Elements of medicine : a compendious view of pathology and therapeutics, or the history and treatment of diseases / by Samuel Henry Dickson.

  • Dickson, Samuel Henry, 1798-1872.
Date:
1855
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Licence: Public Domain Mark

Credit: Elements of medicine : a compendious view of pathology and therapeutics, or the history and treatment of diseases / by Samuel Henry Dickson. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    I am not prepared to give an unqualified assent to any one of the numerous theories of inflammation. Let us for a moment reflect upon the difficulty of constructing any hypothesis which shall explain or con- sist with all the observed facts, as they are not only differently de- scribed by the authorities, but acknowledged by all to vary during the several stages of the process. The circulation is at one time slower, at another more rapid! What state of the affected vessels will account for these opposite conditions? If we attribute the afflux of blood to spontaneous dilatation of the vessels (as Hunter did), we shall find it difficult to explain the slowness and ultimate stagnation of the blood described by the microscopic observers, in arteries and veins, whose powers of action are heightened, and whose functions performed with greater vigor. If, on the contrary, we regard the vessels (with Thomson) as weakened and debilitated, we shall be embarrassed to account for the accelerated circulation of the early periods, the lively sensibility, the florid redness so quickly restored after the surface has been made pale by pressure. Thomson affirms the velocity of the blood to be sometimes increased and sometimes diminished. What common vascular condition may serve as the cause of these contrasted states ? Parry refers all the symptoms to an increased momentum of the blood in the part affected; but this he does not ascribe to any satisfactory cause, and has thus removed the difficulty but one step back. For my own part, I consider every theory insufficient in its own nature, and untenable, which shall proceed upon the supposition of a mere increase or abatement, enhancement or diminution of action, excitement, power. Inflammation is a condition essentially morbid, not in degree only, but in its very nature; and this is made equally clear, whether we refer to its consequences, its symptoms, or its causes. These causes, infi- nitely varied as they are, not only affect the force or intensity of action in the part which they impress, but go mainly to determine the mode which that action shall assume, and the results which it shall produce; an influence which is exerted as well by the exciting, occasional, or accidental causes, in many instances, as it is in all by the predisposing or constitutional. In the meanwhile, the normal or physiological actions are suppressed, subverted, and substituted by the new and diseased actions, and these may be either more or less forcible than the former. Inflammation, like fever, may be either sthenic or asthenic; an alternative probably determined by the state of the system at the time, which may be either entonic or atonic. Less frequently, perhaps, it may take a local cha- racter, from the nature of a cause locally applied. The condition of the blood in inflammation deserves attention here, as it has been supposed to throw some light on the obscurities of this dark subject. Not long since, says Andral, in his Hematology, Meckel defined inflammation to be congestion, with a tendency to new production. The study of the blood, proceeds Andral, shows the justness of this definition. For what else than a new production is