NON-INFLAMMATORY FORMATIONS. 329 



i'lon 2^(0' excellence; a proceeding wliicli seems to owe the favour 

 with which it has been receivedj only to the summary way in 

 which it removes all scruples concerning the qucestio vexata of a 

 definite boundary-line between hypertrophy and inflammation. 

 To my mind, there really is no sharp line of demarcation 

 between the two. Inflammation is but a perverted image of 

 normal nutrition, and hypertrophy is but a minor degree of the 

 very same perversion. Of course I do not presume to arrest all 

 discussion by any dogmatic statement; on the contrary, I 

 willingly admit that I do not feel myself in any w^ay ripe for a 

 conclusive utterance on this subject. I seek only to justify 

 myself for describing the changes with which we are now con- 

 cerned, as simply hyperplastic, without attempting to prejudge 

 their mode of origin and causation from the form which they 

 assume. 



§ 281. The " milky cloudiness " alluded to above, is pecu- 

 liarly striking when it afffects the serous coat of a dark-coloured 

 organ, especially the capsule of the liver or the spleen, and the 

 visceral pericardium (tendinous spots of the heart). Were the 

 brain not itself of a white colour, the sclerosis of the ependyma 

 in chronic hydrocephalus would undoubtedly present itself to 

 our eyes as a milky cloudiness. Sclerosis (to repeat what has 

 already been said) is merely the lowest degree of hyperplastic 

 overgrowth of connective tissue, as regards which it is still 

 uncertain, whether we ought to consider it as a proliferative 

 change, or as a simple condensation of pre-existing connective 

 tissue. 



Besides sclerosis, we are acquainted with a whole series of 

 connective-tissue proliferations, which have one feature in com- 

 mon, viz. that they all tend to assume more of a circumscribed 

 character. In closest relationship to sclerosis, we have the 

 development of sharply-defined, flat elevations of cartilaginous 

 texture. These are most common on the capsule of the spleen, 

 Avhere they exhibit angular outlines and a yellowish- white 

 translucency, and may attain a height of from half a line to one 

 line. On the plem-a they are more circular and transparent, 

 with a lenticular surface ; while on the tunica vaginalis of the 

 testicle they are characterised by their often considerable size 

 and hardness. These cartilaginous elevations are closely related 

 to the cartilage of the cornea in their minute structure. Next 



