From the Cincinnati Medical News for December, 1876. 
What is the Nature and Purpose of the Fe- 
ver Process in Human Bodies? 
By Z. Collins McElroy, pl. D., one of the physicians to the 
Muskingum County Infirmary; Physician to the Home of 
the Friendless; Secretary of the Muskingum County Medi- 
cal Society; Member of the Perry County Medical Society; 
Member of the Licking County Medical Society; Fellow of 
the Zanesville Academy of Medicine; Fellow of the Meigs 
and Mason Academy of Medicine, etc., etc. 
From the Proceedings of the Muskingum County Medical Society at its 
session in the city of Zanesville, Ohio, October 12, 1876. | From the Cincinnati Medical News for December, 1876.] 
What is the Nature and Purpose of the Fever 
Process in Human Bodies? 
By Z. Collins McElroy, M. D., One of the physicians to the Mus- 
kingum County Infirmary; Physician to the Home of the Friendless ; 
Secretary of the Muskingum County Medical Society; Member of the 
Perry County Medical Society; Member of the Licking County Medi- 
cal Society; Fellow of the Zanesville Academy of Medicine ; Fellow 
of the Meigs and Mason Academy of Medicine, etc., etc. 
From the Proceedings of the Muskingum County Medical Society at its session in the city of 
Zanesville, Ohio, October 12, 1876. 
The term fever is derived from one or the other of these Latin words, 
viz: " Feritas," wildness ; " Fervor." heat; or " Februo," I purify. In the 
olden time the condition of body now known as fever was called the 
" Burning Disease." This was the state of the public and professional 
mind during many centuries. As the cloud of the dark ages lifted, fevers 
were attentively studied ; and as they presented a certain train of phenomena 
they were grouped in genera, orders, species, and varieties of species, 
until their number was, metaphorically speaking, legion. So the matter 
' stood for another century, when nosology began to lose ground, until 
now it has fallen into disuse. In its place certain phenomena-with 
many variations-are recognized as presenting certain types of fever, as 
periodical, eruptive, and typhoid or continued, as the phenomena are peri- 
odical, or continued, or are accompanied by an eruption of the skin. But 
there is no agreement in the professional mind as to any classification of 
fevers. The late International Medical Congress had before it the ques- 
tion of the identity of, or specificity of, typho-malarial fever, and concluded 
that there was not evidence sufficient to establish it as a distinct disease; 
but that the name, or term, might be useful in designating types of fever 
of mixed origin and character. In the same number of a medical journal 
I receive, containing a very full report of the proceedings of the Congress, 
there is published a Clinical Lecture by an American Professor of Theory 
and Practice, devoted to establishing the specific character of typho-malarial 
fever ; and the precise differential diagnosis between it and typhoid. A 
recent discussion of what is called puerperal fever, in a London Medical 
Society, culminated in rejecting such a name for any specific disease, it 
being fully established that the only feature common to such cases was, 
that they occur to lying-in-women. The mutual inter-convertibility of all 2 
THE FEVER PROCESS IN HUMAN BODIES. 
non-eruptive fevers-including typhus-is insisted upon by Dr. Graves, of 
Dublin, in his recent work on fever. 
I may add my conviction that there is a growing tendency in the pro- 
fessional mind to regard all fevers as a unity in their essential nature and 
purpose; and that the divisions of them in professional works may be 
continued as a convenience of description only. 
To my own mind there is a simple division or classification of fevers 
which exactly corresponds with, and represents the facts in, each individual 
case, viz: fevers originating from external causes, and those from internal 
causes. Thus: Small-pox, scarlet fever, measles, etc., are due to the intro- 
duction of some material from without, as a general thing, which, whether 
gaseous, fluid, or solid, stores up force, which, in a living body, so modifies 
its processes-repair and waste of flesh-as to change, or, as I prefer to 
think of it, spoil the dynamic capacities of tissue, necessitating a fever 
process for its removal, and the reconstruction of the body-in the main- 
from new material-with natural, or the capacity for performing functions 
more or less natural-physiological. 
On the other hand, I find many reasons for concluding that intermittent 
and remittent, as well as typhoid types of fever, owe their existence to 
causes originating inside of the body, as in so-called hectic fever, or septi- 
caemia, etc. These causes are changes in nutrition, sometimes due to 
cosmic influences beyond our control. Others to causes which may be 
prevented, or over which human beings have more or less control. I do not 
feel confident that the eruptive fevers, so-called, are always due to contagion 
-man to man contact-or external causes Epidemics of scarlet fever, 
measles, etc., are not satisfactorily explained by contagion. But the con- 
clusion that they are sometimes due to cosmic influences, and therefore 
beyond control, satisfactorily accounts for all the facts of epidemics. This, 
I think, disposes effectually of the specificity supposed to belong to them. 
They originate de no-vo. And if epidemics are so, why not sporadic cases ? 
Thus much for causes, I may pass over phenomena or symptoms com- 
mon to all fevers, or peculiar to the several recognized types, and consider 
at once the nature and purpose of a fever process of any type. 
It seems to me that the probability of any fever process being due to 
chance, or accident, and not to an adequate cause, may be safely left out 
of consideration, seeing that throughout nature inorganic and organic 
law and order reigns supreme. Human beings are closely connected with 
external nature. And when large numbers of living beings or things 
sicken simultaneously over large expanses of territory, as the epizootic of 
horses in 1872, I prefer to think of the cosmic influences at work, as a sick- 
ening of the earth itself, when a portion, greater or less, of the life on its 
surface will sicken in consequence, whether human or inferior, or both. 
The necessity for a fever process is ordinarily announced by changed 
functions; particularly by loss of dynamic capacities-as moving about, 
work mental and physical, changed mental characteristics, the demand 
for food-new material much decreased or entirely gone, while natural 
evacuations may be largely increased, modified, or altogether suspended. 
Why is a fever process set up in such a condition of body ? That I 
think can be understood with a tolerable approach to exactness The 
structures of a living body have no permanence. Life phenomena are 
dependent on the decay of the structures themselves. The correlative of 
natural or physiological decay is function, i. e., the various phenomena of 
life, dynamical, sensory, emotional, intellectual, and thermal. A modified 
structure will still decay, but in place of the correlative being physiological 
function, it is heat. The changed structures do not, in the act of decay, THE EEVER PROCESS IN HUMAN BODIES. 
3 
provide for their own reproduction from new material. There is, therefore, 
little or none of the order of physiological life decay. Hence, the variable 
speed, and therefore variable temperature, of the decay of structures unfit 
for the purposes of life. In a word, when the structures have, by any 
causes, external, internal, or cosmical, become unfit for the purposes of 
life, the living being has but one of two alterations, viz : the removal by 
a fever process of the changed or modified tissues, or death of the whole 
individual. Destructive metamorphosis, or per-oxidation, or decay by the 
fever process, takes place in the shadows of the border land between phy- 
siological decay and ordinary putrefaction. Just beyond these limits the 
decay of structure is known as erysipelas. Mortification or moist gan- 
grene, does not differ to any considerable degree, though somewhat in 
mode, from ordinary putrefaction. The waste of living structure by a 
fever process carries wi[h it a possibility of reconstruction from new ma- 
terial, with natural forms of structure, and, therefore, natural physiological 
capacities for function That by so-called erysipelas and moist gangrene, 
is hopelessly lost, never to be reproduced. I have long been impressed with 
the gravity of the consequences of missing a fever process when one has 
become necessary by changes 'of structure from whatever cause, which, it 
seems to me, is the source of much, if not all, so-called chronic disease, 
which is not amenable to remedial proceedings, and not the result of time 
or age. I often meet with persons suffering from wnat are called functional 
derangements, who would, it appears to me, get well, if a fever process 
were set up in their bodies, and guided through by intelligent professional 
aid, till the changed structures were wasted, and partially, or wholly, re- 
constructed from new material, which would have more or less natural 
functional capacities-that is, recover their natural health. 
What are the so-called counter-irritants and alteratives, emetics, purga- 
tives, etc., but art imitations, in their actual operation and results, of na- 
ture's proceedings in a fever process ? Do they hurry up waste of structure ? 
Do they do any thing else? Certainly not, however much the real effects 
they produce may be concealed by misleading names. Every practitioner, 
of a few years standing, can recall cases of so-called chronic disease, 
which got well during a fever process; or at least-speaking in the ordinary 
way-the chronic disease did not return when the fever process had com- 
pleted its course. The necessity, that is, the pathology of a fever process, 
includes, so to speak, the loss of the natural structural arrangement of 
tissue as shall impair, seriously, functional capacity. Or, as I prefer to 
think of it, ''spoiled tissue;" tissue spoiled for the purposes of healthy 
life. For, without this previous alteration of the structural condition, 
there can be no loss of functional power, and, therefore, no pathological 
condition. 
A living body struck by lightning, so to speak, is found dead in a 
moment after the stioke, died instantly it may be. Why and how ? Only 
in one way. The forms of structure on which life depends have been 
changed by the velocity and mode of motion communicated by the elec- 
tric force. This change in the natural molecular arrangement of the 
material of structure may be too subtile to be detected by either the naked 
or the microscopically assisted eye. But that such changes have occurred is 
fully attested by the sudden cessation of function. The effects of such in- 
stantaneous changes are observed in photography, were light, striking a plate 
covered with a thin film of collodion, upon which has been spread a solu- 
tion of silver nitrate, makes it possible, by further chemical manipulation, 
to develope an image of the objects from which the light was reflected. 
What has occurred to the silver nitrate ? Decomposed, chemically, and 4 
THE FEVER PROCESS IN HUMAN BODIES. 
therefore structurally changed ; for if it were not so no image could be 
brought out by further chemical proceedings by the artist. 
It seems to me not unlikely that the necessity for a fever process in a 
living body is not unfrequently brought about almost as suddenly as death 
by the lightning's flash, by emotions, impressions, or falls, or railroad ac 
cedents, etc., where there have been no traces of violence visible after the 
most careful scrutiny by competent observers. The effects of such sud- 
denly brought about molecular changes in structure are known in medi- 
cine as " shock." On the other hand, it seems to me equally certain that 
the bulk of cases have a much slower origin, sometimes spread over many 
days, weeks, months, or it may be years. But however tardy the action 
of any cause, there comes a time when the alternative is presented of fever 
process or death. 
It does not seem possible that anv attentive student of human life should 
fail to get a more or less accurate understanding of why a fever process is 
set up in a living body ; and it is worth while not to forget that dead bodies 
never have a fever, whose tissues have been more or less spoiled for life's 
purposes, by causes acting suddenly or more slowly. Living flesh has 
little stability, and particularly living flesh capable of performing a func- 
tion. Remember it must decay, and the decay of structure with natural 
functional capacity gives rise to that exuberance of "animal spirits," 
as it is called, which is, so to speak, worked oft'by physical exercise, whether 
expended in useful industry or in mischief-particularly noticed in the 
young. Age is another name for changed structures, whose decay exhibits 
that gravity which is so becoming and dignified as the end is neared. If 
the changed structures perform no function, continue to grow, and have no 
perceptible decay, they constitute neoplasms, or tumors, or other mor- 
bid growths. If any of these decay, their functional correlative is heat; 
and as they cannot, and do not, provide for their own reproduction from 
new material, they are said to be " absorbed," or " resolved." But decay 
is not the ordinary course of neoplasmic growths. Growth and sta- 
bility is their habit, not decay, except by the suppurative process. 
And that marks out a tolerably distinct line of separation between neo- 
plasms and spoiled tissue unfit for the purposes of natural life, but yet 
possible to decay by the fever process, and not be reproduced from .iew 
material. Spoiled tissue, which can undergo the process of decay in the 
border-land of natural life, is " consumed," " burnt up," and the body is 
" purified" by the Februo. Not so with neoplasmic growths. If they de- 
cay it is by suppurative or gangrenous processes. They perform no useful 
function, and do not reproduce themselves from new material, though sep- 
arate germs or cells introduced into living bodies may, in virtue of the 
force stored up in them, so modify the acts of nutrition as to reproduce 
their like. They are parasites, not independent organisms. The means 
by which the structures are reproduced in health, and during and after a 
fever process, are the same. What are they? There is but one way, and 
that is in the same manner that all other forms of life are multipled and per- 
petuated in both animal and vegetable realms of nature The structures 
themselves, in the acts of functional decay, store up the force in the requisite 
material for their own reproduction from new material. This special material 
it is the function of the complicated and elaborate lymphatic system in the 
human body to separate from the debris of the structures, and restore to the 
blood-stream to be united with the new material at a suitable place and time. 
That suitable place, and the only suitable place, and at the only proper time, 
is just where and when the contents of the thoracic ducts pour their contents 
into the blood current. If the lymphatic system has escaped the damage THE FEVER PROCESS TN HUMAN BODIES. 
5 
to tissues elsewhere, and the tissues themselves have not lost the capacity to 
provide for their own renewal, it may supply the needful force, in the 
requisite material, to unite with the requisite new material, and thus 
reconstruct the wasting structures with natural life powers. If the structures 
by damage-spoiling too far for self recovery-and the lymphatic system 
have shared the same fate, the body lingers a longer or shorter time and dies. 
When a death occurs during the fever process, the judgment of the 
profession, and the people who have been taught by the profession, is that 
the fever caused the death. That Mr. Smith died of typhoid fever, and 
Mrs. Jones' child died of measles. Is that judgment correct? It seems 
to me not. As well might a man who has made every effort to rescue a 
body from death by drowning, and failed, be charged with the death. 
The mischief to structure, which is the real cause of death in fatal cases, 
ante-dates the fever process. The fever process is nature's last and su- 
preme effort to save life. 
Medical text books and oral instruction in early life taught me that the 
fever process was the work of an enemy. And that opinion was held a 
good many -far too many-years. Arriving at a conclusion exactly the 
reverse of my early educational training was a very slow process. It was 
not one great fact, but a great many facts, small and great, that now compel 
me to look at the fever process as the work of a friend to life, and 
always in the interest of life; and this conclusion, with the full knowledge 
that a large number of human beings die during the progress of a fever. 
But the spoiled tissue behind, and constituting the necessity for a fever 
process, is the real cause of death. Our saying that Mr. Smith died of 
typhoid fever is like our saying that the sun rises in the morning and sets 
at night-a convenient fiction to express an apparent fact. The fever 
process, no matter of what type, is the supreme struggle for life, to i emove, 
by the slow and safe process of oxidation (burning), tissues which have 
lost life properties. 
Such a process, in so.complicated an apparatus as a living human body, 
cannot be expected to take place evenly in all tissues and viscuses, for the 
very simple and satisfactory reason that the spoliation has not been so. 
The points of most rapid waste are now regarded as foci of the inflam- 
matory process, whatever that may be. At all events, no matter what they 
are called, they are points where the tissues have been rendered more fully 
unfit for life's purposes than at others, and, therefore, more rapidly un- 
dergo the process of burning up-oxidation-or the februo-purifying. 
Of the tissues existing at the commencement of a fever process, in any 
given body, the bulk, in so-called grave or severe cases, will disappear 
before complete convalescence is established. The length or duration 
and apparent severity of a fever process will exactly correspond with the 
amount, structure, or tissue to be removed by the burning process This 
will be the case provided the sufferer is surrounded by conditions favorable 
to life, and over which man has control. Some conditions unfavorable to 
life are not under man's control. Thus, high temperatures in July and 
August, annually, in our position on the globe, are unfavorable to life, 
and always bring up the death rate, more noticeable among the young. 
A sudden cold snap in later November and December is also sure to 
bring up the death rate, but more conspicuous at the other extreme of 
life. Remedial management has something to do with it in these respects. 
The fever process being interrupted by therapeutic agencies before its 
purpose is accomplished, is very generally followed by relapses, until the 
purpose is completed. In some cases this relapse has peculiar features or 
symptoms, and is then called relapsing fever. 6 
THE FEVER PROCESS IN HUMAN BODIES 
Or, the sufferer may have an imperfect fever process, and, as a result, an 
imperfect recovery; some modified tissue, capable of, and performing 
modified functions, will remain. The condition is then called chronic 
disease-or, organic disease-of whatever structure, or viscus, which hap 
pens to have been modified, and not wasted and reconstructed again with 
natural capacities for the purposes of life. 
All the facts concerned in the causation of fever; the symptoms, the 
type, the remedial management, and finally the post mortem condition of 
structure after fatal cases, are all harmonised when the fever process is re- 
garded as in the interest of life, and not the work of an enemy and in 
the interest of death. 
Ehe cor elusions to which the foregoing discussion lead may be stated 
as follows s- 
1. 'That the fever process, irrespective of type or cause, is a unity, vary- 
ing only in mode and speed of the process of oxidation, or waste of tissue. 
2. That it never occurs in any living body without adequate cause. 
3. That the cause is always a modification of the dynamic capacities- 
life properties-of the tissues. 
4. That the cause may be the introduction of some material from without 
into the body, solid, fluid, or gaseous, storing up a mode of force capable 
of changing or modifying the processes of nutrition and waste, and of 
the life capacities of existing tissues. 
5. That it is always nature's supreme effort to save life and prevent the 
modification of tissues constituting chronic disease, or organic disease, 
so-called. 
The session was largely attended, and the paper was very generally 
discussed, receiving many commendations. 
Dr. Ball made, perhaps, the gravest objections to the doctrines of the 
paper. His remarks, and Dr. McElroy's replv, are therefore apppended. 
The remainder of the discussion, though very interesting, would occupy 
too much space to be presented in connection with the paper. 
Dr. Ball said that the paper claimed for all fevers a unity of nature and 
purpose. If the author means that all fevers have an elevation of tem- 
perature, he would agree with him. If he means that there is an increased 
rate of blood circulation, common to them all, he would agree with him 
in that too. Conceding these, and perhaps some other features present 
in all fevers, there was to his mind something essertially distinct between 
an ague and small pox. If, as the author claims, they aie always in the 
interest of life, they would require no treatment. If the fever process is 
in the interest of health, then, it seemed to him, the more of it any patient 
had the better for him. Such are some of the impressions made on his 
mind by.the paper. Probably not such as the author intended, but what 
has actually occurred. 
Dr. McElroy said that Dr. Ball was right in supposing that such impres- 
sions were not those he designed to make on the members present. Dr. 
Ball's remarks reminded him of an incident on an Ohio river steamer some 
years ago. Among the passengers there were a number of Methodist 
clergymen, returning from conference, and a Universalist preacher. Two 
of the Methodist ministers concluded they would have a chat with the 
Universalist. In the course of their conversation one of the Methodist 
clergymen said to the Universalist : "If your doctrine be true, that all 
men shall be saved, what is the use of preaching it to the people? Foi, 
no matter what sort of lives they live here on earth, they will all reach 
THE DISCUSSION OF THE PAPER IN THE SOCIETY. THE FEVER PROCESS IN HUMAN BODIES. 
7 
heaven at last." "Do I understand you to ask," said the Universalist, 
" what is the use my preaching Universalist doctrine, seeing that all men 
will be ultimably saved?" "Yes sir," was the reply. "I preach Universalist 
doctrine to my fellow beings because it is true; and because its tendency 
is to induce men to lead better lives on earth," exclaimed the Universalist. 
That, Mr. President is about my position. I am trying to teach you 
that there is a unity of nature and purpose in all fevers, irrespective of type 
or cause. I do so because I am as sure I am right as I am of my existence. 
The materials concerned, and the force which gives motion to the materials, 
are the same in all fevers. But different modes of the same force oper- 
ating in the same body gives rise to differences in external appearances. 
And therein lies the difference between an ague and small-pox. The cause 
is different, and therefore the mode of motion, and therefore external 
appearances. 
The President has on his feet a pair of leather boots, and very probably 
a leather wallet in his pocket They have different functions to perform, 
and therefore have different external forms. In the two articles the materials 
are the same, and the physical motion or motions which converted leather 
into boots, would never convert another part of the leather into a pocket wal- 
let. Between the two articles there is nothing to mark essential differences. 
So also in regard to the carpet covering the floor and the cloth of Dr. 
Ball's coat. Both are of the same mateiial, but the modes of motion of 
materials which converted wool into a carpet and a coat were not the 
same in mode, and therefore the differences in results. There is no essen- 
tial difference between bone and brain matter. Both contain the same 
materials, but the proportions of the elementary parts composing them are 
different. And the modes of motion which converts blood into bone and 
blood into brain matter are different, and hence the differences between pro- 
ducts. Dr. McElroy said he was not concerned about consequences. If a 
wider and truer conception of the nature and purpose of the fever process in 
hum n bodies interfered with present conceptions of the professional man- 
agement of fever, he could not help it. He was sure that in early profes- 
sional life he was like the woman who had had four husbands, three living, 
and she a grass widow. Her conclusion was that "she had been too much 
married." So it was with him in regard to the treatment of fevers; he was 
now satisfied that while he regarded the fever process as the work of an 
enemy to life he had " treated it too much." He could not say any thing 
in regard to others, but tl at much he would confess in regard to himself. 
Since he had come to understand the nature and purpose of fever, he no 
longer " pickled " his patients in " whisky." In studying the progress of 
a fever process in any patient, he felt he had a higher duty to perform 
than in trying to cure them with drugs and medicines. 
For his part he could see the same necessity for the professional super- 
vision of a fever process as there was for the services of an engineer on a 
locomotive. If once started the locomotive would go without an engineer. 
But safety to passengers and freight required skillful professional manage- 
ment on the part of the engineer. Dr. Ball's horse would haul his carriage 
without being driven ; but would hardly carry the doctor when and where 
he wanted to go as safely as if he held the lines and guided the horse. So 
it was with Dr. McElroy, it seemed to him that as the fever process was 
the work of a friend, it was more imperatively necessary than ever to have 
it under wise professional supervision and guidance. 
He felt equally certain in regard to another thing, viz: that it was of the 
highest possible importance to both physicians and fever patients that each 
should know the truth.