Broussais, on the contrary, contends that the primary and essential seat
of inflammation in fever is the mucous membrane of the stomach, or of
the intestines, or both, but especially the former, and that, therefore,
the proper designation of it is _gastro-enteritis_. While it had long
been conceived that inflammation of the digestive organs is the cause of
certain symptomatic fevers, Broussais maintains that the most important
discovery (most important because so intimately connected with the
treatment of the disease) that this affection is the cause of all
fevers, idiopathic as well as symptomatic, and that there are in fact no
essential fevers, is peculiarly and exclusively his own. Thus, according
to this theorist, all the fevers of authors are connected with
gastro-enteritis, simple or complicated. “The simultaneous or successive
inflammation of the stomach and small intestines, designated by this
term,” says M. Rayer, “is of all the phlegmasiæ the most frequent, and
at the same time that which has been oftenest overlooked or mistaken. It
is not designated in any nosological table. Not long ago gastritis
itself was generally looked upon as a very rare disease: of twenty-eight
thousand two hundred and ninety-nine sick admitted into the civil
hospitals of Paris in 1807, six only were designated in the returns as
labouring under inflammation of the stomach, whilst six thousand one
hundred and forty-three were treated for continued or remittent fevers.”
The prevailing doctrines relative to the nature and seat of fever at
present then are two, the direct reverse of each other; one, that it is
a general disease affecting the entire system; that this affection of
the system consists of debility which is manifested first in a loss of
energy of the brain, but which rapidly extends to every organ and every
function, and that consequently _the absence of any primary local
disease_, ought still to form, as it has so long formed, an essential
part of the definition: the other, that it is in the strictest sense a
local disease; that its primary seat is invariably fixed in some one
organ; that the affection itself consists of inflammation; and that that
inflammation is seated, according to one opinion in the brain; according
to the other in the stomach.
Public-domain text, read in full here on John Shaqi.
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