The ordinary symptoms which characterize inflammation may be known if we observe what takes place when an external part is injured. Let us suppose that a healthy man has a piece of glass stuck in his arm. He soon has pain, then redness in that part of his arm, then swelling, which is hard near the injury, and increases so that some swelling may be observed, though not so hard at a little distance, and the part is quite tender and hot.
These are the ordinary symptoms of inflammation: pain, redness, heat, and swelling, with tenderness that is manifested when the part is pressed.
If the inflammation increases there are signs of disorder in other parts of the body; the patient may be first chilly and feeble, then the skin may become hot and dry all over the body, the pulse fall hard and frequent, lassitude comes on with headache, perhaps pain in different parts of the body; he has also other symptoms of fever; is restless, sleeps ill, loses his appetite, his tongue becomes white, his mouth is dry, he is thirsty, the secretions of the body are diminished, has what is called inflammatory fever, or sympathetic fever, or pyrexia, the last term being now most generally used.
These phenomena, this inflammation, ends in two or three different ways. If measures have been taken for subduing the inflammation—in the supposed case of the arm—if the glass has been removed, it will probably happen that the symptoms above named will disappear. This is to end in what is called RESOLUTION.
When the inflammation goes on until pus is formed it is said to end in SUPPURATION. The symptoms grow more severe for several days, the swelling at length assumes a more pointed form, the skin in its centre begins to look white, and the swelling there gets softer; there is throbbing pain, perhaps the patient has chills or rigors; then when the swelling is cut open or the cuticle breaks a yellow creamlike fluid is poured out which is pus, and there is generally an abatement of the symptoms. If, however, the suppuration or discharge of pus continues for some time, other symptoms are manifested such as frequent shiverings, followed by flashes of heat which end in perspiration; this is HECTIC FEVER.
When the inflammation is still more intense it sometimes ends in MORTIFICATION, the part dies by the violence of the disease, the red color changing to a livid or purplish, or greenish black hue, the flesh losing its sensation and having an offensive odor.
Of course inflammation may be in an organ or structure that is internal, and we determine the seat of the disease, partly by the character of the pain. Sometimes the pain is sharp and piercing; this is its character generally in serous membranes such as the pleura or peritoneum (membranes covering the lungs and intestines.) There is less pain when the inflammation is in the mucous membrane, or in the parenchymatous structure of organs, such as the lungs, liver, and spleen.
There is generally an aggravation of pain upon pressing a part that is inflamed. Pain caused by air distending the bowels and stretching the nerves may be relieved by pressure. Spasmodic contractions of the muscles will cause pain without much tenderness.
OF HEAT AS A SYMPTOM OF INFLAMMATION.
The temperature of an inflamed part exceeds that which belongs to it in health. In inflammation as in fever, it has been known to rise to 107°. The increase of heat depends upon an influx of arterial blood, and therefore of oxygen into the part. There is probably always some increase of heat, though it may not always be noticed in every case of inflammation.