ORGANISATION AFTEH SUPPUEATION. 125 



to the formation of the so-called ^^ proud flesh ** {caro liuumans)^ 

 Avhereof more anon. As a rule however, a farther chano-e no\y 

 occurs which is suited to check any excess of production on the 

 affected surface, and to pave the way for cicatrisation. The em- 

 bryonic connective tissue undergoes conversion into cicatricial 

 tissue. The change begins in the deepest layers of the granula- 

 tions, and exhibits the same phases and transitions with Avhich we 

 were made acquainted in repair by the first intention. The first 

 step is the formation of spindle-cell tissue. 



The plane in which the spindle-cells are stratified determines 

 the direction in which the earliest fibrilla3 become visible. Xext, 

 the formation of cicatricial tissue and its contraction succeed 

 each other, as described in § 93. The phenomenon is the same ; 

 but the results are more complicated than in repair by the first 

 intention. For as it begins (as already said) in the deepest layers 

 of the pyogenic membrane, the base on which the granulations 

 are situated is the first part to undergo contraction. The raw 

 surface shrinks ; and it is the vessels which are primarily affected 

 by this shrinking, inasmuch as they penetrate vertically through 

 the cicatrising base. They are compressed, their calibre is 

 diminished ; nay, they undergo complete obliteration here and 

 there. In proportion as this takes place the granulations lose in 

 volume, they contain less juice, and the pus-formation grows 

 feebler and more slow. Thus, by a really astonishing consilience 

 of the various formative forces, the way is paved for the last 

 step ; and this consists in the secretion of an epithelial covering, 

 the skinninor over of the o;ranulatincT surflice. 



§ 104. True that the cuticular investment usually sj^reads 

 from the edges of the granulating surface towards its centre. To 

 this rule however there are exceptions ; small patches of cuticle 

 have often been noticed at some distance from the edge, j^atches 

 which gradually increased in size and finally blended with the 

 marginal skin. Even Avere there any difficulty in determining 

 this fact with the unaided eye, all doubts would be removed bv 

 carefully examining a vertical section through the edge of a 

 granulating surface in process of repair (fig. 39) ; this shows 

 conclusively that the raw surface gets its cuticle not by an inde- 

 pendent ingrowth of the epithelium from the edges over the 

 granulating surface, but by the conversion of the outermost layer 

 of the granulation-tissue into epithelium. At e (fig. 39) the 



