GRANULATIONS, PUS. 465 



When we examine granulations for the purpose of 

 comparing them with medullary tissue, we find that no 

 two descriptions of tissue more closely correspond. The 

 marrow of the bones of a new-born infant could at any 

 time, both chemically and microscopically, be passed off 

 as a granulation. Granulations are nothing more than a 

 young, soft, mucous tissue, analogous to marrow. There 

 is an inflammatory osteoporosis, which, as has been cor- 

 rectly stated, merely depends upon an increased produc- 

 tion of medullary spaces, so that the process which is 

 quite normal in the interior of a medullary cavity, is met 

 with also more externally in the compact cortex. It (the 

 osteoporosis) is distinguished from granulating peripheral 

 caries only by its seat. If you go a step further and 

 suppose the cells, which in osteoporosis are present in 

 moderately large numbers, to become more and more 

 abundant, whilst the intercellular substance constantly 

 becomes softer and diminishes in quantity, we have pus. 

 The pus is here no special product, separable from the 

 other products of proliferation and formation ; it is cer- 

 tainly not identical with the pre-existing tissues, but its 

 origin can be directly traced back to the elements of the 

 pre-existing tissue. It is not produced by any special 

 act, by any creation de novo, but its development pro- 

 ceeds from generation to generation in a perfectly regular 

 and legitimate manner. 



We have therefore before us a whole series of trans- 

 formations ; the bone first produced and proceeding from 

 cartilage may undergo a transformation into marrow, 

 then into granulation-tissue, and finally into nearly pure 

 pus. The transitions are here so gradual, that the pus 

 which is in immediate contact with the granulations, con- 

 stitutes, as is well known, a more mucous, stringy, and 

 tenacious matter, which really contains mucin like the 

 granulation-tissue, and only when we proceed farther out- 



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