SURGERY. 
plicated with some morbid tendency, as in 
erysipelas, scrophula, lues venerea, &c. and 
hence arise numerous species of unhealthy 
inflammation. Again, it may be acute or 
chronic, in respect to its duration. 
Healthy acute inflammation has been 
called phlegmon. Its symptoms are pre- 
ternatural redness, increased heat, and a 
circumscribed, throbbing, painful swelling 
of the inflamed part. The exciting cause 
is generally some external violence, of a 
mechanical or chemical nature. Some- 
times it arises spontaneously ; or, in other 
words, no perceptible cause can be assigned 
for it. The proximate cause is an increased 
action of the vessels of the part. 
During its existence in any important or- 
gan of the body, blood taken away from the 
system has the inflammatory crust, or butF, 
on the upper surface of the clot, which is at 
the same time concave, or cupped. 
Treatment. 1. Removal of the cause, 
where that is practicable, 2. Bleeding, 
both topical and general. The latter is 
only necessary when the inflammation of 
the organ endangers life itself, as the brain, 
lungs, liver, &c. ; or when tlie part has in- 
ferior powers of recovery, as a joint; or 
where suppuration would entirely destroy 
the organ, as in ophthalmy. The former is 
effected by means of leeches, or cupping. 
3. Purgatives, chiefly of the saline kind, as 
Glauber’s and Epsom salts, &c. 4. Anti- 
monial medicines, which relieve the skin, 
and diminish febrile action. 5. Reduced 
diet, including abstinence from fermented 
or spirituous liquors, and animal food. 
6. Evaporation constantly kept up from the 
surface by folded cloths, wetted with cold 
washes. This is very powerful in reducing 
the heat and increased actions of the part. 
A solution of ceriiss. acetat. ^ ss. in ^ iv. of 
vinegar and tb ij. of distilled 'water is a very 
good application. Wliere, on account of 
concomitant extravasation of blood, as in 
bruises, it is desirable to excite the absor- 
bents, washes supposed to have this effect, 
and therefore termed discutients, are em- 
ployed: such as pt. ammon. muriat. ^ss. 
aceti et spir. vin. rectif. aa tb j. 7. Warm 
applications, as poultices or fomentations, 
occasionally relieve, when the cold washes 
are ineffectual. 
Inflammation terminates in resolution, 
which is the gradual subsidence of all the 
symptoms ; in suppuration, or the formation 
of matter ; or in mortification. 
Suppuration,. The inflammatory symp- 
toms, instead of yielding to the tjreatment, 
are aggravated; and afterwards suddenly 
subside, the patient being seized with, 
shiverings. The swelling becomes softer, 
and white at its most elevated part ; and if 
the collection be supeificial, a fluctuation 
can be felt. At this time a fluid, called mat- 
ter, or pus, is contained in a cavity formed 
in the centre of the inflamed part, and 
termed an abscess. This peculiar fluid is 
separated from the blood by the inexpli- 
cable power of the secerning arteries, just as 
ordinary secretion takes place. In a healthy 
state it is a homogeneous light yellow fluid, 
about the consistence of cream, and pos- 
sessing little smell ; but under many circum- 
stances of disease its appearance and pro- 
perties are entirely changed. The cyst, 
containing the. pus, has a smooth and some- 
what villous surface : it seems to be lined 
with a layer of coagulating lymph, and the 
surrounding cellular substance is thickened 
and agglutinated by the inflammation, so as 
to prevent the matter from spreading. 
From the arteries of this part the pus is 
secreted. 
The matter always makes its way towards 
the external surface of the body ; even if 
the parts should be very much thinner, and 
less resisting towards any cavity. 
Treatment. A soft poultice until the ab- 
scess bursts, or has been opened. The lat- 
ter operation is performed by a straight 
two-edged scalpel, or an abscess lancet. 
It is not necessary, unless the collection he 
under a fascia, which may prevent it from 
coming forwards; or near a joint, or large 
cavity of the body, as the belly or chest. 
A poultice should still be applied after the 
bursting of the abscess. 
Mortification ensues when the violence of, 
the inflammation, or its duration, has com- 
pletely exhausted the powers of the part. 
The pain subsides ; the part becomes livid, 
or otherwise discoloured ; the cuticle is 
elevated into a vesication by a turbid fluid ; 
the pain and tension are diminished ; and 
air is disengaged into the cellular substance, 
so as to cause a crackling sensation. To 
this stage the term gangrene is applied; 
but when the part has become quite black, 
and has lost its motion, sensation, and heat, 
it is called sphacelus. 
The blood coagulates in the large vessels 
leading to the part, and consequently the 
separation of the limb is not followed by 
hemorrhage. 
But mortification often occurs without 
preceding inflammation in parts and sub- 
jects where there is great weakness. Tying 
