410 
J. A. SLOAN. 
regardless of the presence or absence of foreign material. If 
proliferation is repeatedly interfered with, as, for instance, be¬ 
cause of great irritation by pathogenic germs or external vio¬ 
lence, the cells lose their power of regeneration and an ulcer is 
the result. On the other hand, proliferation in a healthy 
patient may be so active and extensive that exuberant granula¬ 
tions appear with a considerable thickening of the adjoining 
parts. At this stage anything that will reduce inflammation 
will check granulation. 
Wounds are divided according to cause into : Incised, punc¬ 
tured, lacerated, contused, etc. In veterinary practice external 
wounds are generally infected. This condition it is impossible 
to avoid because of septic surroundings and the impossibility in- 
many cases to apply a bandage. 
Wounds are said to heal by first intention, second intention, 
granulation, etc. The reparative process is much the same in 
all of these, for in all there has been destruction of tissues and 
regeneration is necessary to repair. Therefore such a classifica¬ 
tion seems unnecessary except as a matter of convenience. 
There is a macroscopic difference in the healing of a wound 
whose edges are held in close apposition and whose changes are 
hidden from the eye, and that of a large, open wound where 
the granulations can be plainly seen, but practically the means 
of repair are similar. 
Healing by first intention occurs in slight aseptic wounds 
where there is a little destruction of tissues, in incised woujids 
and where the edges can be brought in close apposition. If 
there is no foreign material to be eliminated there should be an 
almost imperceptible amount of inflammation present and very 
little exudate to be absorbed or otherwise disposed of. Union 
is then hastened by plastic adhesion of opposing edges by 
means of the serous exudate. This adhesion plays a passive 
part in regeneration of wounds and, as repair progresses, is ab¬ 
sorbed. Adhesion has been mistaken for healing and desiccation 
of the exudate for formation of a scab. That this adhesion is not 
healing is proven in cases where pus germs have been enclosed. 
