Manual of Surgery - Volume First: General Surgery. Sixth Edition. by Alexis Thomson;Alexander Miles
page 63 of 798 (07%)
page 63 of 798 (07%)
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giving rise to an _inflammatory Ådema_, or, if the inflammation is on a
free surface, forming an _inflammatory exudate_. The quantity and characters of this exudate vary in different parts of the body, and according to the nature, virulence, and location of the organisms causing the inflammation. Thus it may be _serous_, as in some forms of synovitis; _sero-fibrinous_, as in certain varieties of peritonitis, the fibrin tending to limit the spread of the inflammation by forming adhesions; _croupous_, when it coagulates on a free surface and forms a false membrane, as in diphtheria; _hæmorrhagic_ when mixed with blood; or _purulent_, when suppuration has occurred. The protective effects of the inflammatory reaction depend for the most part upon the transudation of lymph and the emigration of leucocytes. The lymph contains the opsonins which act on the bacteria and render them less able to resist the attack of the phagocytes, as well as the various protective antibodies which neutralise the toxins. The polymorph leucocytes are the principal agents in the process of phagocytosis (p. 22), and together with the other forms of phagocytes they 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 |
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