Page:A Handbook of the Theory and Practice of Medicine - Volume I - Frederick T. Roberts.djvu/65

 INFLAMMATION.

49

and nerve, are never developed under these circumstances. This org-anization is well seen in the chang-es which occur in the granu- lation-tissue by which wounds cicatrize, and in the adhesions and thickening- formed in connection with inflamed serous membranes. The consequences of these changes are often very serious, struc- tures becoming thickened, hardened, contracted, or bound together, and transparent tissues being rendered opaque.

After organization a process of degeneration may set in, evi- denced by wasting or withering, the substance becoming dry, yellow, horny, and stiff; by fatty or liquefactive change, which may lead to its absorption ; or by the formation of black pigment. Similar changes may occur in the products of corpuscular lymph.

c. Blood is sometimes present in variable quantities in inflamma- tory exudations. It is partly the result of migration of the red corpuscles, but some may have escaped owing to the actual rupture of vessels, especially of those recently formed.

d. Mucin. — In inflammation of mucous membranes this substance is sometimes met with, and gives a tenacious, stringy character to the fluid discharged from the surface.

3. Suppuration or Formation 0/ Pus. — The tendency to suppuration varies according to the tissue affected, and the constitutional condition of the patient, but it is generally more liable to take place if the inflammation is very severe and concentrated. Pus may form on a free surface and be discharged, being then often mixed with other materials ; it may accumulate in serous or other cavities ; or it may involve the substance of tissues and organs, either as a circum- scribed abscess, or as diffuse purulent infiltration. In its physical characters healthy pus is a thick, viscid, pale-yellow liquid, odour- less, alkaline in reaction, with a specific gravity of about 1030. It consists of a fluid — liquot puris — in which float pus-corpuscles and other microscopic particles. Liquor puris is an albuminous fluid, but also contains salts, pyin, chondrin, and fat. The corpuscles, as usually seen under the microscope, closely resemble white blood-corpuscles in size and appearance, being more or less round or sometimes irregular, and granular, and having one or more nuclei, which are rendered more evident by acetic a^d, and often break up when acted upon by this reagent. Taey have the power of spontaneous movement and migration, and can alter in form, as well as increase in number by fission.

Fig. 2.

Pus-corpuscles, a. From a healthily-granulating wound ; 6. From an abscess in t'l: areolar tissue ; c. The same treated with dilute acetic acid ; d. From a sinus in bo:i : (necrosis); e. Migratory pus-corpuscles. (Rindfleisch.)

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