Thus the vasa vasorum, ramifying on the divided ends of the minute
vessels, secrete a substance which is transformed into a set of minute
capillaries, and these also, assuming a secretive action, produce an
arterial or venous tube, similar to that nourished by the original
vasa vasorum. By this process the lymph becomes well supplied with
bloodvessels, those from the opposite surfaces meeting, and freely
inosculating with each other. These bloodvessels, as already stated,
have been produced from arteries possessing different powers, and hence
the newly-formed assume actions similar to those of the primary, and
thereby interstitial matter is deposited of its proper kind and in
its proper place, a cuticular membrane superficially, then cellular
tissue, afterwards muscular, and so on according to the primary tissues
which had been divided; these parts do not at first resemble exactly
the corresponding natural tissues, but, by the continued action of
the new vessels and capillaries, they are moulded and prepared for
the due performance of their respective functions. If the degree of
action necessary for the accomplishment of these processes increase to
inflammation, adhesion is interrupted till the action be lowered to its
previous standard.
From this view it is evident, that, besides a certain excitement of
the bloodvessels, it is necessary that the raw margins be in close
apposition, and carefully retained so, for, by ever so slight movement
of the parts, the recent and delicate bond of union will be ruptured;
and, if this motion be allowed to continue, adhesion may be at divers
times begun, but can never be perfected. Whereas, if the necessary
precautions are adopted, union is often completed in thirty or forty
hours, sometimes sooner, seldom later. From a knowledge of the
astonishing powers of nature in repairing injuries, many and important
improvements have of late years been made in the practice of surgery.
In the majority of instances it is also requisite that the parts be
brought in contact soon after division, otherwise granulation will have
commenced in the different parts of the wound, and the surfaces then
approximated will not so readily adhere: pus is formed, and, having
lodged between the surfaces, acts as an extraneous substance, keeping
them apart, and separating them still farther by its accumulation.
All foreign bodies in the wound must be removed before adhesion can
occur; and, on the same principle, care ought to be taken that no
effused blood be interposed. In many cases the margins of the wound
can be accurately adjusted by careful attention to the position of
the part, or by the application of a few strips of adhesive plaster;
but the latter, from indiscriminate use, often prove the source of
much irritation, and totally frustrate the end for which they are
designed. When employed, they ought to be narrow and few. If such means
be considered insufficient, recourse must be had to a few points of
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