FEVER.
Definition. Symptomatic. Idiopathic. Symptoms. Contagion. Incubation. Premonitory symptoms. Chill, rigor. Reaction, hot stage. Defervescence. Crisis. Lysis. Natural temperature. Fever temperature. Retention of water in the system. Production of waste materials. Typhoid condition. High fever, low, hectic. Treatment in vigorous subject, in weak one. Regimen. Solipedes. Ruminants. Carnivora. Drink. Rest. Clothing. Air. General and local bleeding. Cupping. Warm baths, tepid, compresses, derivatives. Cold. Diaphoretics. Laxatives. Diuretics. Sedatives. Alkalies. Antipyretics. Stimulants. Tonic refrigerants. Tonics. In low fever. No depletion. Judicious elimination. Stimulants. Refrigerants. Antiseptics. Diet. Local treatment of inflammation. Cold. Astringents. Antiseptics. Warm applications. Stimulating embrocations. Blisters. Firing. Massage. Suppuration.
Definition. Whether occurring as an accompaniment of inflammation or independently of it, fever is an unnatural elevation of the temperature of the body, the direct result of an excess of destructive chemical change in the blood and tissues, and more remotely of disordered nervous function.
Of all extensive inflammations fever is the constant result and accompaniment, rising as the inflammation rises or extends, and subsiding as the inflammation subsides. It also occurs as a distinct affection, as in all the infectious diseases, as the result of a specific irritating poison in the system, and then is the manifestation of the disease, while a local inflammation may or may not be present as a special secondary feature of the malady or as an accidental complication.
Symptoms of Fever. Fever is marked by certain definite stages, each of which has its own special manifestations. In the cases due to a specific disease germ, or contagium, these are, however, preceded by a period of latency or incubation in which no symptoms whatever are manifest, but during this time the germ is rapidly multiplying in the system, and it is only when it has gained a certain increase that it disorders the nervous system, wastes the tissues, raises the temperature of the body, and induces the other phenomena of fever. The same may be said to hold in the fever attending on inflammation. The slight and circumscribed inflammation is at first productive of no fever, and it is only when it gains a certain extent that the nerves and nutrition are disordered so as to bring about a feverish condition.
Premonitory Symptoms. These usually last but a few hours and are often entirely absent or unnoticed. There is a lack of the customary vigor and spirit, an indisposition to exertion, a loss of clearness and vivacity of the eye, a manifest dullness, with hanging of the head, and frequent shifting of the limbs as if fatigued. Appetite is less sharp and ruminants chew the cud less heartily or persistently.
Cold Stage. These are soon succeeded by the chill, rigor, or shivering fit, in which the hair, especially that along the back, stands erect (staring coat), the skin is cold and adherent to the structures beneath (hidebound), the extremities (legs, tail, ears, horns, nose) are cold, and the frame is agitated with slight tremors, or even a shivering so violent that a wooden floor or building is made to rattle. The back is arched, the legs brought nearer together (crouching), the mouth is cool and clammy, the breathing hurried, the pulse weak, and it may be rapid, but with a hard beat, the bowels costive, and the urine higher colored than natural. The temperature of the interior of the body, taken by a thermometer in the rectum, is already found above the normal, the excessive destruction of tissue having begun, and the blood driven from the cooler surface, and accumulating in the hot interior, at once favors tissue change and maintains the extra heat thereby produced. In cattle the end of the tail is soft and flaccid from this stage onward. The cold stage lasts a few minutes, or one or two days in different cases.
Hot Stage. The hot stage appears as a reaction from the chill, the contraction in the minute vessels of the skin giving place to dilatation, so that the whole surface, including the extremities, becomes hot and burning, but still dry and parched. The burning is especially noticeable in the more vascular parts, like the roots of the horns and ears, the muzzle or snout, the mouth, the hoofs, the bare parts of the paws in carnivora, and the mammæ (udder) in suckling animals. The mucous membranes lining the nose and mouth become hot and red, the breathing freer, but not less rapid, the pulse softer but accelerated, appetite (and rumination) greatly impaired or lost, thirst great, costiveness increased, 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 inflammation the interruption of the hot stage by a chill usually implies either a considerable extension of the inflammation or the occurrence 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 symptoms (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 indicates sinking. A similar fall, with a free secretion (perspiration, urination, relaxed bowels) and general improvement in symptoms, 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 secretions are arrested or diminished, and liquids go on accumulating in the system. The sudden bursting forth of secretions (especially sweating) implies that the fever has, at least temporarily, given way.
The production of waste matters in the system is necessarily proportionate 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 confounded with the specific typhoid fever, in which a special fever germ expends itself, mainly on the bowels, and that runs through a regular course. The typhoid condition is that state in which an animal system, already greatly weakened by a severe disease, and perhaps further prostrated by a specific disease-poison, is subjected to a species of poisoning by the retained chemical products of the waste of the tissues.
Types of Fever. These are as characteristic as the types of inflammation, and of the same kind. The strong type of fever which attends on an acute inflammation in an otherwise healthy vigorous system, is spoken of as a high or inflammatory fever. The weak type which occurs in a broken down or debilitated system, or in connection with the action of a specific disease germ, or with the saturation of the system by waste chemical products is known as low, typhoid (better typhous), or adynamic fever. That form which persists in the utterly debilitated system, where the power of assimilation is practically lost, is known as hectic.