Historical Milestones

John Hunter on Inflammation

SAUL JARCHO, MD

New York, New York

To understand in detail the history of our present unless by inflammation. Such violence at least is
day concepts of inflammation, one must come to naturally capable of exciting it.
grips with John Hunter’s Treatise on the Blood, Secondly, from some irritation which does not de-
Inflammation, and Gun-Shot Wounds (London, stroy the texture of parts, but simply the natural
Richardson, 1794). The tripartite title of this dif- actions, as many irritations, such as pressure, fric-
tion, heat, cold blisters, pungent applications, and
ficult classic gives only a hint of the diversified often fevers of every kind.
contents. Thirdly, from a particular disposition in parts them-
The somewhat confusing introduction pro- selves, as boils arising spontaneously without the con-
pounds some hypotheses of morbid actions. The stitution having been preconcerned, so little so, as to
main part of the text proper is divided into four have given the idea that such inflammations were
main parts. These deal respectively with (1) hemo- healthy. Each of these will be of a kind peculiar to the
coagulation and the structure and function of the constitution; but from whatever cause inflammation
cardiovascular system ; (2) wound healing, inflam- arises, it appears to be nearly the same in all, for in
mation, suppuration, and granulation ; (3) ab- all it is an effect intended to bring about a reinstate-
ment of the parts nearly to their natural functions.
scesses ; and (4) gunshot wounds and their treat-
Inflammation may first be divided into two kinds as
ment. first principles, viz. the healthy and the unhealthy.
The diversity of Hunter’s valuable treatise is The healthy probably consists only of one kind, not
complicated by disordered thinking and relative being divisible but into its different stages, and is
obscurity of style. This at times makes his book that which will always attend an healthy constitution
appear chaotic. Therefore, it has been difficult to or part, is rather to be considered as a restorative
choose and to embody in a brief discussion an action than a diseased one, and would rather appear
intelligible series of excerpts which would display to be an effect of a stimulus than an irritation. The
Hunter’s views on inflammation. The following unhealthy admits of vast variety, (diseases being al-
passages have been taken from Part II, Chapter most numberless) and is that which always attends
an unhealthy constitution or part, and will be accord-
II (Fundamental Principles of Inflammation),
ing to the kind of health in that constitution or part,
sections 6 and 7.* but principally according to the constitution . . . .
Inflammation is capable of producing three different
Excerpts from Hunter effects, viz. adhesions of the parts inflamed, suppura-
Inflammation has several well marked local peculi- tion in the parts, and ulceration of those parts; which
arities by which it is distinguished. I have called the adhesive, the suppurative, and the
I shall call by the name of inflammation whatever ulcerative inflammation ; the last or ulcerative, is,
produces the following local effects, viz. pain, swelling, properly speaking, only a secondary effect of inflam-
and redness, in a given time, and these dependent on mation, not being performed by the same vessels ; how-
or the effects of one immediate cause. ever it is possible it may keep up inflammation, as it
Inflammation appears capable of arising from three always keeps up a species of violence, viz. a destruc-
causes, which may be called remote. tion of the parts.
First, from some accidental force applied to a part, The two first do not take place in the same vessels,
making a wound or bruise which cannot recover itself, at the same time, but succeed one another, although
all the three effects may exist at the same time in the
different parts of the same inflammation.
I have placed the adhesive first in order, although
* These passages will be found at p 250 ff. of the 1794 it is not always so, for with respect to the priority of
edition and at Vol. 3, p 286 ff. of the slightly revised ver- those three actions of inflammation, it depends prin-
sion edited by James F. Palmer, Philadelphia, Haswell, Bar- cipally upon the nature of the parts, together with the
rington, and Haswell, 1841.
degrees of violence of the inflammation . . . . We shall
This study was based on research assisted by the Na- treat of each according to the nature of the parts, and
tional Institutes of Health (HE-10948). of the inflammation joined, and observe their effects,
Address for reprints: Saul Jarcho, MD, 35 East 85 St., which will show that the common effects of one, as to
New York, N.Y. 10028. priority, may be changed into those of the others and

VOLUME 26, DECEMBER 1970 615