Charcot's Disease 533

163. Charcot's Disease of Left Knee 534

164. Charcot's Disease of both Ankles: front view 535

165. Charcot's Disease of both Ankles: back view 536

166. Radiogram of Multiple Loose Bodies in Knee-joint 540

167. Loose Body from Knee-joint 541

168. Multiple partially ossified Chondromas of Synovial 542
Membrane from Shoulder-joint

169. Multiple Cartilaginous Loose Bodies from Knee-joint 543

MANUAL OF SURGERY

CHAPTER I

REPAIR

Introduction--Process of repair--Healing by primary union--Granulation
tissue--Cicatricial tissue--Modifications of process of
repair--Repair in individual tissues--Transplantation or grafting
of tissues--Conditions--Sources of grafts--Grafting of individual
tissues--Methods.

INTRODUCTION

To prolong human life and to alleviate suffering are the ultimate
objects of scientific medicine. The two great branches of the healing
art--Medicine and Surgery--are so intimately related that it is
impossible to draw a hard-and-fast line between them, but for
convenience Surgery may be defined as "the art of treating lesions and
malformations of the human body by manual operations, mediate and
immediate." To apply his art intelligently and successfully, it is
essential that the surgeon should be conversant not only with the normal
anatomy and physiology of the body and with the various pathological
conditions to which it is liable, but also with the nature of the
process by which repair of injured or diseased tissues is effected.
Without this knowledge he is unable to recognise such deviations from
the normal as result from mal-development, injury, or disease, or
rationally to direct his efforts towards the correction or removal of
these.

PROCESS OF REPAIR

The process of repair in living tissue depends upon an inherent power
possessed by vital cells of reacting to the irritation caused by injury
or disease. The cells of the damaged tissues, under the influence of
this irritation, undergo certain proliferative changes, which are
designed to restore the normal structure and configuration of the part.
The process by which this restoration is effected is essentially the
same in all tissues, but the extent to which different tissues can carry
the recuperative