In an abscess, in appendicitis, and similar internal conditions, inflammation serves the same defensive and reparative purposes as when it develops in the superficial structures of the body. It is never anything to combat. It is the combat.

Nature always localizes inflammation wherever possible and this is usually possible. If resistance is low, if the blood is foul, or if meddlesome methods of treatment are resorted to, the inflammation may spread. It is seldom that the primary occasion for inflammation is sufficient to occasion more than a local inflammation. Even in so-called syphilitic infection, the primary ulcer is usually the end of the trouble.

Before inflammation can arise there must be an occasion or necessity for it, in the form of some agent or influence inimical to health and life, either of the whole body or some part of it. Such occasions may be chemical (poisons), thermic (burns and freezing), mechanical, (cuts, bruises, particles of iron, wood, bone, etc.), electrical, or vital (parasites, etc.), and mental (as in hypnosis.)

Scarcely an injury or impediment, whether mechanical, chemical, thermal, or electrical, can be mentioned but that inflammatory action will be established for its removal.

The essential nature of inflammation is always the same--that is an accumulation of blood in the part. The process of inflammation will differ in degree and character depending on the nature of the injurious agent, the intensity of its action, the character of the tissue affected, and the individual affected. Examples of the different reactions of different tissues to the same occasions are common. A blow which would not affect the general surface of the body may easily produce serious results if it strikes the eye. Many substances that produce no perceptible irritation when applied to the skin produce intense irritation if dropped into the eye or taken into the mouth. Traumatic injuries produce less serious results in healthy, robust individuals than in the weak and ailing. A cut that at one time heals rapidly without suppuration, may under different conditions of the system, heal slowly and form pus. Cuts and bruises heal more readily in the young than in the aged.

Inflammation is roughly divided into acute and chronic. If the changes take place rapidly the inflammation is said to be acute. Its intensity will depend on the amount and character of the in jury or the concentration and virulence of the irritant or poison, the length of time through which it acts and the condition or susceptibility of the individual. The stronger the irritant and the greater the reactive powers of the individual the more apparent will be the reaction. The healthier the individual, however, the less will be the time required to overcome the irritation or repair the injury.

Chronic inflammation is met with more often in old age rather than in the young; and is seen more often in the weak than in the strong. It is more complex than acute inflammation and presents more variations in single conditions. Its chronicity may be due to a number of conditions, such as the persistence of cause, (chronic "disease" is due to chronic provocation), imperfect healing, due to a depraved condition of the system, etc.

An example given by Dr. Tilden makes clear the relation of the systemic condition to healing:-"Mothers of such children (sickly children) have no resistance, or very little, and their systems are kept at the saturation point--full of byproducts seeking every opportunity for vicarious excretion. The following facts are worthy of the reader's most careful attention : If these mothers suffer laceration at childbirth, an accident they can't well avoid, because the children are overweight, and their systemic perversion renders their tissues unyielding, the tear will not heal. Instead of closing up or healing over, the raw surface drops down into a low grade granular inflammation, which is called catarrh, or catarrhal inflammation.

"When a physician examines a case of this kind a few months after childbirth he will find a tear, not necessarily large; the edges will be thick and granular, and for some distance back, in what was once normal tissue, there is infiltration, causing thickening and induration; the parts are several times larger than normal, and the catarrhal inflammation extends through the neck into the womb. This disease is what is called endocervicitis (inflammation of the lining membrane of the neck and body of the womb). Why did the tear in the neck and the bruise in the uterus not heal? This is exactly what should and would have taken place if the woman had been normal, but she was not normal; her body was charged with waste products, so that the plastic material thrown out for healing these wounds was of such low grade, and the tissues were so devitalized, that healing could not take place. When such a state of the fluids and solids as this obtains healing is very slow, if it takes place at all, and when it does not all such raw, denuded surfaces are utilized as portals of exit, rather than portals of entry. This is contrary to current and general professional opinion."

A chronic inflammation may be nothing more than an almost continuous series of acute inflammations. Repair in such cases, is continuously less perfect.

Where the irritant is mild, or if it is powerful but introduced in minute quantities over a long period of time, much connective tissue is formed at the site of irritation. This is seen in cirrhosis of the liver, hardening (sclerosis) of the arteries and in the so-called "replacement" fibrosis of nerve degeneration. In such cases, it appears that the poison is incompatible with the life of the higher cells so that these are destroyed and their places filled by tissue of lower grade but more resistant qualities.

No alarm is commonly felt when inflammation is placid and effective; but when it rises to a fierceness equal to the extent of the mischief it is intended to overcome, it is both feared and fought against as the enemy of life, while the real mischief maker is too often ignored.

Jennings remarked that: "Inflammatory heat never rises high enough to do positive harm. (He is here combatting the suggestion that cold water be applied to the inflamed area.--Author.) It is not the cause of the distress or any other accompanying symptom, but a concomitant effect (and an actual necessity to the rapid work of repair that is going on-- author) with them of a common occasion, which will remove when the occasion removes."--Philosophy of Human Life, p. 167.

The violence of the inflammation depends on the extent and nature of the injury or poison, the purity or foulness of the blood and lymph and the reactive powers of the individual. It is well known that wounds heal more quickly and with less inflammation in those of pure blood than in those of foul blood. There is also far less likelihood of suppuration in the individual of pure blood. Healing, ultimately, is more perfect and satisfactory. Broken bones, too, heal more quickly in those of pure blood. It has long been known to surgeons that vegetarians recover from wounds and operations much more quickly and satisfactorily than meat eaters. Indians, living outdoors, their nude bodies exposed to the direct rays of the sun, recover from wounds with remarkable rapidity.