MINIMAL SURGICAL SUBJECTS.
Sympathetic Fever. No part of the ani mal body can be very considerably disor dered, without occasioning a correspon dent derangement of the whole constitu tion. Such disorder has been considered by Mr. Hunter as the result of universal sympathy. This consent of the whole constitution with its parts manifests itself in particular instances, by a greater dis turbance of the functions of some organs than of othe rs ; and from this circumstance these diseases have derived the appella tons by which they are commonly dis tinguished. If the actions of the sangui. ferous system be principally disturbed, and the temperature of the body subject to unnatural variations, the disease is term ed fever; if the nervous system be chief ly affected, a state of vigilance or deliri um may be produced ; convulsions and tetanus take place, when the muscular system is more particularly disordered. Though the especial disorder of particu lar organs thus gives a character and de nomination to the disease, it is sufficient ly evident, in every instance, that the whole constitution is disturbed.
The fever which accompanies local accident or disease has been termed symptomatic, as if it were one of the symptoms of the local disorder ; the epi thet sympathetic is preferable, as it is founded on the real nature of the disor der, viz. a sympathy of the whole consti tution for the disturbed state of a part.
The sympathetic inflammatory fever is accompanied with a frequent, strong and full pulse, hot and dry skin, scanty and high coloured urine, dry furred tongue, thirst, lossof appetite and sleep : in some cases delirium.
When the local affection is in such parts as are essential to life, the powers of the constitution seem to be much depressed ; and the pulse is frequent and small.
Treatment. The cure of the local inflam mation which excites and keeps up this sympathetic disturbance of the whole constitution, is the most effectual step for stopping the general disorder. But as the fever may react on the local disorder, palliative means may be necessary for the constitutional symptoms. Bleeding, sa line purgatives, and diaphoretics, as the preparations of antimony, and the aqua ammonia acetate, are the best means. The use of the lancet is only advisable where the local mischief is to be feared on account of its situation or extent.
The sympathetic fever, just described, is produced by the irritation of a local injury upon a healthy constitution ; when, however, the disease has continued un subdued for a long time, the constitution still sympathizes, although in a different manner; and the disorder then produced is called the sympathetic hectic fever. This form of constitutional sympathy at tends such local affections as debilitate and harass the frame ; and it is the reac tive effort of an irritated and weakened constitution. The symptoms are, a fre quent, small pulse, moist skin, pale and copious urine, great weakness, moist tongue, deficient appetite, often sickness, nocturnal sweats, loss of sleep, indiges tion, &c.
Treatment. The alleviation or removal of the local complaint is the most effectu al remedy. When this cannot be accom plished, we must try to strengthen the patient ; and if there were a medicine possessing the direct power of communi cating strength to the constitution, these cases would be very proper for its em ployment. Particular symptoms may be combatted, so as to keep all the functions in a state approaching as nearly as we can to that of health, and digestion pro moted. Bark, with gentle cordial and aromatic draughts, are the most proper medicines. The food should be light and nourishing, and taken frequently in small quantities. Opium is often of great ser vice, both in procuring sleep, and in checking the purging.
Disorder of the digestive Organs. The stomach and bowels bear a considerable share in the sympathetic derangements already considered. But in many instan ces of local complaints they are deranged in a still more striking way ; and again, a disturbed state of these organs, arising from various causes, will either give ori gin to various obstinate local complaints, or very much increase the difficulty of their cure. Many observations connect ed with this subject are scattered in the works of surgical writers ; but the public are indebted for a general, scientific, and original view of the whole subject, to Mr. Abernethy ; to whose surgical observa tions we must refer the reader.