14 SURGERY. 



It is most remarkable in loose textures ; also in the breast, testicles, 

 and lymphatic glands. 



Heat. — This depends upon a more rapid oxidation of the tissues, 

 which are also supplied with an increased quantity of blood. Heat 

 of inflammation may be partly actual, as ascertained by the touch or 

 the thermometer, and partly the result of a perverted nervous func- 

 tion, estimated only by the patient. It must be permanent, and con- 

 joined with other symptoms to be characteristic, for in hectic there is 

 burning of the hands and feet, yet no inflammation is there. 



Pain — is caused partly by the pressure u^on the nerves of the in- 

 flamed spot, and the distension of the arteries which are supplied by 

 small nerves; and partly by disordered function. Mechanical pres- 

 sure increases it, for instance, by the hand in peritonitis, or inspira- 

 tion in pleurisy. Pain varies with the natural sensibility of the part 

 affected, hence inflammation of the skin is more painful than that of 

 cellular tissue. It is proportionate to the yielding nature of the struc- 

 ture affected ; thus inflammation produces more pain in bones and 

 ligaments, than in mucous membrane. 



Pain is not always indicative of inflammation — for example, in 

 spasm and neuralgia. In spasm the pain comes on suddenly, and is 

 relieved by pressure ; in neuralgia it is intermittent. Not so with in- 

 flammation — in the latter the pain gradually increases from the first; 

 if it suddenly disappears suspicion is excited lest gangrene has su- 

 pervened. Pain may be sympathetic, and referred to a part at a 

 distance : in coxalgia, the pain is at the knee ; in liver disease, in the 

 shoulder ; in disease of the kidney, at the orifice of the urethra. This 

 is a point of practical importance in the application of remedies. 



Increased sensilnlity. — This may be illustrated by intolerance of 

 light when the eye is inflamed ; the tenderness of the skin in erysi- 

 pelas ; the rejection of food by the stomach, and the constant urina- 

 tion if the bladder is the seat of inflammation. 



Disorder of function, — The stomach cannot digest, nor the kidne!y 

 secrete. If the brain or spinal cord be the seat, we may expect con- 

 vulsions, or paralysis. 



The causes of inflammation may be divided mio predisposing and 

 exciting. 



Predisposing causes. — Include sanguine temperament, excitability; 

 plethora, excess in food, drink, or exercise; debility, miasmata, bad 

 air, food, and clothing ; previous disease, &c. These may be con- 

 sidered as constitutional or idiopathic. 



Exciting causes. — May be direct, such as the chemical effects of 

 acids, salts, &c. ; or mechanical effects of wounds, pressure, &c. 

 Indirect, or vital, such as heat and cold, cantharides and turpentine. 

 Specific, as in the instance of vaccine virus. 



The duration and character of inflammation are modified by the 

 nature, situation, and condition of the part affected, and the tempera- 



