The first lines of the practice of surgery: designed as an introduction for students, and a concise book of reference for practitioners (Volume 1).

  • Cooper, Samuel, 1780-1848.
Date:
1822
Catalogue details

Licence: Public Domain Mark

Credit: The first lines of the practice of surgery: designed as an introduction for students, and a concise book of reference for practitioners (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    cannot exist, and which existing, the disease must also* exist. As this last definition, however, conveys no useful informa- tion, it might as well be suppressed, for, according to it, the proximate cause is only another name for the process itself, from which, as Professor Thomson observes, it neither can nor need be distinguished. In such an explanation, says Dr. C. H. Parry, ''the proximate cause is, strictly speaking,a part of the disease, which implies the absurdity, that a thing is the cause of itself. The very name, causa proximo, or that which is nearest to any thing, shows that it cannot form a part of that thing, unless we admit that a thing can be at the same time a part of another, and not a part of it. Causation, according to all our conceptions respecting it, implies not only difference and separation, but also priority. This ingenious author, therefore, prefers defining a proximate cause to be that phenomenon in the body, or part immediately- preceding the state which we call disease, without which pre- vious phenomenon, the disease is not known to exist.! The subject, it must be confessed, has been one of much unsuccessful disquisition. While Galen and Boerhaave ascribe the proximate cause of inflammation to particular states' of the blood and humours, Stahl, Gorter, Hunter, and Cullen, all concur in imputing it rather to an affection of the vessels. If the state of the whole mass of the blood were the cause, why should inflammation be confined to any- particular part? It is a general opinion, that a larger quan- tity of blood is determined to an inflamed o^rt, than passes to it in the natural state.i And, certainly, if an incision be made into it, the blood gushes out more profusely and vehe- mently than from a cut in a similar part free from inflam- mation. Now, although this does not completely prove that there was actually an accelerated flow of blood through the inflamed part previously to the incision, it is a pheno- menon which cannot arise from any peculiarity in the action of the heart; an organ, which drives the blood equally into the whole arterial system. The fact must be referred either to the augmented diameter of the vessels of the part affected, or to the peculiar property of the arteries, which, in the healthy state, at least, are not simple mechanical tubes for the transmission of the blood, but active instruments in the * Pearson's Principles of Surgery, p. 23. edit. 2. t Parry's Elements of Pathology and Therapeutics, vol. i. p 89—91. t Mr. Hunter every where expresses his belief, that the blood circu- lates in greater quantity, and with increased velocity, though inflamed parts.