228 
PATHOLOGY, 
thefecernent veflels; and one peculiar connexion between 
eryfipelas and thofe veflels is (hown in what is called 
cedematous eryfipelas. It is alfo connedted with a vaft 
majority of that difeafed action of the fecernents which 
are called cutaneous difeafes. It is unattended with the 
throbbing which is experienced in the arteries of phleg¬ 
monous limbs. The following charadteriltics may be alfo 
added. When eryfipelas is of an unmixed kind, it has 
not the dark red colour which common inflammations 
have, but a lighter red, with a yellow tinge, which is par¬ 
ticularly obfervable towards the termination of the dis¬ 
order. The fwelling which occurs is unattended with 
any remarkable induration, and forms a very inconsider¬ 
able prominence. The Ikin of the inflamed part has a 
Shining appearance, and, on being touched with the finger, 
turns white at the fpot where the preffure is made ; but 
the bright red colour immediately afterwards returns. 
The pain is ufually of a burning Shooting defcription ; 
and the patient frequently complains of a fort of itching, 
which is found to be particularly annoying. The fwelling, 
which happens in cafes of eryfipelas, is not only lefs hard 
and elevated than that of phlegmonous inflammation, 
but it is, at the fame time, quite irregular. Another re¬ 
markable feature of eryfipelas, is the manner in which 
this inflammation often changes its Situation, by getting 
well on one fide, while it is Spreading in fome other di- 
redtion. The alteration which the Skin undergoes in 
eryfipelas confifts in its feeling at the part affedted lefs 
pliable than in the natural State, and a little thickened. 
It will be recolledted that we have objedted to all fur¬ 
ther divifion of inflammation than this, into phlegmo¬ 
nous and eryfipelatous ; but many divifions have been 
founded on the terminations of inflammation. Thefe 
we confider as dependent on the adtion of Secreting vef- 
iels; and the latter adtion dependent on the plethoric 
Slate of the blood-veffels in inflammation, and the altered 
condition of their own nerves. We proceed therefore to 
Speak of the terminations of inflammation. 
The firfi: termination is that in which, the capillaries 
recovering their powers, and the nerves lofing their in- 
creafed fenfibility, the phenomena of inflammation ceafes 
to exift, and the natural functions of the parts affedted 
continue. This is the molt favourable event that can 
happen; but, according to Dr. Parry, the leaft: frequent. 
This is true of phlegmon, but by no means of eryfipelas. 
Even in phlegmon, refolution often takes place before 
the fwelling of the injured part has come on. ^ 
Now as to the connexion between inflammation and 
its products, it is to be noted, that the latter are pro¬ 
duced in two ways : firft, by Simple increafe of alteration 
in the adtion of the fecernents, as in extravafation of 
fluids on the nervous and ferous membranes; the Se¬ 
cond, by the abfolute acceflion of new properties in fome 
of the inflamed veffels, or, by the adtual growth of new 
veSTels, as in adhefion, fuppuration, and ulceration. 
It was a favourite opinion of the late John Hunter, 
and one which has been very generally adopted, that not 
only inflammation, but each of the above-mentioned 
terminations, w'ere instituted for the determinate purpofe 
of curing difeafe; that, if the powers of a part were not 
competent to produce one adtion, they Set up another, 
which required lefs power, and which might attain the 
objedt in view, though more Slowly and lefs efficiently. 
There is Something hypothetical in all this ; yet whoever 
attentively considers the reparative procefles of the body, 
cannot fail to conclude, that the laws to which they are 
fubjedted are framed in fuch a manner that their opera¬ 
tion tends under ordinary circumstances to the fanity 
of our frame. As, however, the immediate agents con¬ 
cerned in their laws can have no choice of adtion or 
adaptation of means to ends; as they cannot vary with 
uncommon circumstances ; fo we frequently witnefs 
from their operation baneful effedts ; and hence it be¬ 
comes our province to control their operations under 
many circumstances, though upon the whole we muft 
view them among the molt beautiful phenomena which 
the animal economy prefents. 
The firft divifion of the produdts of inflammation em¬ 
braces the hiftory of thofe arising from the Simple increafe 
of, and alteration in, the adtion of fecernent veSTels. It 
is obvious that thefe produdts of inflammation can only, 
be manifested in particular ftrudtures. Various divifions 
of thefe ftrudtures have been made by Bichat; but it is 
pretty generally allowed, that the divifions of membra¬ 
nous parts made by this author are too minute. The 
production of the firft terminations of inflammation re¬ 
quires the prefence of an apparatus furnished with exha- 
lants or fecretory veflels from the arterial or capillary 
fyftem of the refpedtive parts. This apparatus confifts. 
either of fome Ample furface, as the lkin and various parts 
of the mucous membrane ; of fome natural cavity, the 
internal furface of which is lined with Similar membrane 
as the Stomach, bowels, bladder, &c. or of lome difconti- 
nuity of fubftance, forming a virtual, though often not a 
real, cavity ; into which either exhalants open imme¬ 
diately, as in the cellular fyftem; or which is lined with 
membrane, capable, by means of Similar exhalants, of 
furnishing its appropriate fluid, as the ventricles of the 
brain, medulla oblongata, and nerves; the intervals be¬ 
tween the coverings or Sheaths of the fame parts, the 
duplicatures of the pleura and peritonaeum, the pericar¬ 
dium, the fynovial receptacles, &c. Or, laftly, this appa¬ 
ratus confifts of fome excretory dudt or dudls communi¬ 
cating with the part, if glandular, as in the mamma;, 
liver, kidneys, falivary glands, &c. in which cafes the 
duel anfwers the double purpofe of providing during 
health a falutary fluid, and of evacuating the part, when 
affedted with exceffive momentum of blood. 
It is obfervable alfo, that the feveral organs fo fupplied 
have, ufually, the combination of two of thefe circum¬ 
stances of Structure, fo as to acquire a double power of 
evacuation, either immediately from themfelves, or from 
neighbouring portions of the fame arterial branches. 
Thus the lungs have pleura without, and mucous mem¬ 
brane within ; the liver, peritonaeum without, and pori 
biliarii from within, &c. To thefe may be added the cel¬ 
lular, parenchymatous, and other, fubitances, forming a 
proportion of the mafs of various parts, and affording a 
third emundtory for the fuperfluous contents of blood- 
vefiels, by means of exhalants and fecretory capillaries, 
every where opening into them, as through the mem¬ 
branes before defcribed. This is the cafe in the medulla 
of the brain, and in various other organs ; in which we 
often find exhaled fluids, as well as between the mem¬ 
branes and in the ventricles of the former, and on the 
feveral furfaces of the latter. 
The nature of the fluids effufed in inflammation, and 
their effedts on the feveral parts, vary confiderably, ac¬ 
cording to the nature of the texture from which they 
originate, and to the degree of the malady which gives 
them birth. From each of thefe ftrudtures fimilar produdts 
are derived. In all of them the firft operation of inflamma¬ 
tion is generally to increafe the natural fecretions. Hence 
mucus is more copioufly fecreted in the alimentary and 
pulmonary expanfions of the mucous membrane, in the 
uterus, and in the vagina. Serum is copioufly effufed in 
the cellular tiflue, on the ferous membranes ; and the Se¬ 
cretion of tears is increafed from the eyes, &c. As the 
inflammation advances, or as it is more intenfe, the pro¬ 
dudts vary: the mucous membrane pours forth coagu¬ 
lating ferum, fibrine, pus, or blood ; and the ferous mem¬ 
brane fimilar produdts. Neither chemical analyfis nor 
the known properties of thefe fubftances allow us to in¬ 
fer any material difference in them, whether they arife 
from the ferous or mucous membranes. 
All thofe parts which are fecreting furfaces, and at the 
fame time have outlets, as the mucous membranes, are 
not commonly fubjedt to that procefs called adhefion.; for 
the 
