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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    LECTURE III. In the last lecture I gave at some length my reasons for believing that the thermogenic function of the skeletal muscles, the chief sources of heat in health and in disease, is dependent on their innervation. I spoke of this innervation as twofold, corresponding to the motor and inhibitory inner- vation of the vascular and visceral muscles and of the heart. From the point of view of the chemical changes which take place in thermogenesis, I spoke of the nerves concerned as respectively catabolic and anabolic. The latter nerves were inhibitory of heat-production, inasmuch as their influence is towards the upbuilding of the hypothetical thermogen and the simultaneous absorption of energy. The former were excitors of heat-production inasmuch as they induce destruc- tive metabolism with oxidation and the liberation of energy. Briefly this view of thermogenesis was suggested (l) by the chemical fact that in the normal thermogenic, as in the normal contractile, metabolism of muscle there is no adequate evidence of increased nitrogenous waste, but only of the absorption of oxygen and the liberation of carbonic acid and water; the nitrogenous molecule of the muscle-substance must be continuously upbuilt again as it is continuously being unbuilt, anabolism going hand-in-hand with catabolism; and (2) by the cardinal physiological doctrine taught us by Dr Gaskell, that catabolism or disintegration is the symptom of motor or excitor nervous action, and anabolism or restoration of inhibitory nervous action. The phy.siological doctrine was, you will remember, strongly supported by the phenomena presented by the heart-muscle and its double nerve-supply through the sympathetic and the vagus ; it was rendered probable in the case of the visceral and vascular involuntary muscle.s, and on analogical and other grounds inferred in the case of the voluntary muscles and the secret- ing gland.s. Another line of analogical reasoning to which you may or may not be inclined to give weight suggested that, as the nervous mechanisms of heat-loss—namely, those subserving circulation and respiration—had a twofold character, and 3