of a continuous high bodily
temperature, not intense enough at any time to compromise life, all the
muscular tissues of the body undergo a peculiar granular degeneration.
Many a typhoid-fever patient has undoubtedly died from the heart-muscle
having undergone this change, when, if by artificial cooling the
temperature of the body had been kept down, the alteration of the
heart-structure would have been prevented, and death averted. It is
obvious, also, that the old plan of thwarting the intentions of Nature,
and depriving the fever-patient of the free use of cooling drinks, was
practically a baneful cruelty. As the body is burning up in fever, it is
also evident that to deprive it of sustenance is to aid in the
production of fatal exhaustion. The burning will go on, whether food is
given or not, so long as the tissues can serve as fuel. Of course no
more food should be taken than the patient can digest, but every grain
of digested food is so much added to the resources of the system, which
is engaged, it may be, in a close and doubtful conflict with disease.

If it were possible, of course the best treatment for fever would be
that which lessened the production of heat. Fortunately, we have some
drugs--notably, quinine and alcohol--which do exert a decided influence
upon the vital chemical movements, but, unfortunately, their power is
limited. As we are therefore often unable to control heat-production,
the best we can do is to abstract the caloric from the body whenever it
becomes so excessive as to threaten serious results. To do this, all
that is necessary is to put the patient in a cold bath, or wrap him in a
sheet wet with ice-cold water, or lay him upon an ice-mattress, or
surround him with coils of tubing through which cold water runs, or use
some similar efficacious device. I do not wish to be misunderstood.
External cold is not to be lightly employed: it is a powerful two-edged
weapon, capable of cutting both ways--a weapon as injurious and
destructive in the hands of the ignorant and inexperienced as it is
efficient in the hands of those to whom study and experience have taught
its skillful use.

To illustrate what cold water may effect when employed by intelligent
and skillful physicians, I may be permitted to cite a few hospital
statistics from Germany and Switzerland, the only countries where the
so-called antipyretic treatment of continued fever has been efficiently
carried out on a large scale. From 185