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INFLAMMATION. 129

to fatal termination, if the cause is not removed, through com-
bustion of tissue material to supply the fever heat. The regular-
ity of the night sweats, and the pulse retaining its frequency
during the apyrexia, even in the morning, when the temperature
is normal, are the diagnostic signs of hectic from typhoid and
malarial fevers.
The most unfavorable symptoms of hectic fever are the higher
fever in the evening, the increase in the frequency of the pulse,
the more exhausting night sweats, with the occurrence of
aphthae in the mouth, and diarrhoea.
Chronic Inflammation.—Chronic or asthenic inflammation
is a process in which all the cardinal symptoms of inflammation
may be present, but in less degree than in the acute form, by
which it is generally preceded. In chronic inflammation there
is present a permanent local hyperaemia, attended with an exuda-
tion into the interstices of the inflamed part, or from its surface.
The pain in this form is usually light, or may be intermittent, or
even absent, or be no more than an itching sensation ; heat is
present, but is not a prominent symptom; the redness is of a
light hue, sometimes livid, from passive hyperaemia and the
stretching of the vessels by the over-distention to which they
had before been subjected, and the diminished force of the circu-
lation ; the swelling is in the form of induration, owing to the
exudation having become organized into tissue. This latter ac-
counts for the hardness around an indolent ulcer, and an old
sinus. Inflammatory induration is a process of hardening the
tissues due to coagulation of the fibrinous elements of the exu-
dates or the fixed tissue cells, and new formations in the con-
nective tissues. In mucous membranes induration is indicative
of chronic inflammation, and is caused by exudative infiltration
into the substance of the submucous connective tissue, and a
considerable change of structure in these membranes often
occurs. Although the symptoms of chronic inflammation are
present in a limited degree, yet they are more persistent, on ac-
count of the object for which the increased nutritive effort was
made proving unsuccessful. Causes.—The causes of chronic in-
flammation are long-continued irritation, functional activity, and
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