Dr. J. Burdon Sanderson on the process of fever.

  • Burdon-Sanderson, John Scott, 1828-1905.
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: Dr. J. Burdon Sanderson on the process of fever. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    6/38 (page 14)
    Arp. No 1. On tho Process] ol’ fever, by Dr. Burdon Sanderson. Increased dis- , charge of urea in induced fever is not dependent on accumulation. Discharge of carbon. Reasons for inferring that if a comparison were made of the carbonic acid discharge of tho fevered animal body and that of the normal at the same tem- perature, it would be found to be greater in the latter. ticularly tho “ insensible loss ” ns indicated by the rapid loss of weight, being decidedly increased. In association with this, the urea discharge “ remains excessive during tho whole course of the fever,” while the rate of discharge of urine increases so markedly towards the end of the first day, that, notwithstanding the diminution which is the immediate consequence of the injection, the quantity for the 24 hours is in excess. Senator further draws attention to the very remarkable fluctuations and inequalities which all the functions investigated exhibit when they ! are continuously observed. This is seen to be true, not merely of the rate ’ of discharge of urea and carbonic acid, but more strikingly of the loss of weight. When the weighings are repeated at short intervals, it is found, that whereas at one time the loss is scarcely to be estimated, at another * it is three or four times as great as that which occurs in health during the same period. The increase of urea discharge in artificial fever cannot possibly be dependent on the excretion of urea which has previously accumulated in the blood or tissues, for, from the well-established fact that in those tissues which constitute the greater part of the weight of the body, viz., muscles and hones, urea is entirely absent, and that in those organs in which it is most abundant, e.g., the liver, its per-centage never exceeds 0-02 — 0'03, it is clear that even if the whole quantity stored in the body were discharged at once, the effect on the rate of discharge would be barely perceptible. It is therefore obvious that, in the dog at least, its augmentation in the urine is an indication of increased activity of those processes by which it originates in the body, and that the degree of that increased activity may be judged of pretty correctly by the rate of discharge. As, therefore, we are certain that urea derives its nitrogen from albumin, we are also certain that, at all events in artificial fever, albumin of some kind is disintegrated in greater quantity than in health. So far as the frequently ventured assumption goes that in fever the discharge of carbonic acid is necessarily increased, these results go a long • way towards negativing it. They have no value, however, as evidences that the carbonic acid discharge is diminished, although from a number of considerations it seems highly probable that it is so. For in the experimental comparison of fever with health, it is to be borne in mind, that however exactly you may assimilate the conditions of observation, there is one important condition which, while it appears to belong to the organism, belongs in reality to the environment, viz., that of temperature. The temperature of the body, although it is a direct consequence of the chemical processes of life, may from another point of view be quite as correctly regarded as their cause, or at all events as a modifying condition, for the very increase of heat which fever produces, reacts on and influences the fevered body. Consequently, in experiments made on Senator’s plan, even when the utmost has been done to render the two observations strictly comparable, the living tissue is not really under identical condi- tions, for every bit of living protoplasm is acted upon by the general pyrexia, just as if heat were communicated to it from outside. Now we know that when heat is communicated to the body from surrounding media, so as to elevate its temperature even very slightly, the effect of such slight elevation is to produce a very considerable augmentation ot the discharge of carbonic acid, and that this effect is rapidly increased as the temperature communicated to the body approaches that of pyrexia. It is, indeed, quite possible, that if in Senator’s observations the com- parison had been made between normal and fevered.animals at the same bodily temperature, it would have been found that the carbonic aci^ discharge in the former would have been largely in defect. ( onip.ua iv' observations of this kind have not. yet been made, but in the mean 1 we need have no hesitation in adopting Senator’s conclusion, ia