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XXXI.  On  the  Early  Stages  of  Inflammation.  By  Joseph  Listee,  Esq.  F.B.C.S.  Eng. 
and  Edm.,  Assistant  Surgeon  to  the  Royal  Infirmary,  Edinburgh.  Communicated  by 
Dr.  Shaepey,  Sec.  R.S. 
Eeceived  June  18, — Bead  June  18,  1857. 
INTEODTJCTJON. 
The  morbid  process  designated  by  the  term  Intlammation,  being  one  to  which  every 
organ  and  probably  every  tissue  of  the  body  is  liable,  and  comprehending  as  it  does  in  its 
progress  and  consequences  by  far  the  greater  number  of  the  ills  to  which  flesh  is  heir, 
possesses  a deeper  interest  for  the  physician  or  surgeon  than  any  other  material  subject 
which  could  be  named.  The  practical  importance  of  inquiries  tending  to  elucidate  the 
essential  nature  of  this  process,  has  been  for  centuries  recognized  by  all  enlightened 
members  of  the  medical  profession ; for  it  is  obvious  that  just  views  regarding  it  must 
tend  to  promote  the  establishment  of  sound  principles  in  the  treatment  of  the  diseases 
which  it  produces.  At  the  present  day  more  especially,  when  theory  is  allowed  such  free 
scope,  and  is  permitted  to  attack  the  most  time-honoured  rules  of  practice,  we  stand  in 
peculiar  need  of  the  beacon-light  of  correct  pathology  to  enable  us  to  steer  a safe  course 
amid  the  various  conflicting  opinions  which  assail  us.  Yet  so  far  from  our  knowledge 
of  inflammation  being  in  a satisfactory  condition,  authorities  are  at  variance  upon  the 
fundamental  question,  whether  it  is  to  be  regarded,  in  accordance  with  John  Huntee’s 
opinion,  as  active  in  its  nature,  and  consisting  in  an  exaltation  of  the  functions  of 
the  affected  part,  or  whether  it  should  not  rather  be  considered  a passive  result  of 
diminished  functional  acti\'ity. 
In  seeking  for  the  solution  of  this  great  problem,  we  cannot  expect  to  gain  much  from 
the  contemplation  of  the  more  advanced  stages  and  results  of  inflammation,  such  as 
copious  exudation  of  lymph,  suppuration,  ulceration,  or  gangrene.  When  any  one  of 
these  has  taken  place,  the  nature  of  the  original  disease  is  masked  to  a great  extent  by 
the  subsequent  changes ; and  the  cell-development  which  occurs  in  lymph  after  its 
efiiision,  is  no  more  proof  of  activity  in  the  inflammatory  process,  than  the  loss  of  the  vital 
powers  in  gangrene  can  be  accepted  as  evidence  in  the  opposite  direction.  It  is  upon 
the  first  deviations  from  health  that  the  essential  character  of  the  morbid  state  will  be 
most  unequivocally  stamped,  and  it  is  therefore  to  the  early  stages  of  inflammation  that 
attention  must  be  chiefly  directed  in  this  inquiry. 
If  the  palm  of  the  hand  be  chafed  by  long-continued  friction,  as  for  example  in 
rowing  a boat,  the  first  thing  that  will  be  observed,  when  attention  has  been  directed  to 
the  part  by  a feeling  of  uneasiness,  will  be  that  the  skin  is  redder  than  natural,  implying 
