IH-l 



THE MODERN SYSTEM 



PROXIMATE CAUSE. 



Numerous opinions have been entertained 

 npon this s.ibject; but almost every theory 

 has been built upon the supposition of there 

 being some kind of obstruction in the inflamed 

 parts. While the ciiculation of the blood was 

 unknown, and the hypothetical notions of the 

 power of the liver, in preparing and sending 

 forth the fluid continued to prevail, it is not 

 astonishing that the theories of so many 

 writers should be imperfect. 



It was formerly supposed that the liver was 

 the centre of the vascular system, from which 

 the blood went forth by day to the extremi- 

 ties, and returned again by night. If then, 

 any peccant matter irritated the liver, the 

 blood was sent out more forcibly, and if at the 

 same time any part of the body were weak- 

 ened, or otherwise disposed to receive a 

 greater quantity of fluid from the rest, then a 

 swellina: was produced by a flow of humours 

 to this place. Flu.vions, or flows of humour 

 to a place might happen, either from weak- 

 ne.ss of the parts which allowed the humours 

 to enter more abundantly, or from the place 

 attracting the humours, in consequence of the 

 application of heat, or other agents. 



The ancient writers who supposed that the 

 blood had very little motion, and that its 

 course could be easily directed, or changed, 

 recommended heat to some part which was 

 remote from a recent inflammation, by which 

 they imagined that the current of blood was 

 altered, and a revulsion made. A revulsion 

 M as also made by raising a tumour in some 

 other part, or giving nature an opportunity of 

 discharging the humours from distant parts, 

 by applying l>listers, &c. When blood was 

 drawn from the vicinity of the fluxion, or con- 



gestion, the mode was called derivation 

 which only differed from revuhion, in the 

 distance to which the humour was drawn 

 being less. Our present object is only to trace 

 the leading doctrines which have at different 

 times prevailed, as being the proximate cause 

 of inflammation. 



From the theories of fluxion and congestion, 

 which were quite incompatible with the Ia\\s 

 of circulation of the blood, we turn our atten- 

 tion to the doctrine of obstruction 



By some writers obstruction has been 

 strongly advocated, attributing it to a viscidity 

 of the blood, and also was imagined to 

 occasion a resistance to the circulation in the 

 part affected ; hence, increased it in the othei 

 vessels, proving an irritation to the heart, and 

 augmenting the force or attraction of the blood 

 in that part of the vessel which was behind 

 the obstruction, causing heat and pain, and 

 consequently, an acrimonious state of the 

 fluids, and gangrene in all probability likely 

 to follow. 



The viscidity cannot be admitted as a 

 proximate cause of inflammation, because we 

 have no proof (say some authors,) that this 

 stale ever exists ; for, as they say, " Were a 

 viscidity to occur, it would exist in the whole 

 mass of blood alike, and could not be sup- 

 posed to produce only a lofcal disorder." But 

 this is not true, for all parts are not so .suscep- 

 tible of taking on disease as others ; conse- 

 quently, any poison producing inflammation 

 that may have been taken into the system, 

 may affect one part, and that only, and this 

 from the susceplibility of the part. 



As for the supposition of the co-operation of 

 an acrimony of the fluids, the proportion nC 

 the saline matter of the blood has never been 

 proved to be greater in this than in any other 



