The granulations are pale, and imperfectly formed, partaking less of the firmness and organisation of the healthy fleshy granulations in proportion to the affection of the action. They are obtuse, and scarcely at all elevated; and, therefore, the surface loses its doted, or red pointed appearance. The discharge is thin, and of a whitish colour, at the same time that we frequently observe isolated spots of lymph interwoven here and there with the imperfect granulations. Although these granulations are said not to be elevated, yet the surface often exhibits a species of fungus; but the individual granulations are not elevated, or pointed. This fungus never rises higher than the twentieth part of an inch above the level of the surrounding skin[50], and often appears only at particular parts of the surface. It is pale, and somewhat of a gelatinous appearance. The pain is trifling. [50] The cause why these granulations rise, even this trifling height, above the level of the skin, is the indolence of the action, which prevents a cuticle from being formed in due time. In more advanced cases, the whole disk is covered with a thin layer of lymphatic substance, which adheres firmly, and gives the idea of a thin pellicle being thrown over the granulations, which are seen imperfectly and irregularly through it. The discharge is generally thin, like serum, and considerable[51]. The edges are hard and tumefied, sometimes of a light purple colour, at other times white[52]. The surrounding integuments are also hard and thickened, at least in old ulcers, and the veins are generally more or less varicose. [51] Indolence of the action does not imply that the quantity of a discharge should be lessened, but only that its nature should be changed. In this species, the discharge is much the same in quantity as in a healthy ulcer of the same size, but its perfection is greatly less. [52] Sometimes the granulating action and the cicatrizing one seems to be confounded, the surface exhibiting a fibrous fleshy appearance. This I have seen most frequently in the calf of the leg; but it may occur in other parts. These appearances vary in degree from the soft pale surface, and thin whitish purulent discharge, with slightly thickened edges, to the state now described. The pain, when compared to the size of the ulcer, is not considerable. This genus may occur, in a slight degree, in recent sores, from neglect, &c.; but it is chiefly after ulcers have been of long standing, that they assume these appearances in the greatest degree. They may then be said to have become chronic, or habitual; and, in many instances, it is absolutely impossible to restore the action to its natural state, and produce recovery[53]. [53] These ulcers, after long continuance, frequently induce a disease in the bones or muscles seated below them, as will afterwards be mentioned.