INFLAMMATION (Lat. inflammatio, from inflammare, to set on fire, from in, in flame; connected with flagrare. Gk. 0V-rely, phle gein, to blaze, Skt. bhraj, to he bright). A mor bid condition characterized by altered function of the elements of the tissue involved, changes in circulation. derangement of local nutrition, and generally an exudation infiltrating the tis sues affected. It is a process of extreme com plexity. presenting variations depending upon the exciting cause and upon the kind of tissue in which it occurs. It is therefore impossible to define it satisfactorily. The most obvious symp toms or phenomena of inflammation. when it at tacks an external or visible part, are pain, red ness, heat, and swelling, together with altered function. The genera] characters of the process will be best understood by an assumed case. if a healthy man has a splinter of wood or any other foreign body imbedded in any fleshy part, Ile begins to experience pain at the part. and this is soon succeeded by redness of the skin, firm and extremely tender swelling at and around the spot, and a sense of abnormal heat. These purely local symptoms are succeeded, if the inflammation reaches a certain degree of in tensity, by a general derangement of the vascular and ....Nst.• mil. to which %arious names, such constitutional s?mimplonmatie .r inflammatory xma. (lc.. hate been al plied. It the foreign body is extratted. the probability i; that all these lOptoIII. trill grade.
i1 I ly until the part ;it length regains its natural .ippearammec and It. howel• T. the cause of iiritation i, not removed, or if the intensity 111 the inorlmid process ex. eed a certain point, following phenomena ....air: Th. swell ing assumes a mon . projecting or pointed Ione', the part scene. and the -km at its centre, 1\ 11101 is miNually the nest projecting part, becomes •I•llene a sensation of throh• ling pain. :n1.1 if the skin I not divided with a knife it. finally breal:s, and a yello•, cream like fluid, known a; !III: tv.ysls ,"'ii after which the symptoms rapidly abate. This process is known as suppuration.
If the original injury very :11141 t Ile i1111311111111t 1011 there may he Ocillal of the part alreeted. In that ease, the color of the skin becomes purple or greenish Imlack, the pain ecases, and the part heroines dead putrid. is 'nor, ilicu I ion. niter favorable t his Ilea(' part, 'which is called a slough, spontaneously from the adj:p cent living parts by a process; 1:nown ulcera tion.. and the cavity ''midi is thus formed grad nall? imp and heals.
The /min may vary from mere discomfort to intense agony. Them is usually most pain in Ilmse parts in which the tension produced by the swelling is the gveate.t, as under the periosteum, or beneath serous or tlbeeo, membranes, eh% The pain occurring in intlammatbm is always aggravate• by pressure. by this means the physician can often distinguish between inflam matory and nomintlammatory disorder;.
A. at is seldom so much increased as the tions of the patient would lead him to believe; it does not rise above the maximum heat of the blood in the interior of tie body. This increase of heat depend,: the increased 0f ar teri•l for oxidized) blood to the part. The d Tends upon there being more blood than usimal in the vessels of the a•eeted part. •o.clliro depends in part upon the distention of the. I.I. 0.1-vess. Is and upon the pre,..nee of various fluids, as blood-serum and pus, in Ihe tissue of the affected part.
For the study of the details • f the III thIIIIM:1 OTT process and of the of 1 la. changes whieli lake place, it. is most to oh their progress in living tissues. If the int•sentery of a frog whose muscular sr-tent has been paralyzed hN" r;11•P he exposed 10 t he air, till: IMO (T11.1.11101 starts inflammatory changes which call he fill-o•I'VVII minder the micro scope. There is first seen to he an increase in the rate .11 blood flow throu"11 the capillaries:
then the capillaries lmcconie somewhat dilated, and the blood current beemnes slower than nor mal. \\ line blood madls aeemoulate along the capillary walls. and at various points stop and attach themselves to the endothelial cells. If these whit,' blood-eells he 'watched •arefolly. some of them many le seen to pass through the cement substanee between the endothelial cells. and in this way pass out into the surrounding tissues. Some fold is also seen to aeemnulate in the tissues, this fluid havin.,z evidently conic from the fluid elements of the blood. Also red blood-rells in greater or numbers may pas; out of the awl be found in the surround ing .1 hese element, which lea% I he tossels a nd aeeuutulale in the tissue, during the are called 'exudate,: I heir passage from the into the tissue, is known as 'exudation: and this t. rot imitlanimatien '11o11 designated. 'exudative inflammation.' •flte of the blood-cot out into the tis sue; is called 'emigration' or ••li ilaalesis: The ruun of the fibrin 1. rimming element, of the :11111 so may lead to the formation of more or fibrin in the tissues. I lie white blood cells.1i.• and las they are especially prone to do in the presence form is .of haute 1. and form with the serum the thick, opaque, yellomish fluid that Loons as 'I'll,: t he dead white blood tells the \cconling to t he way in whiell the elements if the exudate are associated and their rt.lati%e proportion, the inflammation is known a; serous, sero fibrinous, or purulent. \\lien red cells are present iu unusual wimbe•s. the inflammation is designated 'hem . r•limigie' lull:mint mat ion. Snell an inflammation it that described in the frog's may subside on the removal ..f the exciting The serum is realmsorbed into the blood or lymphatics. the living Wood cells lind their way back into I he circulation, while those that are dead di,integrne and are This !uses; known as 'resolution.' 'I he character of an inflammation is largely modified by the 'mature of the tissue in which it occurs. Thus, when an infialainathal occur, in dense libron, snP there is little ..lionce for inuell distent ion. and the amount of exudate i; limited by pressure. In tissues of looser texture the amount of exu date is apt to be larger. ...Nimmons surfaces such as those lining the f...ra inal (qui•l, the respiratory tract, and the genito-urinary tract react to the inflammatory process by at first a Merease in the amount of mucus, following which there is a marked increase of mucous se cretion. 'Phis being in many eases the dominant feature, the inflammation it designated 'mucous' or 'catarrhal' inflammation. (In serous surfaces ...nelm as the pleura, peritoneum, and pericardium, the senefibrimms exudate often leads to an ag glutination of the opposing snrfaees and the fern ation of adhesions. These adhesions bind the surface; baa.ther and materially interfere with the natural free nut ion of the parts. Snell condition obtains in the so-called form of pleurisy. it is very after hi flannnations the pelvic. organs in the female and aft. r appendi•itis. These adhesions may 1...eom• a...inized by the development of 1)11111111.. VC Is in them, std so become concerted into netted living In abdominal operations, extensive adhesions resulting from present or previons inflammatory and binding to• _other the dilferent viscera often offer the most ditlieult prold• in with which the surgeon is con fronted. In inflammation of time iris the !midi may be rendered irregular or immovables or may he even closed up by the formation of adhesions. In endocarditis, or inflammation of the IlleI11 1)rano lining the heart, fibrin may be deposited in wart-like ma 1111011 the valves, thns inter. te•ill,!! With their functions and causing some of the worst forms of cardiac disease. See TTE.‘ttr, DISEASES Or.