ORIGIN OF THE SOLID TISSUES. 453 



can be more firmly applied, and where the space to be filled up is proportion- 

 ably thinner. This mode of union is ordinarily considered by British surgeons 

 to be the result of an adhesive inflammation. In so regarding it, they con- 

 ceive that they are following out the views of Hunter ; but he expressly states 

 that wounds may heal without any pain or constitutional disturbance, the re- 

 union proceeding "as if nothing had happened ;" so that he in effect admits 

 that reparation of this kind may take place without inflammation. It is well 

 known that if a slight wound which is thus healing be provoked to an increased 

 degree of inflammation, its progress is interrupted ; and all the means which 

 the surgeon employs to promote union, are such as tend to prevent the acces- 

 sion of this state. The doctrine that the effusion of lymph for the reparation 

 of the tissues is not to be regarded as necessarily a result of the inflammatory 

 process, is not so novel as its opponents have regarded it, since it has been 

 maintained by. many eminent observers, even from the earliest times. The 

 only case in which the occurrence of inflammation can be regarded as salutary, 

 is that in which there is a deficiency of fibrin in the blood, causing a deficient 

 organizability of the lymph. It has been seen that the amount of fibrin is 

 rapidly increased by inflammation ; and the surgeon well knows that a wound 

 with pale flabby edges, in a depressed state of the system, will not heal until 

 some degree of inflammation has commenced. 



596. When the Liquor Sanguinis of the Blood, known as Coagulable Lymph, 

 is effused between the two edges of a wound, or upon the surface of a membrane 

 lining a closed sac, the following appears to be the history of its organization. 

 The new matter, which is poured out in a fluid state, and which seems to have 

 been subjected to the peculiar influence of the white corpuscles that rapidly 

 collect in large numbers at the injured spot, undergoes a Coagulation resem- 

 bling that of Blood ; the Serum, being set free by the concretion of the Fibrin, 

 is absorbed ; and the fibrino'us coagulum speedily obtains an almost membra- 

 nous density. If examined with a microscope at the commencement of the 

 process of organization, it is seen to contain a large number of the exudation- 

 corpuscles already mentioned ( 660) ; these originating probably in the 

 granules set free by the rupture of white corpuscles. In"a short time, these 

 corpuscles present the appearance of regular cells, disposed in layers, and 

 adhering together by an intermediate unorganized substance ; bearing, in fact, 

 a strong resemblance to the cells of tesselated epithelium. Some hours later, 

 the mass exhibits an evidently fibrous character ; which is probably due to the 

 further elaboration of the plastic material, by the cells just mentioned. Between 

 the fibres, a considerable amount of unorganized substance yet remains ; and 

 they may be readily separated, or torn in any direction. A vascular rete next 

 makes its appearance, in connection with the vessels of the subjacent surface ; 

 the first appearance of this network is in the form, of transparent arborescent 

 streaks, which push out extensions on all sides ; these encounter one another, 

 and form a complete series of capillary reticulatipns, the distribution of which 

 very nearly resembles that which has been seen in the villi of the intestines 

 (Fig. 60). From the observations of Mr. Travers* it appears, that isolated 

 globules enter these capillary tubes, and perform an oscillatory motion in them 

 for some hours, before any series of them passes into it ; so that we cannot 

 regard the new channel as burrowed out by a string or file of red corpuscles, 

 pushed out from the nearest capillary by vis a tergo, as some have maintained. 

 And he has further established two important facts, in the history of the Repara- 

 tion of Tissues, which correspond with the observations just cited: 1. That 

 the Liquor Sanguinis first effused is not sufficiently organizable to become an 

 entirely new and permanent tissue ; although adequate both to afford nutrition 



* Physiology of Inflammation and the Healing Process. 



