CHAPTER VII. 



INFLAMMATOKY AND SUPPUEATIVE 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 suppura- 

 tion, 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 infrequently more than one organism may be 

 present. 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 sup- 

 purations or a general septicaemia. The principles on which 

 this diversity in results depends have already been explained 

 (p. 174). Furthermore, there are conditions like acute pneu- 

 monia, epidemic meningitis, acute rheumatism, etc., which have 

 practically the character of specific diseases, and yetf which, as 

 regards their essential pathology, belong to the same class. 

 The arrangement followed below 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 

 en masse, where the tissue is not liquefied, and leucocyte 



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