American practice of surgery : a complete system of the science and art of surgery . hyperplasia of the connective tissue, are usuallycalled atrophic. (See Fig. 51.) They occur particularly upon the mucousmembranes of the gastro-intestinal tract and the bladder, and in the liver andkidneys. In the gastro-intestinal tract the epithelium becomes atrophic as theresult of persistent desquamation or necrosis, the connective tissue either beingunaffected or undergoing necrosis at the same time. It rarely shows markedhyperplasia in this location. In the case of chronic inflammations of the liverand k
American practice of surgery : a complete system of the science and art of surgery . hyperplasia of the connective tissue, are usuallycalled atrophic. (See Fig. 51.) They occur particularly upon the mucousmembranes of the gastro-intestinal tract and the bladder, and in the liver andkidneys. In the gastro-intestinal tract the epithelium becomes atrophic as theresult of persistent desquamation or necrosis, the connective tissue either beingunaffected or undergoing necrosis at the same time. It rarely shows markedhyperplasia in this location. In the case of chronic inflammations of the liverand kidneys, the atrophy and necrosis are accompanied or followed by a INFLAMMATION. 145 more or less marked hyperplasia of the connective-tissue stroma (hepatic cir-rhosis, contracted kidney). In the case of the liver, imperfect attempts at re-generation of liver tissue lead to a hyperplasia of the small bile ducts. (SeeFig. 52.) Such chronic inflammations are known as productive, indurative,hy per plastic, etc. The treatment of chronic inflammations is both constitutional and U a h Fig. 52.—Connective-tissue Hyperplasia and Proliferation of Bile Ducts in Chronic Hepatitis (al-cohol, haematoxylin). a, a-^. Liver lobules; h, hyperplastic periportal connective tissue; c, old bileducts; d, newly formed bile ducts; e, foci of small-celled infiltration. X 55. (After Ziegler.) The general condition should be built up and improved by proper food, hygiene,tonics, etc. The cause of the chronic reaction must be removed or inhibitedwhen possible. Dead tissue, exudates, foreign bodies, etc., should be sought forand removed. The general indications for the treatment of inflammatory condi-tions—rest, absolute cleanliness, asepsis, etc.—should be met. The formationof granulation tissue should be stimulated in the various ways mentioned above,plastic operations and skin grafting carried out when necessary, and the promo-tion of cicatrization and new epithelial growth encouraged. VOL.
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