Nutritive material is brought in abundance to a wound, caused by the irritation of the injury. Irritation, pain, redness, and swelling follow injury. At first, irritation causes contraction of blood vessels. This stops hemorrhage. As a result of the contraction--overstimulation--reaction sets in; the overstimulated blood vessels are enervated, and because of the enervation they relax and fill with blood; then exudation takes place. The cell-building elements cover the cut or mutilated surface, and crowd the border so much that there is a heavy discharge through the drain, if the wound has been properly dressed or has been left open. Where drainage is unobstructed, the healing behind the barrage of nutritive material thrown out moves along without a halt. The proportion of enzymes and nutritive material furnished by a healthy, not overfed, wounded individual insures rapid renewal of tissue. If obstruction takes place, microbic fermentation is set up in the pent-up surplus. This is a conservative process; for it thins the discharge, irritates the wound, and causes an extra amount of serum to be exuded. The purpose is to melt down any incrustations and new-made tissue that is obstructing drainage. When this fails, and the microbic fermentation gains the mastery over the enzymic fermentation that is protecting the healing surface, then the enemy--toxin or septic poison--pushes its way into the circulation, and septicemic fever and death follow very quickly.

Inflammation is almost nil when a wound is in a state of health; for it must not be forgotten that wounds, as well as all the phenomena we call disease, are different states of health. The strategic move for preserving the health of the wound, when it becomes obstructed, is little short of a miracle in appearance; yet it is the most natural workingout of cause and effect. We have seen that, unless the obstruction is overcome, the state of health will be lowered until it ends in death. In obstruction to wounds, nature destroys to make alive.

All nutritive changes which we call disease are due to influences which increase, decrease, or pervert cell-life; every symptom called disease is a conservative move; and, when not understood, or suppressed as doctors (not physicians) do, harm follows.

Inflammation is due to the local speeding-up of the nutritive processes caused by injury. The injury may be physical or chemical--a cut, tear, bruise, bum, blister, or a local irritant of any kind. When a wound is healing normally, the heat is about that of the normal viscera--namely, 99° to 100° F. When the temperature exceeds 100°, there is something going wrong--either the drainage is not perfect or the patient is eating too much.

The phenomena of inflammation are pain, heat, redness, and swelling.

Where the increase of heat is not more than one or two degrees above normal--above the temperature under the tongue--all is well with the wound.

The whole question of wound infection hinges on drainage. Any wound that drains well may be smeared with the most virulent septic poison without infection. The infecting agent must be rubbed into the wound so that it will be pushed into, or below, the granular surface. The infecting material must find a lodgment so secure that the flushing--enzymic--serums cannot dissolve and wash it away.

Injuries in canals, tubes, ducts, and air passages will heal normally if drainage is not obstructed; but, when obstructed, the usual conservative methods of nature may further obstruct, and death may result from a rational therapeutic measure mechanically obstructed in its execution.

It is painful to watch members of the medical profession floundering about in a vain endeavor to save a patient from death from septicemia by injecting into the veins or subcutaneously a solution of salt, or a hastily prepared serum, regardless of the fact that the source of the infection has not been discovered; or, if it has, no adequate effort is being put forth to overcome it. What must be the conclusion when such floundering is observed? Obviously, that either the medical gentlemen are acting, or they have not a very accurate knowledge of the principles involved.

If the case is one of septicemia, following abortion, an intra-uterine douche of an hour's duration (hot salt water) is the first thing to do; and it should be repeated every three hours, if the patient continues to live. The douche removes the infecting material, establishes drainage, relieves the nervous system, brings on relaxation, lowers the tension that is interfering with all the life-processes, and, neither last nor least, places the organism in the most favorable state for resumption of secretion and excretion. A hot bath of from thirty to forty minutes' duration will prove a great auxiliary to the douches. Certainly no food should be given; for the work of elimination and neutralizing the poison--antidoting the organized ferments by the unorganized ferments, the germs by the enzymes--must not be hindered by interrupting the enzymic activities of repair with an intake of food, which, under the circumstances, is wholly superfluous and disease-producing.

Why does an injury or a local irritant or irritation cause inflammation at one time and not at another?

It is all a question of natural immunization; and natural immunization has for its elements an alkaline state of the blood, a normal nerve energy, and an optimistic psychology.

The blood, if normal, is alkaline and well charged with enzymes.

When an injury is received, there is first a shock, which causes a constriction of blood vessels. In time there must come a reaction, and the reaction equals the shock--the dilation of the tissues (blood vessels) will be equal to the contraction from shock. This means congestion or crowding of the parts, and, as in the case of a congested thoroughfare, traffic or the function of trade is impaired--too much blood is in the parts, causing an exudation, There can be no rest or standing-still; the exudates must be excreted, thrown out, or reabsorbed. To fit these exudates for absorption, they must be treated with enzymes, in order to fit them to reenter the circulation. If there is enervation and a lack of enzymes, then it will be "up to" bacterial fermentation to prepare the exudate for expulsion from the body. If there is no break in continuity--if there is no open wound--then the bacterially treated exudate must be absorbed into the general circulation, causing infection; or the infection will be corralled by walling in the devitalized territory and lining the inclosure with an impervious pyrogenic membrane. The pus that forms is retained--not allowed to escape into the general circulation; for, if it should, it would cause pyemia. If the body's natural resistance is too low to fortify it in this way--if it cannot localize and immunize the infecting material--then general infection takes place and the victim dies of septicemia.

Anything-any influence that causes irritation--attracts an extra flow of blood to the point of irritation. The engorged blood vessels exude a fluid. This fluid must get out of the body. If it cannot, it must be digested and reenter the circulation; or it must be bacterially liquefied and carried out of the body through the open wound. If there is no point of escape, an abscess must form, as described above, or general systemic infection must take place.

If the point of irritation is the pleura, the exudate may accumulate, and, from lack of bacterial influence, the fluid is neither digested and absorbed, nor decomposed and converted into an abscess of the pleura, nor absorbed, creating septic fever and death; but remains a bland, innoxious fluid in the pleura.

The life of man, from his entrance to his exit in this world, is a process of metabolism. If this process is done well, he has health and well-being; if the process is carried out badly, he has impaired health.

Metabolism is carried on well or badly. When well done, we say that the individual is well--healthy; when badly done, then man is sick. Health and disease are states, not entities.