XXXI. On the early stages of inflammations

Abstract

The morbid process designated by the term Inflammation, being one to which every organ and probably every tissue of the body is liable, and comprehending as it does in its progress and consequences by far the greater number of the ills to which flesh is heir, possesses a deeper interest for the physician or surgeon than any other material subject which could be named. The practical importance of inquiries tending to elucidate the essential nature of this process, has been for centuries recognized by all enlightened members of the medical profession; for it is obvious that just views regarding it must tend to promote the establishment of sound principles in the treatment of the diseases which it produces. At the present day more especially, when theory is allowed such free scope, and is permitted to attack the most time-honoured rules of practice, we stand in peculiar need of the beacon-light of correct pathology to enable us to steer a safe course amid the various conflicting opinions which assail us. Yet so far from our knowledge of inflammation being in a satisfactory condition, authorities are at variance upon the fundamental question, whether it is to be regarded, in accordance with John Hunter’s opinion, as active in its nature, and consisting in an exaltation of the functions of the affected part, or whether it should not rather be considered a passive result of diminished functional activity. In seeking for the solution of this great problem, we cannot expect to gain much from the contemplation of the more advanced stages and results of inflammation, such as copious exudation of lymph, suppuration, ulceration, or gangrene. When any one of these has taken place, the nature of the original disease is masked to a great extent by the subsequent changes; and the cell- development which occurs in lymph after its effusion, is no more proof of activity in the inflammatory process, than the loss of the vital powers in gangrene can be accepted as evidence in the opposite direction. It is upon the first deviations from health that the essential character of the morbid state will be most unequivocally stamped, and it is therefore to the early stages of inflammation that attention must be chiefly directed in this inquiry.