The principles and practice of medicine / [John Elliotson] ; edited by Nathaniel Rogers and Alexander Cooper Lee.

  • John Elliotson
Date:
1842
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Licence: Public Domain Mark

Credit: The principles and practice of medicine / [John Elliotson] ; edited by Nathaniel Rogers and Alexander Cooper Lee. Source: Wellcome Collection.

    116/1242 page 96
    lar membrane, there is a more or less cedematous condition, which can be observed externally. But if these effects be very slight, — only tem- porary,—perhaps no inconvenience is produced; and the termination of inflammation is then said to be in “ resolution.” If, however, it be a serous membrane that is attacked, and there be a copious secretion, it is said to terminate in “effusion.” If it be a cellular membrane that has been inflamed, and it does not terminate in resolution, a new fluid is formed, called “pus”; and tbc formation of tbis new fluid is denominated “sup- puration.” If it be a mucous membrane which has been affected, a great discharge either of mucus or pus supervenes ; so that suppuration either from a cellular or mucous membrane may occur. It is actually pus that is formed, in inflammation of a mucous membrane; pus likewise may even be produced by the interior of a vessel. But it is right to say, that although authors call these phenomena “terminations”, vet these copious secretions are not necessarily terminations; and that when the}7 begin, it is not a matter of course that inflammation shall end. Although the part may sup- purate, or fall into a state of effusion, these processes may, nevertheless, be inflammatory. It may still be desirable to go on with anti-inflammatory measures;—since beat, pain, tenderness, and all the marks of inflammation may continue. We ought, I think, rather to say that inflammation, sooner or later, induces these changes; or that these occurrences take place in inflamed parts;—whether the inflammation subsides or not. Inflammation may terminate, however, not in health, either directly or after these pro- cesses, but in death, either general or local. It may destroy life, without the occurrence of any farther change. It is very common to see persons die of enteritis, without mortification, or any other change. It sometimes hap- pens, however, that inflammation does not destroy general life, but the life of the individual part; and then it is said to terminate in “ mortification.” But the inflammation may still continue,—not in the dead part, but in the parts around; and may extend farther, till more parts die. (^Before proceeding to the individual effects of inflammation, it is neces- sary to understand that, according to the accepted theory, in every degree of inflammation, contradistinguished from congestion and irritation, effusion must necessarily occur; the quantity of which obviously varies directly with the intensity of the action. This maybe regarded as a law established by the numerous observations of Kaltenbrunner. Tbc stages of irritation and congestion may pass away without the occurrence of any extravasation ; but he lias uniformly observed, that so soon as the stasis of the blood in the capillaries, which constitutes true inflammation, takes place, so soon does the liquor sanguinis permeate the coats of the vessels, to gain and occupy the surrounding cells. It is therefore certain that, although inflammation may end in recovery by resolution, an exudation of the more fluid part of the blood has taken place. This, of course, wall vary with the character of the structure in which inflammation occurs;—being adhesive albumino- fibrin in serous membranes, glutinous mucus in mucous membranes, and consisting, in the parenchymatous structure of organs, for the most part of inspissated liquor sanguinis.—T. Williams. ] Resolution.—I will now speak particularly of these various “termina- tions”, as they arc called; the first of which (resolution), is reallv a ter- mination. When an inflammation is resolved, all the symptoms decline, and no fresh symptoms arise ; and this is essential to the character of reso- lution. While the inflammation is going on, the urine is gcnerallv bi«vh- coloured, and clear; but when it subsides, there is usually a copious red sediment. The reason assigned for this bv chemists, is the following.
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