Volume 1
The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen.
- Date:
- 1895
Licence: Public Domain Mark
Credit: The science and art of surgery : a treatise on surgical injuries, diseases, and operations / by John Eric Erichsen. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
206/1272 (page 174)
![cities. Hahihial excess in eaiing is almost as injurious as excessive drinking ; for, as only a certain amount of food can be properly digested and assimilated, excess above this tends to interfere with healthv nutrition. Chronic lead-, mercury-, and phosphorus-poisoning are other examples of the same class of causes. The alsorption of the chemical products of putrefaction from a wound, as we shall see hereafter, causes severe fever ; and the rapid wasting of the body which occurs in this condition is clear evidence of the serious disturbance of nutrition that it gives rise to. It is the experience of all Surgeons that wounds made during septic fever are exceptionally liable to inflammation, and generally do badly. Saccharine diahctes, which of all conditions exerts the most iujurious influence on wounds and injuries, may perhaps be most conveniently classed under this heading ; as also jaundice when due to simple obstruction of the ])ile ducts. Amongst the causes of impurity of Mood from insufficient elimination of the normal products of tissue change, Bright's disease is the most important. Gout also is perhaps most properly included under this heading. Both these conditions are powerful predisposing causes of inflammation. Diseases of the lungs and liver act in the same way. Amongst conditions due to the insufficiency of some of the normal cotistituents of the blood is anaemia, such as is commonly seen in young women ; and here also might be classed those conditions due to a deficient supply of the necessary elements of food, such as scurvy, from want of fresh, green vegetables, and the general condition of mal-nutrition brought about by deficiency of oxygen in the air habitually breathed and want of food in general. Lastly, there is the constitntional condition known as scrofula, in which inflammation tends to occur under the influence of exciting causes less in degree than those which affect healthy subjects; but the essential nature of this condition is still but imperfectly known. Exciting Causes of Inflammation.—Inflammation is usually said to be the immediate result of local irritation,'''' and the causes of inflammation are commonly spoken of as irritants. Irritation properly means excitement (irrito, I excite) ; and consequently the physiologists speak of tissues possess- ing irritability, when a healthy manifestation of functional activity can be induced by the application of external stimuli. At the time when inflamma- tion was believed to be an exaggeration of the normal activity of the inflamed tissues, the cause that produced it was very naturally spoken of as an irritant. Now that acute inflammation is known to be essentially a condition of dimin- ished vital activity of the tissues in the inflamed area, the term may give rise to some misconception unless the sense in which it is used be clearly understood ; at the same time, its use in the sense of something causing inflammation has become so firmly fixed, not only in surgical but in popular language, that it would be most inconvenient to try to change it. An irritant may, therefore, be defined as something tending to damage the tissues on which it acts, and ternporarily to lower their vitality ; if acting more feebly, it frequently acts as'a stimulus, calling forth manifestations of normal function ; if more severely or persistently, it causes the death of the tissue upon which it acts. Heat may be given as an example. If the skin be exposed to a temperature of about 100° F., simple hypereemia results with increase of normal function, as shown by perspiration ; boiling water applied merely for a second causes](https://iiif.wellcomecollection.org/image/b2197407x_0001_0206.jp2/full/800%2C/0/default.jpg)
