CELLULAR TISSUE. 



615 



inflammation of glands, as the testis, mamma, 

 liver, tonsil, &c. ; in the lymphatic glands, 

 especially in scrofulous persons ; in various dis- 

 eases of the joints ; in the hard swellings so often 

 seen in scrofula, gout, and rheumatism ; in 

 imperfectly cured erysipelas, pellagra, and ele- 

 phantiasis ; in the callous edges of old ulcers ; 

 in the uterus, labia pudendi, and prepuce of 

 the penis ; and, according to Otto,* in that pe- 

 culiar induration of the cellular tissue which 

 occurs in new-born children. This distin- 

 guished pathologist, in common with many 

 other continental writers, attributes phlegma- 

 sia dolens to the same cause. The incorrect- 

 ness of this opinion has been demonstrated by 

 the researches of Dance, Arnott, Lee,and others. 

 (See VEIN.) 



The great induration often induced by long- 

 continued chronic inflammation was called by 

 the older writers scirrhus ; and even in the 

 present day most of the French pathologists 

 apply that term to the hardness thus induced, 

 as well as to the malignant disease, to indicate 

 which English practitioners restrict the word. 



The substances that are effused into the cel- 

 lular tissue in chronic inflammation are various, 

 according to the part attacked, the circum- 

 stances of the disease, constitution, &c. It 

 generally consists of a whitish or greyish matter, 

 of a lardaceous, homogeneous appearance, caus- 

 ing what is called by modern pathologists, white 

 induration ; and sometimes it is of a yellowish, or 

 even bluish colour. It is doubtful whether this 

 substance consists of the fibrine or albumen of 

 the blood, or of some newly formed material. In 

 scrofulous individuals the deposition consists of 

 the well-known caseous matter, so characteristic 

 of the strumous diathesis; lastly, this form of 

 inflammation, especially in strumous constitu- 

 tions, often leads to the formation of chronic 

 abscess, the contents of which, as Gendrin, 

 Mayo, and others have observed, do not, how- 

 ever, consist of true pus, but of serum generally 

 mixed with a flakey matter, or even tinged with 

 blood. 



c. Spreading or diffuse inflammation. The 

 cellular tissue, constituting in all parts of the 

 body an uninterrupted secreting surface, is sub- 

 ject to spreading inflammation, which, from the 

 extent of the parts implicated, the disorganiza- 

 tion induced, and the alarming character of the 

 attendant constitutional disturbance, must be 

 regarded as one of the most formidable diseases 

 to which the human body is subject. In what- 

 ever manner this disease originates, whether 

 from poisoned wounds, from phlegmonous ery- 

 sipelas, from external injury, or from any other 

 cause, it progressively and rapidly attacks a 

 large extent of the cellular tissue, often invading 

 an entire limb, or even a considerable part of 

 the trunk. In examining parts thus affected 

 after death, they are found to be variously 

 altered, according to the duration of the dis- 

 ease and the order in which they became in- 

 volved ; in those which are most recently im- 

 plicated, the cellular substance is merely rede- 



* Compcnd. of Pathol. Anat. by South, vol. i. 

 P . 91. 



matous, containing a large quantity of limpid 

 or reddish-coloured serum, which readily flows 

 out on making an incision, and which after- 

 wards acquires more consistence, and becomes 

 more deeply coloured. In the subsequent 

 stages, pus, sometimes pure, sometimes dis- 

 coloured, is effused : the matter is at first con- 

 tained in the cells, which are gorged with a 

 whitish semifluid matter, but afterwards depots 

 of matter take place in the disorganized tissue ; 

 there being, however, no proper cyst, owing to 

 the want of that barrier of lymph which is 

 effused in common phlegmon. These abscesses 

 are often numerous, but insulated and distinct 

 from each other : at other times they occupy a 

 great extent, and contain a large quantity of pus, 

 often mixed with shreds of mortified membrane. 

 In the more severe forms of this affection the 

 natural organization is in some places totally 

 destroyed, and the cellular substance, from the 

 effects of gangrene, is converted into a greyish 

 or dark-coloured slough. 



These changes are not confined to the sub- 

 cutaneous membrane, in which, however, they 

 are principally observed, but are seen in the 

 cellular sheaths of the muscles, and even in the 

 processes which separate their different fasciculi. 

 The muscles themselves, under these circum- 

 stances, partake in the disorganization, and lose 

 their proper colour. 



The progress of this formidable disease would 

 seem to shew that an acrid and irritating hu- 

 mour is effused into the cellular substance, 

 where it rapidly causes suppuration and slough- 

 ing, in the same manner as when urine is ex- 

 tra vasated into the perinseum and scrotum. 

 That a vitiated state of the blood is often pro- 

 duced is a now well-known fact, and such a 

 condition appears to be induced in the disease 

 under consideration, either in consequence of 

 the introduction of a poison into the system, as 

 from the bite of a venomous serpent, or from a 

 deterioration of the constitution, as in draymen, 

 coal-porters, and others, who in large towns con- 

 sume enormous quantities of fermented liquors; 

 or, lastly, from both these causes combined, as 

 from punctures received in dissection by indi- 

 viduals who at the time are in an indifferent 

 state of health. 



II. INFILTRATION, or effusion. The escape 

 of various fluids from their proper receptacles 

 into the cellular tissue is of extremely frequent 

 occurrence. 



a. Blood. This is effused either as a conse- 

 quence of external violence acting on the arte- 

 ries and veins, or from an internal cause, of 

 which the nature is more obscure. When the 

 hemorrhage is extensive, the surrounding tissue 

 is unable to resist the progress of the blood, 

 and the infiltration becomes of considerable ex- 

 tent. It is by effusions of this kind that ecchy- 

 moses, false aneurisms, &c. are formed. 



b. Serum. A very common morbid change 

 is the infiltration of a thin watery fluid into 

 this tissue, consisting of an accumulation of 

 the serum naturally exhaled into its cells. The 

 effused fluid, apparently owing to its contain- 

 ing a larger proportion of albumen than usual, 

 is occasionally of a more viscid nature, so as 



