TREATMENT OP INFLAMMATION. 17 



in the dark and putrid mass alive, whilst all is dead around them. 

 At length they yield, and death is hurried on by hsemorrhage. 



The constitutional symjitoms are of a typhoid form. The pulse 

 is frequent and small, irregular or intermittent. The countenance 

 is anxious, the face livid, the nose pinched, and the lips contracted. 



Anxiety is soon changed into stupidity of expression, as if the 

 patient were under the influence of opium or alcohol ; sighing, hic- 

 cup, and involuntary movements of the hands and fingers are now 

 observed, such as picking and fumbling with the bedclothes. Appe- 

 tite fails ; the tongue is coated with a brown fur, except at the tip 

 and edges. The lips and mouth are dry and incrusted ; swallowing 

 is difficult. The mind is stupid, wavering, and subject to illusions; 

 the articulation is thick and broken. Still more marked are the 

 deathlike coldness, the clammy sweat, the small, indistinct, and 

 flickering pulse, and the cadaverous expression. In this state a 

 patient will sometimes lie for hours, and die without a struggle. 



Mortification may be acute or chronic. The acute comprehends 

 the humid, inflammatory, and traumatic. The chronic — the dry 

 and idiopathic. 



The cause of mortification is a tvant of vital power, and may be 

 the result of high inflammation, mechanical injury, pressure, heat, 

 obstruction to the return of venous blood, deprivation of nervous 

 agency, interruption to arterial supply, as by aneurism or tourni- 

 quet, cold, genera] debility, bed-sores, improper food, spurred rye. 



TREATMENT OF INFLAMMATION. 



The first object is always to remove the cause, and afterwards to 

 prevent or diminish the inflammatory action. The chief means are 

 termed antiphlogistic, and consist of 



General Bloodletting. — This is only required when the inflam- 

 mation is severe, as in erysipelas, and compound fractures, when 

 important organs are involved, such as the lungs, bladder, kidney, 

 eye, and peritoneum. If resorted to unnecessarily, it produces con- 

 gestions, effusions, and atrophy. Syncope, or fainting, is produced 

 when bleeding is pursued to a great extent. It is occasioned by 

 the removal of the natural stimulus of the heart — the blood, and by the 

 sedative influence transmitted from the brain, when deprived of its 

 share of arterial blood. The benefit to be derived from bleeding is 

 not merely the loss of superabundant blood, but also the sedative 

 influence, whereby the emptied capillaries can resume their natural 

 tone. A rapid full stream from a large orifice will soon produce 

 syncope, if the patient be sitting or standing ; whereas the system 

 may be almost drained of blood by a slow stream from a small 

 aperture, before faintness ensues, if the recumbent position is main- 

 tained. Bleeding is not to be regulated by its amount, but by its 

 effects. As a general rule, the blood should flow until there is some 



