The practice of surgery : a treatise on surgery for the use of practitioners and students / by Henry R. Wharton ... and B. Farquhar Curtis.

  • Wharton, Henry R. (Henry Redwood), 1853-1925
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: The practice of surgery : a treatise on surgery for the use of practitioners and students / by Henry R. Wharton ... and B. Farquhar Curtis. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    39/1268 (page 25)
    SYMPTOMS AND TREATMENT OF INFLAMMATION. By B. Faequhar Curtis, M.D. Symptoms.—Prom antiquity tlie local symptoms of inflammation have been enumerated as rubor, dolor, calor, et tumor, and to these the moderns have added only one, largely a consequence of the others, functio Iwsa— impaired function. The redness is due to the congestion. The ][)ain is due to the pressure exerted upon the sensory nerves by the surrounding swell- ing, as is well shown by the intensification of the distress as every beat of the heart forces more blood into the space already overfilled. In some cases, however, it may be caused by the direct action of the inflammatory agent on the nerves. The lieat is caused by the increased supply of warm arterial blood, for it has been abiindantly proved that the local temperatnre never rises above the heat of the circulating blood. The swelling is due to dilated vessels, to the effusion of lymph and cells, and to the presence of pus. The impaired function is chiefly caused by the pain, which is often increased by any attemjat to use the part, and by the swelling, which jprevents its free movement, though the loss of function may also be dependent upon the direct action of the inflammatory cause upon the nerves. The constitutional symptoms of inflammation are an elevation of tem- perature, with or without a chill, and the general disturbance due to this condition, leucocytosis, and disturbances of certain organs, such as the ner- vous centres, which are poisoned by the toxic substances produced in the inflamed parts, and the liver, kidney, and intestine, which endeavor to eliminate the poison from the system. Leucocytosis.—An increase of the i^olynuclear leucocytes in the circu- lating blood over the normal amount of seven thousand five hundred to the cubic centimetre is called leucocytosis, and this is a common symptom of inflammation, although it may be due to other causes. This increase occurs physiologically to the amount of ten or twelve thousand during the diges- tion of proteid fopds, and the same amount or more is frequently observed during the latter months of pregnancy. The leucocytosis of inflammation is caused by chemotaxis (see page 18), and runs from fifteen thousand to fifty thousand, although seldom over thirty thousand. The amount is independent of the extent of the focus, and may be as great with a minute panaritium as with a large abscess. It is found in suppurative and gan- grenous inflammations, in pneumonia, in acute articular rheumatism, scarlet fever, actinomycosis, glanders, and many similar conditions. If a sudden overwhelming septictemia accompanies the beginning of an inflammation, as in peritonitis caused by intestinal perforation, leucocytosis may fail to develop, and it may be absent when an abscess exists but is well encapsu-