362 CHAPTER 48. 



converted into connective tissue. The lymph thus organised always 

 partakes more or less of the structure, into which it is exuded. The 

 deposition of lymph will continue under favorable circumstances, until 

 the chasm is filed up to a level with or above the surrounding parts. 



Good lymph, it will be remembered, is only secreted in the moderate 

 or " active " stage of inflammation. It is not secreted in the acute or 

 chronic stages. In most injuries the degree of inflammation is at first 

 excessive. Hence in the treatment of wounds our first object generally 

 is to reduce the inflammation by means of cold applications or fomenta- 

 tions. When this has been done, the probability is that good lymph will 

 be exuded. Nature, not art, conducts the healing process. All that man 

 can do is to get the part into a state favorable for the operations of 

 nature ; and if the patient is healthy and other circumstances connected 

 with the particular case are favorable, she will soon complete the cure. 



In some cases however it happens, and especially where the constitution 

 is weak and unhealthy, or where the part injured is of low organisation, 

 that the inflammatory process becomes torpid, before sufficient lymph has 

 been exuded. It may then become necessary to stimulate the part to 

 renewed activity by the application of irritants. 



On the other hand, if the local inflammation continues for too great a 

 time, the lymph will soften into pus. 



739. Combination of modes of Union. 



In a wound of considerable extent, several of the above modes of union 

 may often be seen in operation in different parts at the same time, as for 

 instance the 1st, 2nd, and 4th. 



There is a greater disposition in the horse than in man to suppurative 

 action. Hence wounds of any extent seldom heal completely in the horse 

 by direct union or by adhesion. These modes should, however, be sought 

 for and obtained as far as possible in each case, with the view of reducing 

 the size of the part requiring to be filled up by granulations. 



740. Recapitulation. 



Such are the various modes of healing wounds, and like all nature's 

 processes they are simple enough. In practice, however, innumerable 

 modifications occur, arising from the nature of the wound, the degree and 

 seat of the injury, the presence or otherwise of foreign bodies in the 

 injured part, the amount of haemorrhage, the health of the patient, and 

 degree of irritability peculiar to his system. In short, no two cases are 

 exactly alike. 



Details connected with these varying circumstances will now demand 

 our attention. 



741. Gleaming of Wounds. 



All foreign bodies in a wound should at once be removed, as far as 

 possible, by allowing lukewarm water to fall in a stream over it from the 

 mouth of a vessel. Or a sponge or a piece of fine tow may be pressed on 



