Journal Complémentaire du Dictionnaire des Sciences Médicales. Paris. Journal Universel des Sciences Médicales. Paris. Revue Encyclopédique. Paris. Bulletin de l'Athénée de Médecine de Paris. Bibliothèque Médicale. Paris. Journal de Médecine et Chirurgie Militaires. Paris. Journal des Progrès des Sciences Médicales. Paris. Journal des Connaissances Médico-Chirurgicales. Paris. Philosophical Transactions of the Royal Society of London. Medico-Chirurgical Transactions. London. London Medical Repository. Transactions of the Medico-Chirurgical Society of Edinburgh. Edinburgh Medical and Surgical Journal. London Medical Review and Magazine. FORBES'S British and Foreign Medical Review. DUNCAN'S Annals of Medicine. Transactions of the Associated Apothecaries and Surgeons of England. London. Transactions of the Association of Fellows of the College of Physicians. Dublin. London Medical Gazette. Medical Times. #SIMMONS, S. F., M.D., London Medical Journal. 8 vols. London. 8vo. +North of England Medical and Surgical Journal. †London Medical and Physical Journal. †Transactions of a Society for the Improvement of Medical and Surgical Knowledge. 3 vols. London. 8vo. +Medical and Chirurgical Review. 16 vols. London JOHNSON, JAMES, M.D., Medico-Chirurgical Review and Journal of Medical Science. London. 8vo. +Provincial Medical and Surgical Journal. St. Thomas's Hospital Reports. +Guy's Hospital Reports. Dublin Hospital Reports. 4. AMERICAN. New England Journal of Medicine and Collateral Branches of Science. Boston. New York Medical and Physical Journal. American Medical Recorder. Philadelphia. Philadelphia Journal of the Medical and Physical Sciences. Medical and Surgical Register. New York. +North American Medical and Surgical Journal. Philadelphia. 8vo. 5. ITALIAN. Biblioteca Italiana ossia Giornale di Letterature, Scienze ed Arti, etc. Milano. Giornale di Medicina Pratica da VALERIANO-LUIGI BRERA. Padoue. Dizionario Periodico di Medicina. Giornale di Chirurgia Pratica da GIUS CANELLA. Trieste. Repertorio di Medicina. Antologia di Firenze. Giornale Critico di Medicina Analitica. Atti dell'Academia dei Gurgafili di Firenze. Annali Universali Medicina; da ANNIBALE OMODEI. Milano. FIRST DIVISION. OF INFLAMMATION. FIRST SECTION.-OF INFLAMMATION IN GENERAL. BRAMBILLA, G. A., Tratato Chirurgico-pratico sopra il Flemone ed il suo esito, ed altri punti importanti di Chirurgia. Milano, 1777. 2 tom. 4to. Milano, 1777. BOSCH, H. van der, Theoretisch-practischer Versuch uber Entzündung, ihre Endigungen und mancherlei andere Krankheiten des menschlichen Leibes, wobei die Muskelkraft der Haargefässe zum Grunde gelegt wird. Munster und Osnabrück, 1786. 8vo. WEDEKIND, G., Allgemeine Theorie der Entzündungen und ihrer Ausgänge. Leipzig, 1791. 8vo. HUNTER, JOHN, A Treatise on the Blood, Inflammation, and Gunshot Wounds. London, 1794. 4to. MEYER, J., über die Natur der Entzündung. Berlin, 1810. 8vo. DZONDI, C. H., Aphorismi de Inflammatione. Halæ, 1814. 8vo. GRUITHUISEN, FRZ. V. PAULA, Theorie der Entzündung in Med-chirurg. Zeitung. THOMSON, JOHN, M.D., Lectures on Inflammation, exhibiting a view of the general 8vo. TRAVERS, BENJAMIN, An Inquiry concerning that disturbed state of the Vital Func- SOMME, C. L., Etudes sur l'Inflammation. Brux., 1830. 8vo. TRAVERS, BENJAMIN, A further Inquiry concerning Constitutional Irritation and the EARLE, J. W., On the Nature of Inflammation, with an Account of its Principal Phe- VOGEL, J.. Entzündung und ihre Ansgänge; in Handwörterbuch für Physiologie mit Rüchsicht auf physiologische Pathologie von R. WAGNER. Braunschweig, 1842. p. 311. GERBER, FRIED., Handbuch der allgemeinen Anatomie des Menschen und der Haussängethiere. Bern, Thur, und Leipzig, 1840. 8vo. Ib. translated as " Elements of the general and minute Anatomy of Man and the Mammalia;" to which are added Notes and an Appendix, by GEORGE GULLIVER. London, 1842. 8vo. TRAVERS, BENJAMIN, The Physiology of Inflammation and the Healing Process. London, 1843. 8vo. 1844. JONES, WHARTON, Report on the Present State of Knowledge of the Nature of Inflam- 1844. 8vo. 1. INFLAMMATION (Inflammatio, Phlogosis, Lat.; Entzündung, Germ.; Inflammation, Fr.) is that condition of an organized part in which the vital process and plasticity of the blood are unnaturally raised, and which is manifested by pain, redness, increased temperature, and swelling. The elevation of the vital process must be of a certain duration and intensity, that is it must be actually diseased, when we apply to it the name Inflammation. Thereby, alone is inflammation distinguished from the temporary condition of active congestion and increased turgor vitalis. The proximate cause of these phenomena is indeed the same as in inflammation, and may run into it. The same applies to the so-called inflammatory irritation. [The term "inflammation" has been objected to by ANDRAL (a), one of the most able French writers on pathology. He says:-"Created in the infancy of science, this expression, (inflammation,) completely metaphorical, was destined to represent a morbid condition, in which parts seemed to burn, to inflame, as if they had been subjected to the action of fire. Received into the language, without any precise idea having ever been attached to it, under the triple relation of symptoms which announce it, of lesions which characterize it, and of its actual nature, the expression "inflammation" has become so vague, and its interpretation so arbitrary, that it has really lost all value: it is like a piece of old money without the impress, which must be put out of circulation, as it causes only error and confusion. Inflammation can only be considered as the expression of a complex phenomenon, comprehending many other phenomena, the dependence of which is neither necessary nor constant." (vol. i. p. 9.) He has, therefore, chosen to set aside the term "inflammation" as generally characterizing the phenomena we are about to consider, and has employed that of "hyperamy," restricting it, however, only to that condition of the vessels in which they are loaded or congested with blood, from whatever cause, healthy or unhealthy, such condition may arise. JOHN HUNTER (b) seems to have anticipated these objections; for, he observes:— “The term or idea of inflammation may be too general, yet it is probable that it may form a genus, in which there is a number of species, or it may be more confined in its classification, and be reckoned a species containing several varieties. These are, however, so connected among themselves, that we cannot justly understand any one of the species or varieties without forming some idea of the whole, by which means, when treating of any one, we can better contrast it with the others, which gives us a clearer idea, both of the one we are treating of, and of the whole." (p. 265.) The difficulty, however, is to distinguish the onset of the diseased action, inflammation, from the natural one, congestion or turgescence. Their close resemblance was first pointed out by HUNTER, who observes :-" The very first act of the vessels when the stimulus which excites inflammation is applied, is, I believe, exactly similar to a blush. It is, I believe, simply an increase or distension beyond their natural (ordinary?) size. This effect we see takes place on many occasions: gentle friction on the skin produces it; gently stimu lating medicines have the same effect; a warm glow is the consequence similar to that of the cheek in a blush: and, if either of these be increased or continued, real inflammation will be the consequence." (p. 279.) So ANDRAL:-"Will anatomy establish any line of demarcation between physiological (healthy) and pathological congestion? No more than the latter can always be strictly separated from the complex phenomenon called "inflammation." Thus, under the influence of violent emotion, vessels appear on the conjunctive coat of the eye, and the lids become red. The same effect follows a grain of sand falling on the front of the eye; insensibly does the congestion increase from that almost normal condition in which vessels appear on the conjunctive coat to that when the mucous membrane of the eye, becoming uniformly red and considerably swelled, presents that variety of opthalmy known as chemosis." (vol. i. p. 13.) The same language is held by MULLER (c): -"Inflammation begins, indeed, with phenomena which are similar to turgescence. The organs attract more blood than usual, in consequence of the altered affinity between the blood and the tissue, and obstructs its efflux; but we must be very cautious in calling increased vital action that important change caused by inflammatory irritation which produces functional disturbance, and has consequent to it an effort of nature to compensate an injury which has interfered with the action of the organ. Had the vital action been increased, so would not the morbid processes of inflammation have occurred." (vol. i. p. 218.) HUNTER also observes :-" Though pure inflammation is rather an effort of nature than a disease, yet it always implies disease or disturbance, inas(b) On the Blood, Inflammation, &c. (c) Handbuch der Physiologie des Menschen. (a) Précis d'Anatomie Pathologique. much as there must be a previous morbid or disturbed state to make such effort necessary." (p. 260.) Again:" Inflammation is to be considered only as a disturbed state of parts which require a new but salutary mode of action to restore them to that state wherein a natural mode of action alone is necessary: from such a view of the subject, therefore, inflammation in itself is not to be considered as a disease, but as a salutary operation, consequent either to some violence or some disease." (p. 249.) "Inflammation is not only occasionally the cause of diseases, but it is often a mode of cure, since it frequently produces a resolution of indurated parts, by changing the diseased action into a salutary one, if capable of resolution." (p. 250.) "Inflammation may first be divided into two kinds as first principles, viz., the healthy and the unhealthy. The healthy probably consists only of one kind, not being divisible but into its different stages, and is that which will always attend a healthy constitution or part, is rather to be considered as a restorative action than a diseased one, and would rather appear to be an effect of a stimulus than an irritation. The unhealthy admits of vast variety, (diseases being almost numberless,) and is that which always attends an unhealthy constitution or part, but principally according to the constitution: however, many parts naturally have a tendency to run into inflammations of particular kinds.**The simple act of inflammation cannot be called specific, for it is an uniform or simple action in itself; but it may have peculiarities or specific actions superadded. Inflammation is either single or compound: it may be called single when it has only one mode of action in the part inflamed, as in its first stages; compound, when attended with another mode of action, or when it produces other effects." (p. 251.)] 2. All organs of the body may become inflamed except the cuticle, hair, and nails. The disposition to become inflamed depends on the number of nerves and capillary vessels in a part. The actual seat of inflammation is always the capillary-vascular system, and the ganglionicnervous system, accompanying the most delicate branches of the vessels, which specially presides over vegetation in the organism. 66 ["Inflammation," says HUNTER, "may arise from very different causes, and often without any apparent cause, and its operations are far more extensive than simply the act of producing union in parts divided by violence." (p. 248.) Susceptibility for inflammation may be said to have two causes-the one original, the other acquired. The original constitutes a part of the animal economy, and is probably inexplicable. Of the acquired, it is probable that climate and modes of life may tend considerably either to diminish or increase the susceptibility for inflammation. The influence, however, of climate may not be so great as it commonly appears to be; for it is generally accompanied by modes of life that are not suited to others." (p. 226.) Inflammation, when the constitution is strong, will be commonly the most manageable, for strength lessens irritability; but in every kind of constitution inflammation will be the most manageable where the power and the action are pretty well proportioned; but, as every part of the body has not equal strength, these proportions cannot be the same in every part of the same constitution. According to this idea of strength, the following partsviz., muscles, cellular membrane, and skin,-and more so, in proportion as they are nearer to the source of the circulation-will be most manageable in inflammation and its consequences, because they are stronger in their powers of action than the other parts of the body. The other parts, as bone, tendon, ligament, &c., fall into an inflammation, which is less in the power of art to manage, because, though the constitution is good, yet they have less powers within themselves, and therefore are attended with the feeling of their own weakness; and I believe they affect the constitution more readily than the former, because the constitution is more affected by local disease, when the parts have less power within themselves of doing well; and the effects, if bad on the constitution, reflect a backwardness on the little powers they have. The inflammation, if in vital parts, will be still less manageable; for, although the parts themselves may have pretty strong powers, yet the constitution and the natural operations of universal health become so much affected, that no salutary effect can so readily take place, and therefore the disease becomes less manageable. *** In weak constitutions, although the inflammation be in parts which admit of the most salutary operations, in the time of the disease, and in situations the most favourable to restoration after disease, yet the operations of inflammation are proportionably more backward as to their salutary effects in such constitutions, and more or less, according to the nature of the parts affected.” (pp. 228, 9.)] |