does this fibrous tissue take the place of normal cells, whose activity is of the utmost importance in preserving the health of the individual, but it invariably tends after a time to contract; from which contraction further damage and the gravest results are likely to ensue. It will be observed that in its simplest form a fibrotic change is of the nature of real repair. Thus, after a deep cut or extensive injury to the skin, we all know that a 'scar' results. This affords admirable protection to the damaged area. Nor does the subsequent contraction seriously matter. Care has to be taken to allow for it in the treatment of extensive burns, and considerable allowance is made for contraction in the suturing of skin incisions made in the course of an operation. But except when the scar is on the face, where it is objectionable for cosmetic reasons, a contracting superficial scar is seldom a cause of serious inconvenience. But the case is very different in the kidney or the spinal cord. Contraction there causes an extensive destruction of delicate cells, and, by cutting off the blood supply, a great impairment of function, if not actual necrosis, of an infinite number of cells which were not directly affected by the preceding inflammation. And so the vicious circle goes on.
