ABNORMAL FORMS OF NUTRITIVE PROCESS. INFLAMMATION. 571 



specific diseases, in different individuals, according to the previously healthy or 

 abnormal condition of their blood. There can be no doubt that a very large 

 proportion of what are called " unhealthy inflammations/ 7 especially those of 

 the erysipelatous type, are to be regarded as owing their peculiarity to a defi- 

 ciency in the due elaboration of the fibrin, and to the low vitality of the cellular 

 components of the blood, both of which conditions seem to be favored by the 

 presence of those decomposing matters whose accumulation in the blood acts 

 in many ways so prejudicially on the system at large ( 210). That the quality 

 of the exudation is in some degree determined by the seat or tissue in which the 

 Inflammation occurs, appears from the different character of the product of the 

 disordered action occurring simultaneously in different organs of the same in- 

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

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

 nected by an organized exudation 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 pro- 

 duct 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 inflammations of bone the lymph 

 usually ossifies, in those of ligaments it is converted into a tough ligamentous 

 tissue, and in those of secreting organs it contains a mixture of the ordinary 

 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 inflam- 

 mation, 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 in- 

 flammation 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 in- 

 flamed tissues, is shown in the tendency to degeneration which it impresses on the 

 exuded 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 metamorphosis, 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 adhesion 

 are formed, and that the material of most thickenings and indurations of parts 

 is composed ; and it is by the production of this tissue, also, that losses of sub- 

 stance are in the first instance repaired, and that divided surfaces are made to 

 adhere. The mode in which this development takes place has been already 

 described ( 223, 224). Various kinds of degeneration may take place, ac- 

 cording 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 common is the fatty ( 593). 



614. But the most frequent of all the degenerations of lymph, being almost 

 invariable when the lymph is placed from the first in conditions unfavorable to 

 its development, is into the entirely unorganizable or aplastic product which is 

 known as Pus. This, as already mentioned, is specially liable to occur in lymph 

 which is originally rather corpuscular than fibrinous ; and every gradation may 

 be seen from the most characteristic form of the lymph-cell to that of the pus-cell. 



