Again, it not unfrequently happens, when inflammation has occurred in
the surface, and continued for a short period, that it spontaneously
disappears, and does not again return; the action is said to terminate
in _Delitescence_, and of course this is always a favourable
occurrence. But if the inflammation, after having suddenly disappeared,
attacks another part at a distance from that first affected, the change
is termed _Metastasis_. If the inflammation leaves an internal viscus,
and appears on the surface of the body, the circumstance is favourable;
but if it leaves the latter to attack the former, the result is highly
dangerous.
_Treatment._—In the treatment of inflammation, with a view of procuring
resolution, our attention must be first directed to the exciting cause:
it is, if possible, to be discovered, and removed. Thus, foreign bodies
are to be extracted—fractures reduced—strictures divided—unnatural
accumulations of fluid withdrawn, &c. In many cases, if the exciting
cause is removed, nothing more is required; the inflammation speedily
subsides. If the cause cannot be removed, or if, after its removal, the
inflammation proceeds unabated, the arterial action must be reduced
by general and local abstraction of blood. By general depletion, the
action of the whole sanguiferous system is diminished, as well as of
those vessels more immediately engaged in the morbid action; but the
affected capillaries are still dilated, and less capable than the
larger trunks of effective contraction to propel their contents; and
are therefore only sufficiently depleted by the local abstraction of
blood, by leeches,[3] cupping, punctures, or incisions.[4] Blood may
be drawn either from arteries or from veins. In Arteriotomy, the blood
is discharged more rapidly, and its flow is of longer continuance,
than from a vein, so that the system may thereby be almost completely
deprived of its circulating fluid; and perhaps a more speedy impression
may be made on the inflammatory action. One objection to venesection
is, that after frequent and copious venous hemorrhage, the internal
vessels become gorged with blood, and a disposition to apoplexy is
induced.
But bleeding is not to be had recourse to without due consideration of
the age, strength, constitution, and idiosyncrasy of the patient; if
employed, it must be modified according to these; and it has already
been mentioned, that depletion is not always to be persevered in on
account of the presence of the buffy coat.[5]
Public-domain text, read in full here on John Shaqi.
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