INFLAMMATION. 75 
Describe the proliferative changes. 
There is simply an increased growth or proliferation of connective- 
tissue cells. 
What are the degenerative changes ? 
These changes are necrotic in character. There is a disintegration, 
solution and liquefaction of the entire tissue (cells and basement sub- 
stance). Sometimes there is a coagulation of the exuded liquid and 
also of the disorganized tissue cells. Fatty degeneration is not 
uncommonly a secondary result of the vascular changes. 
Describe the reparative changes. 
When the circulating blood restores the vessel-walls to their normal 
state recovery begins. As soon as the vessel-walls perform their func- 
tions properly reabsorption takes place. The fluid portion of the 
exudate is absorbed by the lymphatics and bloodvessels, the cells, 
necrotic tissue, and coagulated exudations are liquefied and carried 
off in the same way. If these products lie on the surface they may be 
directly cast off. Finally, if the parts are vigorous and the area 
destroyed be not too great, there takes place a regeneration of the 
cells of which the affected part is composed. On the other hand, 
if the destruction of tissue is too great to be repaired by cell regen- 
eration, then there is a production of new tissue (granulation and 
cicatricial). 
Describe granulation tissue. 
It is composed of cells, like white-blood cells, small, polygonal cells 
with large, single nuclei, epithelioid cells, branched or fusiform cells, 
bloodvessels and basement substance. The most important factor in 
this plastic process is the formation of new bloodvessels. They are 
numerous and at first thin walled, and are formed by a budding out 
from the original connective-tissue vessels, of solid sprouts of proto- 
plasm, which become tunnelled, so that blood passes through them, and 
changed, so as to form a wall of endothelial cells. The basement sub- 
stance is at first scanty, and is homogeneous or finely granular. As 
the tissue grows older it becomes more abundant, more dense, and 
fibrillated. 
What is cicatricial tissue ? 
It is a modified granulation tissue, in which the basement substance 
has increased and become dense. The cells and new bloodvessels have 
disappeared and there has been formed a dense contracted area of 
fibrous connective tissue. 
