s. When withdrawn,
the temperature of the patient can be read at a glance.

The temperature of the skin, however, is not the only indication of
fever. It is accompanied simultaneously by accelerated action of the
pulse, up to 120 beats per minute, and even more; also by increased
thirst and, as an indication of very intense affection, extreme
exhaustion and lassitude. The increased excretion becomes manifest
through dark and strong-smelling urine and, especially at the time when
the fever begins to abate, through intense perspiration.

In the beginning of fever the change alternating between chills and
abnormal heat is very characteristic; frequently, and especially in
severe attacks, it begins with shivers. The patient suddenly feels an
intense chill, so that he commences to shake all over, his teeth chatter
and he grasps whatever covering he can for warmth. Suddenly, following
this, a rapid increase of temperature occurs, and the patient begins to
complain of intense heat. In other cases patients complain of feeling
very cold, while their skin indicates a marked degree of warmth.

With higher degrees of temperature, the fever may induce a loss of
consciousness. The patient becomes delirious, loses urinary and fecal
control and displays the signs of total collapse.

Fever, as I have already indicated, is a kind of physical revolution, a
state of excitation which, differing so widely as to cause, character
and degree, cannot be judged according to any fixed rule. The
temperature of a patient we may read from the thermometer; but the real
nature of the fever we do not learn until we consider his constitution,
his innate faculties and the strength to which his various organs have
attained. For this purpose we must take into consideration not only the
physical attributes, but also the quality of the senses and of the mind,
since these items are of the utmost importance in determining the
tenacity, i.e., the power of resistance of the patient.

From this point of view it will be understood that people possessing a
calm and phlegmatic temperament, will not attain to high degrees of
fever, except in cases of very serious complications, while nervous
people may quickly reach very considerable degrees of temperature.
Children and younger people are more inclined to high fever, since their
organs are still immature. This explains why simple inflammations, which
are not general throughout the body, or frequent indigestion, wh