Surgery, its theory and practice / By William Johnson Walsham.

  • Walsham, William Johnson, 1847-1903.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Surgery, its theory and practice / By William Johnson Walsham. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    22/1350 (page 2)
    When the cause remains chronically active {Chronic inflammation, see p. 17), degeneration and regeneration continue, the latter often indeed going on to fibrous thickening in excess of that useful for repair. A clean-cut wound, involving simply a division of the continuity of the tissues, is followed by very little cell and tissue degeneration and pathological exudation, so long as the causes of suppuration, especially the pyogenic micro-organisms, are prevented by the methods introduced by Lord Lister (see Wounds, pp. 48, 177) from becoming active. Thus the inflammation leading to the repair of such a wound is one mainly of cell and tissue regeneration. Inflammations of a special character are set up by vario\is organisms (see Infective Organisms, p. 57), the character varying with the organism. Whilst inflammation includes regeneration by cell-proliferation, and whereas in chronic inflammation the cell-proliferation may continue beyond that useful for repair, yet the continuous cell- proliferation which characterises neiv growths or tumours proper, whether benign or malignant (see Tumours, p. 116), is not at present regarded as similar to the process of inflammation either in its causation or in its course. However, these new growths, by the products of their excretion and degeneration, act as a cause of inflammation. Naked-eye outlines of the process of inflammation,— Inflammation may occur anywhere in the body, and in whatever tissue or organ it occurs, whether on the surface of the skin or of a serous or mucous membrane, or in a deep organ, in a tissue vascular or non-vascular, hard or soft, the process is essentially the same. Inflammation of the skin.—The affected area of skin shows, in com- parison with that surrounding it, the four classical signs of inflamma- tion : redness, swelling, heat and pain, to which may be added a fifth, viz., disturbance of function. The redness may be uniform and towards the margin fade away into the natural colour of the surrounding skin ; at first it disappears momentarily on pressure, but later may become mottled and of a deeper hue, and not disappear when the finger presses on the skin. This redness is due to dilatation of the blood-vessels; hence it varies much, being marked where the skin is vascular and the vessels dilatable, as on the face and limbs, or the reverse, as on the hairy scalp and palm. The increased heat is due to the same cause, dilatation of the blood- vessels, so that the inflamed surface gives off more heat and feels hotter than is normal for that particular siirface. The warmth of the skin surface thus more nearly approaches the heat of the blood in the large vessels, varying according to the vascularity. Normally the skin over the patella, when exposed for a minute, strikes cold to the palm of the hand, but a sensation of warmth is felt when the knee-joint is even slightly inflamed and although no redness can be