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Why Does Having a Fever Make You Feel Cold?

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During fever, why do we feel cold when our body temperature rises?

Nicole Van Groningen:

Anyone who has ever had the flu knows that fever isn’t uncomfortable because you feel hot—it’s uncomfortable because you feel freezing cold. You get goosebumps, you’re shivering, you’re piling on the covers.

Fever, also known as pyrexia, is defined as an elevation in body temperature above the normal range due to an increase in the body’s natural set point. Most people associate fever with infections, but fever can also frequently occur with autoimmune diseases, cancer, drug reactions, and even blood clots. Fever is not a direct result of these conditions, but rather a consequence of triggering the body’s inflammatory pathways. One key member of this inflammatory cascade is a group of molecules called pyrogens, which directly interact with the hypothalamus in the brain to produce fever.

The hypothalamus serves as the body’s thermostat. When triggered by pyrogens, the hypothalamus tells the body to generate heat by inducing shivering, goosebumps, and constriction of blood vessels near the surface of the skin. It even causes a subjective feeling of cold, which encourages behavioral responses to raise the body temperature, like reaching for the covers.

All of these things are adaptive when your body temperature falls below its usual set-point (about 98.6 degrees Fahrenheit), which typically occurs in cold weather. But they become abnormal in the setting of fever, when your hypothalamus signals to the body to raise its temperature well above the normal range.

If pyrogens suddenly disappear from the bloodstream, as is the case with intermittent fevers, the hypothalamus all of a sudden senses that things are way too hot, and tells the body to kick in its usual cooling-off mechanisms. That’s why people sweat profusely when their fever “breaks.”

This post originally appeared on Quora. Click here to view.

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Big Questions
Why Is the American Flag Displayed Backwards on Military Uniforms?
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In 1968, famed activist Abbie Hoffman decided to crash a meeting of the House Un-American Activities Committee in Washington by showing up in a shirt depicting the American flag. Hoffman was quickly surrounded by police, who ripped his shirt off and arrested him for desecration of the Red, White, and Blue.

Hoffman’s arrest is notable today because, while it might be unpatriotic to some, wearing the American flag, burning it, or otherwise disrespecting it is not a violation of any federal law. In 1989, the Supreme Court ruled that it would be unconstitutional to prosecute any such action. Still, Americans have very fervent and strict attitudes toward displaying the flag, a longstanding symbol of our country’s freedom. According to the U.S. Flag Code, which was first published in 1923, you shouldn’t let the flag touch the ground or hang it upside-down. While there’s no express prohibition about reversing the image, it’s probably a safe bet you shouldn’t do that, either.

Yet branches of the U.S. military are often spotted with a seeming mirror reflection of the flag on their right shoulder. If you look at a member in profile, the canton—the rectangle with the stars—is on the right. Isn’t that backwards? Shouldn’t it look like the flag on the left shoulder?

The American flag appears on a military uniform
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Not really. The flag is actually facing forward, and it’s not an optical illusion.

When a service member marches or walks forward, they assume the position of a flagpole, with the flag sewn on their uniform meant to resemble a flag flapping in the breeze. With the canton on the right, the flag would be fluttering behind them. If it were depicted with the canton on the left, the flag would be flying backward—as though it had been hung by the stripes instead of the stars nearest to the pole. The position of the flag is noted in Army Regulation 670-1, mandating the star field should face forward. The official term for this depiction is “reverse side flag.”

As for Hoffman: His conviction was overturned on appeal. In 1970, while at a flag-themed art show in New York, he was invited to get up and speak. He wore a flag shirt for the occasion.

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Big Questions
What Causes Sinkholes?
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Mark Ralston/AFP/Getty Images

This week, a sinkhole opened up on the White House lawn—likely the result of excess rainfall on the "legitimate swamp" surrounding the storied building, a geologist told The New York Times. While the event had some suggesting we call for Buffy's help, sinkholes are pretty common. In the past few days alone, cavernous maws in the earth have appeared in Maryland, North Carolina, Tennessee, and of course Florida, home to more sinkholes than any other state.

Sinkholes have gulped down suburban homes, cars, and entire fields in the past. How does the ground just open up like that?

Sinkholes are a simple matter of cause and effect. Urban sinkholes may be directly traced to underground water main breaks or collapsed sewer pipelines, into which city sidewalks crumple in the absence of any structural support. In more rural areas, such catastrophes might be attributed to abandoned mine shafts or salt caverns that can't take the weight anymore. These types of sinkholes are heavily influenced by human action, but most sinkholes are unpredictable, inevitable natural occurrences.

Florida is so prone to sinkholes because it has the misfortune of being built upon a foundation of limestone—solid rock, but the kind that is easily dissolved by acidic rain or groundwater. The karst process, in which the mildly acidic water wears away at fractures in the limestone, leaves empty space where there used to be stone, and even the residue is washed away. Any loose soil, grass, or—for example—luxury condominiums perched atop the hole in the ground aren't left with much support. Just as a house built on a weak foundation is more likely to collapse, the same is true of the ground itself. Gravity eventually takes its toll, aided by natural erosion, and so the hole begins to sink.

About 10 percent of the world's landscape is composed of karst regions. Despite being common, sinkholes' unforeseeable nature serves as proof that the ground beneath our feet may not be as solid as we think.

A version of this story originally ran in 2014.

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