286 Inflammation. 



tough, the young fibroblastic elements like the cells from which 

 they were derived giving rise to a fibrillar intercellular substance 

 (cf. Regeneration). The bundles of fibrils continually growing 

 thicker add firmness to the tissue, and with the cessation of inflam- 

 mation the young tissue shrinks gradually to smaller bulk. By 

 such changes it is transformed into scar tissue, here producing the 

 depressed scars of surfaces, there constricting the lumen of tubes 

 (stenosis, atresia), or again permanently and securely enclosing 

 necrotic tissue or foreign bodies (encapsulation). Productive in- 

 flammation usually stops when the lesion which caused the inflam- 

 mation has been finally dealt with, that is after elimination or en- 

 capsulation of the foreign body, necrotic tissue or other substance 

 which originated the inflammatory process. Where, however, the 

 irritation continues and final cicatrization is delayed tlie prolifera- 

 tive changes sometimes take on an exuberant character. This may 

 be particularly well seen in superficial granulations, which may 

 grow up out of the lesion as projecting tumor-like masses (zvild 

 flesh, caro lu.vnrians, granuloma) [proud flesh] perhaps as large 

 as a human head. Indeed, interstitial proliferation of fibroblasts 

 proceeding uninterruptedly for a long time may produce a mass of 

 young inflammatory tissue far in excess of the original tissue it 

 replaced and producing huge connective tissue enlargements {fihro- 

 matous inflammation, fibrous hypertrophy^). On mucous membranes 

 as that of the gall bladder, such proliferations meet but little re- 

 sistance from the fluid in the cavity and often give rise to villous 

 enlargements (polyps). 



Specific Inflammations. — There are a number of parasitic micro- 

 organisms or infections which induce inflammatory changes but 

 which give rise to tissue reactions of such special peculiarity that it 

 is possible to conclude the agency of some one special infection 

 from the nature of the inflammatory proliferation and the changes 

 which take place in the products of the inflammation. Although 

 the ordinary inflammatory irritants, the thermic, toxic and mechani- 

 cal causes, act according to the intensity of their influence to cause 

 now this now that type of exudate, there are some causative in- 

 fluences which give rise to inflammatory reactions invariably having 

 the same appearance and constant characteristics. These infectious 

 agents are said to act specifically (that is peculiarly). Usually these 

 types of disease are considered under special names, and will here 

 be treated of in special chapters (v. Tuberculosis, Actinomycosis, 

 Botryomycosis, Glanders). 



