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thought that they were dying from burns or from injuries caused by the shock wave. The doctors were moving quickly from one victim to the next, treating burns and lacerations and broken bones in what had become, in an instant, a ruined city. But very quickly a pattern emerged: nausea, headache, diarrhea, malaise, massive hair loss, and fever. What is now called acute radiation syndrome (ARS) was killing off survivors. Among other things, the radiation attacked blood cells as they were generated in bone marrow. A few days later, when these damaged blood cells entered the bloodstream, survivors fell ill.
    At Hiroshima, two key symptoms became apparent: high fever and low white blood cell counts. Patients with fevers that remained high or with white blood cell counts that dropped below one thousand generally died. Fevers could climb as high as 106 degrees.
     
    In Old English, fever was fefor, said to have come from the Latin word febris, which itself may have come from the Latin word fovere, meaning “to warm” or “to heat,” as in warming a kettle of tea or heating a bowl of soup. Fovere can be traced to an earlier word, something like dhegh, from the hypothetical proto-Indo-European language of nearly six thousand years ago, where it may have meant “burn” and may have led in other directions to mean “heat” and then “day,” recognizing that daylight brought warmth. There is also a possible link to the Sanskrit bhur, meaning “to be restless.” In German, it is fieber, and in Swiss it is feber.
    Ancient Egyptians, Chinese, and Mesopotamians had dissected enough bodies to understand anatomy, but fever was attributed to evil spirits.
    Pliny the Elder, Roman soldier and scholar, completed his thirty-seven volume Natural History in AD 77, filling it with observations and anecdotes, covering topics from astrology to agriculture. He wrote of fever: “Some persons are distressed by a perpetual fever. Such was the case with C. Mæcenas; during the last three years of his life, he could never get a single moment’s sleep. Antipater of Sidon, the poet, was attacked with fever every year, and that only on his birthday; he died of it at an advanced age.” Pliny wrote that all men experienced fever, with the exception of one particularly healthy specimen, Xenophilus the musician, who lived to be 105. Pliny knew about malaria and recognized its pattern of high temperatures coming and going, cycling through as if driven by a clock.
    Years after writing about fever, Pliny died during the eruption of Vesuvius.
     
    In the middle of the nineteenth century, in the time of Faraday, the German physician Carl Wunderlich grew interested in fevers. Over sixteen years, he compiled data on twenty-five thousand patients. He used a thermometer that could require twenty minutes to stabilize. Wunderlich promoted the reality of fever as a symptom of illness rather than an illness in its own right. In 1871 he wrote, “All abnormal temperatures denote a disease, but all diseases do not show an abnormal temperature.” From another passage: “The temperature may be determined with a nicety which is common to few other phenomena. The temperature can neither be feigned nor falsified. We may conclude the presence of some disturbance in the economy from the mere fact of altered temperature.”
    Wunderlich was not interested in why warm-bloodedness and certain sicknesses were accompanied by the fever response. “And though theoretical questions as to human temperature and kindred subjects must not be overlooked,” he wrote, “my purpose has been to prepare from these notes a practical book.”
    Fever arises when a foreign substance, such as a lipopolysaccharide in the cell wall of a bacterium, triggers the release of cytokines from white blood cells. The cytokines signal a part of the brain just above the brainstem and straight back from the bridge of the nose—a part of the brain called the hypothalamus—to turn up the heat. Muscles