Volume 1
A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr.
- Date:
- 1885-1886
Licence: Public Domain Mark
Credit: A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr. Source: Wellcome Collection.
24/1084 page 40
![acid and urea, s]lo^v that tlie febrile human subject produces ver^' much more heat than the fasting, though less than the fully-fed, healtliy man An mpreased production of heat in fever is generally admitted, althoudi It alone is uot to be regarded as the essential feature in the elevated ranee ot the temperature. The fasting man or animal under ordinarv circum- stances IS not febrile, and an increased production of heat from full feedin<r m health, equal to that observed in fever, not being associated with fever It IS apparent that the retention of the produced heat is of importance for the existence of fever. Although it has been shown by various oKservers that more heat is dissipated during fever than in health, this increased loss IS not in proportion to the increased production of heat. A persistent elevation of temperatm-e is the necessary result. This elevation is subject to clai y and hourly differences, as is the temperature of the healthv individual. These variations in the range of the febrile temr^erature are apparently due to an agency like that which dominates the course of normal temperatures—viz. a vaiyiug action of the vaso-motor nervous apparatus, as well as of that controlling the secretion of sweat, now per- mitting, now checking, the dissipation of the produced heat. _ For the existence of the elevated temperature of fever, therefore there IS demanded the presence of an agent within the body which, as stated by Wood, shall act upon the nervous system which regulates the produc- tion and dissipation of animal heat—a system composed of diverse parts so accustomed to act continually in unison in health that they become as It were, one system and suffer in disease together. It may be that there exists, as claimed b)^ Wood and Tscheschichin, a heat-centre independent of the vaso-motor and other centres, through which heat is dissipated, or It may be, as maintained by Rosenthal, that the vaso-motor svstem alone is concerned in the regulation of temperature. Such action mav be mhibitoiy or excitant, according to the views of the one or the other author, without affecting the main question as above stated. The elevation of temperature suffices to explain for the most part certain of the other phenomena of fever, as thirst, digestive disturtj&nces, increased respiration, and emaciation. A coincident affection of various cerebro-spinal centres is demanded to explain the altered action of the heart and the numerous nervous symptoms which are to be found in fever. The agent producing siuih manifold effects is obviouslv no unit. It may be introduced from without or it may arise within the bodv, and its transfer to the nervous centres is undoubtedly accomplished tlirouo-h the circulation. * Among those agents Avhich act from without are to be included the specific causes of infective diseases. It is probable that these produce the fever, as they occasion other symptoms of the disease, and their action may be regarded as direct, or indirect through the secondarA' ])roducts of their own vital changes. In the light of the existing facts the products of minute organisms develojicd outside the human bocfv may give ri.se to fever when introduced, without the organism, into the'body. The history of septicfemia contains numerous illu.strations of the pvro- genetic properties of material produced in connection with wouiided surfaces of the body exposed to the action of minute organisms. The introduction of blood of the same, or of a different animal, into the cir-](https://iiif.wellcomecollection.org/image/b20415023_001_0024.jp2/full/800%2C/0/default.jpg)
