which forms the union by the first intention: for union by the first intention is no more than the living parts when separated, whether naturally, or by art, forming a reciprocal attraction of cohesion with the intermediate coagulum, which immediately admits of mutual intercourse, and, as it were, one interest."[9] "When the blood has coagulated, so as to adhere to both surfaces and to keep them together, it may be said that union has begun."[10] "The uniting medium becomes immediately a part of ourselves, and the parts not being offended at it, no irritation is produced." "If the quantity of blood extravasated be large, the whole will not become vascular, but the surface only, which is in contact with the surrounding parts."[11] The process thus described in general terms may take place in serous cavities. In the third plate at the end of Mr. Hunter's work, is represented a coagulum of blood adhering to the _tunica vaginalis_. "The adhesion was firm, though it admitted of a separation at one end; when separated, fibres were seen running between it and the testis." [8] Vol. x, p. 45-82. [9] Op. cit. p. 26. [10] P. 200. [11] P. 205. It might seem unnecessary to dwell upon this process further, had not some of the highest authorities in surgery, both here and on the continent, described it as identical with adhesive inflammation. Thus Bichat[12] says, "The cicatrization of wounds in veins after bleeding is a result of inflammation." Now, it is submitted, that when the blood coagulates, either in serous cavities or in veins, the process of union is not usually one of inflammation, or one in which the powers of the constitution are called into increased activity. It is true, that in both cases, inflammation may take place, and lymph, as the result of such inflammation, may be secreted; but this is only when, to use Mr. Hunter's language, the "primary intention" has not been fulfilled.[13] [12] Anatomie Générale, vol. ii, p. 423. [13] In speaking of the two principles, I shall use the term by "first intention", to designate that the fibrin is derived from coagulated blood; and restrict the term "adhesive inflammation" to indicate the effusion of lymph from inflamed vessels. When a membranous layer of lymph is deposited from effused blood, it adheres with some firmness to the surface with which it is in contact; but, as there is at first no vascular connexion established between them, it may be separated, leaving the part to which it adhered in its natural condition. Lymph derived from adhesive inflammation, on the other hand, when separated, leaves the surface upon which it was formed rough and uneven. Coagulated fibrin, when recently deposited, may thus be distinguished from effused lymph.