Dr. Jennings observed: "It is common for physicians to estimate the danger in inflammatory affections, by the degree of violence or force of inflammatory action, and hence they are solicitous to keep down the action to obviate the danger. Now admitting, for argument's sake, that the danger in these affections lies somewhere in the symptoms, it is still far from being true that the danger is to be measured by the degree of violence or strength of inflammatory action; for it is not uncommon to see pure inflammation of any and every part of the system, susceptible of such action, run very high, and yet terminate kindly by what physicians term resolution; while other cases, with little pure inflammatory action, often end in effusion of water, producing dropsies; in exudation of lymph, causing adhesions of contiguous surfaces; thickening of the lens, or other opacity of the eye, occasioning partial or complete blindness; in schirus, or induration, of gland; or in mortification. From these facts it is obvious that if deranged action in general produces the evils that follow such action, the evils that follow inflammatory action are not attributable to that action according to the amount of pure inflammation, or excessive action, but considerably, if not principally, to some other circumstances connected with it.

"These remarks are made in reference to spontaneous inflammation, or such as arise from remote causes, where an interval of time has intervened, sufficient to allow the animal economy an opportunity to accommodate parts that have been injured, to the unavoidable changes through which they must pass immediately by surgical operations, blows, and other injuries."--Philosophy of Human Life, p. 72. Evils that follow inflammation are not to be attributed to the inflammation, but to the thing that occasioned the inflammation. The impairment in a lung that has been wounded is not to be attributed to the inflammation that healed it, but to the thing that caused the wound. The evils that follow vaccination are not to be attributed to the inflammatory process by which the body resists and casts off the septic matter, but to the pus with which the physician infects his victim.

The terminations of inflammation are (1) regeneration or resolution, (2) repair by scar tissue, and (3) suppuration followed by granulation.

Granulation, the formation of granules, is a process of healing (tissue repair), by which broken tissue is re-united.

Resolution is the subsidence of inflammation after repairs have been made and offenses removed. Pneumonia, pleurisy and arthritis each offer excellent examples of this. In each of these there are exudation products to be removed and disposed of. In the former the exudate is in the lungs and pleural cavity. In the latter, in the joint cavity. The exudate or serum is rapidly absorbed and removed. In the so-called second or Hepatization stage of pneumonia, the exudate in the lungs becomes more or less solidified, forming a liver-like consistency. In the so-called third stage, or that of Resolution, the exudate normally undergoes liquification and absorption. This is the return to health. If the body is unable, due to weakness or suppression, to liquify and absorb the exudate this undergoes destructive changes, producing chronic pneumonia, gangrene, abscess or death.

Repair by Scar Tissue is healing by second intention or union by granulation and occurs when there is an abscess or wound, the edges of which are far apart and there is a large amount of exudate present.

Suppuration, which is the process of casting away toxins, foreign bodies and broken down flesh and blood, occurs when there are poisons, as in vaccination, or an inert body or sliver, to be removed, or when drainage is blocked so that the exudate becomes foul, or, when the blood is foul as when gastro-intestinal putrefaction and fermentation fill the blood with putrescence. Ulceration is simply a chronic suppurating process upon a free surface. Suppuration is followed by granulation which is healing.

An abscess occurs when the inflammatory area is walled off. It is a circumscribed cavity containing pus. Suppuration begins at the center of irritant action and extends to the surrounding uninvolved tissues. The extension follows the line of least resistance, until the abscess points ("comes to a head") at some surface. The overlying tissue is thinned and liquified and spontaneous evacuation of the abscess occurs. The fibro-elastic layer forming its walls are now supplied with blood vessels, the walls are converted into granulation tissue and, beginning at the bottom, this granulation tissue fills up the cavity. This is healing.

Medical pathologists tell us that inflammation may also end in gangrene or necrosis. We have previously distinguished between these destructive results of poisoning and mechanical obstruction and the constructive and protective work of inflammation. We do not consider gangrene and necrosis as endings of inflammation, nor as forming any part of inflammation.

Gangrene is the death of a tissue followed by its putrefaction while it is yet in the body. Necrosis is the same process confined to the bones--is the death of bone tissues.

The condition is considered to be due to (1) such great devitalization of the cells that they are unable to assimilate nutriment; and (2) circulatory impairment or blockage so that the tissues do not receive sufficient nutriment. One or both of these conditions may result in gangrene or necrosis. Various kinds of gangrene are named, depending on the conditions causing it. These distinctions are unimportant. Dry gangrene occurs where the arteries become blocked but the veins remain open so that the tissues are drained. Moist gangrene occurs where arteries and veins are blocked. In the first the tissues become dry, hard and shriveled. Sepsis is absent. A line of demarcation or ulceration forms at the expense of the dead tissue. It does not spread. In the second the parts are purple, or greenish and become covered with blisters. The adjacent tissues undergo an inflammatory reaction. Symptoms of toxemia with fever are present. A line of demarcation or ulceration forms at the expense of the living tissue.

The really vital or physical acts associated with gangrene or necrosis, which are the results of inflammation, are the formation of the line of demarcation between the dead and the living tissue, sealing of the blood vessels, building up a defense against absorption, the sloughing off of the gangrenous section or the encasing and final elimination of the necrosed bone, and ultimate granulation or cicatrization, which is healing. The ultimate end of all true inflammation is healing. Any other supposed ending is due to other factors and not to inflammation.

All schools of "healing," past and present, have agreed to call inflammation disease. They have divided it into classes, orders, genera and species. Thus we have, apparently, many inflammatory "diseases." All of this confusion grew out of ignorance of the true nature and character of inflammation and the failure to recognize its essential unity.