Popular Lectures on Zoonomia / Or The Laws of Animal Life, in Health and Disease

by Thomas Garnett

After each contraction of the muscular coat, the elastic will act as its antagonist, and enlarge the diameter, till the vessel arrive at a mean degree of dilatation, but after this there is no further power of distention inherent in the vessel. The action of the elastic coat ceases; and no one will assert that a muscular fibre has power to distend itself.

The only power by which the vessel can be further distended, is the vis a tergo: after the vessel arrives at its mean degree of dilatation, both the elastic and muscular coats act as antagonists to the vis a tergo, or force which propels the blood into, and thus tends further to dilate the vessel. If then the vis a tergo become greater than in health, the powers of resistance inherent in the vessels remaining the same; or if the latter be weakened, the vis a tergo, or propelling force, remaining the same, the vessel must suffer a morbid degree of dilatation. These appear to be the only circumstances under which a vessel can suffer such dilatation.

But if, while the powers of the vessels remain the same, the vis a tergo, or propelling force, be diminished, or the propelling force remaining the same, the power of the vessels become increased; then an opposite condition or state of the vessels, viz. a preternatural diminution of their area, will take place.

In the one case the distending force bears too great a proportion to the resisting force; and preternatural distention is the consequence. In the other the resisting force bears too great a proportion to the distending force, and preternatural contraction is the consequence.

It is not necessary that the vessels should be in a state of greater debility than in health, in order that an inflammation or distention may take place: it is only necessary that the proportion which their action bears to the propelling force be less than in health. If the propelling force remain the same, the vessels must be in a state of debility before an inflammation can take place; but if the propelling force be increased by a fullness of the vessels and sthenic diathesis, inflammation may take place, although the vessels of the part act as powerfully as in health, or more so. But after inflammation has taken place, as the vessels are preternaturally distended, they must also be debilitated.

The degree of inflammation is not however proportioned to the debility of the minute vessels of an inflamed part, but to the diminished proportion of their power to the propelling force.

When, therefore, inflammation arises from an increased action of the arterial system, or an increased propelling force, while the force of the capillaries or minute vessels remains the same, it constitutes what is called an active inflammation, and is to be cured by general bleedings, and then by gentle applications of tonics to the part, to increase its action; but when it arises from a debility of the minute vessels, without any increase of the propelling force, it forms what is known by the name of passive inflammation; in which general bleeding is not required, but the application of stimulants and tonics to the inflamed part to enable the vessels to recover their lost tone, and restore the balance between their action and the vis a tergo. From what has been said, it must be evident, that if inflammation depend on the diminished proportion of the power of the capillaries to the propelling force, it will be more apt to supervene under the three following circumstances.

1. In a state of plethora, because then all the vessels are over distended, and consequently any cause tending further to distend them, whether it be a cause which debilitates them, or increases the propelling force, will be more felt than in health.

2. In a state of general debility, because the vital powers in any part are more readily destroyed than in health.

3. In a state of general excitement, because then the propelling force is every where strong, and consequently apt to occasion distention of the vessels, wherever any degree of debility occurs. These are the states of the system which are found to predispose to inflammation. In the first and last, the inflammation is generally of that kind, which is termed active: the propelling force is considerable, and the larger arteries are readily excited to increased action. In the second state the inflammation is of the passive kind.