The nature of fever : being the Gulstonian lectures delivered at the Royal College of Physicians of London in March 1887 / by Donald MacAlister.

  • MacAlister, Donald, 1854-1934.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: The nature of fever : being the Gulstonian lectures delivered at the Royal College of Physicians of London in March 1887 / by Donald MacAlister. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    with what I may call the thermogenic heat. In some of the experiments of Lukjanow it was much less than i per cent, of the heat liberated simultaneously with contraction. The processes which issue in motion on the one hand and in thermogenesis on the other are of course associated with chemical movements in the muscle, with metabolisms whose terminal steps are the accretion of oxygen and the excretion of carbonic acid and water. The considerations I have ad- duced, and especially those relating to the power of recovery in a fatigued muscle under the influence respectively of rest and of the blood-supply, point to the conclusion that the two metabolisms are in some way different. In other words, that the contractile stuff in the muscle is not the same as the thermogenic stuff. Both of them are stored in the muscle ; so far as function is concerned they are the muscle. The store of each can be exhausted by repeated stimulation, but in some cases the thermogenic store sooner than the other. Both can be upbuilt again by the circulating blood, but in some cases the contractile store sooner than the thermogenic. Both the metabolisms are affected by cold, but the thermo- genic much sooner and much more intensely than the con- tractile. We know little of the exact nature of the chemical changes involved in either form of metabolism. Oxygen is taken up in each, and carbonic acid is discharged, but the processes passed through between these terminal stages are much more complex than simple oxidations. The evidence rather goes to shew that it is the living substance as a whole, contractile stuff and thermogenic stuff, which is continually being decomposed and as continually being recomposed by the blood. The net balance shews only gain of carbonic acid and loss of oxygen, but the nitrogenous parts also of the working substance have in the process undergone partial destruction and equivalent reconstruction. This is in health ; but if the reconstructive part of the process is inadequate or absent, the balance of accounts will give evidence of a nitro- genous residuum which is morbid. The muscle-substance will appear to be itself consumed ; it will no longer be what I may call merely the circulating medium of consumption. I say it will appear to be consumed ; this only means that the net result is loss of nitrogenous substance. The cast-out nitrogenised molecules of the muscle are not really excre- tionary in the sense that carbonic acid is excretionary. They have merely failed of that immediate upbuilding into muscle- substance again which is characteristic of the healthy meta- bolism. This incessant upbuilding of the muscle-substance,