Licence: Public Domain Mark
Credit: The principles of surgery / by James Miller. Source: Wellcome Collection.
Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)
46/560
![parting with their tone. And partly from this <%*>}*%!* ^o' of change io the hlood itself, winch seems^roore ™c,dwith its puseles less distinct, and when examined by^ ™«™* ffimph g]o. longer limited to the central current but are f,nCr^ac^n? nm?re ™ more on the lateral and clear lymph spaces. Elation is more copious than in the previous stage ; it consists of ^um and ofh^or sanguinis, the latter usually predominating: and when the action has been for some time sustained, and, as it were, established in the part, fibrin alone may be deposited. The fibrin of the blood is increased, not only in quantity, but also in plasticity, or tendency to become organ- ized. The natural function of the part is not simply exalted, but begins to be perverted: for example, secretion is not only increased, but changed in its character. By the fibrinous interstitial deposit, the tex- ture of the part is softened and enlarged. The formative power, as it is termed, of the part is impaired or overborne ; the supply of plastic material is greater than can be usefully and normally appropriated by the implicated tissues.f Nutrition, or the normal and vital relation which subsists between the living tissues and nutrient materials con- tained in the blood, is becoming more and more disturbed ; and this, perhaps, constitutes the most important part of the inflammatory pro- cess, leading ultimately to change of structure, more or less permanent, and more or less inimical to resumption or continuance of normal function. Thus is constituted Active Congestion; the arterial trunks in increased play; the amount of the blood in the part still farther augmented ; its vessels beginning to be over-distended, and losing tone thereby ; its circulation becoming slow; its blood undergoing change, the fibrin especially being increased, both in quantity and plasticity ; function and nutrition perverted. We are leaving the confines of health, and have, indeed, already made some progress into the territory of disease. * Atony and flaccidity of blood-vessels may become a cause of impediment to a cur- rent through them, not by preventing these vessels from actively contracting on their con- tents, but by removing that tone by which the vessels maintain the calibre and the tension best calculated to transmit onwards the force of the current. Vessels thus weak and in- elastic, instead of equably conveying the current, become distended, lengthened, and tor- tuous in receiving it: and by their very mass, as well as by their inelasticity, they partly break the force of the current, and partly turn it into other channels. Williams' Prin- ciples of Medicine, p. 207. t The various solid tissues which are in continual process of change, more or less rapid, derive the materials of their reconstruction from the blood, especially from its fibrin; which they have the power, by their vital endowments, of causing to assume their own re- spective forms of organization. The vitality of the tissues in any part may vary in its degree; so that their formative power may be increased or diminished. When their for- mative power is increased, the process of nutrition is performed with unusual rapidity and the fibrin of the blood is rapidly drawn from it: but when the formative power is dimi- nished, the process of reconstruction is slowly and imperfectly performed, and the demand for fibrin is less.—Brit, and For. Med. Rev., No. xxxv., p. 102.](https://iiif.wellcomecollection.org/image/b21141228_0046.jp2/full/800%2C/0/default.jpg)
