E. MINK. 
166 
amount of effusion cannot take place, ahd what little there is is 
so blended with the textural elements that it is not apparent as a 
separate constituent, but simply causes swelling of the organ. 
Effusion is most prominent in tissues of loose texture, as lungs, 
serous and mucous membranes. 
The increased activity of cell life is manifested by livelier 
amorboid movements in those which are usually active; and 
those which normally undergo no alteration in form and are usu¬ 
ally inactive, become active, and send out processes in various 
forms. This activity is usually attended with protoplasmic 
growth, and by its division or endogenous development new cells 
are formed. 
Now, although the earlier changes in inflamed tissues are 
those of increased growth and multiplication of cells, yet in the 
later stages of acute inflammation the changes are in the main 
characterized by impaired nutrition. These changes in the tis¬ 
sues vary with the character of the inflammation. They may be 
such as attend those of an intensely acute type, and end in suppu¬ 
ration or terminate in necrosis ; or they may be such as attend 
those of a subacute or chronic character, in which new growth of 
connective tissue occupies a prominent place. 
To follow these changes to their final results would require 
. more time than I felt willing to devote to that purpose; and it 
would occupy more time in reading than any of you would be 
willing to devote to listening to it. To exhaust the subject of 
inflammation in all its details would require almost an intermin¬ 
able effort of even the most accomplished pathologist. 
I feel, however, as if I ought not to drop the subject here 
without saying something about the destructive effects of inflam¬ 
mation. On this topic I propose to read to you the following 
paragraphs, reprinted from the article on the same subject which 
appeared in the former editions of Holmes’ system of surgery. 
After pointing out that both for pathology and practice it is need¬ 
ful that the student recognize the reality of destructive changes 
as an essential part of inflammation, Mr. John Simon, who 
contributed the article, continues in this masterly strain : 
“ Let him examine inflamed muscle, as, for instance, in the 
post-mortem examination of a compound fracture, or of a recently 
