 and, therefore, an aggravation of the morbid condition. The 

 increase of noxious waste-products of cellular activity, which enter 

 the circulating fluids, may also add to its toxicity. 



But, in addition to this thermal cause of increased metabolism, 

 the toxaemia throws extra work upon those cells that are charged 

 with the function of maintaining the quality of the blood or lymph. 

 The kidney contains such cells, and is one of the organs most likely 

 to be severely affected with albuminoid degeneration (acute paren- 



