The star of the north. [volume] (Bloomsburg, Pa.) 1849-1866, 1856-08-20
From The Medfcqi Reforuer.-
INFLAmMATvON.
ny JOHN s. pRErTYMAN, NJ. D.

ny JOHN 8. PRETTYMAN, MD.
The term Inflammation is applied to a col.
lection of phenomenon that are found asso-
ciated together in any portion Of the organ
| ism where sufficient obstruction to the vi
tai functions exists. These phenomena are
all the result of the increased amount of
blood determined to the part by kind of
vital, vegetal action peculiar to all the high
er grades of organized bodies.
1t is unnecessary that we enter into an
original minute description of all the ana.
| tomical, physiological and pathological
changes that occur from the inception to the
| termination of the inflammatory condition,
| for in such case it would necessarily be a
repetition of what had been well said by
many writes of modern times, and perhaps
| by no one better and more concisely than
| by the world renowned author of 'Iectures
| on the Principles and Practice of Physic,"
Thomas Watson, M. D., ETC., from whom
for, the purpose of analysis and induction.
as well as for the description, we shall
| quote:
! Let US suppose, that healthy man re-
|
| he falls, for instance against window, and
gets piece of glass stuck into his arm. In
a short time he begins TO have pain in that
| part of the arm, and this is soon succeeded
by redness, and increased heat and swell
| ling. The skin becomes of bright red col,
| or the swelling increases. In the immedi
ate place of the injury the swelling is firm
and hard, and exquisitely tender: at some
distance from that centre, although there is
still swelling, the parts are softer and more
| yielding. In the seat of the reduess and
swelling the patient experiences sense of
heat, burning pain; the part is sensibly
hotter than natural TO the touch of by
stander; and if its actual temperature be
| measured by means of thermometer, it
will be found to exceed the temperature of
the neighboring surface. Thepart is i'vamed.
The first condition here noticed is one of
injury TO the vital organs of the part. Our
author states that in a short time he begins
to have pain in the part; but it is very GER
tain that the sensation of pain is felt on the
instant the injury is inflicted. This messen.
ger (pain) instantly conveys TO the sensori-
um an indication of the injury, and the con-
tinued presence of an irritant, keeps up this
effect upon the nerve, which constitutes ir
ritation. Irritation then is vital act, excl
ted and maintained by any thing that inter-
feres with the integrity of the organism. 1t
is simply continuation and eXaltation of
sensibility, in consequence of the continued
application of the cause or condition that
excites it. Irritation then, may be consider
ed the first step, on the part of the organ
ism, toward inflammation. The sensation
received by the nerves at the seat of the at
tack, by a reflex action, excites change in
the circulation of the part and the bloodves-
sells are seen to contract, (Pagets Lectures
on surgical pathology p. 1857 and their con-
tents are forced onward more rapidly. If
now the excitant or the condition that gave
rise to this action is removed, this state grad.
ualy ceases and the vessels and the circu-
lation through them assume again their av-
erage or normal slate. But in the case pro-
posed by Mr.. Watson the remote or exciting
cause is still continued and we soon have
the second step in the inflammatory pro-
cess, active congestion, fully developed.
This state consists in general enlarge
| ilCut VI thO plooo-FCco0io VI tuO pdit, Will
an increased flow of the blood in them, ac-
companied by redness, heat and swelling.
s'In the immediate place of the injury the
swelling is firm and hard, and exquisitely
tender: at some distance from that centre,
although there is still swelling, the parts
are softer and more yielding" In the i'm.
) mediate place of the injury, the power and
elasticity o. the vessels is weakened and
overcome; consequently they are unable to
force the blood, that is driven into them from
the sound and healthy arteries, on, in its
natural channels. This stale of the vessels,
a state of loss or debility of function, is a
sine qua non Of the inhammatory process
The inability of action on the part of the in
jured vessels admits all the blood that can
be forced into them, without the power on
their part to expel it. This constitutes a
state of "passive congestion at the imme.
diate seat of the injury, and plainly indi-
Gates the reason of the firmness ofthe swell
ling at that part; while the sound vessel Of
the immediate vicinity are in condition ol
"active conjestion," until their natural con.
tractility is overcome by the encroachments
of the passive coniestion' at the seat of the
injury. In every case of Inflammation we
have these two conditions of the circulation
: plainly manifest. That of "passive conges
q tion" at the immediate seat of the injury, as
: the legitimate result of a loss of function
i. and that of ''active congestion" consequen
s upon an exaltation of function in the sount
!. and unobstructed vessels of the immediate
vicinity, In consequence of the loss Of func
tion in the vessels, that are the seat of the
e "passive CONGESTION" the circulation in tha
g part ultimately ceases, and the blood loose,
}. its vitality, when destructive chemica
9 process is set up by which the solids and
!, fluids that have been deprived of their vital
: ity are changed into pus.
The symptoms Of this second stage of the
inAammatory process, are increased red
g ness, heat, pain and swelling; let us exam
n inc them. z,..... y9s4
I'll The redness is increased because the yes