The presence of pain, as a symptom of inflammation, may be easily
explained. The connexion of the vascular with the nervous system
is very constant and intimate. Their ramifications accompany each
other, and are contained in the same cellular sheath; and without the
reciprocal influence of each, neither could perform its functions
perfectly. By injecting a limb soon after its separation from an
animal, and before its vital heat has departed, spasms of all muscles
are sometimes produced; showing the intimate connexion between these
two systems. This, however, is distinct from the contractions of the
muscular fibre produced by the application of stimuli. In the former
case, the contractions are universal, and induced through the medium of
the nerves. In the latter, the irritability of the fibre is excited.
When the circulation is excited, the nerves accompanying the affected
vessels are unusually compressed, and over-stimulated by the
circulating fluid, in which, probably, some change takes place, and in
this manner unnatural impressions are produced; the nerves themselves
are likewise the seat of disease, in consequence of the enlargement
of the minute capillaries which permeate them. Over-distension of the
coats of the vessels may also be supposed to give rise to painful
feelings, independently of any affection of the accompanying nervous
trunks.
The degree of pain is generally in proportion to the sensibility of
the part when in health; it also depends upon the distensibility
of the parts affected, and on the intensity of the inflammatory
action. When bones, tendons, &c., which in their uninflamed state are
nearly insensible, become inflamed, the pain and suffering are most
excruciating, owing to the resistance opposed to the dilatation of the
vessels, and the prevention of the effusion by which they naturally
relieve themselves.
The kind of pain also varies, in consequence of different modifications
in the action causing different impressions on the sensorium. Pain
is not always increased in proportion to the natural sensibility of
the part; for in some instances the sensibility is rendered much more
intense, while in others it is much obtunded.[1]
The last, and, according to some writers, the only unequivocal symptom
of inflammation, is _Heat_. In extravasation of blood into the cellular
texture, as under the conjunctiva, there is redness, swelling,
and occasionally pain; but at first, and unless the action of the
bloodvessels be excited, there will be neither heat nor throbbing.
In many internal inflammations heat is much complained of; and in
Enteritis it has been considered a pathognomonic symptom.[2]
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