General Anatomy, Applied to Physiology and Medicine, Vol. 1 (of 3)Bichat, Xavier
Science
General Anatomy, Applied to Physiology and Medicine, Vol. 1 (of 3)
Bichat, Xavier
Human anatomy; Human physiology
The production of fleshy granulations succeeds to inflammation. It
presents the following phenomena; small reddish bodies, like tubercles,
arise, unequal and irregularly disposed upon the surface of the wound;
they are not fleshy, as their name, given, no doubt, on account of
their colour, would indicate; they are little cellular vesicles, filled
with a thick substance, like lard, which we are unacquainted with, and
which it is important to analyze. This substance so fills the cells,
that in blowing air into the texture subjacent to a wound, whether in a
living or dead body, this fluid does not enter the granulations; they
are raised up entire, but no one of them is developed or distended as
the cells which this substance does not fill; the granulations remain
the same in the midst of the general bloating. I have often made these
experiments upon animals that I have wounded for the purpose.
In proportion as the granulations are developed upon an exposed
cellular surface, we see them unite together, and form, by their
union, a kind of provisional membrane, which absolutely prevents the
contact of air upon the subjacent organs, while the true cicatrix,
that which is to be permanent, is forming. This provisional membrane
of cicatrices, this kind of epidermis destined to defend the parts
during the work of cicatrization, differs from common serous membranes
in this, that they are smooth and every where uniform, whilst the
granulations produce here an unequal and rough surface. This inequality
of the granulations and their separation, appear to be opposed to what
I have said concerning the first state of cicatrices; the following
experiment leaves no doubt upon the subject. I made a large wound
upon a dog, and let it go through its first periods; the animal was
then killed. I removed a portion of flesh upon which the granulations
were developed; I distended it by a prominent body, placed on the
side opposite to the granulations, so as to make the granulated
surface convex, that had been concave; the tubercles were effaced; the
provisional pellicle, stretched out, became very evident; it might have
been taken for an inflamed serous membrane.
It follows hence, that when the granulations are united together, that
the air is entirely excluded, and that what is commonly said of the
contact of this fluid is inaccurate and contrary to the arrangements
of nature, which knows how better than we can do by our dressings, to
cover over a divided part, whilst the work of cicatrization is prepared
and effected.
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