424 INFLAMMATION. 



modified, often containing the so-called colloid or waxy material. 

 The subjacent tissue is hypertrophied, and, in certain districts, 

 the epithelia are completely destroyed and a profuse new forma- 

 tion of fibrous connective tissue is produced. This condition is 

 called atrophy. 



Diphtheritic inflammation consists of a fibrinous exudate in the substance of 

 the connective tissue, with an isolation of portions of this tissue, and their 

 subsequent death viz. : putrefaction and throwing off of the so-called mem- 

 brane. Organisms of decomposition, micrococci and bacteria, are secondary 

 products of putrefaction. For a long time the difference between croupous 

 and diphtheritic inflammation was held to be that in the former the exudate 

 forms on the surface, in the latter in the substance of the tissue itself ; but 

 they are, in essential points, identical processes. 



(c) Suppurative inflammation consists of an albuminous exu- 

 dation, a complete breaking down of the connective, muscle-, or 

 nerve-tissues, and of all blood-vessels, into pus-corpuscles, also a 

 new formation of these corpuscles from epithelia. Acute suppur- 

 ative inflammation results in the formation of an abscess in the 

 middle of the tissue, or a flow of pus from free surfaces, the 

 so-called pyorrhoea, or an accumulation of pus in closed cavities 

 the so-called empyema. Blennorrhoea and intense catarrhal 

 inflammation blend with suppuration, and may be either acute or 

 chronic. Chronic suppurative inflammation is characterized by 

 intense hyperplasia of the connective tissue, together with per- 

 sistent augmented secretion and a partial destruction of blood- 

 vessels and tissues the ulcer ation. 



The healing process of wounds by suppuration is accompanied by an 

 active outgrowth of freely vascularized, newly formed, connective tissue, 

 which is at first of the myxomatous variety, and is termed granulation tissue. 

 How much pus is produced by emigration of colorless blood-corpuscles in 

 blennorrhoea, pyorrhosa, and in healing and granulating wounds, we are 

 unable to say. The originally myxomatous tissue of granulating wounds is 

 changed into fibrous connective tissue ; the at first numerous blood-vessels 

 are, to a great extent, also transformed into fibrous tissue, and these processes 

 terminate finally in a scar, cicatrix. 



If the inflammatory new formation be not supplied with newly formed 

 blood-vessels it is called a tubercle, and the totality of the avascular new 

 formation represents the tuberculous mass, which, by the breaking and the 

 shrinkage of the inflammatory corpuscles, becomes " cheesy." Tubercle, 

 therefore, with some reason, may be termed a dry abscess. 



No allusion is made in this chapter to the parasitic origin of the inflam- 

 matory process, especially the germ theory, as applied to inflammation. 

 Unquestionably, organisms of decomposition, if brought into the interior of 

 a living tissue, or, perhaps, even only in contact with it, will excite inflamma- 



