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Symptoms of Inflammation

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There are four chief symptoms of inflamma tion, namely, redness, heat, swelling, and pain. These can each be related to the occurrences in the inflamed region which have been already fully described.

Redness and heat are both due to the in creased quantity of blood flowing to the part along the widely-dilated blood channels. The redness may vary from a bright pink in the early stages, when the blood is easily passing along the vessels, to a duskier hue as stagnation tends more to occur. If complete congestion is taking place, then the part assumes a deep-pur plish hue. The recognition of the causes of these differences in colour is of the utmost im portance from the point of view of treatment. For instance, heat or cold may be applied locally to an inflamed region, in some cases iced cloths may be a suitable application, and it is sometimes difficult to say beforehand whether beat or cold will be the more suitable. _mit if the part is rosy red, one knows that while there is an active rush of blood the vessels are not blocked, and the stream is flow ing on freely. In these circumstances cold is more likely to be useful by contracting the still active vessels and limiting the rush. But if the part is already purple, the vessels choked with blood, and that blood nearly stagnant, one knows the whole area must be of greatly im paired vitality, and cold can only still further impair it, and possibly irretrievably damage it, while warmth may be able to promote a re storation of the flow.

While the beat of the inflamed part is greater than that of surrounding parts, it is not higher than that of the blood in the interior of the body.

Swelling is due to the cells which have migrated from the blood-vessels and to the fluid exuded from them, as well as to the ex cessive quantity of blood in the part. In later stages of inflammation it will also be partly due to the production of new cells by the inflamed tissue. It will depend upon the proportion of

each of these contributing causes whether the swollen area is to the touch firm and hard, or boggy and dropsical — oedematous, as the technical word is. In the latter case the swell ing is due mainly to fluid effusion.

Pain is due to pressure upon nerve-endings within the inflamed tissue, exerted by the accumulated cells and exudation. Wherever, therefore, the tissues are dense and yield with difficulty, the pain is more severe; wherever the tissues are lax, and room can easily be made for the increased material among the tissues, the pain is less. This explains why toothache is so severe, the products of Milani illation, being confined within the narrow space of the pulp cavity of the tooth, pressing on the sensitive pulp. It also explains why the pain of inflamed bone is of so boring and intense a character.

Referred is not always con fined to the region of inflammation, is indeed not always felt there. In early stages of hip joint inflammation the pain is felt at the knee; the pain due to appendicitis may be felt at first, not over the site of the appendix, but <;n the region of the navel, and at the pit of the stomach. Pain thus felt at a distance from the seat of production is called referred pain.

Loss of Function, more or less, occurs in an inflamed part, due frequently to the para lysing effect of the pain, but partly also to the mechanical difficulty caused by the swell ing.

Attending these local symptoms there may occur other symptoms indicating that the body in general is being affected by the local inflam mation. The most of these is a rise in the temperature of the body, that is to say, fever. This is discussed elsewhere (see p. 504).