A system of surgery / by James Miller.

  • James Miller
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: A system of surgery / by James Miller. Source: Wellcome Collection.

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    operandi is similar to what has just been explained in regard to cold. 8. Undue exercise of function, in like manner, may either predispose or excite ; according as it is habitual, or casual and excessive. It operates by inducing local plethora, at the same time exalting nutritive activity j not only inviting the change, but giving the first move in its advance. 9. Vitiated secretion acts as a direct communicator of irritation ; (1.) From one part to another, in the same patient ; as tears to the cheek, or dis- charge from the rectum and vagina to the cleft of the nates. (2.) From one patient to another; as gonorrhoeal discharge from the urethra, acting- on the conjunctiva, or on the genital organs. (3.) From the lower ani- mals to man ; as in the case of the vaccine virus, and glanders. 10. Retention of the ordinary secretion of an organ tends to inflammatory access ; retention of urine may be followed by cystitis ; distention of the lachrymal sac by suppuration, and the establishment of fistula lachry- malis. The inflammatory process, when it occurs without any apparent or assignable exciting cause, is said to be spontaneous or idiopathic. III. Maintaining Causes.—When any cause of the inflammatory process continues to act after the commencement of the morbid conditions which characterize its access, that cause, whether predisposing or exciting, then becomes a maintaining cause, by which the disease is not only prevented from spontaneously abating, but positively aggravated in point of extent, violence, and intractability. The lodgment of a foreign body beneath the eyelid serves as a good illustration of this important practical fact. It first acts as an exciting cause of the inflammatory pro- cess, and, until it is removed, continues both to excite the disease afresh, and also to prevent any treatment, however active or sustained, being of the slightest avail; but no sooner is this maintaining cause removed, than the inflammatory symptoms abate, repair ensues, and that almost without the use of treatment of any kind. Duration and Character of the Inflammatory Process. Generally speaking, rapidity of progress and intensity of disease are phrases nearly synonymous. Sometimes the process is very gradual in its advancement ; requiring, as in the example of the vaccine pustule, formerly adduced, eight or nine days for its completion ; and many in- flammatory changes are yet more protracted. But after a wound, or other mechanical injury, the process is usually complete, and suppuration commencing, by the second or third day. One day, or less, suffices for the occurrence of suppuration in many cases of phlegmonous erysipelas. And the secondary abscesses attendant on phlebitis, there is every reason to believe, are often begun and completed within a few hours. I regress varies, as to time and character, according to—1. The Structure of the part affected. The more highly organized, vascular, and en owed with nervous energy, the more rapid and intense the change. Situation of the part. The nearer to the centre of circulation, the more disposed to rapid and acute disease. 3. State of the part. When vita power has been impaired, by previous disease or other debilitating
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