REPAIR. 259 



ing superficial destruction of tissue and loss of substance 

 constitute an ulcer (see Fig. 98J). 



Parenchymatous and interstitial inflammation : In inflamma- 

 tion of glandular structures, in some instances, the degenera- 

 tive or proliferative changes in the epithelial cells may be the 

 more marked, while in others the changes in the interstitial 

 tissue are the more pronounced, suggesting the term parenchy- 

 matous for the former and interstitial inflammation for the 

 latter condition, though they cannot be strictly separated from 

 each other (see Fig. 99). The same terms are sometimes 

 employed in a somewhat similar manner in inflammations of 

 muscle and nerve-tissue. 



Productive inflammation (see Fig. 100) is a term occasion- 

 ally employed when the proliferative changes predominate 

 over the exudative and degenerative, due either to the nature 

 of the cause or the extent of the injury. In the viscera, when 

 the action of an irritant is long continued, such proliferative 

 activity of the connective-tissue cells may lead to a marked 

 increase in the sustentacular tissue and a secondary atrophy 

 of the parenchyma, the term chronic interstititial inflammation 

 being applied to the condition. Productive inflammation is 

 well illustrated in the process of repair. 



REPAIR. 



Healing by first intention : Immediate reunion of an aseptic 

 wound takes place with scarcely any vascular phenomena. 

 The prompt juxtaposition of the lips of the wound leaves no 

 opportunity for an exudation of any great extent. There is 

 more or less hemorrhage, a small amount of the blood coagu- 

 lating between the edges of the wound. The filaments of 

 fibrin which form constitute a sort of scaffolding between the 

 wounded surfaces. 



By the end of twenty-four hours there is evidence of a 

 superactivity on the part of the injured connective-tissue cells. 

 They become hypertrophied, their divided prolongations 

 grow and new ones are protruded, extending along the fibrin 

 scaffolding, uniting with similar prolongations from other cells, 

 and thus forming a second scaffolding firmer than the first. 

 The cells then complete the formation of the cicatrix by the 



