INFLAMMATION. 



121 



obliterated and ulcers partially filled and drawn into cicatricial healing, 

 Large free surfaces, like the pleura and the peritoneum, may, through 

 the intervention of granulation tissue, pass from the denuded condition 

 of an active exudative inflammation, either with or without adhesions, 

 into a condition which, though by no means a return to the normal, we 

 yet designate as repair. 



The so-called organization of a thrombus in a blood-vessel is brought 

 about by processes practically identical with those which have just been 

 described in the formation of new tissue in reparative inflammation in 

 an external wound. The eudothelial cells of the vessels and the con- 

 nective-tissue cells in their walls proliferate, new blood-vessels develop 

 by sprouts from the already existing smaller vessels in their walls or 

 close about them. The new cells and new blood-vessels thus derived 



FIG. 51. EXUBERANT GRANULATIONS. 



From the inner surface of a granulating ovarian cyst containing pus. The tissue between the new capil- 

 laries is ill-formed, oedematous. and with few cells, most of which have undergone fatty degeneration. 



gradually penetrate the clot forming new connective tissue, which re- 

 places step by step the fibrin and blood which are gradually softened by 

 autolysis and absorbed or removed by phagocytes. 



The part which the thrombus plays in its so-called organization is 

 thus a wholly passive one. It acts only as a temporary supporting text- 

 ure for the development of the new tissue derived from other sources 

 which step by step replaces it. % 



Hyperplasia and Interstitial Inflammation. 



Hyperplasia of the fibrous interstitial tissue of the internal organs and 

 other parts of the body as, for example, in the liver, kidney, heart, 

 nervous system, etc. is of frequent occurrence and is usually associated 

 with changes in the parenchyma. In some cases the formation of fibrous 

 tissue clearly follows evident and often acute inflammatory processes and 

 bears the same relation to antecedent reaction to injury that the cicatrix 

 in a healing wound does to the granulation tissue from which it is 

 formed. In other cases it is associated with long-continued hyperremia 



