CHRONIC INFLAMMATION. 25 



witnessed in the delirium of the first stage of phrenitis, and 

 almost suspended during the comatose or later stage. In 

 enteritis it is often found that the bowels will act excitedly, 

 small quantities of fseces being passed very frequently at the 

 commencement of that disease, but at a later stage their action 

 will be entirely suspended. 



In inflammation of the muscles, again, we find that there is 

 almost total loss of their proper contractile power, and that 

 what remains of it is brought into action with difficulty and 

 pain ; showing that though their functional activity is lost, their 

 sensibility is highly exalted. 



CHRONIC INFLAMMATION. 



Inflammations, according to the severity of their causes, and 

 duration of their action, manifest certain alterations in their 

 progress and termination, and the terms acute, sub-acute, and 

 chronic have reference to the periods of the duration of the 

 inflammation, or the rapidity or slowness of its course. 



In chronic inflammation the action of the irritant, though less 

 immediate and severe, is much more prolonged, and has a greater 

 tendency to excite the formation of an abundance of tissue, 

 which, though less highly organized than the normal, yet is not 

 so prone to undergo those retrogressive changes which charac- 

 terise the exudates of acute inflammation. 



Whilst the more highly vascular organs are by no means 

 exempt from chronic inflammation, it is found that the less or 

 non-vascular tissues more commonly undergo those changes 

 which characterise it ; changes due either to the nature of the 

 irritant, the vital tone of the tissue irritated, or to the strength 

 of the cause being insufficient to excite the more acute and 

 rapid inflammation. 



Chronic inflammation may run its course independently of the 

 acute ; it may also supervene or precede it ; but generally the 

 milder it is at the outset, and the more prolonged in its course, 

 the more highly organized and more permanent will be its pro- 

 ducts. From this it will be gathered that chronic inflammation 

 — unimportant perhaps when not located in vital organs — 

 becomes exceedingly grave when involving organs or tissues 

 essential to life, inasmuch as the inflammatory new formation 



