514 



CELLULAR TISSUE. 



condition which is called red heputlzation. I 

 have in my possession a specimen of com- 

 mencing hepatization, taken from a lung in 

 another portion of which that change was quite 

 complete. In this preparation a portion of the 

 pulmonary tissue is of a reddish brown colour, 

 and evidently infiltrated with a solid substance, 

 consisting, it may be presumed, of fibrine 

 mixed with the colouring matter of the blood. 

 The manner in which this deposition took place 

 in the cellular tissue of the organ is distinctly 

 seen, the reddish colour being gradually shaded 

 off till it is lost in the healthy structure. 



It sometimes happens that the morbid action 

 now ceases, and that by a process of absorption 

 the interstitial effused matter is removed, so as 

 slowly to restore the part to its proper condition : 

 this is the termination of inflammation to which 

 the term resolution is applied. 



3. Suppuration. I ^usually happens in acute 

 inflammation of the cellular tissue, that after 

 the lapse of a certain period, a softening takes 

 place towards the centre of the circumscribed 

 hardness, in consequence of the diminution of 

 cohesion above described gradually increasing, 

 and of the deposition of purulent matter. It is 

 not certain how the pus is formed in the first in- 

 stance; several modern pathologists, especially 

 in France, imagine that the lymph and serum 

 which were previously effused experience a 

 change by which they are converted into pus, 

 a theory which is rendered probable by the 

 physical properties of pus so nearly resembling 

 those of the blood : according to other autho- 

 rities, pus is a proper secretion derived from 

 the neighbouring arteries. I believe that in the 

 beginning the purulent matter results from 

 changes in the effused matters ; but that when 

 suppuration is fully established, the pus is 

 poured out or secreted from the bloodvessels. 

 In the commencement the pus is observed in 

 the cells of the tissue, under the form of whitish 

 spots; subsequently the walls of these inter- 

 stices are broken down by the softening alluded 

 to, and the purulent matter is collected together 

 so as to constitute an abscess, which is sur- 

 rounded by a rather dense layer of cellular 

 tissue, still retaining the characters of inflam- 

 mation. This layer constitutes the sac of the 

 abscess, and presents at first a rough and reddish 

 surface; but it soon happens that the walls 

 acquire a greater firmness, and that the surface 

 of the sac assumes very much the appearance 

 of a mucous membrane. 



4. Ulceration. When an abscess has thus 

 been formed, the cellular tissue intervening be- 

 tween it and the external surface of the body, is 

 removed by the action of the absorbents. This 

 process, which is always preceded by inflam- 

 mation, and accompanied by suppuration, is 

 distinguished from various other morbid actions 

 of the absorbents by the term of ulceration. 

 Other instances of ulceration occurring in the 

 cellular tissue might be adduced ; ex. gr. 

 the separation of the slough in carbuncle, after 

 extravasation of urine, &c. 



5. Mortification. If the inflammatory action 

 be sufficiently intense, it causes the destruction 

 of the vitality of the part affected, and pro- 



bably in the manner suggested by Professor 

 Andral. "In the most acute form of hyper- 

 aemia,* the circulation of the blood is sus- 

 pended, and if this stagnation be prolonged so 

 as to become complete, the parts being gorged 

 with blood that is no longer renewed, and 

 which, therefore, soon becomes unfitted to sup- 

 port nutrition and life, must necessarily perish, 

 and in this manner gangrene is produced, as in 

 the experiments performed by Dr. Hastings. 

 In these cases the black colour announces the 

 stagnation of the blood, and this stagnation 

 being prolonged, must of necessity lead to 

 gangrene. Such, in my opinion, is the manner 

 in which the species of gangrene usually attri- 

 buted to excess of inflammation, is produced." 

 M. Gendrin has ascertained by dissection that 

 some of the vessels are filled with coagulated 

 blood ; whilst others are actually ruptured, and 

 allow their contents to escape. The cessation 

 of the circulation has for a long time been 

 remarked as the most striking character of mor- 

 tification ; in fact, that cessation, in whatever 

 manner it may have been induced, whether by 

 inflammation, by continued pressure, by the 

 application of tight bandages to a limb, &c., is 

 in the great majority of instances the imme- 

 diate cause of mortification. The consequence 

 of this loss of vital action is, that the natural 

 properties and appearance of the cellular tissue 

 are destroyed ; the affected part becomes dis- 

 coloured, usually assuming a black or ash- 

 coloured appearance; the proper texture is 

 lost, and the part is infiltrated with a dark 

 sanious fluid, and is subsequently converted 

 into a shapeless mass of pulpy substance, which 

 is cold to the touch, and extremely offensive 

 to the smell, owing to the gases which are 

 generated by putrefaction : in fact, the part is 

 dead, and presents the usual appearances caused 

 by the decomposition of animal matter, con- 

 joined with those which result from the pre- 

 vious effects produced in the circulation by the 

 inflammatory action, especially the engorge- 

 ment of the bloodvessels. These are the changes 

 induced in the cellular substance when it is 

 attacked by humid, or, as it has been called, 

 inflammatory gangrene. In dry gangrene, on 

 the contrary, the black and discoloured part 

 shrivels up, and does not undergo the same 

 changes which are produced by the decompo- 

 sition of a texture which is loaded with fluids. 



b. Chronic inflammation. As we find that 

 in phlegmon there is a great tendency to the 

 formation of pus, so in chronic inflammation 

 there is usually a deposition of solid matter, 

 which produces more or less of induration and 

 enlargement. This deposition seems almost in 

 every instance to occur in the cellular tissue, 

 either where it is interstitial, or where it pene- 

 trates into the interior of the several organs. 

 This is observed among other parts in chronic 



* This is a general term employed by M. Andral 

 to designate the increased quantity of blood which 

 is contained in the capillary vessels of any organ, 

 without any reference to the cause which produces 

 the accumulation. In the passage above quoted, 

 he is speaking of acute hyperacmia, which is syno- 

 nymous witli acute inflammation. 



