Page 127 - My FlipBook

INFLAMMATION. 125
a jelly-like consistence, and somewhat smooth and firm. Its
surface, when in a normal condition, is studded over with small
conical prominences called granulations^ in which very minute
vessels are situated very superficially. Healthy granulations are
also non-sensitive, elastic, and discharge laudable pus. Unhealthy
granulations are coarse, dark red in color, and bleed readily.
Pus of a yellow color is found between the granulations, which
vary in size, form and color, a moderate bright-red color being in-
dicative of a healthy healing process.
When there is a want of power in the process of forming the
cicatricial or repair tissue, the granulations become large and trans-
lucent, and the pus which surrounds them is pale and thin. If
the affected surface is exposed to friction, or irritation from other
causes, the granulations become extremely small and of a deeper
red color than is normal, and at length may disappear at points,
leaving grayish spots or smooth patches. If the process of
cicatrization is prevented in its first stage, the granulations become
large and coalesce, protruding and overhanging the edges of the
wound, and forming what is commonly known as " proud flesh."
During the entire healing process a flow of pus is going on from
the affected surface as a normal act, and the first appearance of it
is indicative of repair. Its appearance is also coincident with the
organization of plastic lymph. When the suppuration is well
established, the heat, tension and swelling of the inflamed part be-
comes less in degree, and the frequency of the pulse and the tem-
perature of the body diminish. Whenever the granulating sur-
face is formed, union by the second intention^ or second adhesion^ as
it is termed, will take place, if separated surfaces are brought into
apposition.
Origin and Characteristics of Pus.— Pus is a secretion furnished
by the blood at the expense of the tissues, an exuberant quantity
of plastic material, for which excess there is no demand in the
reparative process. The leucocytes which are brought to the
surface of a granulating wound are discharged from it in the form
of pus, while those that remain behind develop into tissue. This
effect, by which the excess of leucocytes is gotten rid of, is ac-
complished by liquid exudation, the supply of which comes from