Violations and their causes alphabetically:
violation of the body's thermoregulation -
Thermoregulation disorders are violations of the constancy of body temperature caused by dysfunction of the central nervous system. Thermal homeostasis is one of the main functions of the hypothalamus, which contains specialized thermosensitive neurons.
The vegetative pathways begin from the hypothalamus, which, if necessary, can provide an increase in heat production, causing muscle tremors or dissipation of excess heat.
Which diseases there is a violation of the body's thermoregulation:
When the hypothalamus is damaged, as well as the pathways following from it to the brain stem or spinal cord, thermoregulation disorders occur in the form of hyperthermia or hypothermia.
Heat transfer by the body to the external environment depends on the ambient temperature, on the amount of moisture (sweat) emitted by the body due to heat consumption for evaporation, on the severity of the work performed and the physical condition of a person.
When high temperature air and irradiation, the blood vessels of the body surface expand, while blood, the main heat accumulator in the body, moves to the periphery (body surface).
As a result of this redistribution of blood, heat transfer from the body surface increases significantly.
Violations of the body's thermoregulation can occur when the central or peripheral link of the thermoregulation system is damaged - hemorrhages or tumors in the hypothalamus, with injuries accompanied by damage to the corresponding pathways, etc.
Thermoregulatory disorders are associated with many systemic diseases, usually manifesting themselves as fever or fever.
An increase in body temperature is such a reliable indicator of illness that thermometry has become the most commonly used procedure in the clinic.
Temperature changes can be detected even in the absence of an obvious febrile condition. They manifest as redness, blanching, sweating, tremors, abnormal sensations of warmth or cold, and may also consist of unstable fluctuations in body temperature within the normal range in patients with bed rest.
During physical work, the balance between heat production and heat transfer is temporarily disturbed, followed by a rapid restoration of normal temperature at rest due to long-term activation of heat transfer mechanisms.
In fact, with prolonged physical activity, the vasodilation of the skin in response to an increase in the temperature of the core of the body stops in order to maintain this temperature.
With fever, the adaptive capacity decreases, since upon reaching a stable body temperature, heat production becomes equal to heat transfer, however, both are at a level higher than the initial one. Blood flow in the peripheral vessels of the skin plays a more important role in the regulation of heat production and heat transfer than sweating.
With a fever, the body temperature, determined by thermoreceptors, is low, so the body reacts to it as if it were cooling.
Trembling leads to an increase in heat production, and narrowing of the skin vessels - to a decrease in heat transfer. These processes explain the sensations of coldness or chills that occur at the onset of the fever. Conversely, when the cause of the fever is removed, the temperature drops to normal, and the patient feels fever. Compensatory reactions in this case are vasodilation of the skin, sweating and suppression of tremors.
At high ambient temperatures, four clinical syndromes develop: heat cramps, heat exhaustion, heat stress injury, and heat stroke. Each of these states can be differentiated based on different clinical manifestations, however, they have much in common and these conditions can be considered as varieties of syndromes of the same origin.
The symptom complex of heat injury develops at high temperatures (over 32 ° C) and at high relative humidity (over 60%). The most vulnerable are the elderly, people suffering from mental illness, alcoholism, taking antipsychotic, diuretic, anticholinergic drugs, as well as people in rooms with poor ventilation. Especially many heat syndromes develop in the first days of the heat, before acclimatization begins.
Which doctor should I contact if there is a violation of the body's thermoregulation:
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A violation of the body's thermoregulation or a disorder of the constancy of body temperature is provoked by dysfunction of the central nervous system. In case of violation of thermoregulation processes, two types of reactions are possible. If the body temperature rises, the peripheral vessels dilate, sweating begins. If the temperature, on the contrary, decreases, the blood vessels narrow, the muscles contract, the limbs become cold, tremors appear.
Higher animals possessing the property of constant body temperature have a system for maintaining temperature in equilibrium. Thermoregulation balances heat production and heat release. There are two main types of thermoregulation: chemical (its main mechanism is increased heat generation during muscle contractions - muscle tremors) and physical (increased heat exchange due to the evaporation of fluid from the body surface during perspiration). In addition, the intensity of metabolic processes and the narrowing or expansion of skin vessels are of a certain importance for heat production and heat transfer.
The thermoregulatory center is located in the brain stem. In addition, hormones of the endocrine glands, in particular, play a role in thermoregulation. The violation of thermoregulation of the body associated with a decrease in temperature is called hypothermia. The violation of thermoregulation of the body in humans associated with an increase in temperature is called hyperthermia.
Violation of thermoregulation processes: hyperthermia
Hyperthermia (overheating) occurs when the mechanisms of thermoregulation are disturbed, in which heat production prevails over heat transfer. Body temperature can reach 43 ° C or more.
Most frequent reasons such a violation of human thermoregulation is an increase in the temperature of the external environment and the appearance of factors that impede adequate heat transfer (for example, excessively warm clothing, high humidity, etc.).
When this type of thermoregulation disorders appears, adaptation mechanisms are activated: behavioral reactions, with the help of which a person tries to avoid exposure to excessive heat (for example, turns on a fan), an increase in heat transfer mechanisms, a decrease in heat production and a stress reaction. In accordance with the results of the interaction of hyperthermia and adaptation processes, the stage of compensation and the stage of decompensation of hyperthermia are distinguished.
In the stage of compensation, there is an expansion of the arterial vessels of the skin and the associated increase in heat transfer. With a further increase in temperature, heat transfer begins to occur mainly only due to perspiration.
In the stage of decompensation, there is a violation of adaptation mechanisms, sweating is significantly reduced, body temperature can rise to 41-43 ° C. There is a violation of the functions and structures of cells in connection with the direct damaging effects of high temperature, which leads to severe dysfunctions of systems and organs, primarily the central nervous system and cardiovascular system.
Heatstroke is a variant of hyperthermia, in which adaptation mechanisms are rapidly depleted. This can occur both at a high intensity of the thermal factor and as a result of a low efficiency of the adaptation mechanisms of a particular organism. The symptoms of such a violation of thermoregulation are the same as in the stage of decompensation of hyperthermia in general, but more severe and growing much faster, in connection with which heatstroke is accompanied by high mortality. The leading mechanisms of the pathogenesis of changes in the body correspond to those in hyperthermia in general. But with such a violation of thermoregulation of the human body, particular importance is attached to intoxication, acute heart failure, respiratory arrest, edema and hemorrhages in the brain.
Sunstroke - This is one of the forms of hyperthermia. It occurs due to the direct effect of the heat of the sun's rays on the body. With such a pathology of thermoregulation, the above mechanisms of hyperthermia are activated, but the leading one is brain damage.
Thermoregulation pathology of the body: fever
Fever should be distinguished from hyperthermia. Fever - this is the body's reaction to irritants of an infectious and non-infectious nature, characterized by an increase in body temperature. In fever (as opposed to hyperthermia), the balance between heat generation and heat transfer is maintained, but at a higher than usual level.
The reason for this violation of thermoregulation is the appearance in the body of pyrogenic substances (pyrogens). They are subdivided into exogenous (waste products of bacteria) and endogenous (decomposition products of damaged cells, altered serum proteins, etc.).
There are the following stages of such a pathology of human thermoregulation:
- temperature rise stage;
- the stage of temperature standing at a higher level than normal;
- temperature reduction stage.
Fever up to 38 ° С is called subfebrile, up to 39 ° С moderate, or febrile, up to 41 ° С - high, or pyretic, over 41 ° С - excessive, or hyperpyretic.
The types of temperature curves (graphs of daily temperature fluctuations) can be of diagnostic value, since they often differ significantly in various diseases.
Persistent fever is characterized by daily temperature fluctuations of no more than 1 ° C. With laxative fever, the difference between morning and evening temperatures is 1-2 ° C, and with exhausting (hectic) - 3-5 ° C. Intermittent fever is characterized by large ranges of morning and evening temperatures with periodic normalization. Recurrent fever combines periods of several days in which the temperature is normal and periods elevated temperaturewhich alternate one after another. With perverted fever, the morning temperature exceeds the evening temperature, and atypical fever does not have any regularities at all.
With a sharp decrease in temperature, they speak of a critical decrease, or a crisis (this may be accompanied by a pronounced decrease - a collapse); its gradual decrease is called lytic, or lysis.
A number of changes occur in systems and organs with fever.
So, in the central nervous system with fever, the phenomenon of oppression is observed. A concomitant symptom of such a violation of the body's thermoregulation is tachycardia, about 8-10 beats per minute for each degree of rise (however, in some diseases, for example, there may be bradycardia, which is associated with the inhibitory effect of a bacterial toxin on the heart). At the height of the fever, breathing may be rapid.
Fever, however, also has a positive effect. So, with a fever, the reproduction of some viruses is inhibited, the vital processes and division of many bacteria are suppressed, the intensity of immune reactions increases, the growth of tumors is inhibited, and the body's resistance to infections increases.
With similar symptoms, the causes of these violations of the body's thermoregulation are different. Fever is caused by pyrogens, and hyperthermia is caused by high ambient temperatures.
With such a pathology as fever, thermoregulation mechanisms continue to operate (the balance between heat production and heat transfer is shifted to a higher level), with hyperthermia, thermoregulation mechanisms are disrupted.
Fever is the body's reaction to certain external and internal influences with certain positive qualities, hyperthermia is, of course, a pathological process that is harmful to the body.
Impaired body thermoregulation: hypothermia
Hypothermia is a condition characterized by a decrease in body temperature below normal.
The leading reason for such a violation of the body's thermoregulation is a decrease in the ambient temperature. In addition, hypothermia against the background of a slight decrease in external temperature leads to disturbances in the mechanisms of heat generation: extensive muscle paralysis, a violation of heat production due to a decrease in metabolic intensity with reduced production of adrenal hormones (including damage to the hypothalamic-pituitary region), as well as an extreme degree of exhaustion. The following factors can also contribute to hypothermia: high air humidity, wet clothes, immersion in cold water, wind (which enhances heat transfer); in addition, starvation, overwork, alcohol intoxication, trauma and illness lead to a decrease in the body's resistance to hypothermia. The consequences of a violation of thermoregulation can be general hypothermia and local cold injury - frostbite.
According to the time of death, acute (within an hour), subacute (within 4 hours), slow (over 4 hours) hypothermia are distinguished.
As with hyperthermia, the development of hypothermia is divided into a stage of compensation and a stage of decompensation.
The stage of compensation is characterized by behavioral reactions (a person is trying to warm up), a decrease in heat transfer (the vessels of the skin narrow, sweating stops), an increase in heat production (blood pressure and heart rate increase, blood flow in internal organs and the intensity of metabolic processes in organs and tissues increase, muscle tremors appear). The body temperature decreases slightly.
If the cold continues to act, and the adaptation mechanisms cannot cope with its pathogenic effect, then the stage of decompensation begins. There is a breakdown of the thermoregulation system, inhibition of the centers of regulation of the brain, which leads to a drop in cardiac activity, weakening of the intensity of respiration, hypoxia and acidosis, disorders of the functions of organs and tissues, as well as microcirculation. The consequence of this is a violation of the exchange of water and electrolytes and the appearance of cerebral edema. Death occurs due to the cessation of blood circulation and respiration due to the increasing suppression of the regulatory centers of the central nervous system.
Frostbite usually affects areas of the body that are not protected or poorly protected by clothing (nose, ears, fingers and toes). In response to the effects of cold, there are such signs of a violation of thermoregulation as spasm of skin vessels, followed by their expansion and arterial hyperemia; with continued exposure to cold, secondary vasospasm may occur, which leads to tissue ischemia and damage to them up to necrosis of the skin and deeper tissues.
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A person is a warm-blooded organism, which means that he can maintain a stable body temperature regardless of external factors. At the same time, each of us was faced with a situation when the temperature rises or, conversely, decreases. MedAboutMe will tell you what these changes may be a symptom of and when you should really see a doctor.
What is thermoregulation
For maintaining thermal homeostasis, constant temperature the human body is primarily responsible for the autonomic nervous system and the hypothalamus. Body temperature depends on the intensity of bioenergetic processes. Therefore, for example, in children, it may normally be higher than in old people, since metabolism slows down with age.
The thermoregulation process is provided in two phases:
- Chemical - due to various metabolic processes in the body, the temperature rises.
- Physical - due to the mechanisms of heat transfer, the temperature decreases. Heat dissipation is carried out with respiration, sweating (evaporation of water from the skin surface), etc. The skin plays a primary role here - it is the main heat exchange organ.
For thermoregulation, hemodynamics is also important - the movement of blood through the vessels. So, for example, when there is a danger of freezing, the body distributes the volumes of circulating blood in such a way that most of it supplies the internal, vital organs. But from the limbs, on the contrary, it casts - this is associated with the danger of frostbite in these areas.
The hypothalamus, a small area in the diencephalon, is responsible for managing the complex process of thermoregulation, namely, for determining when it is necessary to activate cooling or warming mechanisms. The neurons responsible for temperature regulation are located here. Previously, it was believed that the center of thermoregulation is located in the hypothalamus, but today it has been proven that the concept of a single center cannot fully explain all the mechanisms of body temperature stabilization. Heat-sensitive areas are found in the cerebral cortex, hippocampus, amygdala, and even the spinal cord.
External factors are the key cause of thermoregulation disorders in humans. Unlike other warm-blooded animals, in the course of evolution we have become less adapted to temperature changes. Therefore, in critical situations, thermal homeostasis cannot be fully maintained.
Long-term fluctuations of 1-2 degrees from the norm can lead to serious consequences. It should be said that the value of 36.6 ° C used in domestic medicine is not used by foreign doctors. Body temperature can have individual characteristics, and the range of 36.0-37.2 ° C is considered the norm.
- Autonomic dystonia syndrome. Today, VSD (vegetative vascular dystonia) is considered an outdated diagnosis, but some of its signs can be attributed to disorders of the autonomic nervous system.
- Vasomotor neurosis.
- Psychogenic fever.
- Neuroendocrine Disorders.
- Damage to the hypothalamus.
- Organic lesions of the central nervous system (CNS) - tumors, hemorrhages in the hypothalamus, traumatic brain injury.
- Intoxication.
In patients prone to similar manifestations of thermoregulation disorders, it is noted strong rise temperatures in infections and inflammatory processes, the inability to quickly eliminate fever with antipyretic drugs, prolonged fever with acute respiratory infections. It should be noted that in children, a high temperature may be a reaction to acclimatization. Moreover, the process of getting used to new conditions can be delayed for months. In addition, for infants, due to imperfect mechanisms of heat transfer, as well as with increased metabolism, temperature rises to 38 ° C (rectal measurement) may be the norm.
Hypothermia is a condition in which the body temperature drops to 35 ° C and below. At the same time, a person develops lethargy, pulse and blood pressure may decrease, general weakness and "weakness" can be observed.
A general decrease in body temperature is typical for older people - due to a slowdown in metabolism, it can fluctuate between 35.5-36.5 ° C. This is a physiological process and does not apply to thermoregulation disorders.
Also low temperature body (35.5 ° C) in the morning is the norm for young children.
In the event of a drop in temperature in people up to 60-70 years old, the following diseases or conditions can be suspected:
- Defeat of the hypothalamus.
- Disruption of the central nervous system, in particular, the autonomic nervous system.
- Hypothyroidism (lack of thyroid hormones).
- Parkinson's disease.
- Exhaustion.
- Alcohol intoxication.
- Internal bleeding.
- Iron-deficiency anemia.
A low temperature for several weeks can be observed in people during the recovery period from illness. This is especially true for children and the elderly.
High fever is one of the main signs of infections inflammatory processes in organism. How to distinguish a symptom from systemic thermoregulation disorders?
- Other symptoms.
- Psycho-emotional state of a person.
- Reaction to non-steroidal anti-inflammatory drugs.
- General blood analysis.
- Virus antibody test or bacterial culture.
Fever is a protective and adaptive reaction developed in the process of evolution, which develops as a result of exposure to the body of pyrogenic agents and consists in establishing its heat balance at a new, higher level.
The term febris (fever, fever) has been known in medicine since ancient times. Since the vast majority of infectious diseases (in the ancient period and in the Middle Ages it was the leading pathology of mankind) was accompanied by a vivid picture of a febrile state (chills, fever, confusion of consciousness), fever has long been considered as a kind of typical reaction, but for a long time it was rather a nosological concept. , that is, it had the "status" of an independent disease ("febrile illness", "swamp fever", "forest fever", etc.). Traditionally, this trend has continued to this day: as independent nosological forms, they have been identified, for example. "Yellow fever", "Q fever", "rocky mountain fever", etc.
However, gradually in the medical world, the concept of fever as a symptom complex typical for many diseases of various etiologies (both infectious and non-infectious) began to be established. In this case, the main, leading symptom of fever was and remains overheating of the patient's body, the accumulation of heat in it. With the development of ideas about the physiological mechanisms of thermoregulation in homeothermic organisms, the first theories of the pathogenesis of febrile states appeared. So, back in the sixties of the XIX century, the idea arose that fever is the result of a significant increase in heat production in the human body in the absence of a level of heat transfer balanced with this process. At the same time, it was revealed that an increase in the body temperature of a febrile patient does not have a significant dependence on the ambient temperature. So it was established a radical difference between fever and hyperthermia. At the same time, it was suggested that "fever" (pyrogenic) substances cause fever due to their effect on the thermoregulatory centers located in the brain. Numerous studies of this common and characteristic symptom for a variety of diseases have made it possible at the present time to create a fairly clear theory of the onset and development of fever.
An increase in body temperature and the transition of the thermoregulation system to a new, higher level of functioning occurs as a result of exposure to the body of biologically active substances - pyrogens.
Pyrogens are classified into exo- and endogenous.
Exogenous pyrogens enter the body from the outside, and endogenous ones are formed in the body itself either during the decay of dying tissues, or are the result of the interaction of exogenous factors with certain cells of the body.
Microbiological and biochemical studies have made it possible to identify a number of both exo- and endogenous pyrogens. Thus, pyrogens were isolated from the cell membranes of some microbes by high purification, which in their own way chemical composition turned out to be polysaccharides or lipopolysaccharides (pyrogenal, pyromene, pyrexal, etc.). It was also found that some protein substances in the microbial cell also have a pyrogenic effect. Purified exogenous (microbial) pyrogens (poly- and lipopolysaccharides) are thermostable, non-toxic, have no antigenic properties.
Endogenous Pyrogens are formed in the body during phagocytosis of microbial cells, as well as tissues damaged by neutrophilic leukocytes and other phagocytic cells. Endogenous pyrogens, of which the leukocyte pyrogen is the best known, are thermolabile.
The general scheme of the effect of pyrogenic substances on the body is as follows. When exogenous pyrogens enter the internal environment of the body, as a result of their phagocytosis, endogenous pyrogens are formed, most of which are of a protein nature. Endogenous pyrogens can persist for a long time in the internal environment of the body. It is their effect on the centers of thermoregulation that ensures the development of febrile conditions. In aseptic inflammation, fever is the product of only endogenous pyrogen exposure to the body.
However, it should be borne in mind that fever can be caused by the introduction of simpler organic and inorganic compounds into the body. For example, β-tetrahydronaphthylamine, lysergic acid diethylamide (LSD-25), 2,4-α-dinitrophenol, as well as neurotropic drugs such as phenamine, caffeine, cocaine, etc., have these properties. Finally, fever can also be caused by large the amount of NaCl ("salt fever"). Of course, the mechanism of action of these substances on the body is different: this is a direct effect on the centers of thermoregulation, and the effect on metabolic processes. So, for example, 2,4-α-dinitrophenol not only sharply increases oxidative processes, but also helps to uncouple the processes of respiration and phosphorylation.
According to modern concepts, the mechanism of action of pyrogenic substances includes humoral and reflex Components.
Humoral the component lies in the fact that pyrogenic substances, reaching the preoptic region of the anterior hypothalamus with the blood, significantly increase the excitability of cold heat-sensitive neurons and reduce the excitability of thermal ones, as a result of which heat production increases and heat transfer decreases. The body is accumulating heat, which is facilitated by a kind of "misinformation" of the thermoregulation system. The increased sensitivity of cold thermoneurons causes the body to perceive normal ambient temperature as an effect of cooling. As a result, the skin blood vessels spasm, sweating stops, an arbitrary contraction of individual groups of skeletal muscle fibers and skin muscle fibers going to the hair follicles begins, that is, muscle tremors develop - the most effective way of urgent heat production. The patient, even in a warm room, freezes, chills. This is how the first stage of a febrile reaction develops - stage of rise in body temperature (stadium incrementi). Subsequently, against the background of an increase in temperature, the heat transfer mechanisms begin to intensify. After a while, the levels of heat production and heat transfer are compared, and their balance is established at a new, higher level. This is how it develops second stage of fever - stage of plateau (stadium fastigii). The chill stops, the opened cutaneous blood vessels cause the development of arterial hyperemia, and due to the increased flow of warm blood from the deep regions of the body, heat is "dumped" into the external environment.
The duration of the second stage of fever depends on the nature of the pathological process. After a certain period of time, it ends and changes the third stage - the stage of temperature decrease (stadium decrementi), during which the temperature drops to its original value (or even to lower values \u200b\u200bdue to a certain inertness of thermoregulatory systems). The drop in temperature basically contains a significant predominance of heat transfer processes over heat production processes. The main mechanisms that provide a drop in body temperature are the expansion of skin vessels and profuse sweating. By the end of this stage, heat production also begins to decrease, since dying microorganisms (in the case of the most common infectious fever) cannot supply new doses of exogenous pyrogens, and endogenous pyrogens are destroyed by active enzyme systems. The drop in temperature can be gradual (lysis) and fast (the crisis). A critical drop in temperature, associated primarily with a sharp expansion of the skin vessels, is often accompanied by collapse, that is, a state of vascular insufficiency with a rapid and significant drop in blood pressure, which can even lead to death.
In the development of a febrile reaction, a certain role is played by reflex component. In an experiment on animals, it was possible to induce the development of fever in response to presentation of a conditioned stimulus, if it was repeatedly combined with the introduction of a dose of pyrogen. A sharp slowdown in the febrile reaction was observed in the case when the pyrogen was injected subcutaneously into the previously novocainized area. These facts indicate that the role of the central nervous system and, in particular, the cerebral cortex in the development of a febrile reaction is quite large. Experiments with the introduction of neurotropic agents to experimental animals provide additional confirmation of this. Thus, psychostimulants (caffeine, phenamine) intensify the febrile reaction, and deep anesthesia inhibits its development.
The extensive experience accumulated by many generations of doctors who have observed and studied febrile states has made it possible to distinguish several types of temperature curves that characterize the development of fever.
First of all, the classification of febrile conditions is carried out according to the magnitude of the rise in temperature. From this point of view, the following types of fevers are distinguished:
1. Subfebrile fever at which the temperature ranges from 37.1 to 38.0 ° С.
2. Febrile fever with a rise in temperature from 38.1 to 39.5 ° С.
3. Pyretic fever characterized by temperature fluctuations in the range of 39.6 - 41.0 ° С.
4. Hyperpyretic fever - over 41.0 ° С.
Secondly, the classification of the types of temperature curves is carried out depending on their dynamics. ***** 29
1. Febris continua (permanent) - the temperature remains at the same level for a long time, and the difference between morning and evening temperatures does not exceed 1 ° С. This type of febrile curve is observed with croupous pneumonia, influenza.
2. Febris remittens (laxative) - fluctuations between morning and evening temperatures reach 1 - 3 ° C. This type of curve can be, for example, with severe angina.
3. Febris hectica (hectic, depleting) - fluctuations in the levels of morning and evening temperatures reach 3 - 5 ° C. Such a fever is observed, for example, with sepsis.
4. Febris intermittens (intermittent) - periodic, relatively short-term, but very high temperature rises are observed, which alternate with longer periods of their normalization, as, for example, in malaria.
5. Febris undulans (undulating) - characterized by a wavy dynamics of the temperature curve over several days (as a rule, of a continuous type). This kind of curve is observed, for example, with relapsing fever.
With fever, significant violation of the functions of the body and the activity of its organs and systems.
The cardiovascular system. Tachycardia is observed: an increase in heart rate by about 10 beats per minute with an increase in temperature by 1 ° C. This phenomenon is due to the fact that pyrogens irritate the sinoauricular node. Tachycardia and the increase in cardiac output caused by it contributes to the intensification of the heat transfer process.
Respiratory system. In the second and third stages of the febrile process, deep and frequent breathing occurs, which enhances heat transfer.
Excretory system. At the very beginning of the first stage of fever, due to general vascular spasm, a weakening of urine formation occurs, followed by an increase in urine output due to the onset of vasodilation and increased renal blood flow. In the second stage of the febrile reaction, despite the expansion of peripheral vessels, due to the increase in the secretion of aldosterone by the adrenal glands, sodium is retained, and therefore water in the tissues. Urine flow is reduced. In the third stage of fever, due to a sharp expansion of peripheral vessels and normalization of aldosterone production, urine output increases sharply.
Endocrine system. The activity of the endocrine glands changes with fever to varying degrees, without playing a leading role in its development. The state of the endocrine system largely determines the general resistance of the body before the onset of the pathological process, thereby indirectly influencing the severity of the febrile reaction. The pathology of individual endocrine glands can increase or inhibit fever. So, for example, in patients with thyrotoxicosis, fever develops more acutely and in a shorter time than in people who do not suffer from this pathology. With hypofunction of the thyroid gland (myxedema), the intensity of fever, on the contrary, is significantly reduced.
For digestive system characterized by a pronounced suppression of the activity of the digestive glands, which leads to a decrease in appetite.
Intensification of metabolic processes in the liver increases with the development of fever and decreases by the end of the third stage.
Functional state nervous system differs at the beginning of a febrile reaction in excitement, which, with a significant increase in temperature, is replaced by inhibition and oppression.
From the side metabolism in general, the predominance of catabolic processes over anabolic processes is noted. This is especially true of protein metabolism, and that is why most febrile conditions are accompanied by a negative nitrogen balance.
As is clear from the definition given at the beginning of this section, fever is a protective-adaptive reaction of the organism, developed in the process of evolution. An increase in body temperature with fever has a beneficial effect on the synthesis of antibodies, phagocytosis, and can also lead to the death of the infection, since microorganisms can develop normally only in rather rigid temperature limits. It is on this feature of fever that pyrotherapy method some infectious diseases, in particular, the last stages of syphilis (progressive paralysis, tabes dorsalis). This method was first successfully applied by the Austrian psychiatrist Julius Wagner-Jaureg, who in 1916 cured patients from progressive paralysis by inoculating them with malaria and causing them a strong febrile reaction.
At present, progressive paralysis of malaria, of course, is not treated using pyrogenic substances for this purpose.
At the same time, fever can also have a negative meaning for the body due to metabolic disorders it causes, primarily as a result of increased protein breakdown. At hyperpyretic temperatures, immunity is suppressed, there is a deep inhibition of the activity of the central nervous system. Ultra-high fever can lead to the death of the body.