STUDIES IN THE PHYSIOLOGY OF ARTIFICIAL FEVER. I. CHANGES IN THE BLOOD VOLUME AND WATER BALANCE

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Abstract
Changes in plasma, red cell and total blood vol.; and gross water and tissue fluid losses were detd. in patients undergoing artificial fever therapy induced by intraven. inj. of typhoid vaccine, by diathermy, by radiant energy and in the "Kettering Hypertherm." In contradistinction to fever induced by typhoid vaccine, fever induced by physical agencies is characterized by a reduction in plasma and hence total circulating blood vol. This reduction is brought about by a high rate of gross water loss through sweating and hyperventilation, the rate of which may exceed the maximum possible rate of absorption of water from the intestinal tract. The absorption of water from the gut may be retarded at high temps. Plasma vol. may be maintained at normal level by intraven. infusion. Reduction in plasma vol. is most rapid during induction of fever. Gross water loss is detd. by the differential temp, of the patient''s body and atmospheric environment, and to a less extent by the relative humidity thereof, and is not related to the amt. or route of fluid administration. Tissue fluid loss is inversely related to the rate of fluid intake. While individuals vary in their physiological response to artificial fever, for each patient there is a critical level of reduction in plasma vol. beyond which further reduction leads to peripheral vascular collapse. At temps, of 106cF or above a rate of tissue fluid loss in excess of 5 cc. per hr. of fever per kg. of body wt. cannot be tolerated.