24
injected into the circulation of healthy animals, induce malaise and all the signs of excessive exhaustion."
In convalescence from disease, too, how readily does the evening temperature rise after any slight physical exertion; and at the commencement of typhoid fever perhaps nothing tends to intensify the severity of the attack so much as physical fatigue. It would seem in this case as if the soil for the cultivation of the fever germ was materially enriched by the products of disintegration.
In "fatigue fever" these products are formed more rapidly than they can be eliminated or neutralised. With rest the febrile condition soon passes off, if the individual is otherwise healthy. Now it appears to be the function of certain glands besides the liver and kidneys, to get rid of the poisonous products resulting from the disintegration of the tissues, either by neutralising or decomposing them or otherwise. If the action of the glands is checked or modified either by disease or by their removal, the poisonous material soon begins to exert its specific effect on the system. We have recently been taught that following upon disease or removal of the thyroid gland the condition known as Myxoedema, with all its attendant phenomena, arises. Again in disease of the suprarenal capsules "efiete pigments and efiete proteids circulate in the blood; the former or their incomplete metabolites, producing pigmentation of skin and mucous membrane, and appearing often in the urine as urohsematoporphyrin; the latter producing toxic effects, and leading to further deterioration of the blood with its consequences " (McMunn). If, then, from any cause due to glandular, nervous, or other derangement in the system, these poisonous substances are developed or not eliminated they will alter the
