INFLAMMATION. 



[ 340 ] 



INFLAMMATION. 



capillaries appear filled with a red mass, in 

 which the outlines of the globules may be 

 distinctly perceived, but the liquid portion 

 of the blood begins to acquire a red colour, 

 and upon puncturing one of the vessels, the 

 globules are found cemented together. 



Lastly, the liquor sanguinis exudes through 

 the walls of the vessels, sometimes accom- 

 panied with extravasation of blood-corpuscles 

 from rupture of the capillaries. The con- 

 traction of the capillaries appears to result 

 from a vital contractility; the dilatation from 

 increased attraction between the blood and 

 the parenchyma. It does not appear that 

 the stasis is caused by an increase in the 

 number of colourless corpuscles, and their 

 adherence to the sides of the vessels, as has 

 been supposed. 



Soon after the exudation is poured out 

 from the vessels, it usually begins to coagu- 

 late, and the changes which it subsequently 

 experiences, vary according to the intensity 

 of the inflammation, and the part in or upon 

 which it is deposited. 



The principal forms assumed by inflam- 

 matory exudation are 



1. The gelatinous or molecular. After 

 coagulation has taken place, the more solid 

 portion remains as a gelatinous structureless 

 mass, or exhibits numerous molecules, gra- 

 nules, and homogeneous globules, immersed 

 in its substance, and consisting of proteine- 

 compounds or fatty matter. 



2. The fibroid and fibrous. Two forms of 

 this occur. In one, the fibroid, the mass 

 exhibits rather a fibrous appearance than a 

 true fibrous structure, presenting ill-defined 

 striae, principally following one direction, the 

 mass containing also numerous molecules 

 and granules. Some of these striae indicate 

 commencing separation into fibres; others are 

 indications of folds produced by manipula- 

 tion. This variety constitutes a common 

 form of recent false-membrane. In the 

 other, the true fibrous, the mass consists of 

 very minute, crowded, pale and slender 

 fibres, interlacing in all directions or running 

 parallel with each other. Sometimes the fibres 

 are united into bundles; at others, one part of 

 the mass is found to consist of the fibroid 

 structure, another of true fibres. As the 

 lymph or exudation becomes older, the fibres 

 become firmer and more distinct. In some 

 instances, the fibroid and fibrous tissue forms 

 a loose mesh-work, containing a liquid sub- 

 stance colloid tissue of exudation; this 

 consists of fibrine, not gelatine. 



These two forms of tissue consist chemi- 



cally of proteine-compounds. They are 

 mostly rendered more transparent by and 

 swell in acetic acid; but sometimes this 

 reagent slightly coagulates them. 



3. The corpuscular. The corpuscles of 

 inflammatory exudation are of four kinds : 

 a, exudation-corpuscles or granule-cells; b, 

 pyoid corpuscles ; c, pus-corpuscles, and d, 

 fibro-plastic corpuscles. These names have 

 been variously applied by different authors, 

 so that their signification has become vague. 



a. Exudation-corpuscles or granule-cells 

 (PI. 30. fig. 7) sometimes called granular 

 cells, or granular corpuscles, are spherical or 

 rounded corpuscles, of very variable size, 

 perhaps on an average from 1-4000 to 

 1-1500" in diameter. They are sometimes 

 solid, at others consist of cells, and always 

 contain numerous globules of fat, sometimes 

 also a nucleus. Their outline is usually very 

 faint, and often no outline is perceptible, 

 except that formed by the globules. They 

 are scarcely affected by acetic acid, whilst 

 solution of potash disintegrates them and 

 liberates the fatty globules. They are 

 sometimes aggregated into masses com- 

 pound granular masses. The exudation in 

 which they are contained always exhibits 

 numerous free globules of fat, arising from 

 their disintegration. They closely resemble 

 in appearance cells of tissues which have 

 undergone fatty degeneration. 



b. Pyoid corpuscles, sometimes called 

 plastic corpuscles, and c, pus-corpuscles, are 

 described under Pus ; and d, fibro-plastic 

 corpuscles, under TISSUE, FIBRO-PLASTIC. 



The relative proportions in which these 

 elements are contained in various exu- 

 dations depends upon the acuteness, stage, 

 duration and locality of the morbid process. 

 Thus, in wounds undergoing cure by the first 

 intention, the exudation is at first gelatinous, 

 then fibroid and ultimately fibrous. Upon 

 the surface of serous membranes, the above 

 forms occur mixed with pyoid and granule- 

 corpuscles, and sometimes those of pus. The 

 same applies to mucous membranes, but 

 here the corpuscles predominate, and are 

 mostly mixed with epithelial cells. In the 

 substance of organs, the granule-cells gene- 

 rally predominate ; and in inflammation of 

 the brain, these are formed outside the walls 

 of the vessels, and care is required to dis- 

 criminate the compound granular masses 

 from fatty globules deposited in the walls 

 of the vessels. 



BIBL. Works on Medicine; Lebert, Phy- 

 siol. PathoL-, Wed},PathoLHistolog. ; Forster, 



