THE THIRD HUXLEY LECTURE 533 



energies for a considerable period after entire severance from the body : as is 

 illustrated by the success of Thiersch's method of skin-grafting. We are 

 therefore driven to the other alternative, and conclude that the inflammatory- 

 congestion of those kidneys was caused by nervous action upon the renal tissues. 

 And the suddenness with which the effect was produced strongly suggests the 

 view that the prostration of their vital power was the primary effect of an 

 unwonted nervous impulse. 



Abnormal effusion of liquor sanguinis from the vessels, another marked 

 feature of acute inflammatory disturbance in man, would seem a natural result 

 of any degree of inflammatory congestion. I used to illustrate to mv class 

 b}' a simple experiment the enormous increase which takes place in the pressure 

 of a liquid upon the walls of a tube through which it is flowing, when an obstacle 

 is opposed to its passage. When, therefore, the corpuscles begin to block the 

 capillaries the plasma will naturally be forced in undue quantitv through their 

 porous walls. 



When inflammation assumes an intense degree, the effused liquor sanguinis 

 has the peculiarity of being coagulable, producing by its solidification the 

 characteristic ' brawny ' swelling of the parts among which it is poured out. 

 In this respect it differs from the normal plasma forced by pressure through 

 the walls of healthy capillaries as the result of venous obstruction. Here 

 the swelling has the ' doughy ' character of oedema, a condition also caused 

 by inflammation of a mild degree. To that point I shall have occasion to refer 

 again. 



I designated by the title * direct inflammation ' the morbid state produced 

 by the direct operation of noxious agents upon the tissues, as distinguished 

 from inflammation brought about through the medium of the nervous system. 

 This distinction appears to me to be of great importance ; and it enables us 

 to understand what would otherwise be quite unintelligible. One beautiful 

 instance of this is the behaviour of a recent wound in tissues previously healthy. 

 When our means of arresting bleeding were less complete than they are at present, 

 it was no uncommon thing to be summoned a few hours after an operation on 

 account of haemorrhage. It was a sad thing to have to tear asunder the lips 

 of a wound already well glued together by lymph, in order to gain access to 

 the bleeding-point. This lymph was neither more nor less than liquor sanguinis 

 which had been effused from the cut surfaces and had coagulated. From the 

 quality of the effusion we should suppose that we had to deal with inflammation 

 of a very intense character. Yet the lips of the wound were perfectly pale, 

 entirely free from the active congestion which is the \-ery earliest sign of inflam- 

 matory disturbance. How could this inconsistency be reconciled ? N'ery 



