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712 GENERAL PATHOLOGY.
the sum of tlie functional activities. In this inquiry we will be more
or less troubled by uncertainties. The older pathologists seem to have
regarded the nervous system as the one specially aliected, but recent
investigations point to the blood as being primarily at fault, or at least
indicate that fever results from some form of poison that has gained
access to the blood and is circulating in it. Recent experiments demon-
strate that the injection of pure healthy pus into the veins of the dog
produces fever with certainty and promptness, and that the fever thus
induced runs a very regular course, passing away in two days, more or
less, according to the amount of pus injected (Senator). In this case it
would seem that fever has a material cause, in that a substance is in the
blood that in some way interferes with the proper and normal func-
tions so as to increase its temperature. This increase in the tempera-
ture is the one essential factor. Increased frequency of the pulse is a
usual accompaniment of fever, but is not invariably i)resent, and may
be induced by various causes independent of fever. AVe may and do
have fever without increased frequeufy^ of the pulse, and we may reduce
the frequency of the pulse during the existence of fever without mate-
rially altering the temperature. It is well known that during the exist-
ence, of fever the pulse-rate may, by the administration of veratrum
viride, be reduced without lowering the temperature as expressed by
the thermometer. I recall a case of typhoid fever in a boy of twelve
years, m ho when I first saw him had a pulse-rate of 70 to the minute,
and at the same time a body-temperature of 107° F., as registered by a
thermometer in the axilla. In this case veratrum viride had been given.
Occasionally, even where no heart sedative has been administered, fever
may be seen without a frequent pulse, though this is evidently rare. It
is not very uncommon, however, to see the temperature out of propor-
tion to the frequency of the pulse, or the reverse. A high pulse-rate,
therefore, while an accompaniment that is almost universal, is not abso-
lutely essential to the condition of fever. As it is with this, so it is with
the other symptoms, as thirst, loss of appetite, the sensation of heat felt
by the patient, etc. Any of these may be wanting, and in some rare
cases all of them, and still the continued elevation of the temperature
marks the condition of fever as being present notwithstanding. Fever,
then, is shown to l)e present l)y the existence of this one fact of high
temperature, and tlie other conditions that usually accompany it are
due to this increase of the temperature—are caused by the fever—are
products and not essential factors.
Tlie increase of heat in fever is not in any sense local. Even though
the febrile movement may have resulted from a purely local inflamma-
tion, the rise of temperature is always general and affects all parts of
the body alike. Increased locjil heat accompanying local inflammations
must not be confounded with fever. In fever the whole blood is
warmer than normal, and this increase may stop at five or eight degrees
above the normal, or in severe cases it may pass on to ten, but rarely
above this limit. The organism in its normal condition possesses a self-
regulating power as regards its temperature which under the varving
circumstances of climate and seasons preserves the blood at about the
same degree of heat—viz. 98° to 99° F. Therefore when it is observed