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_.