CHAPTER VI. 

 INFLAMMATORY AND SUPPURATIVE CONDITIONS. 



THIS subject is an exceedingly wide one, and embraces a great 

 many pathological conditions which in their general characters 

 and results are widely different. Thus in addition to suppuration, 

 various inflammations, ulcerative endocarditis, septicaemia and 

 pyaemia, will come up for consideration. With regard to these 

 the two following general statements, established by bacteriological 

 research, may be made in introducing the subject. In the first 

 place, there is no one specific organism for any one of these 

 conditions; various organisms may produce them, and not in- 

 frequently more than one organism may be present together. 

 In the second place, the same organism may produce widely 

 varying results under different circumstances, at one time a 

 local inflammation or abscess, at another multiple suppurations 

 or a general septicaemia. The principles on which this diversity 

 in results depends have already been explained (p. 151). 

 Furthermore, there are conditions like acute pneumonia, epidemic 

 meningitis, acute rheumatism, etc., which have practically the 

 character of specific diseases and yet which as regards their 

 essential pathology belong to the same class. The arrangement 

 followed is to a certain extent one of convenience. 



It may be well to emphasise some of the chief points in the 

 pathology of these conditions. In suppuration the two main 

 phenomena are (a) a progressive immigration of leucocytes, 

 chiefly of the polymorpho-nuclear (neutrophile) variety, and (b) 

 a liquefaction or digestion of the supporting elements of the 

 tissue along with necrosis of the cells of the part. The result 

 is that the tissue affected becomes replaced by the cream-like 

 fluid called pus. A suppurative inflammation is thus to be 

 distinguished on the one hand from an inflammation without 

 destruction of tissue, and on the other from necrosis or death 



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