106 PHYSIC 



or structures it may have occurred, the ' ' solution of con- 

 tinuity," according to the distance separating its sides, the 

 amount of interstitial injury, and the presence or absence 

 of foreign matter in the wound, nature's plan seems to be 

 to obtain in the shortest possible time the apposition of 

 the severed textures, and this, when all is favourable, she 

 does by "first intention," but if unable from any of the 

 above or other unfavourable conditions to do so, she first 

 removes these, and then proceeds to accomplish the process 

 by second, third, or continued intentions. 



When all the conditions for healing are present, she 

 proceeds by obtaining, as nearly as possible, the exact 

 apposition of the separated surfaces, and by renewing the 

 continuity which has been dissolved by the traumatic 

 influence by interpolating into the wound an organisable 

 plasma or "mortar," so to speak, which develops into a 

 bond of organic union, which more and more approximates 

 the separated textures while it itself proportionately dis- 

 appears. This organisable "mortar" or intra-traumatic 

 plasma we would regard as largely the product of nervine 

 exudation, sympathetic and systemic, because if sanguine- 

 ous matter be exuded into a wound, it has to be removed 

 or absorbed, minus, it may be, its organisable material, 

 before the process of healing can go on, in the essential 

 reparative matter or cicatricial elements, in which takes 

 place the work of tissue reorganisation and restoration. 

 Moreover, we are of opinion that the reorganising agency 

 is none other than the sympathetic proper fibro-cellular 

 texture immediately surrounding or entering into the 

 traumatised area, and that it proceeds to the accomplish- 

 ment of its benign work by sending out into the inter- 

 polated and enclosed or intra-traumatic plasma a series of 

 proliferating cell organisms, which vivify and organise it, 

 and by it readjust the separated and disorganised tissue 

 elements spider cells appearing in reality, and weaving 

 into organised cicatricial tissue a medium of textural union 

 so complete and lasting that its duration, with a few ex- 

 ceptions of pathological breakdown, is conterminous with 

 the traumatee's life. This immediate union of traumatised 

 textures may be taken as representative of healing by the 

 best, if not absolutely the "first intention." 



