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Date posted: November 29, 2011

Prof Dr R  Santhana Pandian
B.SC, D.M.S, M.B.S 

INFLAMMATION
This is the basic process in all diseases.  Tissue response to noxious and injurious influences causes toxic chemical agents physical factors heat, cold, electricity radiation, trauma, microorganism and their metabolic by products immune response, hypersensitivity, immune complex, auto immune reaction.

Every tissue is susceptible to inflammation.  This is governed by a person’s state of health and severity of noxious influences.

Advantage

  • 1. Localize, neutralize and in activate.
  • 2. Destroys or limits the growth of the micro organisms.
  • 3. Prepares the area for wound healing and repair.

Disadvantages:

  • 1. Pain and swelling causing various disabilities.
  • 2. Hemorrhage, excessive scar tissue.
  • 3. Fistula formation, empyema.
  • 4. Damages – glomerulo nephritis, arthritis, allergic reactions, muocarditis, encephalitis.

Types

Acute inflammation
Vascular cellular events vasodiation, local heat, redness, increased vascular permeability, local oedema, swelling, influx of neutorphils, monocytes, and phagocytosis.

Cordinal signs heat, redness, swelling and pain.

Morphologic patterns

  • 1. Purulent exudation – abcess formation
  • 2. Fibrinous exudates- consequent scarring.
  • 3. Serous exudates (pleural, pers cardial, peritoneal)
  • 4. Catarrhal exudates- hig mucous content, allergic rhinitis, bronchitis.

Chronic inflammation

  • 1. Cells involved, monocytes, lymphocytes.
  • 2. Granulation tissue formation- tends to replace functional tissue.
  • 3. Scarring.
  • 4. Chronic inflammation co exists with acute inflammation- cholycystitis (gallstone) osteomyelitis.

Morphological patterns

  • 1. Non specific chronic inflammation. Ex chronic glomerulo nephritis-loss of functional tissue.
  • 2. Granulo matous inflammation eptheloid macrophages – giant cell formation- cause persistent antigen.

Unknown causes.

Cells involved in inflammation

  • A. Neutorphils
  • B. Basopails
  • C. Eosinophils- inanapylaxis
  • D. Mast cells 

I. Inflammatory response

  • 1. vaso contriction
  • 2. vaso dilation
  • 3. increased vascular permeability.

II. Cellular phase

Emigration of leucocytes. Phagocytosis.

Consequences of inflammation

Healing & repair

Factors inhibiting repair

  • Old age, immune depression, diabetes, malignancy.
  • Anti inflammatory drugs, anti neo plastic agents super imposed infection.

Untoward effects

Perforation, extensive fibrosis, keloids, bowel obstruction, sterility

Complications:

Ascending pyelophlebites large abscess formation in liver, brain infection spreading through lympaatics.

DEGENERATION

1.Hydropic swelling – cloudy swelling, cells swell, cytoplasm contains coarse granules – then ctoplasm contains water vacuoles – Na sodium enters.

2.Fatty change

This is the accumulation of fat in non fatty tissues especially the parenchymatous organs, skeletal muscles.

Heart – inability of the non fatty tissues to metabolise the amount of fat presented to them resulting in accumulation.

Cause

  • 1.Bacterial toxins, chemical toxins chloroform, alcohol
  • 2.Anaemia, anoxia, cardiac failure cellular energy impaired, diminished enzyme activity.
  • 3.Respiration diseases – oxygenation diminished.
  • 4.Diabetes, starvation – incomplete utilization of fat, accumulation of fat in cells.

Organs affected

  • 1.liver
  • 2.Heart – rise in blood pressure.
  • 3.obesity – reduces life expectancy.

Amyloid deposition

  • Waxy substance – abnormal protein deposited around the fibres of blood vessels deposition progresses.
  • Organs pale, enlarged, firm waxy texture. Lugol’s iodine – deep brown.

Nature of amylod

  • a. protein
  • b. carbohydrate.

Pathological effects.

  • 1. pressure on adjacent cells causing atrophy.
  • 2. blood vessels narrowing.
  • 3. increased permeability from blood vessels- leading to trasudation of protein out of vessels.

Diseases

  • 1. kidney – gross protinuria, nephritic syndrome.
  • 2. gastro intestinal tract – dyarrohea.
  • 3. heart enlarged, cardiac failure.

Causes of amyloidosis

Associated with chronic inflammatory diseases – tuberculosis, osteomyelity, rheumatoid arthritis.

HEALING

1. Healing by first intention

In clean incised wounds with good opposition edges – blood clot fills up the small cleft. Mild hyperaemia few poly morphs – 2 to 3 days clot removed by macrophages – fibroblastic activity – fibrous union of edges- good fibrous union.

2. Healing by second intention

  • a. cavity fills with blood.
  • b. acute inflammation
  • c. new capillary loops – macrophages, polymorphs, fibroblasts.
  • d. loose connective tissue formed by fibrosis.
  • e. epithelial covering.
  • f.  wound contraction.

3. Fibrosis is the end results of wound healing, chronic inflammation and organization.

Factors influencing wound healing by fibrosis.

  • 1. Infection & poor blood supply
  • 2. Deficiency of vitamin C amino acids.
  • 3. Excess of adrenal gluco corticoids
  • 4. Zinc traces beneficial

DRUGS

  • Abies Canadensis – catarrhal inflammation of stomach.
  • Abies Canadensis – peptic ulcer aggravation heating
  • Abroma augusta – albuminuria, diabetes mellitus.
  • Abrotanum – tuberculous peritonitis, pleurisy with effusion
  • Acalypha indica – all pathological haemorrhages
  • Achyranthes aspera – boils, carbuncles
  • Aconite – inflammation acute
  • Actaeaspicata – wrist swelling
  • Adonis vernalis – cardiac dropsy
  • Aegle mar melos – amoebic dysentery, bacillary dysentery
  • Aethiops mercuralis, mineralis – hereditary syphilis
  • Aletris farinose – anaemia
  • Cholesterinum – gallstone colic
  • Bacillinum – tuber cular affections
  • Zinc met – brain, spinal degeneration – exhaustion
  • Veratrum viride – congestion base of brain, violent pains attending inflammation  meningitis.
  • Thuja – chronic inflammation – sycosis gonorrhoea
  • Theridion – necrosis, caryes
  • Terebinth – acute nephritis before cast appear
  • Tarentula – abscess, boils carbuncle
  • Syphilinum – craving for alchohol, falling of hair
  • Symphytum – injury to eye
  • Staphysagria – mechanical injuries, sharp cutting
  • Spongia – orchitis spermatic cord swollen, acute laryngitis
  • Spigelia, led, naja – rheumatic affections of heart
  • Silicea – fistula inflammation, suppuration, swelling of glands
  • Sarasaparilla – renal calculi
  • Sanguinaria, bellis, cac,eug. Jam, psor- eruptions on face of young women.
  • Sambocos – rhinitis, asthma of children
  • Sabadilla – allergic rhinitis
  • Sabina exuberant granulations ( thuja, nitric acid)
  • Ruta – warts with sorepains
  • Rumex – catarral inflammation of larynx
  • R.T – arthritis
  • Rhododendron – gout
  • Ranunculus – corns, shingles
  • Rataniha – fissure of anus
  • Pyrogen – septic fever
  • Puls – rheumatism –shifting pain
  • Plumbum – paint at night in limbs, ameleration pressure
  • Phytolacca – mammary glands inflammation
  • Phosphoric acid – caries
  • Petroleum – herpes of genitalia
  • Nitric acid – wrts, condylomata
  • Naja – rheumatic carditis
  • Mezereum – neuralgia after zona
  • Mercurus sulphuricus –hydro thora
  • Merc spl – chancre
  • Merc proto iodide – chancre
  • Merc cyanide – prophylactic in diphtheria
  • Merc dolcis – cattarahal inflammation of middle ear
  • Merc cor – nephritis
  • Medorrahinum – deep seated affections of gonorrhoea
  • Lycopdium – renal colic right side pneumonia base of right lung
  • Lobelia – chronic gastritis, asthma
  • Ledum – gout
  • Lac defloratum – fatty degeneration, obesity, chronic liver complain
  • Lac caninum – to bring back milk, useful to dry off milk
  • Lachesis – annually returning fever
  • Kalibick – catarrhal inflammation
  • Iodium – cancerof cervix, hard goitre
  • Hypericum – injuries of spine
  • Hydrortis – catarrhal inflammation
  • Helonias – diabetes, albuminuria
  • Helleborus – hydrocephalus
  • Hamamelis – effects of injuries
  • Gelsemium – motor paralysis
  • Fluoric acid – caries, necrosis
  • Euphrasia – conjunctivitis
  • Drosera – laryngeal TB
  • Doscorea – felon
  • Acoite – acute inflammation
  • Bell – acute inflammation
  • Arnica – apoplexy
  • Vanadium – increases hemoglobin stimulates phagocytosis a remedy indegerative Conditions of liver, arteries, brain softening, atheroma of arteries, neuro rentinits, blindness, tuberculosis, chrome rheumatism, fatty degeneration of liver.
  • Echinacea – goiter, exophthamia, gangrene lymphangitis
  • Eupion – chronic tubal disease, severe back ache
  • Fabiana imbricate – uric acid diathesis calculi, prostates
  • Variolinum – haemorrhagic fibroma, tubercular lupus, zona, preventive of small Pox.
  • Vaccinotoxinum – post zosterian neuralgia, (arsenic album, rananculus bulb,R.T)
  • B.C.G – always catarrhal, tuberculous back ground, every 15 days and calcphos bio. Infantile asthma
  • Tuberculinum residum – all the cases of chronic articular rheumatism, ligamentary rigidness, deformed by repeated attacks of arthirits, long lasting sclerosis, dupuytren’s disease.
  • Tuberculinum – afraid of dogs; head ache, chronic otitis media, aggravation in sun, reading , ugly eruptions on face, nephritic syndrome, chronic albuminuria, glomular nephritis, juvenile acne, repeated styes, changing places, bilateral ovarian pains.
  • Oscillo coccinum – varicose ulcer, beginning of rhinitis, beginning of otitits, sinusitis, acute rhinitis.
  • Osteo arthritic nosode – swelling of right wrist, right shoulder, aggravation first movement, tendo achilles, worse right side.

Comments

One Response so far.

  1. Dr. Aamir says:

    Greeting!

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