GRANULATION. 



flammation, and that it would be forced off when fuppura- 

 tion came on ; but on the fuccecding day he found it vaf- 

 cular, having all the appearance of healthy granulalions. 



The vedels of grauuUitions lirll pafs to their bafis from 

 the original parts, whatever thefe may be, and then run m 

 nearly parallel lines to tlieir external furface, where they feem 

 as if they ended. 



The furface of the new fubllance continues to have the 

 fame difpohtion for the fecretion of pus, as the parts from 

 which it itfelf was produced. Granulations are very con- 

 vex, which is au appearance the very reverie of what happens 

 in ulceration, or while a i'ore is increafing in fize. They ap- 

 pear rough, in confequence of having a great many points or 

 fmall eminences, and they are deemed the more healthy, the 

 fmaller fuch points are. 



Healthy granulations arc of a deep florid red colour, a 

 circumftance which might lead one to fufpeCl, that the colour 

 was principally owing to the arterial blood ; but Mr. Hunter 

 was of opinion, that this appearance only denoted a briilc 

 circulation in the new-formed fubftance, the blood not having 

 time to become dai-k. 



When granulations are naturally of a livid red, they are 

 commonly unhealthy, and (liew a languid circulation. Such 

 appearances may often be induced by pofitiou, and we fre- 

 quently fee it take place on fores of the leg, when the limb 

 is not kept in a horizontal pofture. In this circumftance, 

 the new-formcd veffels are incapable of fupporting the in- 

 ■creafed column of blood, and of atting upon it. The ftag- 

 nation allows the change of colour to liappen, and the alte. 



and the other from the fcalp, unite over the bare one, wliicli 

 was between them, fo ftrongly in twenty-four hours, that 

 fome force was requijed to feparate them, and when fepa- 

 ratcd, they bled. 



The inner furface of the fl<in, in cafes of abfceffes, not 

 only does not readily granulate, but docs not readily unite 

 with the granulations underneath. Hence the frequent forma- 

 tion of liftulx and iinufes. 



Unhealthy granulations have not an equal tendency to 

 unite with each other : a fmooth furface is formed, which 

 continues to fccrete matter. Thus, Mr. Hunter regarded 

 the internal furface of a iiilulous ulcer as, in fome degree, 

 limilar to the inner furface of the \ircthra, when it is forming 

 the difcharge commonly called a gleet. Such fores have no 

 difpolition in their granulations to unite, and nothing can 

 produce an imion between them, but altering the difpofition 

 of thefe granulations, by exciting a confiderable inflamma- 

 tion and probably ulceration ; fo as to form new granulations, 

 and by this means give them a chance of falling into a found 

 ftate. 



It is alfo noticed by Mr. Hunter, that granulations arc 

 not furnifhed with fo much power as parts poflefs, which are 

 originally formed. Hence tliey more readily ulcerate and 

 flough. He ftatcs, that they not only fliew the condition 

 of the part in which they grow, or the condition in whicii 

 they are themfelves, but alio, how the conftitution is afFeft- 

 ed by many difeafes. 



The fame author has made fome obfervations refpefting 

 the longevity of granulations. He fays, that they often 



ration, in all probability, takes place both in the arteries and feem to be formed with only ftated periods of life, and thofe 



vems. Here may be feen the reafon why fore legs are fre- 

 quently very backward in healing, when the patient is fuf- 

 fered to put his foot on the ground, or to walk about. 



Healthy granulations, iituated on an expoied or flat fur- 

 face, rife nearly even with the furface of the furrounding 

 flcin, and often a little higher ; and in this ftate they are al- 

 ways of a florid red colour. When they exceed this height, 

 and affume a growing difpolition, they are then unhealthy, 

 and they become foft and fpongy, without any difpotltion to 

 form ikin. 



Granulations always have the fame difpofition as the parts 

 upon which they are formed ; and take on the fame mode of 

 adion. If it is a difeafed part, they are difeafed ; and if 

 the difeafe be of any fpecific kind, they are alio of the fame 

 uature, and, of coui-fe, produce matter of the fame quahty. 



When granulations are healthy, they are always prone to 

 vmite with each other, the great ufe of which is to bring 

 about the union of parts, fomewhat like what is the refult 

 of union by the firll intention. See Wound.s. 



much Ihorter, than the life of the part, on which fuch gra- 

 nulations are iituated. Their life, indeed, does not appear 

 tobefofliort, when cicatrization can be accompliflied ; but 

 while a fore is in a granulating ftate, they frequently perifli 

 without any vilible caufc. Thus, fays Mr. Hunter, a pcr- 

 fon may have on his leg a fore, which granulates well, the 

 granulations have a healtliy appearance, the fl^in is forming 

 round the edges, and every thing promifes well, when, all 

 at once, the granulations become livid, lofe their life, and 

 immediately llough off". In fome inllances, they are deftroy- 

 ed, partly by ulceration, and partly by mortification. Then 

 new granulations are frequently produced, and go through 

 limilar changes. Sometimes tliis happens tiu-ee or four times 

 in tlie fame perlon. Mr. Hunter in vain tried various me- 

 thods for rendering the granulations in fuch cafes m.ore du- 

 rable. 



Suppuration and granulation are eflential for the cicatriza- 

 tion and union of almoft every wound, which has not been 

 united by the firll intention : a few fmall wounds and . 



The difpofition which granulations have to unite with each fcratches, which heal under a fcab, being the only excep- " 



other upon coming into contact, without the appearance of tions. 



any intermediate animal lubllance, is perhaps effected, as Our author, in the following fcftion of his treatife on the 



Mr. Hunter conjectures, in the following manner. When blood, notices, that cicatrization feems to be in view immedi- 



two found granulations approach together, the mouths of ately after the granulations are formed. The parts which had 



the fecretin^: veflels of the one coming to oppofe the mouths receded, in confequence of a breach being made in them, by 



of fiuiilar veflels of the other, they are llimulatcd into ac- 

 tion, which is mutual ; fo that a kind of fympathetic at- 

 traction takes place, and as they are folids, the attraction of 

 cohefion is eftablillied between them. Tliis has been termed 

 iiiofculation. The veflels thus joined are altered from le- 

 creting to circulating. There are fome other furmifes ha- 

 zarded by Mr. Hunter refpcfting the rationale of this mi- 

 nute procefs of nature ; but the curious reader mull refer for 

 them to the author's own relation of the fubjeft. 



Mr. Huntt-r informs us, that he has feen two granulations 

 t>D the head, .viz. one from the dura mater after trepanning, 



2 



their natural elallicity, and, probably, by mufcular contrac- 

 tion, now begin to be brought together by this new fubftance, 

 which loon contrafts. The contraclion takes place in every 

 joint, but principally from edge to edge, which brings the cir- 

 cumference of the fore towards tlie centre, fo that the fore 

 becomes fmaller and Imaller, although little or no new Ikin 

 may be formed.' 



Tlie tendency in the granulations to contrail: is, in fome 

 degree, proportioned to the general healing difpofition of the 

 fore, and the loofenefs of the parts, on which they are form- 

 ed. When new flcln cannot be produced, the granulations 



do 



