INFLAMMATION - HUNTER,JOHN ISE-ON-THE-BLOOD,-INFLAMMATION-AND-GUN-SHOT-WOUNDS

John Hunter's A Treatise on the Blood, Inflammation and Gunshot Wounds was published in 1794. Throughout the nineteenth century this was con sidered the most important study of inflammation and has been widely q uoted since. After a section on the nature of blood and the circulator y system, in which he describes the vascular supply in detail, he pass es on to an extensive survey of inflammation. This is based mainly on his wide clinical experience, including that as a military surgeon. He , however, supplements this with a number of experiments, some of whic h are classic. He bases his observations on the four cardinal signs of Celsus (redness, heat, swelling and pain). Inflammation is then divid ed into three main groups: adhesive, suppurative and ulcerative. He di scusses the nature of pus and the formation and treatment of abscesses . He describes his experiments on the transplantation of tissues under the general heading of adhesive inflammation. This, he states, underl ies the union of wounds and thus the union of tissues after transplant ation. Although unaware of the role of infecting organisms as a cause of inflammation, he makes observations on inflammation in smallpox, ve nereal infections and tuberculosis. He relates these to his observatio ns on inflammatory aspects of wound healing. Lister was particularly i nfluenced by Hunter's observations in the development of antisepsis. A s well as the local effect of inflammation, Hunter was concerned with the constitutional effects such as fever.