Page:The American Cyclopædia (1879) Volume IX.djvu/289

INFLAMMATION 27; thinks that in warm-blooded animals stagna- tion will be found in only the most severely inflamed parts, while in the others retarda- tion only exists. The difference of appearance in the red corpuscles in natural human blood and in that drawn during inflammation is worthy of notice. In healthy blood they have a ten- dency to run together in rows like a pile of coins tipped over, while in blood drawn during inflammation there is a tendency to run togeth- er in masses, leaving larger spaces of liquor sanguinis between them. According to pres- ent views, the effect of inflammation in recent wounds is not to promote direct healing, but to prevent it. When a fresh wound in a healthy person is closed and the blood forced out from between the cut. surfaces, the severed capillaries unite directly, without, it is main- tained, the exudation of plastic lymph ; but if the lips of the wound are allowed to gape, an inflammatory action takes place, plastic lymph is poured out, and granulation follows in the manner above described. The conservative action of inflammation rnay be observed in the healing of punctured or gun-shot wounds of the cavities of the body. When a puncture has been made into the abdomen, the great danger lies in the development of extending inflammation of the peritoneal membrane, and it is greatly increased if any of the contents of the intestines are poured into the space be- tween its surfaces. The irritation produced by the injury excites adhesive inflammation between the different layers which compose the walls of the abdomen, and thus a simple channel is established between the exterior and interior, which in course of time may heal by granulation and suppuration. Severe cases of inflammation, as that which supervenes upon a compound fracture, are attended with marked characteristic symptoms. There is a feeling of heat, and of alternate heat and chilliness ; the skin and mouth are dry ; the pulse becomes rapid and the patient restless; the urine be- comes scanty and more highly colored than natural, and great thirst is experienced; the tongue is dry and coated with a whitish fur ; sleep is absent or greatly disturbed, and a de- gree of delirium comes on, more especially at night ; there is usually constipation, but when the bowels act, which generally requires medi- cine, the excretions are very offensive; there is great swelling and tenseness of the tissues of the injured part, which when it subsides is attend- ed with a remission of the constitutional symp- toms; the skin and mouth become moist; the delirium and restlessness pass gradually away, and the patient sinks into a slumber. The causes of inflammation are various, and may be divided into two classes, predisposing and exciting. The predisposing causes embrace constitutional and hereditary tendency, food, climate, season of the year, and habit of body. The exciting causes are poisonous substances, including the poisons of different diseases; irritants, such as cantharides, pepper, mustard ; caustic escharotics, strong acids, very hot and cold bodies, wounds, and also exposure of the person to wet and cold, or to sudden changes of temperature. Excessive mental excitation is a cause of inflammation of the brain. Inflam- mation may be acute or chronic. That which has been described is acute. After a subsi- dence of the intensity, if the action continues, in consequence of any source of irritation re- maining, or from a want of tone of the parts, it becomes chronic, and from the latter cause the symptoms sometimes assume the chronic form from the outset. Inflammation is said to be healthy or unhealthy. If restoration takes place during the process, it is said to be healthy ; but if there is wasting or destruction of tissue, as in ulceration or mortification, it is said to be unhealthy. It may also be common or specific ; the latter term being employed to denote that which is caused by certain conta- gious poisons, such as smallpox, gonorrhoea, and erysipelas. It is sometimes called after the tissue in which it occurs, as mucous or serous inflammation. Inflammation of particular or- gans is usually designated by adding the ter- mination itis to the anatomical name of the part affected, as laryngitis for inflammation of the larynx, gastritis for inflammation of the stomach, cerebritis for inflammation of the brain; but the old nomenclature is often re- tained, as pneumonia for pneumonitis, quinzy for tonsillitis. No nomenclature, however, is better than the employment of the word in- flammation, together with the name of the organ or part inflamed. Inflammation is most likely to attack children under ten years of age, nearly one half of the mortality of the race occurring during these years. Inflam- mations of the pleura, brain, liver, and mem- branes of the heart are more frequent after the age of manhood. Spring is more favor- able than any other season to the develop- ment of inflammation, and moist weather than dry, as is exemplified by the great rarity of inflammatory diseases in the regions bordering on the Pacific coast. The color acquired by an inflamed part differs with the degree of in- flammation and the organ affected. The ten- dons and ligaments are seldom reddened. The fibrous membranes, like the pericardium, the dura mater, and the sclerotic coat of the eye, acquire a lilac or purple hue 'inclining to blue. The mucous membrane of the intestines first presents a bright red, but during the progress of the disease becomes a dark violet or a black, especially when passing into gangrene. These changes may be seen in the mucous mem- brane of the throat in an attack of malignant scarlet fever. In inflammation of the pleura and peritoneum (serous membrane) the color commences with a lilac, which afterward pass- es to scarlet, brownish, or violet. In the arachnoid, the serous membrane of the brain, the discoloration is slight, the chief sign of the inflammation being the serous effusion. The salivary glands assume a pink color, the kid-