INFLAMMATION. 179 



366. Later stages of Sthenic and Asthenic inflammation. 



Throughout the later stages of both the sthenic and asthenic attack 

 our main object is to sustain the strength of the patient, so that he may 

 outlive the course of the disease. For this purpose it is necessary that 

 the powers of nature should be assisted by most careful nursing, good 

 nutritious diet, warm clothing and bandages, and above all by an abun- 

 dant supply of cool fresh air. 



The results which may ensue are the same in all attacks of inflamma- 

 tion which do not end in resolution, namely effusion of serum, formation 

 of lymph, suppuration, ulceration, or even mortification. 



367. Mortality from inflammation. 



Inflammation per se, except that of the bowels, usually terminates 

 favorably. If death eventually ensues, we commonly find that it does 

 not occur for some days or even weeks after the attack has subsided; 

 and even then results from the formation of extensive abscesses, hydro- 

 thorax, want of strength, or some such secondary cause. 



368. After-effects. 



A severe attack of inflammation generally leaves behind it some trace 

 of its effects in serous effusion, in the formation of lymph, in exudation, 

 or in ulceration of the parts. 



Thus for instance in inflammatory diseases of the lungs and air- 

 passages the effused material may impede the freedom of the respiration ; 

 in inflammation of the joints it may become consolidated and organized 

 into bone and produce anchylosis ; in laminitis it may be deposited be- 

 tween the sensitive and insensitive laminae, and may occasion an altera- 

 tion of the whole structure of the foot. 



The chances of perfect restoration of the parts will very much depend 

 on the strength and general health of the patient after the results of the 

 disease have developed themselves. If the patient has been unduly 

 lowered by depleting measures and violent counter-irritants, it is pro- 

 bable that the system may -not have strength and energy enough to take 

 up the effused products, and so bring about complete restoration of the 

 parts. But if on the other hand the strength has been carefully hus- 

 banded and sustained, we may fairly hope for a favorable result. 



369. Treatment by Depletives and violent Counter-irritants. 



The Author is aware that the views which he has put forward in regard 

 to the treatment of inflammation, are not those held by the old school. 



Violent depletives, such as bleeding, are now abandoned; and violent 

 irritants applied to external parts have well-nigh fallen out of use. As 

 regards the first, it was urged that the system was unable to maintain 

 two violent actions at one and the same time, and that therefore if a 

 sufficient amount of irritation could be established in a safe external 



