FEVER

is a term used to describe a group of symptoms of which a rise of the temperature above normal is always one. The other symptoms most citen present are a rise of the pulse rate, a rise of the respiration rate, lo of appetite with coated tongue and diminished digestive power, scantine of the urine which is often also high coloured, languor, headacho and delirium. The cause of fever is the invasion of the body by = germ. This multiplies and produces poisons known as toxins. These toxins arc different for different germs. Hence each germ produces minor variations in the symptoms shove mentioned. In addition, certain symptoms are also produced which are peculiar to each. Of these the diferent varieties of rash are a good example. By means of the ao peculiar to each germ, we are able to recognise different species of fever. These species always breed true; a case of small pox gives rize to other cases of small pox but never to measics or chicken pox. At tho Sarpy day so far as is known they never arise de novo, always from a pre-existing case of the disease, although the connection may be dificult to trace. This is due to the fact that infection can be carried in the case of most fevers by clothing, air, water or milk. By infection we mean the germs in an active state. If these have the power of living outside the body infection can be carried to a greet distance; if not then actual contact of the healthy with the sick is nece ary to spread the disease. In the former case the fever used to be called infectious, in the latter case em, but this distinction is dying out. Germs not cause symptoms directly the body is attacked. because it is the toxins, not the germs themselves, whieh produce the symptoms. To form a sufficient dose of toxin takes time. This time during which tho diseaso develops bofore the onset of symptoms is the inc what i on rag The length of this poriod varies within certain for each fever. Exposure to infection thus leaves it Qneortain whether the fever has been oaaght or not, until tho longest po ible tims for incubation has elapsed. A day or tivo over this time is commonly taken as the quarantine period. The quarantine period is the time during which one exposed to infection must be isolated betore he oan be said to be free of all cisk of having tho disease. For convenience of reference we append a table of these times. most likely | Incubation rantine — = m | bed | Period, Chicken-Pox..|Childhood../ 12-19 days. | 20 days Diphtheria..!2-15 years..} 1-7 sete Inf Au cane le venga... apes da; ” Measles... Childhood ee 10-14 days a1 Ce Gorman Measles} Youth...| 11-18 days./21,, Ps - « «|Childhood..| 14-23 days.) 24,, Small Pox..|All ages...|/1l2day a../16,, Scarlet Fever.|5-10 years..} 1-7 days, Fi usually 3.};10,, Typhold or Knteric Fever} Young Adults. | 5-2) day a. = Whooping Cough | Childhood../5-18 days.[/2h,, The chief advances made in our knowledge of fever during recent times consist in the discovery of (1) the actual zerms which cause them, (2) the way to treat them, (3) the part played by insects in the spread of infection. With rogard to (1) we must admit much remains to be dene, As to (2), we have learnt to feed fevers instead of starving them. Formerly, the patient was starved, bled, and purged with the object of Jacbinn | the fever no food to feed on. Now the equrat strength is supported as far ae posible, to enable him to produce the natural antidotes to the poisons formed by the gorms attacking him, Moreover we have obtained for one fever at lex«t, diphtheria, an antitoxin that baa considerably reduced the percentage of fat a] cases. (See An til or in) Ax to (3) we would mention the relation of the mosquito to the spread of malaria and of elephantiasis, the part played by flies in spreading enteric fever in the South African War. and the tretse Oy in producing the “sleeping sickne=.™ The prevention of fever still remains one of the great problems of the day. We have two courses open: either to render the gerra extinct, or to so alter the constitution of those exposed to attack that the germ is harmle to thom. Whether to pry Saree former or the latter method, or a combination of two, depends on the fever with which we have to deal. We attempt to banish the germ (1) by the isolation of infected cases, (2) by the disinfection of infected houses and clothing. In certain cases isolation may serve the purpose; thus rabics has been a tamped out in England by muzzling all dogs for two years and Guarana ee imported ones. In other cases ixolation comes too to be effoctive: in whooping-congh. for instance, a case is infectious a fortnight before it can be recognised and isolated. In such cases our only chance of succe is to soalter the con at i tut i on of those exposed that the germ becomes innocuous. This can be attempted in two ways: (1) si sparing a0 effort to sot gee the general health; (2) by inducing a mild or modified form of the fover. The adult of to-day in robust health is infected with great difficulty by moxt worms, On the other hand, the le healthy individual, ES his resistance lowered by drink, iat overwork or what oot, is infected far more readily. If then we can eecure for the ma es pay ar sanitary dwellings, wise factory regulations and a knowledge of the laws of hea!th, we shall go far to stamp out many of the fevers. Already in England plague. cholera, and typhne have gone: typhoid is going. Phthisis etill stands out defiant. To attempt to annihilate this by isolation in Sanatoria of the infected cases, and by the disinfection of infected honses is fatile. Hundreds case a will escape detection until the Inter stagos, and these must always keep the infection amongst us. It must be attacked chiefly by sanitary dwellings with more space end air, by moro wholesome food and le “ drink.” There aro certain fevers, however, which the hoslthiest [s. 364]