CHAPTER VII. 



INFLAMMATION. 



OUR ideas of the nature of inflammation have been materially 

 changed by the knowledge we have obtained from bacteriological 

 investigations which have been made during the last fifteen years. 

 Inflammation is no longer viewed as a disease. Many heretofore 

 obscure inflammatory lesions are now known to have been caused 

 by definite, specific microbes. Modern pathology has established 

 the fact that the condition called inflammation is a restorative pro- 

 cess, which has for its object the repair of injured tissues, or the 

 neutralization or removal of the primary microbic cause. From a 

 scientific and practical standpoint, all inflammatory affections can be 

 divided into two classes: 1. Simple, or plastic inflammation. 2. 

 Infective, or destructive inflammation. 



1. Simple or Plastic Inflammation. 



A simple, or plastic, inflammation is a regenerative process, 

 induced by a trauma, or disease, in which the tissues are in an 

 aseptic condition, and the products of tissue-proliferation are trans- 

 formed into normal permanent tissue. During the first stage of 

 inflammation the tissues are weakened, so that they cannot resist 

 in any way the entrance of pathogenic microorganisms, should any 

 reach the tissues by direct contact, or through the circulation. In 

 the second stage, the weak tissue has become removed, and its place 

 is occupied by vigorous granulation tissues, which possess great 

 power in resisting the attack of microbes. In the third stage, the 

 granulation tissue is becoming converted into mature active tissue, 

 Prolonged vascular engorgement and the.first stage of inflammation 

 frequently furnish the conditions which determine transformation 

 of a simple into a septic inflammation. This is frequently observed 

 in cases of acute intestinal obstruction, in which the vascular 

 engorgement and incipient inflammation of the intestinal tunics so 

 alter the tissues of the bowel that pathogenic microbes pass from 

 the intestinal canal into the peritoneal cavity, where they set 

 up a septic inflammation. As long as no septic infection takes 

 place the new embryonal cells undergo transformation into tissues 

 which correspond to the anatomical seat of the lesion. As no toxic 



