GRAFTING 413 



tissue in order to survive must be of a quality that can 

 retain life in spite of this serious handicap. Few tissues 

 are so tenacious of life, and hence very few survive 

 transplantation. Even in those cases in which the 

 implanted tissues can be histologically recognized after 

 an interval of months, they are found to be decadent, 

 and in practically all cases they are destined to disappear. 



It might be supposed that the vitality of the embryonal 

 tissues under the conditions of transplantation would 

 exceed that of the adult tissues because of their greater 

 cellular activity, general capacity for growth, and ability 

 to live upon imperfectly distributed nourishment, and 

 this is true for it is quite possible to effect successful 

 transplantations in such embryos salamander larvae 

 and tadpoles as can be submitted to investigation, 

 though among higher vertebrates reptiles, birds, and 

 mammals it is impossible. 



But some cases of extensive transplantation succeed. 

 When the nose is lost through accident or disease, sur- 

 geons sometimes build up a new nose out of tissues 

 obtained from the patient's finger. The tissue of the 

 face is denuded of its skin over an area of appropriate 

 size, the surface of the chosen finger is likewise denuded, 

 and the two stitched together. Bandages are then 

 applied so as to hold the hand immovably in place until 

 firm union has been established and until the tissues 

 of the finger receive some new vessels from the face 

 through the cicatrix. When the surgeon feels confident 

 that this has been effected, the finger is cautiously 

 amputated, and its tissues so manipulated that a sem- 

 blance of a nose is produced. The operation commonly 

 fails because of the great difficulty of retaining the 

 finger immovably in position and because the new blood 

 supply afforded the digital tissues by the facial vessels 

 is apt to be inadequate. 



In plastic operations of this and similar kinds, where 

 cutaneous and subcutaneous tissues are transplanted, 

 the tissues do not in the strict sense find the environ- 



