INFLAMMATION. 105 



mations follow an orderly progress to repair; exuda- 

 tions are absorbed, dead cells and their debris are 

 removed by the phagocytes and connective tissue cells, 

 and either connective tissue cells or cells peculiar to the 

 organ or tissues involved take the place of those removed. 

 But most inflammations are not of this nature, being 

 caused or complicated by bacteria and their toxic 

 products. The first effect of the latter is the same in 

 all cases, viz., to excite the cardinal phenomena of in- 

 flammation; from this point, however, the further prog- 

 ress and termination of the process is determined by 

 the interaction of three forces: 



1. The nature and intensity of the invading agent. 



2. The tissue or tissues in which the bacteria are 

 localized. 



3. The local and general resistance of the individual. 



Thus the same micro-organism (streptococcus pyog- 

 enes) which on a mucous membrane can produce a 

 false membrane, may in the subcutaneous tissues 

 give rise to an abscess, or to gangrene; or if the local 

 resistance is not sufficient, will invade the blood and 

 cause a bacteriaemia. Another bacterium, the tuber- 

 cle bacillus, produces usually tumor-like growths in 

 tissues, but it often causes rapid necrosis, and not in- 

 frequently pus. 



Here it may be well to direct attention to the fact 

 that in infectious diseases the inflammatory process 

 is not confined to a single locality or organ; but since 



