354: LECTURE XIV. 



or formative nature. If they are jumbled together, as 

 they have been by the neurists, and especially, if the 

 formative and nutritive processes are not kept apart, 

 then it is impossible to arrive at any simple explanation 

 of the phenomena. 



Those states of irritation which we witness in the 

 course of the severer forms of disease the really 

 inflammatory kinds of irritation never in any case 

 admit of a simple explanation. In inflammation we 

 find side by side all the forms of irritation of which I 

 have given you an analysis. Indeed, we very frequently 

 see, that when the organ itself is made up of different 

 parts, one part of the tissue undergoes functional or 

 nutritive, another formative changes. If we consider 

 what happens in a muscle, a chemical or traumatic 

 stimulus will perhaps in the first instance produce a 

 functional irritation of the primitive fasciculi ; the mus- 

 cle contracts, but then nutritive disturbances declare 

 themselves. On the other hand in the interstitial con- 

 nective tissue, which binds the individual fasciculi of the 

 muscle together, real new-formations are readily pro- 

 duced, commonly pus. Here we have to deal with a 

 formative irritation, whilst the inflamed primitive fasci- 

 culus commonly produces no pus, any more than it does 

 new muscular substance ; on the contrary we most fre- 

 quently see, when the irritation has attained a certain 

 height, degenerative processes set in. In this manner 

 the three forms of irritation may be distinguished in one 

 part. Of course there may be in addition also an irri- 

 tation of the nerves, but this has, at least if we do 

 not take function into account, no. connection of cause 

 and effect with the processes going on in the tissue 

 proper, but is nothing more than a collateral effect of 

 the original disturbance. This must, in my opinion, 

 be regarded as the most important result derived from 



