hey ingest and destroy the bacteria.
If the attempt to repel the invading organisms is successful, the
irritant effects are overcome, the inflammation is arrested, and
_resolution_ is said to take place.
Certain of the vascular and cellular changes are now utilised to restore
the condition to the normal, and _repair_ ensues after the manner
already described. In certain situations, notably in tendon sheaths, in
the cavities of joints, and in the interior of serous cavities, for
example the pleura and peritoneum, the restoration to the normal is not
perfect, adhesions forming between the opposing surfaces.
If, however, the reaction induced by the infection is insufficient to
check the growth and spread of the organisms, or to inhibit their toxin
production, local necrosis of tissue may take place, either in the form
of suppuration or of gangrene, or the toxins absorbed into the
circulation may produce blood-poisoning, which may even prove fatal.
#Clinical Aspects of Inflammation.#--It must clearly be understood that
inflammation is not to be looked upon as a disease in itself, but rather
as an evidence of some infective process going on in the tissues in
which it occurs, and of an effort on the part of these tissues to
overcome the invading organisms and their products. The chief danger to
the patient lies, not in the reactive changes that constitute the
inflammatory process, but in the fact that he is liable to be poisoned
by the toxins of the bacteria at work in the inflamed area.
Since the days of Celsus (first century A.D.), heat, redness, swelling,
and pain have been recognised as cardinal signs of inflammation, and to
these may be added, interference with function in the inflamed part, and
general constitutional disturbance. Variations in these signs and
symptoms depend upon the acuteness of the condition, the nature of the
causative organism and of the tissue attacked, the situation of the part
in relation to the surface, and other factors.
The _heat_ of the inflamed part is to be attributed to the increased
quantity of blood present in it, and the more superficial the affected
area the more readily is the local increase of temperature detected by
the hand. This clinical point is best tested by placing the palm of the
hand and fingers for a few seconds alternately over an uninflamed and an
inflamed area, otherwise under similar conditions as to coverings and
exposure. In this way even slight differences
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