40 l^eUrinary Medicine. 



As a matter of fact inflammation, occurring as it does in ver\- 

 different tissues, vascular and nonvascular, fibrous, cellular, 

 jmrenchymatous, etc. , and in connection with a great variety of 

 irritants, must be held to include a large group of morbid pro- 

 cesses, bearing to each other a strong family relationship and re- 

 semblance, and yet differing in man\' important details. Each 

 irritant (heat, cold, electricity, chemical irritant, incised, punc- 

 tured, lacerated or contused wound, rupture, fracture, foreign 

 body, parasite, microbe, toxin, etc.,; has its own special charac- 

 ter and mode of irritation ; each tissue has its own special method 

 of succumbing or reacting and its own amount of blood supply ; 

 and each system and organ has its own native or acquired power 

 of resistance and reaction. 



Inflammation agrees with active h3-i)ersemia in the tendency to 

 dilation of the vessels and an increased flow of blood to the part or 

 if the irritated part is nonvascular like the cornea or articular 

 cartilage, then to the parts adjacent. It differs, however, in the 

 more active cell proliferation, and in the nature of the Hquid 

 transudation which is richer in albumen fibrine. cells and phos- 

 phates. Abstractly the inflamed part retains very active vital 

 processes, trophic and exudative, but these, are largely changed 

 from the normal and are, it is claimed. per\-erted, yet they pre- 

 side over the processes of cell growth and decay, the removal of 

 injured or useless tissue, and later, over the building up of new 

 material, and repair of loss. Active h^peraemia on the other 

 hand is mainly a circulatory disorder, and when it advances so as 

 to determine changes in the cells and tissues it is held to have 

 merged into inflammation. 



The term inflammation (from inflammo. I set on fire ) , is sugges- 

 tive of the local heat of the inflamed part, just as fever ( febris) 

 indicates an elevation of the temperature of the bod\- at large. 

 Celsius enumerated the features of robor. calor, dolor and tumor 

 (redness, heat, pain and swelling i which have come down to our 

 own time as at least suggestive of inflammation. But any diag- 

 nosis, based on these alone, would be today woefulh' inadequate. 

 Redness occurs in the transient blush, heat in the febrile state, 

 though no inflammation can be recognized, pain is present in 

 neuralgic and other ner\-ous affections, and swelling in dropsy and 

 ttmior. On the other hand redness is entirely absent, for a time, 



