REPARATIVE PROCESS. 561 



has ceased. In fact, as Mr. Paget has pointed out (loc. cit.), its amount at 

 different periods of existence, as in different classes of animals, seems to bear 

 an inverse ratio to the degree of development which has already taken place. 

 Thus it is well known to every Practitioner how much more readily and per- 

 fectly 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 has brought together numerous cases, in which, after " spontaneous 

 amputation' ' of the limbs of a foetus, occurring at an early period of gestation, 

 there has obviously been an imperfect attempt at the re-formation of the ampu- 

 tated 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 second- 

 ary 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 instances, however, 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 re- 

 production of a supernumerary thumb, after it had been twice completely 

 removed ; 3 and the Author has been assured by a very intelligent Surgeon, that 

 he was cognizant of a case in which the whole of one ramus of the lower jaw 

 had been lost by disease in a young girl, yet the jaw had been completely 

 regenerated, and teeth were developed and occupied their normal situations in it. 3 



600. 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 condi- 

 tion 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 Inflammation 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 Reparation and Inflammation, as per- 

 formed in the different classes of animals namely, "that the powers of repara- 

 tion and reproduction are in proportion to the indisposition or incapacity for 

 inflammation ; that inflammation is so far from being necessary to the repara- 

 tion of parts, that, in proportion as it exists, the latter is impeded, retarded, or 

 prevented ; that, when inflammation does not exist, the reparative power is 

 equal to the original tendency to produce and maintain organic form and struc- 

 ture; 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 substan- 

 tially correct, although requiring some modification in particular cases. 



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

 which is termed by Dr. Macartney " immediate union." It is often seen in 

 the case of small incised wounds, such as cuts of the fingers, or the incision 



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

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

 the opportunity of examining two living examples, as well ay 'Prof. Simpson's prepara- 

 tions, is perfectly satisfied as to the fact. 



2 See Mr. White's Treatise on the " Regeneration of Animal and Vegetable Substances" 

 (1785), p. 1C. 



3 For a sketch of the Regenerative Process as performed in different tribes of Animals, 

 see " Princ. of Phys., Gen. and Comp.," $g 645 and 646, Am. Ed., and the account of 

 each class in CHAP. vii. 



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



36 



