Lippincott's Magazine of Popular Literature and Science, Volume 15, No. 86, February, 1875

by Various

Believing that the symptoms were due simply to this excessive temperature, I ordered the man to be at once stripped and put in a full bath drawn from the cold-water spigot. The temperature of this bath was found to be 60° Fahrenheit. In one minute and a half after the patient had been placed in the tub he recovered consciousness sufficiently to put out his tongue when told to do so in a loud, commanding tone. In three minutes he began to struggle to get out and to complain of the cold. In six minutes and a half he had become quite rational. He was now taken out, only partially wiped, laid upon an India-rubber blanket and covered with a single sheet, the temperature of the room being between 65° and 70°. Three minutes after this the temperature in the armpit was 94°, in the mouth 105-3/5°; five minutes later the mouth-thermometer marked 103°, and the pain and tenderness had reappeared in the affected joints. It would be out of place here to give further details as to his treatment. It is enough to state that, although owing to a misunderstanding of my orders, the man was left in a cool room for twelve hours upon the gum blanket, wet and covered only with a sheet—or possibly because he was so left—he recovered without a relapse or any bad symptoms.

The first case in which the cold-water treatment was practiced in the Philadelphia Hospital was that of a woman suffering from a desperate relapse of typhoid fever. She was semi-comatose, with a pulse of 150 and a temperature of 107° Fahrenheit: death was seemingly inevitable and imminent. As the bath-tubs were not convenient, the order was given that the woman be laid upon an India-rubber cloth, and be wrapped simply in a sheet constantly wet with water at a temperature as near 32° as practicable. The nurses, aghast, refused at first to carry out the order, but the physician's power being despotic, obedience was enforced. About three pints of whisky were given in the twenty-four hours, besides drugs, the whole treatment being successful.

It has been shown that excessive bodily heat is capable of producing the various symptoms of fever, and that its withdrawal is followed by the immediate relief of these symptoms; and since excessive heat is always present in fever, it is a logical deduction that it is the cause of fever symptoms; or, in other words, that it is the essential part of fever.

It must be borne in mind, however, that the term fever is here used in an abstract sense, to express a general diseased process, a bodily condition. A fever is a very different thing from fever. We may have a fever, such as typhoid, without the existence of fever. In a fever, the fever—i.e., the elevation of temperature—is only part of the disease, and great judgment and experience are often required to decide how much of the general symptoms is caused by the fever, and how much by the disease which is the cause of the fever.

The importance of high temperature having been recognized, it becomes a matter of the gravest scientific and practical interest to determine the method in which it is produced.

There are only two systems which bind the body together—namely, the circulation and the nervous system. As fever is usually a universal phenomenon, occurring simultaneously in every part of the body, it must be produced either through the nervous system or by a poison in the blood acting simultaneously on every tissue. Every physician knows, however, that there are cases of fever in which there has been no introduction of a poison into the blood: hence it follows that at least sometimes fever must be produced by the nervous system.

This being so, the study of the influence of the nervous system upon animal heat is naturally the next step in our investigation. Before making this step it may be well to call to mind the fact that chemical processes are usually accompanied either by the giving out or the withdrawal of heat. Thus, the chemical actions which result when ice and salt are mixed cause a withdrawal of heat, and a "freezing mixture" is formed. When a candle is burnt, the oxidation of its constituents, a chemical process, evolves heat. Oxidation is the great source of artificial heat, and animal heat is chiefly generated by the same process; in other words, animal heat is always the product of the chemical movements of the body, and these movements are almost exclusively of the character of oxidation. In the animal tissues a lessened oxidation is equivalent to a lessened heat-production, and vise versâ.

If a large nerve be exposed in one of the lower animals, and a galvanic current be sent through it for half a minute or more, the temperature of the animal falls very decidedly; and if the irritation be repeated several times at intervals, the diminution of the animal heat may amount to several degrees. Galvanization of a nerve affects very powerfully the circulation, and it has been believed that this derangement was the cause of the lessened chemical movements. But the alteration of the circulation is immediate, and ceases almost at once when the current is broken, whereas the fall of temperature comes on only after several minutes, then progressively increases, and persists for many minutes—it may be hours. The two phenomena being thus differently developed, it is impossible that they should have the relation of cause and effect, and the fall of temperature must be traced to a direct influence of the nervous system upon the chemical processes of the body.

This lowering of temperature under the influence of a powerful irritation of a nerve-trunk or of its minute branches, which everywhere pervade the tissues and spread out in the skin, is common to all species of mammals. If a rabbit be merely tied down tightly upon a table, the fall is perceptible, and if it be severely wounded, the temperature diminishes very greatly. It has long been known that severe burns are followed by a very great depression of the animal heat. Redard, a French physician, made during the late siege of Paris a most interesting series of observations upon the influence of severe gunshot wounds. He found that, entirely independent of any hæmorrhage which might have occurred, the temperature fell enormously, and in direct proportion to the gravity of the wound; so that by the aid of the thermometer he was able to predict whether a fatal issue would or would not occur in the course of a few hours.

We have found that both in man and the lower animals the nervous system is able to check the chemical movements of the body, but before we can decide how it does so facts not yet noticed must be looked at.