THE AUTOGENOUS DISEASES. 359 



the Italian army. He states that in fatigue the blood is 

 subjected to a process of decomposition brought about by 

 the infiltration into it from the tissues of poisonous sub- 

 stances, which, when injected into the circulation of healthy 

 animals, induce malaise and all the signs of excessive ex- 

 haustion. It is possible that in this decomposition of the 

 blood the fibrin -ferment, which, according to Schmidt, is 

 held in combination in the colorless corpuscles, is liberated ; 

 and it has been shown by Edelbeeg that the injection of 

 small quantities of free fibrin-ferment into the blood causes 

 fever, while the injection of larger quantities is followed by 

 the formation of thrombi, as has been demonstrated by the 

 experiments of Edelbeeg, Bonne, Birk, and Kohlae. 



Fatigue fever is often accompanied, especially during the 

 period of elevation, by chilly sensations, and consequently 

 it is pronounced malarial and quinine is administered, but 

 it does no good — often harm, by increasing cerebral excite- 

 ment. The proper treatment is prolonged rest, with proper 

 attention to elimination. 



Then there is the fever of exhaustion, which differs from 

 fatigue fever only in degree. It is brought on by pro- 

 longed exertion without suflScient rest and often without 

 sufficient food. The healthy balance between the formation 

 and elimination of effete matter is disturbed, and«it may 

 be weeks before it is reestablished — indeed, it may never 

 be regained, for some of those cases terminate fatally. The 

 fever of exhaustion may take on the typhus form, delirium 

 may appear, muscular control of the bowels may be lost, 

 and death may result. 



That the fever of exhaustion has been mistaken for 

 typhoid by some of the ablest clinical teachers is shown by 

 Pbtee in the following quotation. "It was in 1852," says 

 he, " when entering upon my clinical studies and ardent in 

 my attendance at the clinic of Chomel, I was witness of 

 the following instance : A young man was received under 

 the celebrated professor's charge suffering from prostration, 

 muscular pain, and rhachialgia. Chomel made the exam- 

 ination with all the care and attention used by him ; then 



