CHAPTER VII. 

 INFLAMMATORY AND SUPPURATIVE CONDITIONS. 



THIS subject is an exceedingly wide one, and embraces a great 

 many pathological conditions which in their general characters 

 and results are widely different. Thus in addition to suppura- 

 tion, various inflammations, ulcerative endocarditis, septicaemia, 

 and pyaemia, will come up for consideration. With regard to 

 these the two following general statements, established by bac- 

 teriological research, may be made in introducing the subject. 

 In the first place, there is no one specific organism for any one 

 of these conditions ; various organisms may produce them, and 

 not infrequently more than one organism may be present to- 

 gether. In the second place, the same organism may produce 

 widely varying results under different circumstances, at one 

 time a local inflammation or abscess, at another multiple suppu- 

 rations or a general septicaemia. The principles on which this 

 diversity in results depends have already been explained (p.* 158). 



It may be well to emphasise some of the chief points in the 

 pathology of these conditions. In suppuration the two main 

 phenomena are (a) a progressive immigration of leucocytes, 

 chiefly of the polymorphic-nuclear (neutrophile) variety, and (b) 

 a liquefaction or digestion of the supporting elements of the 

 tissue along with necrosis of the cells of the part. The result 

 is that the tissue affected becomes replaced by the cream-like 

 fluid called pus. A suppurative inflammation is thus to be 

 distinguished on the one hand from an inflammation without 

 destruction of tissue, and on the other from necrosis or death 

 en masse, where the tissue is not liquefied, and leucocyte 

 accumulation may be slight. When, however, suppuration is 

 taking place in a very dense fibrous tissue, liquefaction may be 

 incomplete, and a portion of dead tissue or slough may remain 

 in the centre, as is the case in boils. In the case of suppuration 

 in a serous cavity the two chief factors are the progressive 



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