Fever. 6i 



urine diminished and of a higher color, the flow of milk greatly 

 impaired or entirely arrested, and the dullness and prostration 

 greatly increased. 



The hot stage lasts longer than the cold one, usually persisting 

 until death or convalescence. It may alternate with chills 

 throughout the whole course of the illness, and in the fever of in- 

 flammation the interruption of the hot stage by a chill usually im- 

 plies either a considerable extension of the inflammation or the 

 occurence of suppuration. 



Defervescence. The decline of the fever may take place by a 

 sudden reduction of the body temperature to the natural standard, 

 or near it, and a sudden and general improvement in the symp- 

 toms (crisis), or by a slow improvement from day to day through 

 a more or less tedious convalescence (lysis). 



Fever Temperature. A temporary rise of one or two degrees is 

 unimportant, but a permanent rise indicates fever. A rise of ten 

 or twelve degrees is usually fatal. A sudden fall to or below the 

 natural, unless with general improvement in the symptoms indi- 

 cates sinking. A similar fall, with a free secretion (perspiration, 

 urination, relaxed bowels) and general improvement in symp- 

 toms, betokens recovery. For normal and febrile temperature see 

 Semeiology. 



Retention of water in the fevered system is as significant as the 

 elevated temperature. The patient drinks greedily but all the se- 

 cretions are arrested or diminished, and liquids go on accumulat- 

 ing in the system. The sudden bursting forth of secretions 

 (especially sweating) implies that the fever has, at least tempo- 

 rarily, given way. 



The production of waste matters in the system is necessarily pro- 

 portionate to the amount of tissue destroyed. This appears in 

 the blood mainly as urea, the organic acid of urine (hippuric in 

 herbivora, uric in carnivora), together with phosphates, sulphates, 

 and chlorides. These thrown off by the urine give it its high 

 density. If not thus thrown off they remain as poisons in the 

 circulation and bring about that prostrate, sunken, debilitated 

 condition which characterizes the advanced stages of all severe 

 and continued fevers — the typhoid condition. This is not to be con- 

 founded with the specific typhoid fever, in which a special fever 

 germ expends itself, mainly on the bowels, and that runs through 



