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Introduction 1

PART Ⅰ 11

Chapter Ⅰ．Degenerative and Regressive Disturbances of Cells and Tissues 13

Ⅰ．Introduction 13

Ⅱ．Degenerative and Infiltrative Changes 15

A．Cloudy Swelling and Vacuolar Degeneration 15

B．Fatty Deposition 18

C．Hyaline Degenerations 25

D．Amyloidosis 32

E．Mucoid and Colloid Degenerations 35

F．Glycogenic Infiltration 36

Ⅲ．Regressive Disturbances 37

A．Necrosis 37

B．Autolysis and Putrefaction 47

References 48

Chapter Ⅱ．Inflammation 53

Ⅰ．Introduction 53

Ⅱ．The Vascular Phenomena of Acute Inflammation 54

A．Lewis＇＂Triple Response＂ 54

B．Microscopic Changes 56

C．Mechanisms of Vascular Changes in Acute Inflammation 59

Ⅲ．The Inflammatory Exudate 63

A．Formation of the Exudate 63

B．Fluid Component of the Inflammatory Exudate 66

C．Cellular Components of the Inflammatory Exudate 66

D．Types of Inflammation 74

Ⅳ．Biochemistry of Inflammation 81

A．Humoral Mediators in Inflammation 82

B．Biochemical Changes in Inflamed Tissues 86

Ⅴ．Endocrine Control of Inflammation 87

Ⅵ．Biology of Inflammation 88

References 90

Chapter Ⅲ．Repair，Regeneration and Tissue Transplantation 96

Ⅰ．Introduction 96

Ⅱ．Repair 97

A．Normal Wound Healing 98

B．Abnormal Wound Healing 110

Ⅲ．Regeneration 111

A．Classification of Tissues 112

B．Regeneration of Some Special Tissues 113

C．Stimulus for Regeneration 119

Ⅳ．Tissue Transplantation 122

A．General Principles of Tissue Transplantation 124

B．Some Practical Uses of Tissue Transplantation 127

References 132

Chapter Ⅳ．Disturbances of Growth and Differentiation of Tissues 139

Ⅰ．Introduction 139

Ⅱ．Disturbances of Growth 141

A．Aplasia，Agenesia and Hypoplasia 141

B．Atrophy 144

C．Hyperplasia and Hypertrophy 147

Ⅲ．Disturbances in Differentiation 151

A．Metaplasia 152

B．Anaplasia 155

C．Nomicoplasia 156

References 156

Chapter Ⅴ．General Pathology of Tumors 159

Ⅰ．Introduction 159

Ⅱ．Definition，Nomenclature and Classification 161

A．Definition 161

B．Nomenclature 163

C．Classification 164

Ⅲ．The Etiology of Tumors 170

A．Experimental Studies 171

B．The Significance of Experimental Studies in Human Carcinogenesis 177

C．Clinical Studies 178

D．Theories on the＂Cause＂of Cancer 193

Ⅳ．Anatomy，Physiology and Biochemistry of Tumors 197

A．Anatomy of Tumors 201

B．Physiology of Tumors 208

C．Biochemistry of Tumors 213

Ⅴ．The Dissemination of Tumors 214

A．Invasion 215

B．Metastasis 220

C．Difficulties in Determining Route of Neoplastic Dissemination 228

D．The Single，Isolated Metastasis 229

E．Frequency and Distribution of Metastases 229

F．Transplantation of Tumors 231

Ⅵ．Diagnosis 232

A．Biopsy 232

B．Histologic Diagnosis of Cancer 234

C．Complications of Biopsy 237

D．Exfoliative Cytology 238

E．The Study of the Surgical Specimen 240

References 240

PART Ⅱ 249

Chapter Ⅵ．General Pathology of Connective Tissues 251

Ⅰ．Introduction 251

Ⅱ．Organization of Connective Tissues 252

A．Morphology and Biochemistry 253

B．Physiology and Functions 265

Ⅲ．Elementary Lesions of Connective Tissues 278

A．Elementary Lesions 278

B．Hypersensitivity and the Connective Tissues 282

Ⅳ．Diffuse Collagen Diseases 283

A．A Concept 283

B．General Pathology 284

C．Etiology and Pathogenesis 293

Ⅴ．Heritable Disorders of Connective Tissues 296

A．Marfan＇s Syndrome 298

B．Ehlers-Danlos Syndrome 299

C．Osteogenesis Imperfecta 299

D．Pseudoxanthoma Elasticum 300

E．Hurler＇s Syndrome 301

References 302

Chapter Ⅶ．General Pathology of the Host-Parasite Relation 313

Ⅰ．Introduction 313

Ⅱ．Defense Mechanisms of the Host 316

A．Local Defense Mechanisms 316

B．Systemic Defense Mechanisms 321

C．Concept of Immunity 327

Ⅲ．Aggressive Mechanisms of the Parasite 329

A．Pathogenicity and Virulence 329

B．Aggressive Mechanisms of Bacteria，Rickettsiae，Viruses and Fungi 331

C．Aggressive Mechanisms of Animal Parasites 333

D．Parasitic Associations 334

Ⅳ．The Host-Parasite Relation 335

A．Types of Host-Parasite Relation 335

B．Establishment 336

C．Factors Influencing，the Host-Parasite Relation 337

D．Nonspecific Reactions of the Host 338

Ⅴ．Chemotherapy 342

A．Definition 342

B．Selective Toxicity 342

C．Mechanism of Action 343

D．Resistance 344

E．Control of Chemotherapy in the Laboratory 347

F．The Host-Parasite Relation 347

References 348

Chapter Ⅷ．General Pathology of the Immune Response 354

Ⅰ．Introduction 354

Ⅱ．Antigens and Antibodies 355

A．Nature of Antigens 355

B．Nature of Antibodies 359

C．Antigen-Antibody Reaction 364

Ⅲ．Hypersensitivity 364

A．Types of Hypersensitivity 365

B．Hypersensitivity and Immunity 372

C．Autoimmunity and Disease 372

D．Biology of the Immune Response 378

References 379

Chapter Ⅸ．General Pathology of Body Fluids and Electrolytes 386

Ⅰ．Introduction 386

Ⅱ．Distribution，Composition and Exchange of Body Fluids 387

A．Distribution of Water in the Organism 387

B．Composition of Body Fluids 388

C．The Exchange of Fluids in the Body 390

Ⅲ．Control of Volume and Concentration of Body Fluids 392

A．Volume 393

B．Concentration 395

C．Integration of Mechanisms Regulating Volume and Concentration of Body Fluids 397

Ⅳ．Pathologic Changes in Volume and Concentration of Body Fluids 397

A．Changes in Volume of Body Fluids 397

B．Changes in Concentration of Body Fluids 398

C．Edema 401

Ⅴ．Regulation of H+Ion Equilibrium 407

A．Basic Principles 408

B．Physicochemical Regulation 410

C．Physiologic Regulation 410

Ⅵ．Disturbances in the Equilibrium of the H+Ion 412

A．Acidosis 413

B．Alkalosis 414

References 414

Chapter Ⅹ．General Pathology of Metabolism and Nutrition 420

Ⅰ．Introduction 420

Ⅱ．Normal Metabolism 421

A．Energy Metabolism 421

B．Intermediary Metabolism 426

C．The Common Metabolic Cycle 436

Ⅲ．Disturbances of Metabolism 436

A．Disturbances in Intermediary Metabolism 437

B．Inborn Errors of Metabolism 448

C．The Metabolic Response to Trauma 452

Ⅳ．Nutrition 459

A．Normal Food Requirements 459

B．Disturbances of Nutrition 462

References 470

Epilogue．The Nature of Disease 479

Ⅰ．The Beginning of the Story，or The Magical Concept of Disease 480

Ⅱ．The Hellenic Contribution，or The Birth of Reason 482

Ⅲ．Galenic Interlude 484

Ⅳ．The Medieval Period，or The Reign of Dogma and Unreason 485

Ⅴ．Paracelsus 487

Ⅵ．From the Renaissance to Claude Bernard 489

Ⅶ．Bernard，Virchow and Cannon，or The Modern Concept of Disease 491

INDEX 495