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INFLAMMATION. 131
the dead tissue presents a further obstacle to the local circulation,
and also adds to the difficulty of elimination, which favors the
spread of the gangrene. The earliest symptoms of gangrene are
hard swelling, burning and tensive pain, and livid color. The
pain then subsides, vesications appear, the part takes on a
marbled, purplish-yellow color, afterward becoming brown or
grayish, and finally cold and insensible, exhaling a putrid odor.
(See Gangrene, Necrosis of Bone, and Caries of Bone.)
Treatment of Inflammation.— It has already been stated
that the causes of inflammation determine in a great measure its
treatment, and this is especially true of inflammation of the oral
mucous membrane. As acute inflammation is now recognized
as the result of the action of certain specific micro-organisms,
both prophylactic and curative treatment by antiseptic methods is
very satisfactory. The old method of antiphlogistic treatment
has given place to antiseptic treatment, although some of the
older measures are still employed, and may occasionally be used
to advantage in relieving certain symptoms of inflammation, and
thus favoring a return to the normal condition. The indications
of treatment are as follows :
Prophylactic Treatment^ which consists in protecting avenues
of infection against the entrance of pathogenic micro-organisms
into tissues deprived of their natural coverings, such as the skin
and mucous membrane, by first securing an aseptic condition of
the parts, and maintaining this by thorough sterilization. Inflam-
mation is prevented if pus-forming microbes are excluded so
thoroughly as to prevent their infection of wounds. Prevention
may also include the removal of a predisposing cause when local,
or the lessening of its effects when it is general or constitutional.
If malaria is present, quinine is indicated; if syphilis, iodide of
potassium, or minute doses of bichloride of mercury. Irritation,
the precursor of inflammation, may often be arrested by the re-
moval of a local cause, such as salivary calculus, or the removal
of diseased teeth, or of foreign substances, for example.
Curative Treatment consists of both local and constitutional
measures. The restoration of the secretion of the different
organs is indicated in the treatment of certain forms of inflamma-