Among the principal clinical alterations noted during the onset of acute infections, the chill plays a notable part. By this term is designated a number of phenomena, the most obvious being the muscle tremor and the actual sensory perception of cold by the patient.
The association of the chill with the invasion of the blood stream by bacteria has been so well established ever since the work of Schottmüller1 that we feel justified in accepting the clinical phenomenon as evidence of blood invasion during an infectious disease. This acceptance of the fact of invasion by no means gives an explanation of the ultimate mechanism involved.
Schottmüller found that the mere presence of bacteria in the blood did not cause a chill. The chill takes place some time after the invasion (from thirty to ninety minutes, depending on the number and type of organism and also on the person involved). From