TUBERCULOSIS. 459 



is primary only as tuberculosis, but not as a process of irrita- 

 tion, whose irritating agency is generally carried in from an 

 atrium." This ingenious remark shows that the irritating agency 

 is to be considered as the cause the irritative process, on the 

 contrary, as the result. The difference between the " irritation 7 ' 

 of Broussais and the " irritative process " of Virchow is obvious. 



The history of the theory of inflammation elucidates the 

 meaning of the process un der consideration. Humoral pathology 

 placed it almost exclusively in the blood-vessels and in the diseased 

 blood. Cellular pathology, on the contrary, set aside the blood- 

 vessels and everything arising from the blood, and 'sought for the 

 essentials in a disease of the tissue, in the inflammatory new 

 formation. To the irritating agency at first the blood-vessels 

 only responded ; later, only the cells of the tissue. 



S. Strieker, in 1870, in opposition to these views, urged the 

 importance of the blood and the blood-vessels as factors in giving 

 rise to the inflammatory process j and he demonstrated that the 

 Mood- vessels take an essential part in the production of tissue 

 changes. 



Since then, somewhat more has been added. It is proved 

 through my own researches that, besides the exudation and the 

 new formation of living matte?, the new formation of Mood and 

 blood-vessels is an essential feature of traumatic inflammation. 

 I have shown that the process of inflammation first causes a 

 liberation of the living matter, which before was infiltrated 

 with basis-substance; that the inflamed tissue first returns to 

 its juvenile or embryonal condition, and that it splits up in 

 the primordial elements from which it originated. The " inflam- 

 matory cell-infiltration," therefore, must be regarded only as the 

 representative of an early normal condition. A real " inflamma- 

 tory new formation n does not take place till later, when the living 

 matter is newly formed and the elements divide in boundaries, 

 depending upon the more compact centers, the nucleoli and the 

 nuclei. 



Rokitansky, in 1854, ascertained that the " tissue-cells" are 

 not by any means the only starting-points of inflammatory new 

 formation, but in the outgrowth of connective tissue the " inter- 

 cellular substance" also participates actively. I demonstrated in 

 1873 that the basis-substance of all varieties of connective tissue 

 is abundantly supplied with living matter, and that after a dis- 

 solution or liquefaction of the glue-yielding basis-substance the 

 living matter is productive as well as the cells. I have therefore 



