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I designated by the title "direct inflammation" the morbid state produced by the direct operation of noxious agents upon the tissues, as distinguished from inflammation brought about through the medium of the nervous system. This distinction appears to me to be of great importance; and it enables us to understand what would otherwise be quite unintelligible. One beautiful instance of this is the behaviour of a recent wound in tissues previously healthy. When our means of arresting bleeding were less complete than they are at present, it was no uncommon thing to be summoned a few hours after an operation on account of haemorrhage. It was a sad thing to have to tear asunder the lips of a wound already well glued together by lymph, in order to gain access to the bleeding point. This lymph was neither more nor less than liquor sanguinis which had been effused from the cut surfaces and had coagulated. From the quality of the effusion we should suppose that we had to deal with inflammation of a very intense character. Yet the lips of the wound were perfectly pale, entirely free from the active congestion which is the very earliest sign of inflammatory disturbance.. How could this inconsistency be reconciled? Very simply, as I believe, by aid of the principles which we have been discussing. Mechanical violence is a noxious agency producing effects proportionate to its degree. A very blunt implement passing through the tissues kills the surface of the parts which it divides; and in former days we had to poultice
