INFLAMMATION. 163 



Inflammation seldom fatal. "iSS. After-effects. 369. Treatment hy deple- 

 tives and violent counter-irritants. 870. Specific inflammations. 871. 

 Curative inflammation. 



327. Theory of inflammation. 



From the very earliest times the subject of Inflammation has occupied 

 the attention and excited the interest of the Medical inquirer ; and the 

 treatment of disease in general has always been largely dependent on 

 the views which have been cm-rent at the tizne in regard to this parti- 

 cular ajffection. The treatment of Inflammation itself has of course fol- 

 lowed the ideas entertained as to its natm-e and causes. 



Until within the last sixty years the state known as Inflammation was 

 universally regai'ded as one of exalted action and increased nutrition of 

 the part affected. Hence depleting remedies were in repute. The seat 

 of the disease was supposed by some to be in the blood, whilst by others 

 the blood was regarded as the food and sustenance of the disease. Hence 

 bloodletting was a favorite practice, whilst in internal attacks violent 

 irritants or blisters to the skin were also freely employed, with the view 

 of withdrawing the blood from the interior to the sm-face. 



These views gradually gave way to the idea that nervous irritation at 

 the part affected was the primaiy cause; — that collapse of the power of 

 the neiwous system of the part rapidly supervened on the previous ner- 

 vous exaltation; — that then the vessels, deprived of their usual nervous 

 stimulus, lost their contractile energy, and were unable to contract upon 

 and propel forward the current of the blood ;— that from this cause stag- 

 nation of the blood followed, and congestion was induced; — whilst from 

 the congestion, constantly increased by the fresh supplies of blood pro- 

 pelled into the part by the action of the heart, arose the well-known 

 results of the disease. The vessels became over-loaded and over-dis- 

 tended, and in consequence the watery parts of the blood, followed in 

 some cases by the fibrinous materials, passed out through the coats, 

 rendered thin by over-distension, — producing, according to circumstances, 

 eft'usion of serum, exudation of lymph, suppuration, mortification, &c. 



With the occm-rence of these views a great change took place in the 

 treatment. Bleeding, strong depletives, and violent irritants or counter- 

 irritants fell into disuse ; and the object sought was to improve the tone 

 of the system and of the part, with the view of enabling nature to regain 

 her power and restore tone, and thus bring about restoration of the 

 usual healthy current of the circulation. Mild irritants were therefore 

 applied externally to the neighbourhood of the part attacked, and diffu- 

 sible stimulants were given internally. 



These views in regard to the theory at least of the disease have again 

 been of late years modified ; but the treatment indicated above is still 

 in a great measure applicable. 



Much difference of opinion still prevails as to the exact natm-e and 

 causes of inflammation, and as to the precise reasons of the various 

 changes which occur in the tissue affected, in the blood, and in the 



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