North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
But whilst maintaining the correctness of many of Dr. A.'s views, we are
inclined to the opinion, that he may do some injury to the doctrine he
is advocating, by invariably making use of the word _inflammation_, to
express that condition of the vessels, giving rise to an excessive
secretion of serous fluid. We are ready to admit, and we dare hope, that
few will refuse to do so, that _inflammation_, strictly speaking, will
occasion such an effect; yet, it often happens, that effusion will occur
in cases, where no inflammation can be detected. In such instances, the
vessels are evidently in a state of increased excitement; or in other
words, in a state of irritation, but not of inflammation, which always
implies congestion. This latter morbid condition, may supervene on the
irritation, and occasion a suppression of the serous effusion, and the
formation of coagulable lymph or pus. It is true, it may be said, that
both these states (irritation and inflammation) being an increase of the
life of the part, and requiring the same treatment, may be designated by
the same name. Nevertheless, to prevent confusion, and the quibbling of
some of the opponents of the theory of inflammation in dropsy, we are
inclined to believe, that it is better to substitute the word
irritation, whenever there is merely an increased secretion, and reserve
the word inflammation, to designate those cases, in which there are
decided marks of local excitement and congestion, attended or not with
general fever.
Dr. AYRE, adopting the opinion of Dr. PARRY, regards some cases of local
dropsy as an effect of a general hydropic diathesis, or of a general
inflammatory action of the vascular system, occasioning a local
excitement, ending in dropsy. This is a natural consequence of the
views, entertained by many physicians in Europe and this country, that
fever produces local inflammation. We must confess, however, that all
Dr. A. has said on the subject, is not calculated to carry conviction to
our minds. Thus, one of his reasons for regarding some cases, as arising
from this general vascular excitement is, that they are produced by what
he considers as a general cause,--as cold, for example. But cold
produces local diseases, occasioning, and not preceded by, a febrile
excitement; and if it can, and does occasion anasarca, who will pretend
to assert, from its being a _general_ cause, that this anasarca is a
general disease? Does not cold occasion also ascites, which, in many
cases, is regarded by every one as a local disease, sometimes
terminating in anasarca? If so, why shall we regard anasarca, ending in
ascites, as a general disease? The cases are analogous, and the action
in both should not be explained differently. If the action of such a
cause were really general, and extended to all parts of the body, then
the effects should also be general, and the dropsy should be universal,
which is very far from being always the case.
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