During its existence in any important organ of the body, blood taken away from the system, has the inflammatory crust, or buff, on the upper surface of the clot, which is at the same time concave or cupped.
Treatment. 1. Removal of the cause, where that is practicable. 2. Bleeding, both topical and general. The latter is only necessary when the inflammation of the organ endangers life itself, as the brain, lungs, liver, &c.; or when the part has inferior powers of recovery, as a joint ; or where suppuration would entirely destroy the organ, as in ophthal my. The former is effected by means of leeches or cupping. 3. Purgatives, chiefly of the saline kind, as Glauber's and Epsom salts, &c. 4. Antimonial me dicines, which relieve the akin, and di minish febrile action. 5. Reduced diet, including abstinence from fermented or spirituous liquors, and animal food. 6. Evaporation constantly kept up from the surface by folded cloths, wetted with cold washes. This is very powerful in reducing the heat and increased actions of the part. A solution of cerusa. acetat. in tiv. of vinegar and tbij. of dis tilled water is a very good application. Where, on account of concomitant ex travasation of blood, as in bruises, it is desirable to excite the absorbents, wash es supposed to have this effect, and there fore termed discutients, are employed : such as a. ammon. muriat. ss. aceti et spir. yin. rectif. at tbj. 7. arm appli cations, as poultices, or fomentations, oc casionally relieve, when the cold washes are ineffectual.
Inflammation terminates in resolution, which is the gradual subsidence of all the symptoms; in suppuration, or the forma tion of matter ; or in mortification.
Suppuration. The inflammatory symp. toms, instead of yielding to the treat ment, are aggravated ; and afterwards suddenly subside, the patient being seiz ed with shiverings. The swelling be comes softer, and white at its most ele vated part ; and if the collection be su perficial, a fluctuation can be felt. At this time a fluid, called matter, or pus, is contained in a cavity formed in the cen tre of the inflamed part, and termed an abscess. This peculiar fluid is separated from the blood by the inexplicable power of the aecerning arteries, just as ordinary secretion takes place. In a healthy state
it is a homogenous, light, yellow fluid, about the consistence of cream, and pos sessing little smell : but under many cir cumstances of disease, its appearance and properties are entirely changed. The cyst, containing the pus, has a smooth and somewhat vinous surface : it seems to be lined with a layer of coagulating lymph, and the surrounding cellular substance is thickened and agglutinated by the in flammation, so as to prevent the matter from spreading. From the arteries of this part the pus is secreted.
The matter always makes its way to wards the external surface of the body, even if the parts should be very much thinner and less resisting towards any cavity.
Treatment. A soft poultice, until the abscess bursts, or has been opened. The latter operation is performed by a straight two-edged scalpel, or an abscess lancet. It is not necessary, unless the collection be under a fascia, which may prevent it from coming forwards ; or near a joint, or large cavity of the body,•as the belly or chest. A poultice should still be applied after the bursting of the abscess.
Mortification ensues • hen the violence of the inflammation, or its duration, has completely exhausted the powers of the part. The pain subsides ; the part be comes livid, or otherwise discoloured ; the cuticle is elevated into a vesication by a turbid fluid ; the pain and tension are diminished, and air is disengaged into the cellular substance, so as to cause a crackling sensation. To this stage the term gangrene is applied; but when the part has become quite black, and has lost its motion, sensation, and heat, it is called sphacelus.
The blood coagulates in the large ves sels leading to the part, and consequent. ly the separation of the limb is not follow ed by But mortification often occurs without preceding inflammation in parts and sub 4ects where there is great weakness. Ty ing the artery of a limb ; impeding the return of the venous blood; continued topical pressure in a weak constitution ; cold, when followed by the opposite ex treme; are causes of this description. A peculiar mortification, beginning at the toes of old persons, and proceeding up wards, is of this kind.