137 



CONGESTION. 



CONGREGATION. 



133 



this Act it is provided that upon every avoidance of an archbishopric or 

 bishopric the king may grant to the dean and chapter a license under 

 the great seal to proceed to the election of a successor, and with the 

 license a letter missive containing the name of the person whom they 

 are to elect. If the dean and chapter delay their election above twelve 

 days after receiving the license, the king may, by letters patent, 

 nominate any person whom he pleases to the vacant see ; if they delay 

 the election beyond twenty days, or elect any other person than the 

 candidate recommended by the king, or do anything else in contra- 

 vention of the Act, they incur the penalties of a prscmunire. Bishop- 

 rics in Ireland are donative by letters patent, without a congu d'eslire. 

 (' Irish Stat.,' 2 Eliz., c. 4.) 



CONGESTION, a preternatural accumulation of blood in the ca- 

 pillary vessels of the sanguiferous system, attended with disordered 

 function of the organs in which such an accumulation takes place. 

 The main functions of the sanguiferous system are performed by the 

 ultimate divisions of the blood-vessels, called, from their hair-like 

 minuteness, capillaries ; the office of the main trunks and the larger 

 branches of the blood-vessels being merely to convey to the capillaries 

 the material acted upon by them in the various processes which they 

 perform. In the natural and healthy state of an organ, the arterial 

 capillaries in which the arterial trunks that supply it with arterial 

 blood terminate, receive a certain quantity of blood ; retain that blood 

 a given tune ; and then transmit it with a given impetus into the 

 venous capillaries, which in their turn convey it into the larger venous 

 branches, and these to the heart with a given degree of velocity. 

 Upon this transmission of the blood to and from the organs in a given 

 quantity and a given time, depends the balance of the circulation ; 

 upon the due balance of the circulation depends the healthy condi- 

 tion of the organic processes ; and upon the healthy condition of the 

 organic processes depends the sound performance of the animal func- 

 tions. 



Of the mode in which the balance of the circulation is disturbed by 

 the preternatural accumulation of blood in the capillary vessels, some 

 conception may be formed by observing the phenomena that take place 

 when a mechanical or chemical irritant is applied to a transparent part 

 of the animal body ; and when such a part is brought under the field 

 of the microscope, so that the circulation in the minute vessels can be 

 distinctly seen. In this case, the first phenomenon observable is a 

 quickened circulation in the part, and the consequent determination to 

 it of a greater quantity of blood ; next, after a time, the blood-vessels 

 are seen to dilate and to become turgid with blood ; and in the third 

 place, the flow of blood through these distended vessels is manifestly 

 retarded ; and ultimately, if the irritating cause continue to operate 

 with a certain degree of intensity, the circulation is wholly stopped. 

 The quickened circulation, the first phenomenon that takes place, is 

 occasioned by the action of the contractile power inherent in the 

 coats of the capillary vessels, excited in an inordinate degree by the 

 application of the unusual stimulus. The dilatation of the capillary 

 vessels, the subsequent event, arises from a diminution of the vital 

 power of the coats of the vessels, from the over-excitement produced 

 by the irritating cause. 



The blood-vessels in this state are commonly said to have lost their 

 tone ; to be debilitated or weakened. The consequences of this loss 

 of vital power in the living tissues that form the walls of the blood- 

 vessels, are the engorgement of the vessels, the impeded, retarded, or 

 abolished circulation of blood through them, and the disordered or 

 suspended function of the part affected. 



From the preceding statement, a distinct conception may be formed 

 of that morbid condition of the blood-vessels, to the designation of 

 which the term congestion is commonly applied. How greatly such a 

 condition of the blood-vessels must disturb their natural functions, 

 and consequently how powerful an agent it must be in the production 

 of disease, it is also easy to conceive. But pathologists have hitherto 

 made but slight progress in determining with precision the nature of 

 the morbid changes which take place, either in the blood-vessels them- 

 selves, or in the tissues in which, as a consequence of this affection, an 

 alteration of structure is sometimes ultimately superinduced. 



From an observation of the phenomena connected with the state of 

 congestion, it i usually distinguished into passive and active. When 

 there is merely an accumulation of blood in the distended and debili- 

 tated capillaries, without any other manifest morbid phenomenon, the 

 state is called simple congestion ; and this state of congestion is com- 

 monly said to be passive. But when to this accumulation of blood 

 there are superadded certain phenomena which accompany and which 

 characterise another morbid state, namely, inflammation, the conges- 

 tion is termed active. In active congestion, the blood-vessels them- 

 selves are in a state of excitement ; the preternatural quantity of blood 

 they contain is determined to them by then- own inordinate activity ; 

 they are in a condition not of diminished but of exalted vital energy. 

 In passive congestion, on the contrary, the coats of the vessels are 

 destitute of their natural tonic, vital resistance ; yield readily to the 

 current of blood which is determined to them, or unable to pass on 

 the current they receive, the blood accumulates in them and distends 

 them. Active congestion, according to this account, however, can be 

 distinguished by no certain and even no appreciable character from 

 inflammation, a state which is always supposed to be different from 

 congestion. 



The tissue of the body in which the state of congestion is most apt 

 to occur, is the cellular, and more especially in the lax and little 

 cohesive condition in which this tissue forms the parenchyma of the 

 different internal organs, as the brain, the lungs, the liver, the spleen, 

 the kidneys, and so on. A congested state of their blood-vessels is 

 also peculiarly apt to occur in the mucous membranes, and more 

 especially in the mucous membranes of the bronchi and air vesicles of 

 the stomach and the alimentary canal, and of the ovaria and uterus. 

 But besides these, other and less yielding structures, as the serous and 

 fibrous membranes, the skin, and even the muscles, may be affected 

 with congestion, after the operation of causes which have exhausted 

 the vital energies of the system in general, or which have diminished 

 the vital cohesion of these structures in particular. 



Congestion, when present to any considerable extent, and when con- 

 tinuing for any length of time, disorders the function of the organ in 

 which it takes place. The signs of this disordered function are signs 

 from which it is inferred that congestion is present. If, for example, 

 the blood-vessels of the brain be in a state of congestion, the activity 

 and energy of the cerebral functions will be diminished, indicated by 

 duluess, heaviness, forgetfulness, inaptitude for mental labour, giddi- 

 ness, lethargy, and so on ; and if the congestion be in great intensity, 

 it may produce all the symptoms of coma and even of apoplexy. [Apo- 

 PLEXT ; COMA.] If the blood-vessels of the liver be in a state of con- 

 gestion, the secretion of bile will be disordered; altered in quality. 

 diminished in quantity, or entirely suppressed. If the blood-vessels of 

 the mucous membrane of the air passages be in a state of congestion, 

 it will occasion uneasiness in the chest, difficulty of breathing, 

 cough, &c. 



Congested states of these and other organs are exceedingly apt to 

 occur in the progress of other diseases, more especially in the different 

 types of fever, the character of which they modify, and the severity 

 and danger of which they always greatly increase. There are fevers, 

 indeed, and those of the very worst kind, that is, the most intense arid 

 the least under the control of any known remedies, in which a high 

 degree of congestion of the blood-vessels of the brain, of the lungs, of 

 the liver, or of the mucous membrane of the intestines, is among the 

 very first appreciable morbid conditions of the system ; but in general 

 such a congested state of the blood-vessels is consequent upon pre- 

 ceding morbid conditions of the organs ; conditions by which the vital 

 energies of the blood-vessels have been exhausted. 



The appearances presented by congested parts after death, vary with 

 their structure and with the degree and dxiration of the affection. The 

 capillary arteries and veins are turgid with blood ; the blood they 

 contain is of a darker colour than natural ; hence the colour of the 

 organ, the seat of the congestion, is darker in proportion to the inten- 

 sity of the affection ; it is also commonly more or less swollen, and the 

 cohesion of its tissues is diminished, so that they are more readily 

 torn than when in a healthy condition. In some organs, indeed, as in 

 the liver and the spleen, when the congestion is in an extreme degree, 

 the cohesion of the component tissues is so much lessened that the 

 organs are broken down on the slightest pressure. 



Anything may be the cause of congestion which diminishes the vital 

 energy of the capillary vessels; or which changes, beyond a certain 

 limit, the quantity and quality of the blood they contain. If the vital 

 energy of the capillaries be diminished, they cannot maintain the 

 tension necessary to prevent distension of their parietes, and a con- 

 sequent preternatural accumulation of blood. If the quantity and 

 quality of the blood they contain be altered, their natural stimulus 

 may be so deficient as not to excite, or so excessive as to exhaust them. 

 For the treatment of congestion, see INFLAMMATION. 



CONGREGATION most commonly signifies an assembly of persons 

 for the purpose of public worship and religious edification. It denotes 

 more particularly a number of ecclesiastics constituting a legislative 

 and executive body ; and in this acceptation it is applied chiefly to 

 certain boards of administration consisting of cardinals and of prelates, 

 or aspirants to the cardinalship in Rome. These congregations serve 

 as a check on the papal authority ; for though their proceedings are 

 usually sanctioned by the pope, he cannot, without alleging the 

 weightiest reasons, put a veto on them. The whole number of these 

 congregations is twenty-one ; that is, fifteen for spiritual and six for 

 temporal purposes. Congregation is also used to designate a company, 

 society, or fraternity of monks forming a subdivision of an order, as 

 the congregation of the Oratory, or of Cluuy among the Benedictines. 

 The Congregation of the Lord was an appellation assumed by the 

 Scotch Presbyterian Reformers, who called the Church of England the 

 congregation of Satan. They appeared first in 1557, under the Earl of 

 Argyle, and were subsequently led by John Knox. 



C'utiffreyationalists are those who compose the congregations which 

 assume an independence not only of the ecclesiastical control of the 

 established hierarchy, but of all authority extraneous to the consti- 

 tuency of the congregation itself. They may therefore in general be 

 said to be identical with the Independents. They are said by some to 

 have appeared first in 1616, under the conduct of Mr. Jacob. (Evans's 

 ' View.') But they are generally considered to be of the same origin 

 as the Brownists, who appeared in 1600. [BROWN, ROBERT, in BIOG. 

 Drv.] The real founding of this sect is attributed to Mr. Robinson, in 

 1640, and the following passage from his ' Apology ' (c. 5, p. 22) ia 

 adduced ao their ha-ling maxim : " Cretum quemlibet particularem 



