216 ON THE NATURE AND PRINCIPLES OF 



quence of determination of blood ; its supervention 

 upon the latter disorder being very frequently induced 

 by the co-existence of a state of general plethora. 

 As the disease under these circumstances originates 

 rather in the arteries, than in the capillaries, of the 

 affected part, an early and vigorous use of measures 

 calculated to fulfil the first-mentioned therapeutic 

 indication, will generally suffice for the restoration 

 of the capillary circulation to its normal state. But 

 when, as more frequently happens, the distending 

 pressure of the accumulated blood has been permitted 

 to act for a length of time upon the walls of the 

 capillaries, the contractility of these vessels becomes 

 gradually exhausted throughout the whole, or a 

 great portion, of their extent ; they cease to oppose 

 any active resistance to the dilating force of the con- 

 tained fluid columns ; the effusion of fibrinous and 

 albuminous matter, or the extravasation of blood, 

 proceeds uninterruptedly, and a tedious and probably 

 imperfect recovery is the most favourable result which 

 can be expected. 



Before, however, considering at greater length the 

 principles which should regulate the employment of 

 the more active antiphlogistic remedies, a few words 

 on the diagnosis of internal inflammation may not be 

 altogether misplaced. For every careful and candid 

 practitioner must have occasionally experienced. the 

 difficulty of distinguishing between cases of real and 

 merely apparent inflammation, and will also admit 

 the possibility of inflammatory disease proceeding in 

 a vital organ to a dangerous and even fatal extent, 

 without occasioning, during it^ progress, anv per- 



