72 INFLAMMATION. 



ptomaines are formed in simple inflammation, sepsis and febrile 

 disturbances are either absent entirely or, when present in a slight 

 degree, are caused by the absorption from the tissues of the products 

 of tissue- wear, or the introduction of fibrin ferments derived from 

 extra vasated blood. It is only a matter of time until the process 

 still known as simple inflammation will be no longer considered 

 and classified with inflammatory processes, but will be assigned a 

 separate place in pathology, as it resembles in every respect the 

 physiological processes as we observe them during the growth and 

 regeneration of the body. 



2. Infective Inflammation. 



The characteristic features of this form of inflammation are, that 

 it is caused by the presence of specific microbes, and that the pro- 

 ducts of the inflammatory process do not undergo transformation 

 into tissue of a higher type. 



Thoma (" Ueber die Ehitziindung," Berl. klin. Wochenschrift, 

 Nos. 6, 7) regards suppuration as a qualitative alteration of inflam- 

 mation. He defines it as an exudation plus fermentation, in which 

 the latter is not essentially caused by microorganisms, as it may also 

 be caused by the tissues, as they also are known to possess zymotic 

 properties. Caseation is also looked upon as the result of fermen- 

 tation, but not in the sense described by Weigert, but more allied 

 to digestive and putrefactive processes. 



The new tissue is destroyed either rapidly or slowly, by the 

 action of the ptomaines ; the cells undergo retrograde metamorpho- 

 sis, and are absorbed after the primary cause has ceased to act, or 

 they are so rapidly destroyed that their interstitial removal is no 

 longer possible and the product of the inflammation is removed 

 spontaneously, or by the intervention of art, or, finally, life is 

 destroyed, either by disturbances due to mechanical causes or by 

 ptomaine-intoxication. The intensity of the inflammation depends 

 as well upon the nature of the microbes as their quantity. The 

 microbes of suppuration, gonorrhoea, and erysipelas always cause 

 an acute inflammation, while tubercular processes and allied affec- 

 tions are noted for their chronicity. Glanders and actinomycosis 

 are chronic or subacute affections. In the same organ, the primary 

 seat of the inflammatory process will be modified by the kind of 

 microbe which has caused the infection. Thus, in suppurative mas- 

 titis, the abscesses which are caused by the staphylococci always 

 begin in the deeper part of the organ, and spread toward the 

 surface, while in infection with streptococci of the same part, the 

 inflammation starts from some superficial abrasion and first attacks 

 the skin, whence the process extends in a central direction to the 



