A twofold relation exists between inflammation and an anomalous crasis, the latter being either a mere result of the inflammatory process and secondary, or else pre-existent and primary, and the inflammation a consecutive, symptomatic phenomenon, - the localization of the crasis.

1. The Undeniable Development Of A Dyscrasial Condition

The Undeniable Development Of A Dyscrasial Condition of the blood, as the sequel to mere local inflammation produced by external and, it may be, traumatic influences, justifies the inference that inflammation is in itself a dyscrasial process. All doubt as to this point is, however, overcome if we consider -

(a.) The qualitative variations in the products of a local inflammation; and still more -

(b.) The fact that, where the blood is in the condition of stasis, the elements of the exudation are found preformed within the vessels. The character of the products is thus shown to be mainly dependent upon inbred transformations of the stagnant blood, and more particularly of its plasma.

Inflammatory stasis is thus shown to be no mere passive congestion; effusion to be no mere percolation of an altered plasma simply divorced from the blood-globules. On the contrary, both are shown to imply every variety of conversion, from simple exaltation of the formative process carried on in normal plasma, to the generation of totally heterogeneous combinations and of corresponding form-elements. For the same reason the plasma effused, and the fibrinous matter thrown out as the result of inflammatory stasis, differ from mere extravasated plasma, or extravasated fibrin. The same arguments, in fine, serve for the solution of the question: in what wise does an anomalous constitution of the entire blood-mass result from local inflammation?

Consecutive Dyscrasy

Consecutive Dyscrasy, as infection of the blood, is brought about -

(a.) Through direct readmission of effused matter into the circulation by endosmosis, or through the indirect way of resorption through lymphatics;

(b.) Through a more copious reception of the products of inflammation into bloodvessels laid open by external injury, or by ulceration and necrosis;

(c.) And (besides these commonly-taught channels) through the ebbing back to the roots of the veins of the altered plasma, issuing from bloodvessels involved in the process of inflammation.

This last mode of infection is decidedly the most common. It is, indeed, the only one possible where endosmosis and resorption of the substances effused are, owing to the density of the latter surpassing that of the lymph or of the blood, excluded. It resembles, on a small scale, that infection of the blood due to inflammatory products directly thrown out into the cavities and canals of the circulation from their internal membranes.

The interest and the practical importance of the subject warrant us, whilst referring to the chapter on blood diseases and on pyaemia, in remarking here that, - if we except cases engendered by very heterogeneous substances, the result of decomposition within or without the vessels, - infection stands in direct relation to the magnitude and number of the inflamed parts, and, as a consequence, to the amount of inflammatory products taken up into the blood. In opposition to a fermentation theory, we may affirm that a minimum of inflammatory product does not suffice to determine a perceptible alteration of its admixture, very small quantities merging in the normal processes of the circulating mass. The most pregnant source of infection is the inflammation of the internal membrane of bloodvessels.

The character of the infection and of the consequent crasis corresponds with that of the products of the inflammatory stasis.

Consummated infection of the blood-mass bears towards every inflammation which it may subsequently call forth, the relation of a primitive crasis localized in congenial inflammation.

2. In Every Crasis, Hyperaemia And Stasis May Occur Accidentally

Here, however, we are more particularly concerned with inflammations resulting from a special crasis as their internal and sole cause. To this class belong a multiplicity of anomalous crases, more especially, however, the fibrin-crasis and pyaemia, the former being usually comprised under the so-called phlogistic crasis. Inflammations dependent upon dyscrasial impulses are marked by their preference for particular organs, and, for the most part, by the acuteness of their career, as well as by the rapid formation of their products.

This last circumstance is, to a certain extent, practically demonstrable with respect to the fibrin-erases and pyaemia. In these, the examination of the blood shows that, the same changes occur in its totality, as in any portion of it in the condition of stasis; that both the plasma and the fibrin are constituted identically with the products of the stasis. Herein a source is supplied for the rapid development of the stasis, and, consequently, of the effusion. In the stasis, a simple increase of the processes carried on in the totality of the blood suffices to furnish forth, in exquisite form, a characteristic exudation.

Inflammation of humoral origin is determined, according to the neuro-pathological theory, by antagonistic palsy of the nerves of the bloodvessels, brought about, at the periphery or at the centres, by the irritating effect of the dyscrasial blood upon the sensitive nerves; or, if passive, by direct paralysis. To such inflammations unquestionably belong many commonly ascribed to an external cause; for example, pneumoniae. These we believe to be, for the most part, the localization of a crasis modified by atmospherical influences.

The relation of the crasis to particular domains of the nervous system, determines the localization of certain erases in particular organs, almost as a definite rule. Still, the modifying power of concurrent external influences is not to be lost sight of.

Inflammation arising out of humoral elements manifests itself not unfrequently as a metastasis, exhausting the crasis and resolving itself into a local evil.

The above becomes invested with greater significance when applied to the exudatory processes upon which the production of various heterologous formations rests.