259 



Since we are thus brought back to the definition given 

 by Virchow, and must regard local disturbance of nutrition 

 as an important sign of inflammation, we may put the 

 question whether by this definition tlie conception " inflam- 

 mation" is exhausted, or its nature determined. This ques- 

 tion must no longer be answered in the affirmative. 



The escape of colourless blood-corpuscles always takes a 

 part among the phenomena of inflammation. That this pro- 

 cess cannot be associated with disturbed nutrition only, is 

 obvious enough. 



Disturbed nutrition, moreover, is not an exclusive sign of 

 inflammation, since it necessarily claims a part in all pro- 

 cesses in wbich new growths, using the term in a restricted 

 sense, arise. If we add to the disturbance of nutrition the 

 escape of blood-corpuscles, we have not even then exhausted 

 the process of inflammation, since it has not been proved, and 

 even is not probable, that simple new growths are free from 

 emigrated blood-corpuscles. 



If we chose to stand by an exclusively clinical conception 

 of inflammation, we must then define it in another manner, 

 or rather we become unable to define it; we must describe 

 it after tlie manner of Celsus. We must enumerate the 

 signs of the process in order to present the clinical process, 

 and among these signs " disturbed nutrition''' must occupy a 

 prominent place. 



A not less important place must be ascribed to the " exu- 

 dation.'''' 



Virchow has underrated the importance, not of the ex- 

 uded fluid, but of the process of exudation. " The exudation," 

 he says, " always proceeds from the blood; it is not, how- 

 ever, driven out by the action of the heart, but is attracted 

 by the action of the tissue elements." 



When I look to recent literature, I find that there is but 

 little need for me to contend much against this method of 

 viewing the matter. The importance of exudatio i in the 

 process of inflammation, again, stands with practitioners and 

 experimenters in much the same position as it did at the 

 time when it was so strongly maintained by Bennett and 

 Rokitansky. A majority of the younger generation now 

 believes that inflammation consists in the migration of the 

 colourless corpuscles of the blood. 



We must, then, arrange afresh the signs of inflammation, 

 and, passing from experiment to the region of history, collect 

 from the chief works of our ancestors that which is able to 

 hold its ground against recent views. 



With this object, I lay stress upon exudation. It is an 



