454 OF NUTRITION. 



to the old, and to form a new tissue of a temporary character : and, 2. That 

 the generation of the new tissues is preceded by the collection of a large num- 

 ber of white corpuscles, in a nearly stationary condition, in the blood-vessels 

 immediately subjacent ; and by the appearance of a large number of similar 

 cells in the newly-forming tissue ; the two together constituting what Mr. T. 

 has aptly called " the new lymph-bed of organization." The views formerly 

 advanced (579) respecting the function of the Colourless Corpuscles, are thus 

 strikingly confirmed. This process of Reparation appears to be conformable, 

 in all essential particulars, with that which has been observed in the first 

 Developement of new parts, such as the toes of the larva of the Water-Newt. 



597. Although many have doubted whether effusions of Blood could thus 

 become organized, there seems no valid reason to think that its Fibrin would 

 comport itself in any other way, when Red particles are included in its coagu- 

 lum, than when they are absent. That large masses of extravasated Blood 

 should exhibit little or no tendency to organization, will not be considered sur- 

 prising ; when it is remembered that only their surface can be in that relation 

 with a living membrane, which has been stated to be essential to the further 

 vitalization of the effused Fibrin ( 555). It has been proved in many instances, 

 however, that Coagula of Blood completely enclosed within the body possess 

 an incipient vascularity, being capable of injection from the surface beneath ;* 

 and there is no valid reason to deny that the thin layer of Blood which remains 

 between the lips of an incised wound, when these are closely brought together, 

 is the medium of their reunion. It is unquestionable, however, that the Fibrin 

 of an ordinary Blood-clot is less highly-elaborated, and consequently less sus- 

 ceptible of organization than that of the Liquor Sanguinis, which is poured 

 forth after an injury, and which has been subjected to the local action that is 

 its immediate result. 



598. To the second mode of Reparation, attention has recently been strongly 

 directed by Dr. Macartney ; and as this, too, is a strictly Physiological action, 

 and is one which the surgeon should aim at producing, it will be here dis- 

 cussed somewhat in detail. The Surgeon has, until recently, regarded the 

 processes of Granulation and Suppuration, which are attended with much 

 local inflammation, and with a considerable amount of Constitutional disturb- 

 ance when the surface is large, as the only means by which an open wound 

 can be filled up. Occasional instances, however, have not been wanting, in 

 which large open wounds have closed up under the dry clot of blood, by 

 which they were at first covered over, without any suppuration, or other 

 symptom of inflammation ; and in these it has been found that the new surface 

 much more nearly resembles the ordinary one, than does the Cicatrix which 

 follows granulation. To Dr. Macartney, however, is due the merit of explaining 

 the rationale of this action ; which is precisely analogous to that which is 

 concerned in the ordinary processes of growth, and to that reproduction of 

 \vhole parts which takes place in the lower animals without inflammation. It 

 is termed by him the modelling process ; and he remarks as characteristic of 

 it that, when it goes on perfectly, and without Inflammation, the patients are 

 so completely free from uneasy sensations, as only to be aware of the extent 

 of the injury by their own examination. In this process, the surfaces of the 

 wound do not unite by vascular connection, even when they lie in contact ; 

 nor is the space between them filled up with coagulable lymph ; but they are 

 smooth and red, moistened with a fluid, and presenting the appearance of one 

 of the natural mucous membranes. " It might be anticipated that, as this 

 mode of reparation bears so strong a resemblance to the natural formation and 



* For well-established cases of this sort see communications, by Mr. Dalrymple in the 

 Medico-Chirurgical Transactions, Vol. xxiii; and in Lancet, March 23, 1844. 



