The mucous membrane, after being torn through and reflected covers over the area of the resulting wound. _The planning of the operation should be so carried out that the torn edges of the mucous membrane may unite with the cut edge of the skin._ This approximation is not usually complete all round the wound. The tearing through of the mucous membrane produces a narrow V shaped rent; this is widened out when the membrane is reflected, and if carefully apposed to the cut skin, will unite with it. But the edge of that portion of the membrane peeled off from the under surface of the glans will often fail to unite with the exit edge of the skin on the under surface of the penis. It frequently does not reach as far back as the cut skin, especially when the foreskin has been freely removed or when the mucous membrane has a tendency to curl up. The result in the majority of circumcisions is that the upper portion of the wound heals rapidly, where the lacerated edge of the mucous membrane has united to the cut edge of the skin, while on the under surface, the mucous membrane will adhere to the raw surface of the penis left by the retracting skin, but there will probably be a gap where the membrane has failed to reach the cut edge of the skin. This gap will necessarily be very small when the reflection of the mucous membrane has been complete. Where approximation of the two edges occurs union is rapid and healing by “first intention” results. Where some loss of substance occurs the gap becomes gradually filled by what is called _granulation tissue_, and the term “second intention” is given to the healing process. _Healing by first intention._ In amputating the foreskin a number of minute hair-like blood vessels which permeate the skin are cut through. There is little or no bleeding, because the blood immediately clots, and almost at once a rim of coagulum is formed at the margin of the circumcision. Besides this the injury destroys a minute amount of living tissue known as _connective tissue cells_. The wound causes a special degree of activity in the adjacent blood vessels, so that certain important constituents of the blood flow out of the vessels and invade the cut margin where the blood has coagulated. This invasion consists of the fluid portion of the blood--or lymph, and the solid elements called white corpuscles--or leucocytes. These latter remove the cells which have been killed by the injury, and get rid of the blood clot, probably by a process of digestion. When this is effected, the way is paved for the healing, i.e. the formation of the scar.