Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    greatest in lax tissue, as the axilla, and least so in the dense and fibrous, as bone or tendon. It is always an iuijiortant sign in chronic inflammation where there may be but little redness or pain. The (lisiiirbance in function, which practically always occurs in an inflamed part, may be iUusti-ated by the in- ability of an inflamed bladder to retain mine, or of an inflamed eye to tolerate light. The cnnstitidional symptoms may be summed up as those of fever. There is a rise of temperature—often pre- ceded by chilliness or even a distinct rigor, a quickened pulse, dry skin, furred tongue, loss of appetite, consti- pation, scanty and high-coloured m-ine, headache and general feeling of malaise. When the inflammation is slight there may be no fever; but when it is at aU intense, or occurs in an important part, it is generally considerable, and in septic and infective inflammation is by far the most anxious symptom. Inflammatorv fever has been divided into the sthenic, asthenic, and the irrita- tive or nervous. In the sthenic the sj-mptoins are acute, the temperature is high (104° or 105°), and the pulse full, strong and bounding. In the asthenic the symptoms assume Avhat is called a typhoid character; the tempera- ture falls, the tongue becomes brown and dry, the hps and teeth are covered with sordes, and the pulse is quick, soft and feeble. In the irritative there is m addition to either of the above set of symptoms delirium, violent in the one case, or low and muttering in the other, and a general nervous state. i • i The cause of the fever has been variously explained. In simple inflammation it mavbedue, 1, m ]mrt to tissue- change caused by the presence in the blood of free hbriu ferment (a substance known to possess pyr<)gciuc, ()r ley(>r- producing, properties), which issupiiosed to be (.erived troin the escaped leucocvtes and drained away in the scrum Irom tlio inflanKMl part by the lymidiatics, and, 1>, in part to dis- turbanceortheheat-regulatingcentrcmtheinedullaohlon- -ata, either induced reilexlv, through the sensory nerves, as when there is much pain and tension in the inflamed part, or directly, by the action on it of the delenorated blood. In septi(! inflammations the absorption of the products of fermentation or putrefaction, as from a septic and i l-dranied wound, has no doubt a largo share in the production of the f(!ver, which is then spoken of as septic {septic ./em-, sapmviia); whil^st in the infective inflammations the
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