REVIEW.—RENAULT ON TRAUMATIC GANGRENE. 659 
“ This is the first degree of influence on wounds which we attri¬ 
bute to the atmospheric air—namely, to become an obstacle to their 
union by the first intention. 
“ When the cicatrization by the immediate adhesion cannot be 
obtained, the cellular tissue which enters into the composition of 
the exposed parts becomes modified. It is injected and vas¬ 
cular, and covered with granulations or minute buds, which, 
uniting together, form a protecting membrane between which is 
' deposed and organized, sheltered from contact with the air, that 
reparatory fluid the coagulable lymph. Under the influence of the 
affinities of atmospheric air, the primitive adhesion of the lips of a 
wound will never take place. 
If among our domestic animals, and especially the herbivorous 
ones, the cure of these lesions is often so troublesome, it is because 
we cannot by means of bandages maintain the lips of the wound 
in perfect apposition. Where we can effect this, or approach to it, 
there is no great difficulty in accomplishing a cure. 
“ The coagulable lymph, however, is not the only agent in the 
reparation of wounded parts. The blood, when it is no longer in 
circulation, or when it overflows its vessels, preserves its plastic 
power, and serves as the nucleus for fresh organic composition; but 
with it, as well as the coagulable lymph, this property exists only 
so long as it is kept from the influence of the air. Thus, when 
blood is enclosed between the lips of a wound immediately and 
perfectly brought into contact with each other, it unites with the 
coagulable lymph in accomplishing their primitive adhesion; but 
if the lips of the wound are not in perfect apposition, the air, pene¬ 
trating into the interior of the wound and coming in contact with 
the blood, changes and decomposes it. 
“ In this case one of two things happens, either blood, in a state 
of putrid decomposition more or less advanced, is eliminated by the 
purulent secretion of the vascular membrane which is formed on 
the surface of the wound, or it modifies, in a peculiar manner, the 
tissues with which it is in contact, and becomes the especial point 
of various remarkable phenomena. The modifications and pheno¬ 
mena which result from the contact of the blood, changed by the 
action of the air, with the exposed tissues, constitute the principal 
object of M. Renault’s work. 
“ I may, perhaps, be permitted to enter into a few details, illus¬ 
trating the importance of this point of surgery. 
I have spoken of the changes which take place in the interior 
of the tissues whose continuity was of so much importance, and of 
the beautiful proceedings of nature to restore that continuity ; but 
in some circumstances the ph(;nomena are very different. A wound 
is effected—the regif)n in which it occurs becomes considerably 
