General Surgery ig 



anesthetic properties. It may be substituted for cocaine, but should 

 not be injected hypodermically other than in warm aqueous solution. 



BIBLIOGEAPHY. 



Bert— Comptes rendus des ScSanceB. 93, 1881, p. 768. 



Ellis— On the Safe Abolition of Pain In Labor and Surgical Operations by Anes- 

 thesia with Mixed Vapors. London, 1866. 



Embly — British Medical Journal. April, 1902. 



Gulnard— Le Morphine et I'Apomorphlne. Situde Experiment. de Pharmaco-dy- 

 namie compar6e. Paris. 1898. 



Hoelscher — Langenbeck's Archly, f. kiln. Chlrurg. 57, 1898 p. 175 



Rudolf— Unly. of Toronto Studies. Physiologic Series. No. 3, 1901. 



INFLAMMATION. 



Inflammation is the reaction to injury. It is tersely defined by 

 Professor Adami as "an attempt of the organism to repair injury to 

 a part." It is to be regarded as a physiologic process following a 

 pathologic action, its one aim being to remove foreign matter from 

 the part and bring about normal restitution. The phenomena of in- 

 flammation are essentially the same in whatever part of the body 

 they occur, the characteristic gross changes being heat, redness, 

 pain and swelling, of various degrees; the minute consecutive 

 changes being temporary contraction of the capillaries followed by 

 their dilation, effusion of serum, thickening and slowing of the 

 blood stream, peripheral migration and diapedesis of leucocytes, and 

 in advanced stages extravasation of the red cells. The causes are 

 either mechanical injury (friction, heat or cold, acids or alkalies) or 

 pathogenic microorganisms. Most surgical inflammations are of a 

 septic nature. The inflammatory process may have one of the fol- 

 lowing several terminations : Resolution with preservation of the 

 integrity of the part, fibroid induration replacing the injured tissue, 

 abscess formation or ulceration with formation of cicatricial tissue, 

 gangrene with formation of cicatricial tissue, and in the extreme 

 degree generalized infection and intoxication and death of the 

 organism. 



Treatment. It must be remembered that a normal grade of in- 

 flammation is healthy and physiologic, and that treatment is only 

 required to assist the organism when either ( i ) it is too weak to re- 

 sist adequately, or (2) where the infective agent is too strong, or 

 (3) when the reaction on the part of the tissues is excessive (exu- 



