Inflammation. Phlogosis. Phlegmasia. 41 



after the outset of inflammation in nonvascular tissues (cornea, 

 articular cartilage), the heat of the inflamed part may be actu- 

 ally lowered when there is much exudation around the capillary 

 vessels and lessened flow of blood, pain may be absent in some 

 circumscribed inflammations of the lungs, and swelling is not at 

 first visible in the inflamed cornea or compact bony tissue. These 

 phenomena which are so common in inflammation and, in general 

 so characteristic of it, cannot therefore be accepted as infallible 

 evidence of its existence, nor can their absence be held as abso- 

 lutely implying its nonexistence. 



Forms of Inflammation. This morbid process might be 

 divided almost indefinitely according to the organ invaded, the 

 cause, and type, yet it will be more convenient to deal with it 

 generically and notice inflammation in nonvascular and vas- 

 cular tissues respectively, and the different t5^es of granular 

 degeneration, exudative inflammation and croupous inflam- 

 mation. It will be requisite further to notice an acute and a 

 chronic type. 



By dealing first with the changes in the anatomical elements of 

 the tissues and in the innervation, we shall virtually cover the 

 phenomena observed in nonvascular tissues, and later the changes 

 in connection with the circulatory system will give the additional 

 characteristics of inflammation in vascular tissues. 



CHANGES IN THE TISSUE ELEMENTS. 



Death of cells and tissue. By the application of an irritant 

 (acid, heat, etc.,) a certain thickness of tissue with its enclosed 

 cells is killed, and a thin layer of necrosis is usually produced. 

 This does not constitute inflammation, but it acts as a foreign 

 body, often septic, in producing inflammation in the parts 

 adjacent. 



Cloudy Swelling, Granular Degeneration. This may occur 

 in the inflamed area surrounding the necrosed tissue in the seat 

 of a burn or other injury, it is exceedingly common in the cells 

 of inflamed parenchymatous tissue (liver, kidney), in the muscle 

 of the heart, in the gastro-intestinal mucosa, in febrile affections 

 and in poisoning with arsenic, phosphorus, or mineral acids. The 

 gross appearance of the tissue is that of swelling, with a dull 



