Licence: Public Domain Mark
Credit: Surgery. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![is soft, threach', and coniprt'ssihlc ; the tcm])eraturc is alst) higher, mounting uj) to 104° V. or 105 F. ; the tongue is dry and covered with a brown fur, and sordes often collects on the teeth ; there is rapid emaciation and loss of strength. The skin feels l)urning hot and is dry ; the face flushed, and the eyes suffused. Delirium is more often ])resent than in the sthenic form, but it is of a low muttering variety, and the patient often lies in bed in a semi-conscious state, and scarcely recognising those about him. The treatment of acute inflammation.—In considering the treatment of acute inHammation, we must discuss its prevention and its cure. Preventive treatment.—The term preventive treatment of inflammation is often used ; but it is not a good one, and is .somewhat loosely applied. If inflammation is the 'response of living tissues to injury,' it is clear that we must have inflammation for the purpo.ses of repair after every injury, and to prevent it would do incalculably more harm than good. What is meant by preventive inflammation is limiting the inflammation to its simple adhesive form, and preventing the occurrence of any of those sequels of the process alluded to above, such as suppuration, ulceration or mortifica- tion. And the way to do this is to, as far as possible, remove the cause and so prevent a continuance of the inflammation, and an excessive exudation of inflammatory products, which is the potent cause of these untoward results. Now the various causes of inflammation may be summed up in the one word 'unrest,' and this may be either mechanical or chemical. Amongst the mechanical causes may be enumerated the presence of foreign bodies, the movement of parts, pressure, tension, gravitation from allowing a limb to hang and thus impeding the circulation. All these causes may be removed by attention to detail, and thus a condition of perfect rest obtained and a limitation of the inflammation to its simpler form. Amongst chemical causes are the various chemical products result- ing from decomposition and the specific poisons of the various infective microbes. The former of these two we can prevent by excluding one of the factors of putrefaction, either the dead animal matter or the ferment, without which the process cannot be carried on. The infective micro- organisms, being sometimes admitted into the body by the respiratory and digestive tracts, we cannot always succeed in excluding by local means. In this place we shall only consider the treatment of inflammation as applicable to cases where there is no wound, leaving the consideration of the treatment of inflammation arising from open wounds until we come to discuss these injuries. We shall consider first the local and then the constitutional treatment of these cases. Local treatment of inflammation.—Having as far as possible removed the cause, the first indication is to lessen the vascular engorgement of the part, for by this means we diminish the pain and reduce the amount of the exudation. There are several ways in which this congestion may be lessened, viz. by the application of cold or heat; by local depletion, by position, or, as has been suggested by some, by ligature of the main artery of the limb. The use of cold as a remedy for relieving the local congestion of an inflamed part is one of the most powerful which the surgeon has at his command, but at the same time it is one which requires using with discre- tion, since if too long applied or too intense it may lead to gangrene ; hence it should only be used very judiciously and in the early stages of](https://iiif.wellcomecollection.org/image/b21210846_0053.jp2/full/800%2C/0/default.jpg)
