174 CHAPTER 18. 



356. Fifth result or Ulceration and Mortification. 



Ulceration generally arises from long-continued or excessive obstruc- 

 tion to the circulation in the part, which in consequence becomes defi- 

 cient in nutrition and weak. The tissues then become softened, lique- 

 fied, and degenerate, and are cast forth as dead in minute particles. 



Mortification results from similar causes, but in this case parts visible 

 to the naked eye perish and slough away. It will be seen that the two 

 processes differ in degree rather than in kind. 



357. Treatment of inflammation. 



We shall now endeavour to sketch out the principles on which the 

 state known as Inflammation ought to be treated. Inasmuch, however, 

 as every organ and tissue in the body is liable to take on inflammation, 

 and almost each of them has some speciality in its organisation, which 

 may under varying circumstances demand some modification, in the appli- 

 cation of any general rules ; inasmuch, too, as inflammation is often com- 

 plicated with, aggravated or modified by other diseases ; and further, 

 inasmuch as inflammation, whether natural or artificially induced, is fre- 

 quently a means of repair, which needs to be assisted and developed, 

 the reader must not expect to receive sharply-defined instructions, but 

 only a general idea of the sort of treatment necessary under the varying 

 phases and circumstances of the state. At present, however, we shall 

 only treat of inflammation as a disease. Its curative aspect will be con- 

 sidered hereafter. 



The cause of inflammation, as stated in the beginning of this Chapter, 

 is irritation of the tissue affected, of its ultimate elements, in conse- 

 quence of which their normal power of selection is destroyed, and that of 

 their attractiveness is increased. The removal of blood by bleeding 

 cannot alter this state of affairs, nor can other lowering remedies, except 

 in so far as that if the inflammation be superficial and circumscribed, 

 local bleeding may relieve the congestion ; but if exudation has occurred 

 it cannot relieve this result. The exudation can only be absorbed by 

 undergoing transformation. Now any such process demands strength, 

 and is arrested by weakness. 



" The strong pulse, fever, and increased flow of blood in the neighbour- 

 hood of the inflamed part are the results, not the causes of inflamma- 

 tion. They may be regarded as agents employed by nature for the 

 restoration of the vital action of the diseased tissue. They may require 

 to be modified, but no attempt must be made to get rid of them by such 

 means as bleeding and depletives." (Abridged from Professor Bennett 

 on the Practice of Medicine.) 



In treatment our aim will be, 1st to check or diminish the inflamma- 

 tory congestion ; 2ndly when exudation has taken place, to further its 

 removal ; and 3rdly, if this cannot be effected, to render its products as 

 little injurious to the system as possible. 



The treatment of inflammation may, we think, be divided into two 



