Manual of Surgery - Volume First: General Surgery. Sixth Edition. by Alexis Thomson;Alexander Miles
page 65 of 798 (08%)
page 65 of 798 (08%)
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_Redness_, similarly, is due to the increased afflux of blood to the
inflamed part. The shade of colour varies with the stage of the inflammation, being lighter and brighter in the early, hyperæmic stages, and darker and duskier when the blood flow is slowed or when stasis has occurred and the oxygenation of the blood is defective. In the thrombotic stage the part may assume a purplish hue. The _swelling_ is partly due to the increased amount of blood in the affected part and to the accumulation of leucocytes and proliferated tissue cells, but chiefly to the exudate in the connective tissue--_inflammatory Ådema_. The more open the structure of the tissue of the part, the greater is the amount of swelling--witness the marked degree of Ådema that occurs in such parts as the scrotum or the eyelids. _Pain_ is a symptom seldom absent in inflammation. _Tenderness_--that is, pain elicited on pressure--is one of the most valuable diagnostic signs we possess, and is often present before pain is experienced by the patient. That the area of tenderness corresponds to the area of inflammation is almost an axiom of surgery. Pain and tenderness are due to the irritation of nerve filaments of the part, rendered all the more sensitive by the abnormal conditions of their blood supply. In inflammatory conditions of internal organs, for example the abdominal viscera, the pain is frequently referred to other parts, usually to an area supplied by branches from the same segment of the cord as that supplying the inflamed part. For purposes of diagnosis, attention should be paid to the terms in which the patient describes his pain. For example, the pain caused by an inflammation of the skin is usually described as of a _burning_ or _itching_ character; that of inflammation in dense tissues like |
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