INSPISSATION (TUBERCULIZATION) OF PUS. 215 



cheesy products which have recently been all included 

 under the term tubercle, and concerning which it has 

 been shown, especially by Reinhardt, that they must to 

 a very considerable extent really be referred to pus as 

 their origin, and therefore be regarded as inflammatory 

 products. Hereafter, we shall see that these observa- 

 tions have been employed for the deduction of false con- 

 clusions concerning tubercle itself ; but that by inspissa- 

 tion inflammatory products can be converted into things 

 which are called tubercles, is indubitable. It is precisely 

 in the history of pulmonary tuberculosis that this opera- 

 tion plays a very prominent part. You have only to 

 imagine shrivelled-up cells like these inclosed within the 

 alveoli of the lungs and undergoing inspissation of their 

 contents in one alveolus after another, and you will at 

 length obtain a cheesy hepatization such as is usually 

 described under the name of tubercular infiltration.. 



This imperfect reabsorption, in which only the fluid 

 constituents are reabsorbed, leaves the mass of solid con- 

 stituents lying in the part as a caput mortuum, as a mass 

 deprived of vitality and no longer capable of life. This 

 is the kind of inspissation which we see occur on a large 

 scale in the case of imperfect reabsorption of pleuritic 

 exudations, when very large layers of a crumbling sub- 

 stance remain behind in the sac of the pleura ; and also 

 round about the vertebral column in caries of the verte- 



Fig. 65. Inspissated hsemorrhagic pus from a case of empyema, some of it in pro- 

 cess of disintegration, a. The natural mass, containing granular debris, shrivelled 

 pus- and blood-corpuscles, b. The same mass treated with water ; a few granular, 

 decolorized blood-corpuscles have become evident, c and d. After the addition of 

 acetic acid. 300 diameters, and at d 520. 



