PAIN, LAUGHTER AND WEEPING 319 



in which there is danger that the disease may be extended 

 by muscular action, or in which fixation of the parts by 

 continued muscular rigidity is of distinct advantage in 

 overcoming the disease. 



In such diseases as scarlet fever, typhoid fever, 

 measles, malaria, whooping cough, typhus, syphilis in 

 the early stages, and in fact in most of the exanthe- 

 mata in which the organism as a whole is quickly in- 

 volved by the dissemination of infection, and in which 

 muscular action can render no assistance, there is, as 

 a rule, no pain. On the contrary, the infections gen- 

 erally associated with pain are the pyogenic infections, 

 of which local inflammation, boils, carbuncles, felons 

 and abscesses are common instances infections the 

 main characteristic of which is a local point of involve- 

 ment or focus. 



A fundamental and striking difference between the 

 painless exanthemata and the painful pyogenic infec- 

 tions is found in the fact that, in the case of the former, 

 the protective response of the body is wholly chemical 

 the formation in the blood of anti-bodies which usually 

 produce a permanent immunity, while in the latter 

 the defense is largely phagocytic. In the pyogenic 

 infections, in order to protect the remainder of the 

 body, which enjoys no immunity, every possible barrier 

 against the spread of the infection is thrown about the 

 local point of infection. Lymph is poured out and 

 the part is fixed by the continuous contraction of the 

 neighboring muscles and by the inhibition of those 

 muscles which by the ordinary exercise of their func- 

 tions would spread the disease. As would be expected, 

 this continuous contraction is associated with pain. 



