ABNORMAL FORMS OF NUTRITIVE PROCESS INFLAMMATION. 459 



some degree determined by the seat or tissue in which the Inflammation 

 occurs, appears from the different character of the products of the disordered 

 actions that occur simultaneously in different organs of the same individual, 

 and apparently under the operation of the same cause; thus it may happen 

 that in pleuro-pneumonia, the two surfaces of the pleura become connected 

 by au organized material of a fibrous character ; whilst the effusion in the 

 substance of the lung is rather of the corpuscular nature, and speedily passes 

 into suppurative degeneration. Mr. Paget ingeniously proposes to account 

 for the determining influence in question, on the idea that the inflammatory 

 product is influenced at the time of its formation by the assimilative force of 

 each part, so that it is to be regarded as a mixture of true lymph with its 

 special product of assimilation ; thus we observe that in inflammation of 

 bone the lymph usually ossifies, in that of ligaments it is converted into a 

 tough ligameutous tissue, and in that of secreting organs it contains a mix- 

 ture of the ordinarily secreted product. The mode in which the intensity of 

 the Inflammation affects the character of the effused lymph, is twofold. 

 For, in the first place, the nature of the original effusion is likely to vary 

 according to the degree in which the ordinary nutritive process is interrupted ; 

 since, the more intense the inflammation, the less will be the assimilating 

 force of the part, and the more will the matters effused from the vessels 

 deviate from the natural plasma which would be drawn from them in healthy 

 nutrition ; whilst, on the other hand, when the inflammation is less severe, 

 its product will not differ so widely from the natural one, and will from the 

 first tend to manifest in its development some characters corresponding to 

 those of the natural formations of the part. But, secondly, the influence of 

 the inflammation, or rather of the depressed vitality of the inflamed tissues, 

 is shown in the tendency to degeneration which it impresses on the locally 

 developed product ; so that, even though this may be disposed to pass on 

 under favorable circumstances to the complete formation of an organized 

 tissue, its development is early checked, and it undergoes retrograde meta- 

 morphosis ; or else, from the very commencement, its development takes 

 place according to a lower or degraded type. The normal product of the 

 organization of either fibrinous or corpuscular lymph, is undoubtedly a tissue 

 closely allied to the ordinary areolar or connective; it is of this that false 

 membranes and adhesions are formed, and that the material of most thick- 

 enings and indurations of parts is composed ;' and it is by the production of 

 this tissue also, that losses of substance are in the first instance repaired, and 

 that divided surfaces are made to adhere. Various kinds of degeneration 

 may subsequently take place in any of these products, according to the stage 

 at which the developmental process is checked ; and among these, in tissues 

 which have once attained an advanced stage of development, the most com- 

 mon is the fatty. 



377. Emigration of White Corpuscles and Diapedesis of the Red. One of 

 the most frequent results of the inflammatory process is the formation of 

 Pus, a serous or albuminous fluid holding a large number of corpuscles in 

 suspension, the origin of which has been the object of much recent investi- 

 gation. The cells are spherical, about the size of the white corpuscles of the 



lished during the last few years on the presence of Bacteria and other low organisms 

 in the blood of patients laboring under various forms of zymotic disease, some of 

 which are referred to in the year books of the New Sydenham Society. 



1 The Author is much disposed, however, to agree with Dr. Handfield Jones, in 

 believing that a chronic " fibroid degeneration," resulting from the substitution of a 

 lowly organized fibrous tissue for the proper texture of the part, may take place, like 

 ''tubercular degeneration," without the occurrence of Inflammation, properly so 

 called. See Brit, and For. Med.-Chir. Rev., vol. xiii, pp. 343, 349. 



