UNION. 



this procefs is Bot prevented by the prefence of inconfiderable 

 efFiifion of blood ; but even in thele cafes, profeffor Thom- 

 fon doubts vsrhether the blood b,e not abforbed before adhe- 

 fion takes place. 



The lymph which is thrown out during adhcfive inflamma- 

 tion, profeffor Thomfon and the generality of modern fur- 

 gical writers confider to be invariably formed by a procefs 

 analogous to fecretion or exhabtion. 



Our knowledge of the procefs of adhefion, or of union 

 by the firft intention, has been confiderably extended by the 

 attempts which have at different times been made to repair 

 and improve thofe parts of the human body which had been 

 cut off, or otherwife mutilated. Celfus treats profeffedly 

 of the method of repairing mutilations of the ears, lips, and 

 nofe ; but the only pradlice of this kind with which he was 

 acquainted, confifted fimply in paring off the callous edges 

 of mutilated parts, in raifing thefe edges by dilTeftion from 

 the parts below tlicm, in drawing them nearer to each other, 

 and retaining th;m together with futures and adhelive 

 plafters. 



Early in the fixteenth century, a new mode of repairing 

 mutilated parts began to be firft praftifed in Italy. Alex- 

 ander Benedidus, who pubhfhed about the year 1527, par- 

 ticularly mentions, that fome ingenious men had difcovered 

 a way of corredling the deformities occafioned by the muti- 

 lations of the note. The plan confifted in raifing a flap of 

 (Icin from the arm, ftitching it to the mutilated part, and 

 after dividing this flap from the arm, modelling it as much 

 as pofllble into the (hape of the nofe. Thefe new nofes, 

 BenediAus remarks, bear ill the cold of winter, and he 

 gives fome wholefome advice about not rafhly or fevereljr 

 pulling them, left they yield and come away. 



This curious fubjeci was afterwards noticed by Gourmelin 

 in 1566, by Vefaliusin 1569, and by Ambrofe Pare in 1582. 

 The two latter erred in fuppofing it a neceflary part of the 

 operation to cut out a portion of the biceps mufcle. 



But, fays profeflor Thomfon, the beft, and by far the moll 

 interefting account that is any where to be found of this mode 

 of repairing mutilated parts, is that which is contained in the 

 elaborate and not inelegant, though certainly prolix work of 

 the celebrated Gafpar Tahacotius, entitled " De Curtorum 

 Chirurgia per Infitionem," printed at Venice I J97. He de- 

 fcribes mort minutely and circumftantially his manner of re- 

 ftoring, by engraftment, nofes, lips, and ears, which had 

 been cut off^. He gives a full account of the mode of pre- 

 paring the flap of (km upon the arm ; the manner in which 

 it was to be marked out, and a flip of cloth infcrted under 

 it for fome days ; of the divifion of the upper extremity of 

 this flap from the arm ; of paring the mutilated part, and 

 fewing, with mathematical precifion, the flap to the nofe ; 

 of the apparatus neceflary for retaining it in this pofition ; of 

 tlie divifion of the lower end of the flap from the arm, after 

 a union had taken place between the nofe and the flap ; of 

 the modelling, or configuration of the feptum ; of the plaf- 

 ters and bandages to be applied in this ftage of the procefs ; 

 and of the means to be ufed for fome time to defend the nofe 

 from accidental injury. He then treats, in fcparatc chapters, 

 of the repair of the upper and lower lips, and of the forma- 

 tion of new ears. The inftruments to be employed, and the 

 progrcfs of the artift in the different ftages of his work, are 

 likcwife illuftrated in twenty-two plates. 



In the repair of the upper lip, this part was joined, like 

 the nofe, to the upper extremity of the flap ; but in that 

 of the lower lip, it became necefTary to divide the lower 

 rnd of the flap firft from the arm, and conneft it with the 

 lip, fo that the fltin of the engrafted part might always be 

 outermoft. 



The occafions for imitating the mode of praAice fo fully 

 defcrlbed by Taliacotius, now feldom occur in Europe ; 

 but in India, where the punifhments are in fome places fimi- 

 lar to thofe which were inflifted in Europe in the time of 

 Tahacotius, the art of reftoring nofes is liill held in confi- 

 derable repute. The Indian method differs from the TaUa- 

 cotian chiefly in taking the flap of fl<in of which the new 

 nofe is to be formsd, from the forehead inftead of the arm. 

 See Gent. Mag. Oft. 1794. Alfo, An Account of Two 

 fuccefsful Operations for reftoring a loft Nofe from the In- 

 teguments of the Forehead, &c. by J. C. Carpue. 



Boyer mentions, that the late M. Chopart had employed 

 a piece of the fkin of the neck to fill up a void fpace left 

 after an operation for a cancerous lip. The union took 

 place, and a tolerably well-formed lip was procured. 



It has been a queftion, whether parts which have been com- 

 pletely feparated from the reft of the body can be again 

 united. This reunion, fays profefTor Thomfon, was long 

 conceived to be in every inftance impoffible ; but the fuc- 

 cefs which in fome cafes has attended the tranfplantation of 

 the teeth, has clearly (hewn, that in one inftance at leaft, in 

 the human body, this reunion is poffible. Of the poflibility 

 of this mode of reunion in brute animals, numerous exam- 

 ples are to be found in authors. 



Duhamel mentions, that it was a very common praftice in 

 the poultry yards in France, to engraft the ipurs of young 

 cocks upon their combs, and that, in this fituation, the 

 fpurs were obferved to grow to a larger fize than when they 

 were allowed to remain on their legs. From a variety of ex- 

 periments and difTeftions, Duhamel deduces the following 

 conclufions. " We fee then (fays he) that an organized 

 part, detached from the leg of a cock, when it was not bigger 

 than a hemp-feed, and placed upon the head of the fame 

 aninrul, forms there an union fufficiently intimate to become 

 feveral inches in length, while it preferves in this new fitua- 

 tion its original organization in every refpcft, except in 

 the mere circumftance of becoming larger. This, there- 

 fore, is a true engraftment performed upon an animal. Se- 

 condly ; we fee a bony nucleus, covered firft with a periof- 

 teum, and then with a horny fubftancc ; in a word, a horn 

 fimilar to that of oxen, and which grows in the fame man- 

 ner, conneifled to the cartilaginous ring by the ligamentous 

 bands which have been already mentioned. Thirdly ; this 

 horn, by its fize, and by the continual motions of the head, 

 being prevented from uniting firmly, or, in other words, 

 from anchylofing with the cranium, forms a kind of joint, 

 furniflied with feveral hgaments fufiiciently ftrong to fupport 

 it. But thefe organs are not to be found in the natural 

 ftate, either under the comb of the cock, or in the neigh- 

 bourhood of their fpurs ; at leaft, I have never been able to 

 perceive them there. Nature in this manner chooles to fup- 

 ply her own wants by tlie dcvelopement of new organs." 

 Duhamel in Mem. dc I'Acad. des Sciences, 1746. 



The experiments of Duhamel were repeated by Mr. 

 Hunter with fimilar refulls ; and he even profecutcd the 

 enquiry further. Amongft other points, he endeavoured to 

 afcertain whether parts peculiar to the male would grow on 

 the female ; and if the parts of the female, on the contrary, 

 would grow on the male. He took the fpur from the leg 

 of a young cock, and placed it in the fituation of a fpur in 

 the leg of a hen chicken ; it took root : the eliickcn grew 

 to a hen ; but, at firft, no fpur grew ; while the fpur which 

 was left on the other leg of the cock grew as iifual. " This 

 experiment (fays Mr. Hunter) 1 have repciled feveral times 

 in the fame fummer with the fame effefts, which led mc to 

 conceive, that the fpur of a cock would not grow upon a 

 hen, and that they wcr« therefore to be confidercd aa dif- 



tincl 



