Some years ago I was asked in public: Could a corpse on the beach sunburn? I answered this reader of who-dun-its by saying: Certainly not. Sun-burning is a physiological process and such processes stop at death. In life the local blood vessels dilate, fluid pours out from them into the tissues; all the signs and symptoms of inflammation result: calor, rubor, tumor, and dolor. Only chemical reactions occur in the corpse.
Inflammation is the local reaction to irritation. The vessels dilate, bringing extra blood to the part, and hence we get the redness and heat and beginning of swelling. Much of the fluid of the blood passes out into the tissues, causing the major part of the swelling. Cells from the blood also work their way through the walls, the white blood cells or leucocytes being in the van. These actually eat up, as it were, the irritants. There are several kinds of leucocytes, the ones doing the bulk of the work in most acute infections being the polymorphonuclear leucocytes. They are so called because, instead of having one small nucleus in the cell, they have several of varying shapes. Medical men, as well as you, are bothered by these big words, so long before the modern alphabetical nomenclature became popular we referred to this leucocyte as p.m.l.
If the inflammation occurs on a large scale, or is of a particularly serious nature, a hurry call for more leucocytes may be sent out. You might not expect an infection at almost any part of your body to have much effect on your thigh and other bones, but blood cells are formed in bone marrow.
Your physician, finding pain and tenderness in the right side of your abdomen, may also be in a quandary as to whether he is dealing with an indiscretion in diet or acute appendicitis. He then does a white blood count. Ordinarily, there are about 8,000 white cells in a cubic centimeter of blood, 75 per cent of them being p.m.l.s. Should he find that you have 12,000 to 15,000, 90 per cent of them being p.m.l.s., you will probably be scheduled for an emergency appendectomy. The bones of your body are rushing shock troops to your aid.
There are many non-living irritants which can produce inflammation: electric and other rays, chemicals, bruises and wounds; but the living irritants would seem to be the most important and, of these, infectious bacteria lead. What I believe are the commonest, and on the whole are easiest to handle, are those which have a tendency to form pus. In a local infection caused by this type of bacteria the blood vessels become plugged with cells so that the circulation ceases and the tissues die. Then they break down and liquefy, and the p.m.l.s congregate in the liquid. The result is pus. As this increases, the pressure of the so-called abscess causes pain, which is relieved when the abscess is opened.
One of the best-known of these local inflammations is the common boil which is an abscess forming in a hair follicle or a grease gland of the skin. One of the commonest of bacteria, the staphylococcus aureus, causes boils and they are miserable afflictions. They are exceedingly miserable for the tension is great, with resulting pain and tenderness, and the tissues do not liquefy quickly but a firm core persists. Hence cutting them open does not give the expected release of pus. Closely related to a boil, and even worse, is a carbuncle, in which the infection travels along just below the skin and comes to the surface at numerous points.
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GENERAL HEALTH
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