It may appear that, in this disquisition, we have omitted the inflammations of the mucous membranes. These, however, make no part of the present subject; for they arise very generally from a morbid poison, carried to the glands, and the inflammation excited in these organs is attended with an increased or a vitiated discharge. If it were necessary to reduce them to this head, they would be found to resemble the inflammations excited by mechanical or chemical acrids without obstruction.

The prognostics in inflammations are more or less favourable in proportion to the importance of the part affected, the constitution of the patient, the violence of the symptoms, and the coincidence of other diseases. Inflammations of the glands, of the ligaments, and the tendons, are tedious in their progress, and the two last leave a disposition for the future attack of a similar disease.

The cure of inflammation will, we think, be greatly elucidated by the former enquiries; and, for this purpose, inflammations must be divided into those attended with a phlogistic diathesis, and those in which distention and dilatation arise in a greater degree from atony than an increased vis a tergo. This distinction cannot be made with accuracy, for the two kinds pass into each other by almost undistinguishable shades. Yet the difference is real, and it will be only necessary to modify the treatment of each when it approaches the confines of the other.

The chief remedy of the active inflammations is bleeding, and blood must be often taken in large quantities from a large orifice, since the relaxation which it produces is in proportion to the quantity lost in a given time. If we peruse the writings of physicians in the early part of the last century, we shall perceive that they bled freely and repeatedly where we find a single evacuation only admissible. Constitutions are greatly changed in this respect; luxury has enervated our habits, and the changes in diet have greatly lessened that active constitutional power which forms the essence of the inflammations now before us. In the robust labourer, in a cold season, where the disease has arisen from cold to which the body when heated has been exposed, a large bleeding may be repeated; but in a crowded city, with a person whose constitution has been enervated by a sedentary occupation, or by luxury, whatever the appearances may be, bleeding must be cautiously employed. After a general bleeding, modern refinement, adapting the remedy to the change of constitution, has employed topical bleedings either by means of leeches or cupping glasses, which relieve, the distended vessels, without too far debilitating the system. The inflammations to which copious and active bleeding are chiefly adapted seem to be phrenitis, carditis, pneumonia, rheumatism, and perhaps the psoas inflammation, when it is certainly known to exist.

Emetics we have seen producing relaxation through the whole system; and though they may appear to becoti-traindicated, when we recollect that a partial debility favours the inflammatory distention, yet any inconvenience which this may occasion is compensated by the freedom which they restore to the circulation in general. In conformation of this idea, we find, that, in the other class of inflammations where the circulation is more languid, they are injurious; and if given in the ulcerated throat, it is rather with a view of emulging the glands of that part, an effect which renders them so useful in pneumonia, than of counteracting an inflammatory state. The nauseating doses of antimonials are peculiarly useful in such active inflammations; nor in diseases of short duration, in constitutions peculiarly strong, have we any thing to apprehend from their debilitating effects. In all inflammations of this kind, it must be remembered that the increased inordinate action of the arterial system is the chief disease.

Cathartics are not generally indicated in these complaints; yet, as they draw the fluids powerfully from the head, and from the chylopoietic viscera, they are useful in inflammations of these parts, as they act without increasing the phlogistic diathesis in general. They are most advantageous in the earlier stages; nor need we wait till the increased action of the arterial system is taken off by bleeding. As cathartics are peculiarly useful in phrenitis and enteritis, so are they injurious in pneumonia. As evacuants they are perhaps singularly advantageous in rheumatism; though the inconvenience of moving tenders them less eligible to the patient than other remedies.

Diaphorelics are apparently well adapted to active inflammation, from the effects which we have already had occasion to explain. In general, however, their stimulant power renders them less advantageous in those cases where the vis a tergo is very actively increased. To this there is only one exception, viz. where the evacuation is from the neighbourhood of the organs affected, as in rheumatism; for it compensates for any disadvantage that would otherwise arise from the increase of the circulation. In general, however, the relaxing diaphoretics, as the nauseating doses of emetics, and the combinations of opium, with either the ipecacuanha in Dover's, the white hellebore in Ward's powder, or with the warmer preparations of guaiacum, are most effectual.

Opium, which we have styled the most certain and powerful diaphoretic, is not always admissible, it is said, from its stimulus, but this is generally inconsiderable, and sometimes unobserved. The chief disadvantage of opium arises from its checking the secretions, so essentially necessary in many of the active inflammations, particularly in pneumonia, hepatitis, and enteritis. When this inconvenience is obviated, as we shall find in speaking of each disease, opium is an useful remedy, and it is occasionally employed, in each, with advantage.

Blisters are of the highest importance in inflammations of every kind; but when the inflammatory diathesis is considerable, they fail of relieving; and it will be obvious, that, while the disease continues in consequence of the force of the arterial system, the advantages derived from topical depletion cannot be considerable. In the most active inflammations we have sometimes found it necessary to bleed previous to each application of a blister, particularly in rheumatisms, where blisters must be often repeated.