INFLAMMATION, a term long used to indicate the phenomena that follow mechanical, chemical or physical injuries to living tissues, These changes have been described for centuries as rubor (redness), calor (heat), dolor (pain) and tumor (swelling), which are the phenomena particularly seen on surface inflammations. At the present time the idea is becoming fixed that inflammation is a conservative process, the phe nomena attending nature's effort to rid the tis sue of harmful substances. In the normal proc ess of repair of an injury there are changes which closely resemble the milder types of in flammation; but when to a mechanical, chem ical or physical injury there is added a growth of micro-organisms, the reply on the part of the body-cells differs from the ordinary repair of injury. The changes witnessed depend upon the strength and kind of invading micro-organ ism and the particular tissue invaded. The first change is hyperemia, a suffusion of the part with blood from capillary dilatation; following this the liquid part of the blood, the serum, is poured out into the tissues and offers its resist ing powers to the poisonous substance. If these measures be insufficiebt, the white blood-cells called phagocytes congregate in the tissues, de stroying the invading organisms, by actually consuming them and neutralizing their toxic products. During this struggle there is more or less death of the cells, called "degenera tion( ; large masses (slough's; the remnants of the cells and the phagocytes killed form the thick fluid called pus. \Vhen an inflammation goes on to the formation of pus, it is spoken of as pw-ideni or suppurative. Certain poisons cause a peculiar reaction on the part of the 6s sues, characterized by the formation, of new is unable to carry on the function of, the part. This tissue is the same as the con nective the process is called produc tive inflammation. The poisons that continue to act for a long time are particularly apt to cause this 'reaction, and the inflammation , is called chromic because of its permanency. Ca tarrhal inflammations are these same processes *hen they occur in mucous membranes; the apptaiance of these catarrhs, however, is differ ent owing to the peculiar structure of mucous membrane and to the fact of the epithelial cov-, ering offering excellent resistance to invasion. When death of cells occurs they.can readily be. cast• off: Croupous inflammation is the term. used to describe those in which there is con siderable destruction of the superficial layers of the mucous membrane, which, with the fibrin of the blood, forms a coating or mem brane on the surface. Granulation tissue (q.v.) is the name applied to the tissue formed during the repair of an injury. Names are given to certain types of inflammation having a characteristic appearance to the naked eye, hut microscopically there is nothing absolutely distinctive in these except their arrangement.
Particular examples of these are tubercular and syphilitic•inflammations.
The majority of the diseases of the body that we recognize as entities are due to inflam mation in some tissue or organ, but the picture depends on the various changes in the functions of.different parts of the hotly. The kind and virulence of the generated poison, together with the •reaction on the part of the body-tissues, the complete picture that we seek to recognize. The treatment of is, iti large pan, the practice of medicine and Surgery. to help the tissues combat against invasion are made with more success as knowledge is gathered of the peculiar invading forces and the natural modes of defense. It is not that we wish to combat the inflammation per se, but rather to make it unnecessary by helping it to a successful issue. The actual de struction of the bacteria by drugs introduced into the body is of little use, for they would be apt to. Cause as much destruction of the bodY-cells as of the invading ells; but their toxines, which cause the actual damage, we are learning to neutralize by the administration of artificially prepared „antitoxins, and by placing the body and its special tissues under the most favorable conditions for developing its neutral forces of resistance.
In exposed parts of the body, where anti septics may be applied, the toxic germs may be killed, and various measures that change the blood-supply may be advantageous. Where death of tissue takes place, nature may require help in its removal. It has long been the rule to evacuate pus wherever it is formed, unless from the tissues is easy.
' The treatment of chronic inflammation is en tirely different, as this is a process where actual structure is changed beyond repair in many in stances. The all-important question is whether the tissue can carry on its proper functions; for. if it can, the body need not suffer. The inflam matory process is arrested in its progress by the removal of the irritating cause, by improving the blood-supply of the part and the vitality of the body generally. These constitute • the meas ures in general applied for the cure of chronic inflammations, it being understood that the en deavor is to place the tissues in such a condi tion that they may carry on their functions for the good of the whole organism; and the failure of these measures shows either that they are at fault or that the tissue-change has gone too far. Inflammation of any part is indicated by add ing the suffix °ids* to the name of the organ or tissue. (See. BRONCHITIS, COLITIS, LARYNGITIS, MENINGITIS), etc. Consult Delafield and Prudden, of Pathology' (9th ed., New York 1911), and Smith, A. H. mediate Inflammatory Process' (in Transac tions of the Association of American Physi cians' (ib. 1900).