_Such is granulation tissue_: at first a mere trelliswork of temporary and delicate cell structure, traced in a certain amount of intercellular, homogeneous substance, into which the budding vessels project, the whole mounting, nearer and nearer to the surface, day by day, with variable rapidity, diminishing in this regard as the days go by, so that frequently the granulation process comes to an apparent halt before enough new tissue has been formed. While the superficial granulations preserve the characteristics above noted, those deeper down undergo firmer and more complete organization, and the delicate embryonic structures show the same tendency which they do in the growing embryo, by virtue of what Virchow has called _metaplasia_, to become converted into something higher and more dignified in the tissue scale. These cells do not specialize themselves to the extent of permitting complete repair of organs of special sense. Thus, while a wound in the cornea or retina may be completely healed, it heals by cicatricial tissue, and not by repair of the special structures involved. On the other hand, tissues of more common connective type--fibrous, bone, cartilage, etc.--are capable of regeneration; and it seems to be a part of the privilege of these new granulations to merge themselves into that kind of tissue necessary for filling the gap. Nevertheless the most _common result of granulation is its metablastic conversion_ into fibrous tissue, which has the special characteristic of contractility without elasticity. As a result the _scars contract_, in consequence of which disfiguring results are sometimes the almost inevitable consequence of healing of extensive losses of substance. In certain instances it is possible by constant effort to overcome the unpleasant effect of this cicatricial contraction. For example, after extensive burn of the anterior part of the arm, the forearm will be gradually and permanently flexed upon the arm by virtue of contraction of the scar in front of the elbow unless some forcible means is practised for maintaining extension of the limb for at least a part of the time. So with many other injuries and the various mechanical or other expedients required to prevent the untoward result. Nowhere are the after-effects more disfiguring or serious than about the face, where the eyelids are drawn out of shape, the contour of the mouth altered, and where, sometimes, there are other extensive manifestations (Figs. 10 and 11). [Illustration: FIG. 10 Cicatricial deformity following burn. (Original.)] [Illustration: FIG. 11 Cicatricial deformity following burn: side view of same case.] [Illustration: FIG. 12 Epitheliomatous degeneration of chronic ulcer, necessitating amputation. (Original.)]