INFECTIVE INFLAMMATION. 73 



deeper portions of the gland, where suppuration takes place 

 (Cheyne). This difference depends on the manner of invasion of 

 the two microbes. The staphylococci enter the organism through 

 the milk ducts, and act from their interior, whereas the streptococci, 

 like the streptococcus of erysipelas, enter the tissues through the 

 lymphatic vessels, and their pathogenic action is primarily observed 

 at the surface. Bumm excised a portion of the wall of a commenc- 

 ing abscess of the breast, and was able to demonstrate the presence 

 of staphylococci in the interior of the acini, and their penetration 

 thence into the interacinous tissue. The phlegmonous inflamma- 

 tion of the breast caused by the streptococci takes place along the 

 .course of the lymphatics, and primarily involves the interacinous 

 connective tissue. 



During the first stage of microbic inflammation, the increased 

 afflux of blood may be looked upon as an attempt to wash away 

 the microbes. The increased velocity of the blood-current is well 

 calculated to prevent mural implantation of the microbes, and to 

 detach such as have become fastened upon the vessel wall. The 

 next attempt on the part of the tissues is to limit infection by the 

 production of granulation tissue. The tissues which first come in 

 contact with the primary cause of the inflammation are converted 

 into embryonal tissue, which forms a wall of protection for the 

 surrounding tissues around the primary area of infection. In acute 

 suppuration this granulation tissue is transformed into pus, and the 

 process extends until limitation takes place by the primary cause 

 becoming less virulent, when the abscess wall, composed of living 

 granulation tissue, forms a boundary-line to the suppurative pro- 

 cess. In chronic infective processes, as tuberculosis and actinomy- 

 cosis, the granulating stage remains for an indefinite period of time, 

 and in the former affection, under favorable conditions, retrograde 

 degenerative changes are prevented, the embryonal cells are trans- 

 formed into connective tissue, and a spontaneous cure is the result. 

 During the third stage the microbes have either been removed or, 

 at least, their pathogenic properties no longer exist, and a process 

 of repair is initiated. It has been shown experimentally that 

 microbes enter the organism most rapidly during the first stage of 

 inflammation, as studied in tissues the seat of a simple inflamma- 

 tion produced by the action of chemical irritants, and subsequently 

 infected by the introduction of pathogenic microbes. It has been 

 found, as regards pus-microbes, that if they are circulating in the 

 blood, the induction of a severe inflammatory action does not lead 

 to their localization in the part, while if the inflammation is chronic, 

 or the trauma less intense, they become arrested in the inflamma- 

 tory depot and set up suppuration. Thus, Rhine concluded from 

 his experiments on suppuration, quoted elsewhere, that a violent 



