_Throbbing_, to a greater or less degree, is always felt in an inflamed
part by the patient; and it is frequently so distinct as to be readily
perceived by an attentive examination. This arises, probably, from
the stagnation of blood in the vessels of the part over-excited, and
principally affected by the disease or injury, causing an increase in
the collateral circulation; and it is this rapidly increased action
around that gives rise to the signs and symptoms, and constitutes,
in point of fact, what is known and recognised as inflammation. The
sensation of throbbing is not, however, produced entirely by the action
of the capillary vessels, but in consequence, also, of the larger
trunks in the neighbourhood sympathising with these capillaries,
and so having their action increased also. The obstruction of the
capillaries in the early stage of inflammation must necessarily cause
a greater force of the heart to be expended on the trunks leading to
such capillaries; hence the greater impulse and velocity of blood in
the circumferential and patent vessels. In fact, when the inflammatory
action is extensive or severe, or when the part affected is of much
importance to life, the whole circulating system is disturbed, and thus
arises the sympathetic excitement of the constitution.
The incited action of those vessels in the more immediate vicinity of
the inflamed part is well marked in cases of Paronychia. There the
digital, the radial, and ulnar arteries, with their branches, beat more
violently than usual; and with much greater force, though not more
rapidly, than the vessels in other parts of the body.
_Swelling_ is caused by the enlarged and overloaded vessels relieving
themselves by effusion of part of their contents into the surrounding
cellular texture. The effusion varies in extent and consistence,
according to the degree of inflammatory action, and the species of
resistance offered; at first it is serous, then mixed with fibrin,
and consequently spontaneously coagulable. _Cæteris paribus_, the
greater the resistance, the less the effusion, and the more violent
the inflammatory action; the chance of its speedy and favourable
termination is also more diminished. Even the enlargement of the
blood-vessels produces a certain degree of intumescence previous
to effusion. The relief to the vessels by effusion giving rise to
swelling, when it occurs in loose cellular tissues, may be considered
as a beneficent provision of nature. But in vital organs it may be
productive of the most serious consequences; as in these, very slight
effusion will often endanger the structure of the organ, destroy its
functions, and not unfrequently be attended with fatal consequences.
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