When some of the small vessels by the over-stretching of their contained humours break, together with the lymphatic vessels, and the extravasated blood intermixed with lymph is converted into matter, it is termed a _suppuration_; this is also a favourable way of termination, provided the matter is properly concocted and discharged, and the parts properly healed up again. And this ought to be the second indication when the first does not succeed.
When however the imprisoned humours enclosed by their tubulæ are inspissated, and mix irregularly with the solids that contain them, obstinate tumours are apt to ensue. This is the third kind of termination, and should be avoided if possible; for it either becomes tedious, or occasions malignant ulcers; which in glandulous parts are the first foundation of cancers.
But, when the humours that are obstructed get malignantly corrupted into a pernicious acrimony, and stimulate the distended solids, so that they stretch beyond their natural tone, without admitting any circulation, the parts become insufferably painful; the patient is restless, anxious, and attended with an acute fever; the humours become offensive and fœtid, and the parts at length turn of a livid colour, and this is then called a _gangrene_. Gradually the parts begin to putrefy and grow black, the humours acquire a cadaverous fœtor, the solids lose their natural texture, and die. This is called a _sphacelus_, or mortification; and unless the mortified parts are removed from the sound, death must inevitably be the consequence.
These are the different terminations of inflammation; and whether the cause is from external injuries, or from internal acrimony, the indication must ever be the same, I shall consider each separately.
Inflammation that attends wounds, contusions, &c. should be dispersed by the application I have already mentioned in the foregoing lectures, viz. _camphorated spirit_ (A), or _liniment of soap_ (B), the first suits best the fleshy part, and the latter the inflammation on the joints and tendinous parts. But when with the inflammation a wound is compounded, and is obstructed in its suppuration, recourse should be had to poultices; as thereby the fibres may be the more relaxed, so that the ulcer may the freer discharge the matter, thence drain the inflamed part of the obstructed humour, and consequently remove the cause of the inflammation.