INFLAMMATION. 



INFLUENZA. 



that which perhaps constitutes the nssentisl element of the iuflam 

 matnry process u the exudation of the lym|4i or liquor sanguinis. 



In view of these phenomena, modern pathologist* have adopt 

 uuury theories with regard to the nature of the change* undergone \iy 

 the tiue* in this state, Whilit tome hare thought the bloot 

 globules themselves were at fault, others bam attributed the state U 

 the condition of the nerves of the part, and others again bare tract* 

 t h. change* to the c mdition of tin- capillary vciuel*. All however agree 

 that inflammation involves an altered supply of Uil to the intlamcc 

 part, and a changed condition of the nutritive processes of the blood. 

 The results of this prooew, although .-minimi up in the three teroii 

 nations before mentioued, may I* still further developed. Thus wit] 

 ilr. 1'agct, we may divide these effects into protluctirc and dcntrurt i n 

 live effects are effusions or exudations which are sugcep- 

 nnam-nt developimiit, and also of degeneration. The 

 - f the inflammatory process are softening, degene 

 , .i)>~>rption, uKvr.iti.'ii and death of tisane, or mortification. W< 

 will In i, meifly indicate the nature of these resiii 



i'jniriu* or cntlatiux. Aeeotding to the tissue in which intlum 

 illation occurs, will be the liquid nature of the exudation. Iu serous 

 m. inhranes the exudation is attended with so much water or serum 

 that Urge accumulations of water take place, pnxlucing what ia collet 

 dropsy or effusion. A good example of effusion from inflammation is 

 the action of a common blister. In all ca--es of effusion of serum, a 

 quantity of fibrin is poured out which is left after the water has been 

 absorbed. This is seen in inflammation of the peritoneum, pleura, am 

 pericardium. The distinction between effusion from obstruction, am : 

 effusion from inflammation is, that the latter contains orgoiu&iblt 

 matter, whilst the former does not. 



Blood is sometimes effused during the process of inflammation by 

 the rupture of the capillaries. This effusion must not be confoundec 

 with luemorrhage from accidental rupture, which produces quite n 

 different appearance in* the part. The Utter is bright red, whilst the 

 former is yellow-red or brown. 



The plastic matter exuded from the blood-vessels during inflam 

 mation U called ''inflammatory lymph." or " coogulable lymph," or 

 "exudation." Its inuet characteristic general properties are, that it 

 is capable of spontaneously organising itself, and that thus organi>ed it 

 may proceed by development to the construction of tissues like the 

 natural structures of thu body. It is, however, occasionally modified, 

 and, instead of producing natural structures, it produces structures 

 different from those existing in the body. The exudation, producing 

 new or heterologous formations, has been called 1 >y Williams tuH-iy-lttfti'' 

 whilst Bennett divides exudation into timjJe, tuberculous, and cancerous. 

 '- The rimjJt variety of exudation produces different results, accord- 

 ing to the following circumstances : 



1. The nature of the tissue in which the exudation takes place. 



2. The time at which an exudation is examined after iU occurrence. 



3. The state of the blood in which it takes place, as in small-pox, 

 scarlet fever, tc. 



4. The amount of vascularity of the affected port. 



5. The amount of local exudation. 



6. The suddenness with which the exudation has taken place. 



7. The persistence of the inflammatory process. 



8. The amount of fluid or water poured out with the inflammatory 

 lymph. 



These circumstance* modify the appearances which will be presented 

 by an inflamed port, and will also modify to a less considerable extent 

 tin- local and general symptoms of inflammation. 



On examining the lymph or exudation under the microscope, it is 

 found to consist of a liquid containing in it corpuscles which are called 

 "exudation cells." They are rough on the surface, and about the 

 rJkth to the sjijth of an inch in diameU-r, and at first present neither a 

 distinct cell-wall nor nucleus, but afterwards a distinct nucleus is seen 

 in them. From the lymph thus constituted proceed all the forms of 

 secondary deposit* which are found resulting 1'rom inflammation. 

 These primordial cells pass into all the conditions of texture which are 

 found in the tissue in which inflammation takes place, as muscle, 

 nerve, bone. Ice. 



These cells are exposed to various forms of degeneration. When what 

 U called suppuration comes on they form the "pun cells," and other 

 cells which have been described by microscopic pathologist*. Suppu- 

 ration it either circumscribed, diffused, or superficial. The circum- 

 scribed is well seen in the common abscess, boil, or phlegmon. Thu 

 diffused in pblegmonous erysipelas and purulent ill Miration, whilst 

 superficial suppuration is observed in purulent ophthalmia and inflam- 

 mation of mucous surfaces. 



The remit of the tuberculous and cancerous forma of exudation is 

 the production of deposits known by the names'oi cancer and tubercle. 



i Lt] 



The destructive effects of inflammation are seen in softening, alorp- 

 tion, nice-ration, and mortification more particularly. In softening there 

 u little or no plastic power in the lymph thrown out, and the tissues 

 attached lose their natural cohesivencm. This inflating occurs in 

 inflammation of the mucous membranes, of the brain and spinal cord, 

 and of the bones. Altorptvm frequently occurs with softening, and 

 this is seen in the common process of the pointing of an abscess, in 

 which the tismies soften and are absorbed. 



I ,crration occurs on open surfaces, and is the result of on exi 

 of inflammatory lymph, in which the corpuscles are forn 

 cells, and an abiorpttas] of t|, inflamed tissues takes place. Ku<-h 

 an absorption may take place entirely in i Mood ve 



in cartilage, and is nevertheless called uleer.it. -H. tiranuht: 

 reparative process that occurs in ulcerated surfaces, and consists in tho 

 organisation of the lymph thrown out from the ulcerated Kiiri.e 

 lly leads to thu reparation of thu parts destroyed 1 

 softening and absorptive processes. Mort(ticatioH takes place when thu 

 vital processes of inflammation cease in a (art. Parts : 

 extensive, or the whole of on organ may display this tei. ,'..,;.. U 

 may be attended with effusion, or it may be dry. All ti 

 liable to tho occurrence of this termination of thu inflammatory 

 .. , . .. 



General Symptoms. The symptoms attendant on inflammation will 

 vary of course with the extent, position, and nature of tl: 

 affection. It should, however, be recollected that an extensive in- 

 flammation may come on slowly, and not present any . .I'toms 

 at all, and that the general symptoms of inflammatory fever may be 

 present without any inflammation. There are however certain : 

 symptoms of inflammation which are so frequently present that they 

 constitute what is called inflammatory i; or sympathetic 

 fever. This fever is attended with preiuonitor;, 

 and shivering, which ore succeeded by a reaction. The pulx-. 

 is at first small and alow, becomes quick and hard. There ia : 

 and greatly increased heat of surface. The secretions are dimii 

 the skin is dry, the bowels ore confined, the urine is scanty. 'I 

 pain frequently in tho loins and head. There arc restlessue 

 anxiety, and occasionally delirium. Tho respiration is quie] 

 The tongue U coated, white, and moist. These are the symptoms of 

 inflammatory fever of an active kind, but it is not (infrequent to 

 have this fever from the beginning presenting on adyuamic type. 

 This has been named lyjil-nid inflammatory fever. It is accompanied 

 with great feebleness. The pulse sinks, the skin becomes moist and 

 cold, the features are pinched, the tongue is dry and becomes block. 

 Low muttering, delirium, and stupor are present. These symptoms 

 may be present from the first, or occur when some unhealthy change 

 takes place in the character of the local inflammation. 



Hi: lie fever is another form of inflammatory fever. It accom, 

 those conditions of the inflamed port which are called suppumive. 

 This fever is attended with remissions. In the day the fever is 

 but it recurs at night, and is attended with heated skin, and flushed 

 red face, " hectic spots." The fever is at its height at midnight, and is 

 succeeded by colh'quative sweats, and frequently accompanied l>y 

 diarrhoea, 



!fnt. Of course the treatment of inflammation must vary 

 according to its seat, extent, andnatureof the general symptom... \\ Inn 

 the inflammation is of the simple kind its tendency is tow 

 Mid tho less interference there is the better. The great question that 

 lias been raised on the treatment of inflammation is the propriety of 

 blood-letting in acute forms attacking important organs. The pathol . .- 

 gical views given above have greatly modified the notion that 1.1- 

 was the best remedy in all forms of inflammation. It does not .-. 

 :hat the abstraction of blood exercises any important influence on tho 

 nflammatory process at all, and Dr. Hughes Bennett maintains that its 

 uflueuce on the system is injurious, hence he forbids bleeding for tho 

 sake of the inflammation. In certain inflammations, however, as of 

 the lungs, the circulation of the blood is greatly retarded, and in these 

 cases bleeding, by lessening the volume of blood. 1'.u -ilitatex the circula- 

 tion, and ia to be recommended. The local abstiaetion of li!..,l fr,,m 

 on inflamed part has also been found to relieve the (uu'n aud,consequ 

 of tlie inflammation ina particular organ, and this process is i 

 ccummcndcd where the part can be got at. 



ry, whieh wan formerly recommended in all inflammati< 

 low only very cautiously given by some practitioners, uud< 

 ietion that it subsequently interferes with healthy nutrition. When 

 given it is seldom pushed so far as to produce salivation, other 

 dies for inflammation are tartariscd antimony, digitali 

 of potass, chlorate of potass, saline and other purg pro- 



>erties of these medicines are treated of under th.ir proper headings, 

 md the treatment of inflamed conditions of the more important organs 

 will be found under the heads of these diseases, or of the diseases of 

 articular organs, as I'I.KUIITIS; I'KIUTOMTIS; HKAHT, DISEASES OF ; 

 DXEis, DISEASES OF ; SKIN, DISEASES OF, &c. 



i Hunter, On Infammalivn ; J. Hughes Bennett, Principles and Prac- 

 tice of Medicine ; Watson, Lccturt* on the Practice of Physi'- : A 

 "he Scimx and Practice of Medicine; Wedl, Pathological I 

 Simon. / /'a/h'iliyy ; Paget, Lccturtl on Hnnjical Path'i! 



INFLKXIOX. [Inn it ACTION.] 

 1NFI.HXION. Anoint of contrary flexure [FtEXOBE, COMIIAHV] 



- <alled a point of inflexion. 



INI'U'KN/.A (/-'I '"'//", Fr.). Influenza in the name given 1>y 



be Italians to an epidemic catarrh, which has spread more extensively 



ban any other epidemic ; and this universality of UH attacks, together 



with the greater severity of its symptoms, principally distinguishes it 



rom common catarrh. It attacks all ages and conditions of life, but ia 



seldom fatal except to the aged, or to those previously suffering from 



r having a tendency to pulmonary disease. Notwithstanding tho 



