Wet-cupping has almost entirely been superseded by the use of Klapp’s suction bells.

General blood-letting consists in opening a superficial vein (venesection) and allowing from eight to ten ounces of blood to flow from it.  It is seldom used in the treatment of surgical forms of inflammation.

Counter-irritants.—­In deep-seated inflammations, counter-irritants are sometimes employed in the form of mustard leaves or blisters, according to the degree of irritation required.  A mustard leaf or plaster should not be left on longer than ten or fifteen minutes, unless it is desired to produce a blister.  Blistering may be produced by a cantharides plaster, or by painting with liquor epispasticus.  The plaster should be left on from eight to ten hours, and if it has failed to raise a blister, a hot fomentation should be applied to the part. Liquor epispasticus, alone or mixed with equal parts of collodion, is painted on the part with a brush.  Several paintings are often required before a blister is raised.  The preliminary removal of the natural grease from the skin favours the action of these applications.

The treatment of inflammation in special tissues and organs will be considered in the sections devoted to regional surgery.

#Chronic Inflammation.#—­A variety of types of chronic and subacute inflammation are met with which, owing to ignorance of their causations, cannot at present be satisfactorily classified.

The best defined group is that of the granulomata, which includes such important diseases as tuberculosis and syphilis, and in which different types of chronic inflammation are caused by infection with a specific organism, all having the common character, however, that abundant granulation tissue is formed in which cellular changes are more in evidence than changes in the blood vessels, and in which the subsequent degeneration and necrosis of the granulation tissue results in the breaking down and destruction of the tissue in which it is formed.  Another group is that in which chronic inflammation is due to mild or attenuated forms of pyogenic infection affecting especially the lymph glands and the bone marrow.  In the glands of the groin, for example, associated with various forms of irritation about the external genitals, different types of chronic lymphadenitis are met with; they do not frankly suppurate as do the acute types, but are attended with a hyperplasia of the tissue elements which results in enlargement of the affected glands of a persistent, and sometimes of a relapsing character.  Similar varieties of osteomyelitis are met with that do not, like the acute forms, go on to suppuration or to death of bone, but result in thickening of the bone affected, both on the surface and in the interior, resulting in obliteration of the medullary canal.