Volume 1
A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr.
- Date:
- 1885-1886
Licence: Public Domain Mark
Credit: A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr. Source: Wellcome Collection.
28/1084 page 44
![the tissues outside the vessels, or exerting tlieir action, at tlic outset, u]ion the wall itself. The usual histological relation of vessels and surrounding tissues is such that both are simultaneously affected. The occurrence of an inflammation in non-vascular pai-ts, however, as the cornea, from irritation of its centre, the part farthest removed from the surrounding blood-vessels, shoAvs that the alfection of the vessels may be indirect as well as direct. This indirect action is to be regarded as taking place through the agency of nerves or through that of the nutritive cm-rents. That nei'vous influ- ence alone does not suffice to transmit the effect of an ajiplied cause is apparent from the absence of inflammation of the cornea which has become antesthetized by section of the trigeminus nerve. AVith the protection of the cornea from external irritation there is an absence of inflammation. The consideration of the final symptom of inflammation, the disturb- ance of function, which has been added in recent times, belongs to special rather than general pathology. It varies according to the seat of the inflammation, the disturbed Amction of the brain or heart differing from that of the liver or kidney. The clinical importance of this symptom of inflammation is greater than of all the rest, as it Ls the one whose presence is constant and indispensable. An inflammation may exist, as already stated, -Rnthout heat, redness, or pain. The swelling may escape observation from the limited quantity of the exudation and other causative agents, or from the inaccessibihty of the inflamed part to physical examination. The disturbance of fimction, however, becomes early apparent, and is present tliroughout the course of the inflammation. A knowledge of its nature enables the seat of the latter to be recognized, and its variations furnish a desired test of the efficiency of therapeutic agents. The causes of inflammation may be divided into the traumatic, toxic, parasitic, infectious, dyscrasic or constitutional, and trophic. The traumatic causes are those which act mechanically, producing an injury to tissues by pressure, crushing, tearing, stretching, and the like. Others represent modifications in temperature, thermic agencies, and include extremes of cold as well as of heat. The chemicals whose action is direct, as caustic, include a third variety of the traumatic causes. Such chemicals are applied to surfaces, cutaneous or mucous, and comprise the active element producing the perforating ulcer of the stomach and duodenum, as well as such substances as potash or sulphuric acid which may have been swallowed intentionally or accidentally. The toxic group of causes is closely allied to the chemical variety- of the traumatic agencies. It includes chemicals whose action is indirect, through absorption in a diluted form rather than from direct appliciition in a concentrated condition. Such chemicals are derived from without, as arsenic, phosphorus, and antimony; or may be formed within the body, and the latter include the chemical products of putrefactive changes —in the urine, for instance—and, with considerable probability, certain of the active agents of blood-poisoning in septic diseases. It is not unlikely that some of the inflammatoiy affections met Avith among the so-called constitutional diseases, as rheumatism and gout, may owe their origin to the production of chemical substances within the body, excessive in quantity if not changed in quality.](https://iiif.wellcomecollection.org/image/b20415023_001_0028.jp2/full/800%2C/0/default.jpg)
