290 Inflamination. 



peculiar, however^ in that these cellular activities are not confined to 

 any single organ but extend to all the organs, to the vascular con- 

 nective tissue framework of all parts of the body. 



The favorable or unfavorable outcome of inflammation depends 

 upon accidental factors, upon the nature and mode of action of the 

 causative agents, upon the location of tlie part injured and the de- 

 gree of functional disturbance which the inflamed organ experiences. 

 Of the individual reactions which in combination constitute inflam- 

 mation, it can be accepted that phagocytosis removes structures 

 killed by harmful foreign bodies, that the exudation exerts a di- 

 gestive action upon and washes away injurious substances, that the 

 blood plasma (and possibly too a secretion given off from the leuco- 

 cytes) supplies antitoxic substances, and that the tissues are brought 

 into a state of regenerative ability by the increased nutritive supply. 

 AH of these factors combine to bring about compensation for the 

 influences of a variety of harmful agencies. When the irritant is 

 removed or encapsulated the condition of special stimulation ceases 

 and the inflammation ends m resolution, because no more fresh cells 

 advance into the area and those which have previously escaped from 

 the vessels either break down and are reabsorbed as detritus with the 

 other i)arts of the exudate by the veins and lymphatics, or, in case 

 they retain their power of movement, pass off to other places toward 

 which they are attracted by nutrient matter. 



The inflammatory process cannot invariably bring about com- 

 plete regeneration of destroyed tissue ; as a rule onlv the connective 

 tissue is fully replaced, the specific elements which are lost, as 

 glandular or ganglionic cells, not being reformed. It is in this way, 

 by the formation of connective tissue to occupy the space of a lesion, 

 that inflammation brings about healing of the lesion. The inflamma- 

 tory connective tissue growth which paves the way for encapsula- 

 tion of foreign bodies and demarcation of dead tissue is in the same 

 way to be regarded as an attempt at healing. 



However, there are also disadvantageous features connected with 

 inflammation. Adhesions between organs, the occupation of cavities 

 by masses of exudate, as in the lung or pleura, exudative effusions 

 in the brain or in the kidneys, occasion functional disturbances, 

 which, depending on the importance of the affected organ, may 

 threaten tlie life of the subject ; and inflammation may terminate in 

 death. This does not, however, essentially alter the conception of 

 inflammation as a defensive effort. Ribbert compares it to an 

 army, which, it is true, is in the main a valuable organization, but 

 which ma\' fail at times to overpower a stronger enemy or which 



