iwTLAMMATioN.] MODERN V KT K IM N A 11 Y PRACTICE [inflammation. 



be in the most feeble state ; and the pulse, 

 abstractedly considered, would then rather in- 

 tluco the practitioner to employ tonics and 

 sliinulants, than evacuations; but should the 

 continuance or exasperations of the disorder, 

 or any other indication, lead to the use of the 

 lancet, then the Itijfi/ coat and the concave, sur- 

 face of the blood, clear away all doubt con- 

 cerning the existence of inllaiiunation. 



TERMINATION OF INFLAMMATION. 



LiJIammation is said to have three different 

 terniiuations; or, in other language, after it 

 has continued a certain time, it either subsides 

 entirely, induces a disposition in the vessels to 

 form pus, or completely destroys the vitality 

 of the part. 



AVhen the inflammation is to end in the 

 first-named manner, which is the most favour- 

 able, the pain becomes less, the swelling 

 abates, and every other symptom gradually 

 disappears, till at last, the part is wholly re- 

 stored to its natural size. There is no forma- 

 tion of pus, or any permanent injury of struc- 

 ture. This termination of inflammation is 

 termed resolution. It is fortunately the most 

 common, as well as the most desirable manner 

 in wiiich the affection should end. 



If, however, notwithstanding the applica- 

 tion of the iisual remedies, the several symp- 

 toms of heat, pain, &c., instead of diminishing, 

 rather increase, and the tumour gradually 

 acquires a larger size, becomes soft, and some- 

 what prominent in the middle, or towards its 

 most depending part, the inflammatiou has 

 ended in suppuration. 



The worst, but happily the least frequent 

 consequence of common inflammation, is the 

 death or mortification of the part alfected. 

 The signs of this disastrous event are a change 

 of colour in it, from being of a bright red, to a 

 livid hue ; small vessels, filled with a thin 

 fa'tid serum, arise on its surface, and air is 

 plainly felt to exist in the disordered locality. 

 The pain, indeed, is diminished, but the pulse 

 sinks ; while the tumour is gradually metamor- 

 phosed into a black fibrous mass. 



These are the three most usual termina- 

 tions of inflammation. By many writers, how- 

 ever, another disorder has been treated of, 

 in which inflammation is apt to end — namely, 

 scirrhous. But, although that complaint may, 

 2 L 



perhaps, in a few iiKstuuces, follow inflainina- 

 tion, yet it is far from being a common con- 

 sequence of it. lltMice, ulthougli iiillamma- 

 tory aihi-lion may justly be mcnlioiud au 

 one of tiie many exciting causes of acirihous, 

 yet the consideration of this disorder can 

 never with jiropriety bo introduced into uu 

 account of inllamination. 



Common inllammation, particularlv when it 

 ailects glandular parts, is often observed to 

 leave indurations behind it. Such indurations, 

 however, are not at all malignant, and are 

 very dillcrent in their nature from what is im- 

 plied by a real scirrhous. 



TREATMENT OF INFLAMMATION, 



The grand principle to be observed in the 

 treatment of inflammation, is to endeavour to 

 lessen that immoderate action of the arteries, 

 which is now commonly considered as the 

 proximate cause. 



The first circumstance to be attended to, in 

 all cases in which resolution is to be attempted, 

 is the removal of all such exciting causes of 

 the disorder as may happen to present them- 

 selves, foreign substances in wounds, fre- 

 quently excite inflammation, and ought to be 

 extracted as speedily as possible. A piece of 

 bone, or a nail taken up in the foot, or even a 

 thorn in the leg, often gives rise to the afl'ec- 

 tion, and requires immediate removal. Such 

 things as these may often be detected and re- 

 moved at once ; and this is doing a great deal 

 towards the cure of the inflammation. Many 

 of the exciting causes are only of momentary 

 existence ; yet, though they may no longer 

 exist, the process of inflammatiou continues to 

 follow the violence and irritation which were 

 suddenly produced, and still remain. Hence, 

 when taking away, if possible, the remote 

 cause, it is proper, by other means, to mode- 

 rate the increased action of the vessels. 



If inflammation is consequent on an in- 

 creased action of the vessels, and if a greater 

 quantity of blood is impelled into, and circu- 

 lates through the diseased part than is neces- 

 sary in the natural state, it follows that hlccd- 

 i?ig must be a principal means of relieving it. 

 The reason of this is, that it lessens the action 

 of the whole arterial system, and, of course, of 

 that part which is aft'ected, and thereby dimin- 

 ishes the quantity of blood transmitted to the 



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