448 OF NUTRITION. 



to the degree of development which has already taken place. Thus it is well 

 known to every practitioner, how much more readily and perfectly the 

 lesions resulting from accident or disease are repaired in childhood and 

 youth, than they are after the attainment of the adult state. And there is 

 evidence that, during embryonic life, the regeneration of lost parts may take 

 place in a degree to which we have scarcely any parallel after birth : for 

 Prof. Simpson 1 has brought together numerous cases, in which, after "spon- 

 taneous amputation" of the limbs of a foetus, occurring at an early period 

 of gestation, there has obviously been an imperfect attempt at the re-forma- 

 tion of the amputated part from the stump; and it seems probable from the 

 history of normal development, that in the cases in which perfect hands and 

 feet have been present without the corresponding limbs, these hands and feet 

 have been secondary productions from the stumps of amputated limbs, since 

 any original defect of development would have affected the hands and feet 

 rather than the arms and legs. There are occasional examples, moreover, 

 in which this regenerative power has been prolonged to an unusually late 

 period : thus an instance is recorded, on authority that can scarcely be 

 doubted, of the twice-repeated reproduction of a supernumerary thumb, 

 after it had been twice completely removed ; 2 and the Author has been as- 

 sured by a very intelligent surgeon, that he was cognizant of a case in which 

 the whole of one ramus of the lower jaw having been lost by disease in a 

 young girl, the jaw had been completely regenerated, and teeth were devel- 

 oped, and occupied their normal situations in it. 3 



362. It has been a general opinion among British surgeons (founded upon 

 what they believe, but erroneously, to have been the doctrine of Hunter), 

 that Inflammation is essential to the process of Reparation. There is no 

 doubt that, as usually conducted, the healing of wounds is attended by a 

 greater or less degree of Inflammation ; but it does not thence follow that 

 this morbid condition is essential to the renewal of the healthy state ; and in 

 fact it can be shown that, in the majority of cases, the occurrence of Inflam- 

 mation is injurious rather than beneficial. It was by Dr. Macartney that the 

 first clear enunciation of this important truth was made ; and his conclusions, 

 founded upon a philosophical comparative survey of the operations of Rep- 

 aration and Inflammation as performed in the different classes of animals, 

 namely, " that the powers of reparation and reproduction are in proportion 

 to the indisposition or incapacity for inflammation ; that inflammation is so 

 far from being necessary to the reparation of parts, that, in proportion as it 

 exists, the latter is impeded, retarded, or prevented ; that, when inflamma- 

 tion does not exist, the reparative power is equal to the original tendency to 

 produce and maintain organic form and structure ; and that it then becomes 

 a natural function, like the growth of the individual, or the reproduction of 

 the species," 4 may be regarded as substantially correct, although requiring 

 some modification in particular cases. 



363. The simplest of all the methods of healing of an open wound, is that 



1 Those cases were brought by Prof. Simpson before the Physiological Section of 

 the British Association, at its meeting in Edinburgh, Aug 1850. The Author, having 

 hud the opportunity of examining two living examples, as well as Prof. Simpson's 

 preparations, is perfectly satisfied as to the fact. 



' J See Mr. White's Treatise on the Regeneration of Animal and Vegetable Sub- 

 stances (178o), p. 1G. A case was under Dr. Carpenter's observation, where the re- 

 production of a supernumerary digit, after removal, occurred once, and a second 

 ope.ration was postponed till the child hud ceased to grow. ED. 



3 For analogous cases, see Wagner, On liesections, Sydenham Society's transl., 

 p. 137. 



4 Dr. Macartney's Treatise on Inflammation, p. 7. 



