ADHESION, (from ad-hccrere, Lat. adhesio, Fr. adherence, Germ. wiederanheilung, Ital. ade stone,) that process, by the occurrence of which, when two living surfaces, naturally or artifi cially separated the one from the other, are brought into mediate or immediate contact, and inflammation is developed, those surfaces may become adherent the one to the other.
This adhesion may be effected either by the intervention of a stratum of exhaled fibrino albuminous matter, inorganic in the first in stance, but at a subsequent period acquiring organization, and becoming a perfect and per manent cellular bond of union ; or it may not occur until after suppuration has been estab lished and granulating surfaces are presented ; these surfaces enter into adhesion, and in this case the bond of union is not so decidedly cellular in character as in the former ; it is more or less dense and fibro-cellular.
In either case, the medium of union pre sents peculiar modifications dependent upon the tissue on which it is developed. This circum stance, and especially the depoSition of osseous matter, where bony union is required, was one of the strongest arguments used for the purpose of establishing the existence of the presiding intelligent principle of Stahl.
If the first process, that in which the fibrino albuminous exhalation obtains, be interfered with, that is, if a more intense degree of in flammation be developed, such exhalation can no longer occur, but the second state, that in which a purulent exhalation shall be the pro duct, may be induced.
It is upon this principle, viz. that a certain quantity of inflammation shall predispose to the first species of union, which is termed union by the first intention ; and that a greater quantity may produce a purulent exhalation, and therefore be opposed to such union, that is founded the following precept. " When it is deemed prudent to prevent union by the first intention, we have merely to introduce between the surfaces, and retain there from eighteen to twenty-four hours a piece of lint, by which a sufficient degree of inflammation will, usually, be excited to ensure a suppurating surface."
From the time when the phenomena of in flammation were first carefully studied, until very recently, it has been commonly, if not uni-' versally maintained, that adhesion could never be accomplished in the absence of inflamma tion.
In the present day, Breschet and some others have endeavoured to establish that adhesion does not, necessarily, imply the pre-existence or' co-existence of inflammation ; and as it appears to me upon very insufficient evidence. They say that adhesion may result from a " primitive disposition of the organization," and as evi dence of the existence of this disposition, they refer to certain congenital affections, occlusion of the eyelids, and of the lachrymal canal, imperforations of the mouth, the anus, and so on. Why they should assume that phenomena, the mechanism of which appears identical, should be effected by a totally different agency in intra and in extra-uterine life, it is not easy to understand, and I believe such is not the fact.
We may have certain, of these occlusions, accomplished in extra-uterine life, but never without the intervention of inflammation ; and what possible reason have we for supposing that if these occlusions do commonly, nay always, occur in consequence of the develop ment of inflammatory action, that this agency shall be wanting during uterine life ? None, I apprehend, beyond simple assumption.
Imperforation of the eyelids and occlusion of the lachrymal canal differ from imperfora tion of the mouth and of the anus, in that the former result, not from the presence of an anomalous membrane, but only from the union of existing membranes, which are normally separated the one from the other. In the greater number of cases the eyelids are simply adherent, either at one or many points, or along the whole length of their border, and I would say are always so in consequence of inflammation.