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" The blood that circulates in our bodies," says Dr. Carpenter, " may be likened to a tidal 

 river, rolling onwards through the centre of a large city, and supplying it with the water needed 

 for the drink of its inhabitants, as well as that which is required for the various manufacturing 

 and cleansing operations that are carried on within its walls. The same stream also receives 

 the drainage of the town, and becomes charged accordingly with the products of animal and 

 vegetable decomposition, and the refuse of all its manufactories ; and, as the flow of the tide 

 brings back a large proportion of what was carried down by the ebb, the waters speedily 

 become so contaminated with offensive matters as to be unfit for use, unless means be pro- 

 vided for getting rid of these as fast as they are poured in. The perfection with which this 

 requirement is fulfilled in the animal body, while it excites our admiration, should also excite 

 us to imitation, so far as the art of man can hope to imitate the works of the Divine Artificer." 



I. Inflammation. 



What is inflammation ? We know that the word is derived from the Latin inflammare to set 

 fire to, or to burn. This givCs at least one of the symptoms of inflammation namely, heat ; 

 and puts one in mind of the saying of old Celsus : " Notae inflammationis sunt quatuor, rubor 

 et tumor, cum calore et dolore." * 



Now let us take one of the simplest cases of external inflammation, and see how far 

 this description of Celsus coincides with it. The case is not hypothetical ; it recently occurred. 

 A large dog, in jumping into a cart at Henley-on-Thames, missed footing, and was struck 

 by the sharp edge of the front step just in the groin and a little on the abdomen. Nothing 

 was observed for two days, when, the dog appearing to walk lame, he was examined, and 

 there was found a very large, very tender swelling, hard in the centre, and getting gradually 

 softer as it neared the surrounding or healthy tissue. Here we have two of Celsus's notce: the 

 tumor cum dolore ; but there were also the other two there was intense redness, deeper in 

 the centre of the swelling and brighter towards the edge, and intense heat. Now these were 

 the local symptoms ; but combined with these we had 



Inflammatory Fever. Symptoms, to wit : at first one or two distinct rigors or shivering 

 fits, soon succeeded by heat of all the surface of the skin ; pulse (which can easily be felt 

 in a large dog) hard, more full, and rather more rapid. Eyes rather injected, nose hot and 

 dry, mouth and breath hot. Coat staring, bowels confined, bladder inactive, and urine scanty and 

 red. The dog cared little to move, unless peremptorily called by his name ; when, on seeing 

 he was not really wanted, he dropped his head again dull and heavily, and with a moaning 

 sigh. The appetite was gone, and all spirit seemed to have left him. The tongue paler 

 than usual, and thirst great. Now the inflammation might have resolved or subsided under 

 the treatment, which would have been looked upon as the favourable termination. It did 

 not, however. Symptoms of pain and fever increased, and by-and-by distinct fluctuation (a 

 bogging feeling) was felt in the tumour, clearly indicative of the presence of pus (matter). 

 Now was the time to plunge the bistoury in, carefully, cautiously, but sufficiently deep withal. 

 Matter escaped plentifully, and with it blood, to the great relief of the congestion, and in a 

 few days the dog was well. 



But had the wound not healed ; had the pus continued to be discharged in abundance, 

 then the weakness would have become great ; frequent shiverings would have alternated with 

 fits of feverish heat. These, of course, would be the symptoms of hectic fever. 



* " The signs of inflammation are four redness and swelling, with heat and pain." 



