ABNORMAL FORMS OF NUTRITIVE PROCESS INFLAMMATION. 457 



the expense of the materials which they draw from the blood of the sur- 

 rounding vessels. 



374. Of the alterations in the condition of the Blood iu Inflammation, 

 an account has already been given ( 199); and it is here only necessary to 

 recapitulate them. The most characteristic is the augmentation, either of 

 the organizable or plastic fibrin, or of the organized colorless corpuscles ; 

 the increased production of these two components seeming to bear iu some 

 degree a relation of reciprocity, the one to the other. The increase of Fi- 

 brin may be considered as the alteration most characteristic of a previously 

 healthy and vigorous state of the system ; and it is in the inflammations 

 which occur in such subjects, that the effusions are most strongly disposed 

 to become organized, and show the least tendency to undergo degenerative 

 changes. On the other hand, the increase of the Corpuscular elements 

 seems to occur iu cachectic or otherwise unhealthy individuals; and the 

 inflammatory effusions which partake of the same character are far less 

 plastic originally, and are extremely prone to undergo degeneration, either 

 at the time of their effusion or subsequently. With this increase in the 

 proportion of fibrin and colorless corpuscles, separately or in combination, 

 there is a diminution in the proportion of the red corpuscles, albumen, and 

 salts of the blood. None of these changes, however, can be legitimately 

 regarded as originally or essentially characteristic of the inflammatory con- 

 dition ; they are, in fact, to be looked on rather as the results of its estab- 

 lishment, constituting that series of alterations in the circulating fluid 

 which is of parallel order to that which occurs in the solid tissues wherein 

 the inflammatory action has been set up. 



375. The Inflammatory state is further characterized by the effusion and 

 local production of certain of the components of the Blood, either upon the 

 surface, or into the substance, of the inflamed tissues. The effusion of pure 

 serum cannot be regarded as characteristic of inflammation ; since it may 

 take place as a mere result of congestion, especially when this congestion is 

 due to an obstruction to the return of the blood ; whilst, again, it may be 

 due to an altered condition of the albuminous constituent of the blood, 

 which favors its transudation ( 196). The so-called serous effusions which 

 are poured forth in inflammation, do in reality contain fibrin in solution; 1 

 but this fibrin may not manifest its presence by spontaneous coagulation, 

 until its passage into the solid state is favored by the introduction of a piece 

 of the washed clot of blood, or of the buffy coat, or of muscle or some other 

 animal tissue, which seems to act as a sort of nucleus of fibrillation. The 

 presence even of fibrin in such an effusion, however, is not in itself a sufficient 

 proof of the existence of inflammation ; for it has been shown by the ex- 

 periments of Mr. Robinson,- Emmiughaus, 3 and others, that when the ob- 

 struction to the return of blood by the veins is so great as to occasion an 

 excessive pressure within the capillaries, the fluid which transudes may con- 

 tain enough fibrin to render it spontaneously coagulable. The locally de- 

 veloped material which is most characteristic of Inflammation, is that which 

 is known as coagulable lymph; it is much to be desired, however, that some 

 other designation should be applied to it, since the term "lymph" can only 

 be appropriately employed for the fluid contents of the lymphatic vessels. 

 The peculiar characteristic of this inflammatory product, is its capability of 

 spontaneously passing into the condition of an organized tissue, either fibrous 

 or cellular, or a mixture of both ; and of thus forming " false membranes " 



1 This is denied by Virchow (Cellular Pathology, p. 392). 



2 Medico-Chirurgieal Transactions, vol. xxvi, p. 51. 



3 Emrninghaus, Bur. d. k. k. Gesellschaft d. Wiss., 1873. 



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