The treatment of local inflammation depends much on the part affected; if a finger, it requires less promptitude than if seated in the eye; gene rally speaking, local blood-letting, anodyne fomen tations or poultices, perfect rest, attention to the bowels, and abstemious diet, are all that is re quisite. The treatment of general inflammation is by abstracting blood from the system, both locally and generally, by active purging, tobacco enemata, the warm bath, low diet, perfect quiescence, and confinement in a darkened apartment. By a dili gent exercise of these remedies, the inflamed part, or inflamed constitution, may he restored to its wonted state of health; and when local, the vessels gradually become more and more quiescent, until they return to their former healthy condition; but if the inflammatory action has been so severe that the capillary arteries have effused coagulable lymph, then the absorbents are excited to remove this superabundant fluid, and the affected part is longer of returning to health. In the case of the con stitution being involved, or a general inflammatory action of the system, the nervous and circulating systems progressively decrease in their excitement, until they at last resume their natural course. Either of these favourable results is termed resolu tion, but this name is more applicable to the local than the general affection.
A phlegmon, which is derived from /xiyv, to burn, is distinguished by the colour being of a dark purple hue, by the inflammation being circum scribed, by tumefaction, and by an intense pain, which soon becomes throbbing; when this tumour is pressed upon with the finger, the purple colour disappears for a moment. In the treatment of a phlegmon, leeches, anodyne fomentations or poul tices, gentle laxatives, mild diet, and rest should be ordered; and after suppuration, treated as an acute abscess: it is very liable to suppurate, and when occurring in the axilla or groin is styled a bubo. When these phlegmons occur on the face or scalp, they excite the whole system, and then re quire the treatment recommended for general in flammation, combined with blisters to the nape of the neck.
The manner of applying leeches is familiar to all. When few leeches can be procured, it has been proposed to cut of the tail while the animal is sucking, that the blood may flow out as fast as it enters; or to incise the inflamed surface with a lancet or bistoury. In order to encourage the bleeding afterwards, the part should be fomented or poul ticed, or a cupping glass applied. Leeches are preferable to cupping, in affections of the eye lids and other parts of the lace, of the forepart of the neck, the scrotum, the penis, the pudenda and the anus.
Fomentations and poultices are preferable to cold saturnine lotions, in all instances of acute inflam mation; heat being more natural and manageable than cold. Caloric subdues the action of the nervous
and circulating systems by relaxation and ex haustion, and can be procured either in cold or hot weather; while cold does it by causing torpidity, but not until it is reduced to a very low tem perature, and then it is liable to produce mor tification. Many authors consider t hat hot and cold applications should be regulated by the feelings of the patient, but these ought never to influence the practice of the surgeon; for the reason why cold at one time, and heat at another, is more agreeable to their feelings, depends entirely upon the time or stage of the inflammatory action. Thus, for example, cold applied during the in cipient stage, will be more liable to produce pain, than when applied in the chronic; again, heat in the chronic stage, is more apt to produce pain than in the acute; and whenever suppuration is estab lished, or the inflammation becomes chronic, heat invariably increases the pain, and should be discon tinued, cold then being the better remedy. When heat is employed, it must be kept constantly up by renewing the poultices and fomentations whenever they become cool. Poultices are made of turnip, carrot, linseed, barley-meal, onions, oatmeal, and bread and milk, kc., but their virtues depend more on the heat and moisture, than on the materials of which they are composed; the best probably is one made of oatmeal, in a solution of opium with acetate of lead: they ought always to be so large as to cover a great extent of the contiguous healthy surface. The best fomentation is a decoction of POPPY heads and chamomile flowers, with a little opium added. Poultices and fomentations will never promote suppuration, they only appear to do so by moderating the increased action, which, if not attended to, might terminate in mortification; when applied, therefore, in inflammation, before the vessels have advanced to suppuration, they will favour resolution; but if not until the vessels are on the verge of suppurating, they merely moderate the increased action, and hence appear to promote sup puration. The practice of applying alternately cold saturnine lotions the one day, and warm poul tices the next, must seem absurd to the most super ficial observer.
We have already stated that this variety of in flammation has a more diffused character, and is i then termed phlegmonous inflammation, which n cludes Paronychia, Opthalmia. Cynanchetonsillaris, Pleu•itis, Pneumonia, Carditis, Peritonitis, Gas tritis, Enteritis, Hepatitis, Ecc. The treatment of these diseases may be said to be the same as that of phlegmon, or general inflammation, and requires to be combined with external irritants, such as ru befacients, blisters, and moxas.