In general, the removal of the hectic cause is followed by immediate
melioration of the symptoms, even though the patient has been reduced
to an almost moribund condition: the feeble hectic pulse of 120 or 130
sinks in a few hours to 90, and becomes more full and strong; anxiety
and restlessness cease, and a patient sleeps soundly the first night
after the operation, who for weeks had scarcely closed his eyes; the
cold sweats and colliquative diarrhœa immediately subside, and the
urine loses its sediment; in effect, all the hectic symptoms disappear,
and are succeeded by such as indicate a marked improvement in the power
and energy of the constitution; and the rapidity with which these
changes take place is in many cases truly astonishing. Nourishing food,
wine, tonics, &c., must be given, in the first instance sparingly, and
afterwards gradually increased in quantity, according as the stomach
can bear them; for it is not to be overlooked, that incautious and too
liberal use of them may be productive of irretrievable evils, as the
action of the system may be increased beyond its resources, in the same
way as the imprudent application of stimulants to a part debilitated
by an excessive degree of cold causes its sphacelation, in consequence
of the arterial action induced being greater than what the power of
the part can support. The mineral acids may be useful in checking
the inordinate perspiration; opium, astringents, and absorbents, in
arresting the diarrhœa; but all are of little avail unless the exciting
cause is removed, and to this latter circumstance the attention of
the practitioner ought therefore to be chiefly directed. It is not
always quite safe, however, to free the patient at once of a great
suppurating drain. Upon the healing up of extensive and long-continued
ulcers, it is often necessary, in order to prevent oppression of and
congestion in the viscera of the chest, abdomen, or head, to insert an
issue or seton, and gradually withdraw it. In amputations also, more
especially in patients above the middle period of life, to rid them of
disease which has caused hectic and wasting, in consequence of profuse
discharge, it is often advisable to keep part of the wound open, so
that it may suppurate, heal, and dry up slowly.
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