The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
1. =Resolution.=--The speedy subsidence of hyperemic phenomena is known
as _resolution_--a term which has also been applied to the retrograde
phenomena after a genuine inflammation. For present purposes it
implies, first, the subsidence into inactivity of the exciting cause
or its complete removal. This may include the passing of an emotion,
the removal of an irritant, the loosening of a bandage, the resort to
certain applications or to constringing or astringing measures by which
the effect is counteracted. A particle of dust in the conjunctiva may
within a few moments produce an active congestion of the conjunctival
vessels, which, ordinarily scarcely visible, becomes prominent and
easily noted. The removal of the offending substance permits a return
to their original size in perhaps a half-hour. This is an example of
the speedy subsidence of the hyperemia of dilatation after removal of
the cause. Should the hyperemia not subside promptly, it is well to use
cold applications, or in this instance an astringent collyrium, or some
agent whose physiological effect it is to produce vascular contraction,
as cocaine, adrenal extract, etc.
2. =Acute Swelling.=--When the effusion above referred to takes place
into loose connective tissues the condition is spoken of technically
as _edema_, while when it occurs into a previously existing cavity,
such as that of a joint, it is known as an _effusion_. The amount of
blood thus effused will be influenced by the anatomical and mechanical
conditions existing about the part. It may be presumed, as a general
rule, that when the extra vascular pressure equals the intravascular
pressure little or no more fluid may escape. As a matter of fact, it is
seldom that the former rises to the degree of the latter. Conversely,
one method of treating such edemas and effusions is by some device
which shall make the extravascular pressure exceed the intravascular,
when the fluid is, as it were, forced back into the vessels, and is
made to resume its proper place within the same. This is often done by
taking advantage of elastic compression, as when a rubber bandage is
applied about the part. In certain parts of the body it may be done by
pressure brought about by some other device. Pressure may be used for
two purposes:
_A._ To so increase extravascular pressure as to limit the possible
amount of an effusion, as when it is put on early after an injury; or,
_B._ When it is used as a later resort for the purpose of reducing
swelling which has already occurred.
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