261 



we have not to consider hypersemia alone. Besides hyper- 

 semia, other lesions have to be regarded. To these attention 

 has been directed by Ludwig, Loven, and Samuel. 



The point is^ not that there are hypereemise that are not 

 followed by inflammation, but that every inflammation is 

 preceded by disturbance of the circulation. The process may 

 attack both a tissue that is directly vascular, and also a tissue 

 which derives its nutritive material from vessels lying at a 

 distance ; in the latter case the lesion is to be referred to the 

 distant vessels. 



It was by the help of this negation that Virchow main- 

 tained the direct action of the lesion upon the tissue itself to 

 be the primary cause of inflammation. 



That cells are susceptible to the action of stimuli has been 

 clearly proved within the last ten years. But that a 

 stimulus applied to one cell should in the course of hours and 

 days be transmitted to other cells, is a view that at the 

 present day is hardly tenable. Such a mode of action might 

 have been assumed so long as the connective-tissue-corpuscles 

 were regarded as forming a system of anastomosing cavities. 

 But this is no longer considered to be the case ; we know now 

 that the connective-tissue-corpuscles are independent organ- 

 isms, which under certain conditions only become connected 

 together. That irritation does extend from one irritated 

 body to another has been disproved by recently acquired ex- 

 perience. 



If the objection should now be made that we can explain in 

 no other way how the extension of inflammation takes place, 

 the remark must be regarded as unscientific. That I do not 

 know anything concerning the nature of an occurrence does 

 not justify me in having recourse to baseless hypotheses. 



I assert once more that the direct irritability of cells has 

 been proved by evidence. All increased activity of cells must 

 result from the application of a stimulus. What we do not 

 know, however, is Avhether the lesion gives rise to irritation 

 in parts remote from its attacking point. The flow of the 

 exudation might here be taken into consideration. And if 

 any one should remind me of the fact that in the neighbour- 

 hood of the injured spot the greatest amount of cell growth 

 takes place, even when, as in the cornea, the vessels be dis- 

 tant, I would not attempt to explain this phenomenon by 

 views inferior to that of Virchow in their probability. I 

 coiiM, for example, say that injury to the tissues, produced 

 either by the knife or by caustic, causes much movement of 

 animal fluids, just as a cavity in the course of a stream may 

 give rise to a movement independent of the general current 



