The principles of surgery / by James Miller.

  • James Miller
Date:
1844
Catalogue details

Licence: Public Domain Mark

Credit: The principles of surgery / by James Miller. Source: Wellcome Collection.

    691/736 page 675
    The plasma having been exuded, consolidates ; its serous por- tion is absorbed ; the fibrin remains, and becomes organized. And this organizing plasma not only occupies the pouch, but is also situate between the fractured ends of the bone, and in their interior. At the same time, a fibrinous exudation is taking place in the soft textures exterior to the pouch, whereby they are still further condensed and tumefied. A portion of this is imperfectly organized; and remains for a time—sometimes con- siderable. The rest is absorbed, previous to organization, on subsidence of the vascular action by which it was induced. That action is a part of the inflammatory process ; but only a part. It never rises higher than active congestion, otherwise the process of repair were arrested and undone. 3. The period of plastic exudation may be said to have passed, after eight or ten days. Then the process of organization advances. The plasma becomes vascularized, and passes into the transition state of cartilage. 4. The organized and transitional mass con- tracts, by interstitial absorption ; increases in density; and gradually passes into the condition of bone. At the same time, the surrounding parts, where immediately in contact with the ossifying mass, are more and more condensed ; become conti- nuous with the ruptured and engorged periosteum; and assume the general characters of that texture, as well as its function of investing and administering to bone. 5. Ossification ad- vances, from the periphery. The most exterior part of the plasma is the first ossified ; and thence the ossification gra- dually approaches the interior. In obedience to the general law, the first act in the process would seem to be that of the parent bone. Nodules of new osseous matter form on it, where in contact with the ruptured periosteum—the bare extremities themselves undergoing an opposite change as yet, parting with a large share of their original earthy matter, as already stated. These nodules would seem to constitute the nucleus or base of the new bony structure ; and are found on each fragment, and on its every aspect. From these nuclei the ossification advances, and a case of bone forms on the exterior of the plasma ; advancing from each fragment, and meeting near the centre of the space ; the ossification begun by the original bone, continued and maintained by the soft parts—first by the original periosteum, and then by the ordinary textures which.
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