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INFLAMMATION. 115

effect of injurious micro-organisms—the latter being regarded as
" immediate determining causes of the more destructive phases
of the inflammatory process." When inflammation owes its
origin to an evident injury, or the reverse, it is termed traumatic^
or idiopatbicy and when no apparent cause can be discovered it is
termed spontaneous.
The causes of inflammation are divided into predisposing and
exciting.
Among the more important predisposing causes are impoverished
blood— defective in quality—such as may result from a want of
proper food and of fresh air, the effects of such deprivations be-
ing manifested in the case of a neglected child where a hard
swelling occurs in the cheek, which, after a few days, presents a
gangrenous condition, constituting the disease known as cancrum
oris or gangranopsis. On the other hand an habitual excess of
food and drink is also a predisposing cause of inflammation, the
blood, as a consequence, being impaired, and also the tissue
which it supplies. Blood poisoning is also another predisposing
cause, resulting, it may be, from the presence of certain diseases,
such as syphilis, diabetes, mellitus, eczema, etc. A local hy-
peremia, constituting the first stage in the development of in-
flammation, may result from certain poisons in the blood, which
cause it to stagnate in limited areas, through an inability to stimu-
late the heart and blood vessels. Syphilitic ulceration of the
mucous membrane of the mouth is an example of such a predis-
posing cause. Weakened vitality of parts is also a predisposing
cause of inflammation and may result from habitual ill feeding,
protracted illness, overwork, long exposure to extreme cold.
Parts such as the mucous membrane of the mouth, which have
already been the seat of inflammation, are prone to such a con-
dition subsequently, from slight provocation.
Defective or perverted nervous supply may also be regarded as a
predisposing cause of inflammation. Certain forms of skin dis-
ease, and inflammatory conditions of the mucous membrane of
the mouth, furnish examples ; also, of the peridental membrane
of the teeth, resulting in severe periodontitis and alveolar abscess.
The influence of climate is also regarded as a predisposing