306 WOUNDS AND THEIR TREATMENT. 



ing the antiseptic method of healing wounds. In closing an 

 entirely clean wound with a strictly antiseptic dressing, the wound 

 having been produced as a result of an operation, and which is no 

 longer bleeding, after having been closed it becomes filled with 

 blood which coagulates. This coagulation, if perfectly antiseptic, 

 fills in the cavity for a short time, when it is soon crowded out by 

 the quick formation of granulations, and soon undergoes a change, 

 becoming yellowish, due to an alteration of the coloring matter in 

 the blood. This healing process is distinguished from that which 

 occurs with the formation of pus by the fact that the constant loss 

 of cells used in building up the tissues is not required, and that 

 the cellular elements which are destroyed as a consequence of the 

 injury are not detached to any great extent by the cleansing process 

 of the wound, but they undergo a quick molecular destruction, 

 and are then as quickly reabsorbed. 



Notwithstanding the fact that under the microscope the healing 

 processes of wounds seem to differ greatly, still the histological pro- 

 cess is the same in all. The formation of a deficient vascular 

 cicatrix is the main point in all forms of wound treatment. This 

 is accomplished by neoformation of bloodvessels, by the appearance 

 of numerous wandering cells, and by alteration of these cells into 

 fixed bodies of connective tissue with a rigid interlaying sub- 

 stance. The various modes of healing already described depend 

 on the degree of irritation that the wound has been exposed to. 

 The most marked symptom of acute irritation under the usual 

 conditions is granulation with suppuration, and we must also 

 point out that it may be well, from a practical standpoint, to con- 

 sider suppuration as an abnormal condition due to infection. "We 

 must also state that the regenerative power of the disconnected 

 tissue varies. The skin and mucous membrane are always closed 

 by a cicatrix, and it usually heals by first intention because the 

 epithelium unites quickly. Compensation tissues which fill up 

 wounds that have been accompanied with a loss of a certain amount 

 of tissue, it either being cut out or destroyed, especially when they 

 contain few or no bloodvessels, seem to fill up very rapidly. 



Diseases Resulting from Septic Infection of Wounds. 



There are a number of conditions which apjiear in wounds that 

 are due to microbes and germs, producing certain irritations of 



