170 Temperature Distiirhances. 



minous substance, various proteins, bacteria and other microorgan- 

 isms, the products of disintegration of red and white blood cor- 

 puscles and other tissue elements all possessing the same influence. 



Foreign albuminates alwa_ys give rise to the development of 

 protective processes, of phagocytosis and the production of specific, 

 antibodies. Certain organs like bone marrow, spleen and lymph 

 glands are stimulated to special activity by the presence of these 

 foreign substances manifesting cellular hyperplasia (mitotic nuclear 

 figures) and probably producing special secretions. This increase 

 of their physiological activity is necessarily associated with 

 increased metabolism and the latter must occasion elevation of 

 temperature. The relation between the production of antibodies 

 and febrile attacks is very striking in many of the infectious dis- 

 eases. For example in case of pneumonia in human beings it is 

 known that in the course of the fever protective bodies are formed 

 in the bone marrow and that the fever diminishes as these sub- 

 stances begin to manifest their bactericidal action. After the crisis 

 these protective substances are found in considerable amounts in 

 the blood (Klemperer, Wassermann). In recurrent fever of man 

 the onset of the fever takes place as soon as the organisms appear 

 in the blood ; protective bodies are then formed by reaction of the 

 body cells and with their accession to the blood the microorgan- 

 isms are destroyed and the fever falls ; if these are removed the 

 spirilla return from their foci of deposit to the blood and the fever 

 returns. In other examples the beginning, rise and fall of the 

 fever are apparently dependent upon definite stages of develop- 

 ment of the infectious agents : in human malaria the fever begins 

 as soon as the parasites reach the phase of sporulation and is 

 checked if by the administration of quinine the maturation or rup- 

 tilre of the sporulating organism is prevented. 



The connection of fever production with substances foreign to 

 the body (infectious and toxic) is so clear that if an animal mani- 

 fest febrile symptoms it seems a permissible conclusion that there 

 must be infectious or toxic substances circulating in its blood. 

 Often the fever is the only manifestation of the disease appreciable 

 during life to indicate the existence of an infection {essential 

 infectious fever) ; usually it appears as a precursor of other symp- 

 toms of the infectious cause {prodromal fever), or accompanies 

 local or general disease processes {secondary fever, traumatic 

 fever, pycviiiic, scpticcrmic, hectic fever, intfannnatory fever) ; and 

 may also develop after the employment of therapeutic measures 



