SURGERY 



INFLAMMATION. 



The immediate or proximate causes of inflammation have been 

 variously ascribed to viscidity of the blood, to enlarged blood-glo- 

 bules obstructing the capillaries, to a spasm of the extreme vessels, 

 to an increased action, to a debility, to a paralysis, to an injury of 

 the nerves, to an attraction of the red globules, to a rapid union of 

 the inflamed parts with oxygen, to abnormal nutrition. The theory 

 which is best substantiated by facts is the following : — The blood 

 circulates with greater rapidity and abundance in the capillaries of 

 an inflamed part ; this is followed by exudation of lymph in the in- 

 terstices ; subsequently the blood stagnates in the focus of the 

 inflammation, by the adhesion of the red globules to each other, and 

 to the sides of the capillaries ; finally, the tissues are broken down 

 and disorganized, pus is formed, the blood ceases to circulate, and 

 the parts mortify. 



The symptoms are redness, swelling, heat, pain, throbbing, in- 

 creased sensibility, disorder of function, arrest and change of se- 

 cretion. 



Redness. — This is due to an afflux of blood to the part ; the ves- 

 sels become distended, and the capillaries convey red blood ; the 

 proportion of the red globules is also increased by the exudation of 

 the serum. The decree varies in different tissues, and according to 

 the intensity of the action ; compare, for instance, an inflamed tendon 

 with an inflamed mucous membrane. The tint varies also between 

 a bright scarlet and a deep purple. Permanency is characteristic 

 of inflammatory redness. The redness of blushing is not indicative 

 of inflammation, because it is momentary, and not conjoined with 

 other symptoms. 



Swelling. — This is occasioned by the increased quantity of blood, 

 and an effusion of serum, pus, &c. The swelling of inflammation 

 must be conjoined with other symptoms also, for in osdema there is 

 swelling, but not inflammation. It must be gradual in its develop- 

 ment : the sudden swelling produced by a hernia or dislocation is 

 not that of inflammation. It must also be recent, not like the tedious 

 growth of a genuine tumour. Swelling may be injurious, as in the 

 brain or orbit of the eye ; or it may be useful, as in a fracture, &c. 



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