PATH 
the natural fecretions of the part a£t perpetually fo as to 
throw off the firmer accumulations, and to evacuate them 
from the body: while, on the other hand, increafed fe- 
cretion on the ferous furfaces, when it becomes indurat¬ 
ed, agglutinates the correfponding parts together, be¬ 
comes organized, and thus are adhefions contracted. It is 
1 y this procefs occurring in artificial cavities, as wounds, 
&c. that reparation takes place. The fame procefs may 
be confidered as the origin of that cream-like fubftance 
depofited in the cavities of joints, in capfular ligaments, 
in the (heaths of tendons, See. which, by the abforption 
of the thinner parts, becomes what is called chalk-Jlune, a 
well-known effect of highly-inflammatory gout, and con¬ 
fiding of urat of foda. The fame is depofited in the cel¬ 
lular fpace between the inner and fibrous coats of the 
larger arteries, becoming true bone, or phofphate of lime, 
and producing fuch diftreffing effeCfs, refulting,according 
to fome late obfervations, from an inflammatory affeCtion 
of the va.fa vaforum 5 and when on the coronary arteries 
of the heart, according to Parry, the proximate caufe of 
fyncope angens. 
Though thefe various products are for the moft part 
the refult of inflammation, yet it is by no means clear 
that they are not fometimes prefent without the occur¬ 
rence of this action. Copious mucous excretions are 
often habitual to old perfons in whom we cannot infer 
increafed vafcular a&ion ; and the various depofitions 
of the fcrofulous diathefis feem generally to be caufes 
rather than confequences of inflammation. On the other 
hand, as increafed fecretion may exift without inflamma¬ 
tion, fo the latter may occur without the former; nor 
does the peculiar modification which gives rife to this 
circumftance feem clearly afeertained. It would feem 
indeed, that the violence of the inflammation had fome 
influence over the fufpenfion of fecretion ; but this does 
not uniformly happen, fince the violent inflammation we 
have mentioned as incidental to fevers of hot climates 
are often accompanied from the firft with copious though 
morbid fecretion. In the generality of cafes, however, 
in which fecretion is flopped, we believe it will be found, 
that the capillary fyftem is lefs fuperficially and more 
violently inflamed than when this aftion is increafed. 
It is alfo to be noted, that on fome occafions increafed 
fecretion brings on inflammation, though by no means 
fo frequently as inflammation induces fecretion. In 
thefe cafes we obferve flight and unimportant exceffes in 
the fecreting powers, after having continued fome time, 
fuddenly exhibit the regular phenomena of inflammation. 
When inflammation terminates by the procefles of ad- 
hefion, fuppuration, or ulceration, we infer, that either 
new fecreting veflels are formed, or that the fanguineous 
capillaries acquire the fecreting faculty. Of adhefion 
we have before fpoken. It is generally allowed to be 
produced by the formation of new veflels. We infer that 
fuppuration and ulceration are procefles which depend on 
the capillaries acquiring new faculties, becaufe there is 
in each a lofs of fubftance which could only be thus ac¬ 
counted for. The capillaries having acquired the above- 
mentioned property, and loft that of tranfmitting blood 
to the affe&ed ftrufture, muftdiminifti from the deficiency 
of fanguineous fupply, abforption being l'uppofed to con¬ 
tinue. Moreover, pus, the fluid fecreted, is, according 
to recent experiments, but (lightly removed in its nature 
from the blood itfelf. Hence it would naturally be the 
production of veflels which poflefled the fecreting power 
in the lead perfeft manner. We infer it alfo from the 
fuppofed inadequacy of the common fecernents of thofe 
parts in which fuppuration is often eftabliflied to pour 
forth fuch copious fupplies of pus ; and laftly we infer it, 
becaufe how, other wife than on the fuppofition that a 
change takes place in the terminations.of the capillaries, 
could we explain the fad, that healthy ulcers do not 
bleed ? 
The laft and moft fatal termination of inflammation is 
gangrene. This alfo exhibits fomewhat different appear- 
O L O G Y. 220 
ances, as it affefts the bones or flefli, or as it is produced 
from the furface of an ulcer, in which latter cafe the 
gangrened portion is called a Jlcrugh. Gangrene is termed 
the death of a part; and is generally fuppofed to be the 
aftual abolition of all vital powers and motions, and that 
the part actually returns to inert matter. The fad that 
gangrened parts look different from dead parts is 
readily explained by the fuppofition, that the former 
have entirely loft their contractility and elafticity, while 
the latter, as is u'ell known, do not lofe the firft pro¬ 
perty for fome hours, nor the fecond for fome days, 
after what is commonly called death. See Gangrene in 
this article. 
The natural connexions of philofophy would lead us 
in this place to an examination and hiftory of local inju¬ 
ries followed by inflammation and the conftitutional or 
febrile difturbances arifing therefrom. As however the 
arbitrary difeafes of Medicine and Surgery have feparated 
the practical application of thefe rules, we inultdefer thefe 
fubjeCts till we arrive at the article Surgery. To that 
article we (hall alfo refer the reader for an account of 
external injuries, or fuch as belong to manual treatment. 
It may not be amifs, however, to obferve, that the fe¬ 
brile (late which fupervenes on local injury does not dif¬ 
fer from common fever, except that, being kept up by a 
certain irritating caufe, it can only be cured by the re¬ 
moval of fuch caufe; and hence that all treatment muff: 
be direCled to the cure of the local difeafe. And farther, 
as the local injuries are intenfe, or the conftitution mor¬ 
bid, the fever will affume inflammatory or heflic charac¬ 
ter, or a mixture of both. 
This Order contains eleven Genera. To explain Dr. 
Good’s arrangement of Inflammation, we (hall copy part 
of a note fubjoined to this order. He therein remarks, 
that “ The whole of the obfervations of Mr. John Hunter 
upon this fubjeft are worthy of being deeply ftudied; and 
will not a little elucidate the nature of the arrangement 
introduced into the prefent method. It may be fuffi- 
cient to obferve, that in treating on inflammation, he di¬ 
vides the body into two parts : 1, the circumfcribed ca¬ 
vities, organs, and cellular membrane which connects 
them ; and 2, the outlets of the body, commonly called 
mucous membranes, as the dufls of the glands, alimentary 
canal, &c. He diftributes inflammatory affections into 
three kinds, ad'hefive, fuppurative, and ulcerative. Ad- 
hefive inflammation belongs chiefly to the former of the 
above two parts of the body, where they are deeply feated; 
and appears intended to take place in order to prevent 
fuppuration. It applies therefore peculiarly to the ge¬ 
nus Emprefma in the prefent order, except in gaftritis, 
enteritis, and cyftifis; in all which, however, we fre¬ 
quently meet with ftriking examples of the adhefive in¬ 
flammation, or true Emprefma ; infomuch that the af- 
fefted organ becomes at times fo clofely united with 
fome adjoining membrane or other organ, as to obtain a 
kind of artificial wall, or paries, and prevent the efcape 
of its contents into another cavity, when ulcerated 
through the whole thicknefs of its fubftance. Suppura¬ 
tive inflammation belongs chiefly to the famedivifion of 
parts, placed near the furface; and confequently applies 
peculiarly to the two genera of Phlegmone and Phyma. 
The ulcerative belongs chiefly to the fecond order of 
parts, as the mucous membranes and outlets; and hence 
principally applies to the genus Erythema, as it muff 
alfo be allowed to do to that of Phlyfis. Deep-feated 
fuppurative inflammations and abfeefles cannot well be 
placed in either of thefe genera ; and have a claim to be 
confidered by themfelves ; they are hence included in 
the genus Apoftema, with which the order opens. 
Genus I. Apojlema, [ctnoftbipu, to recede from.] Deep- 
feated abfeefs. Generic charadlers—Large fuppurative 
inflammation in a deep-feated organ; pus copious and 
confined. This genus contains five fpecies. 
1. Apoftema commune, or fimple abfeefs: inflamma¬ 
tion 
