#Clinical Examination of an Ulcer.#--In examining any ulcer, we
observe--(1) Its _base_ or _floor_, noting the presence or absence of
granulations, their disposition, size, colour, vascularity, and whether
they are depressed or elevated in relation to the surrounding parts. (2)
The _discharge_ as to quantity, consistence, colour, composition, and
odour. (3) The _edges_, noting particularly whether or not the marginal
epithelium is attempting to grow over the surface; also their shape,
regularity, thickness, and whether undermined or overlapping, everted or
depressed. (4) The _surrounding tissues_, as to whether they are
congested, œdematous, inflamed, indurated, or otherwise. (5) Whether or
not there is _pain_ or tenderness in the raw surface or its
surroundings. (6) The _part of the body_ on which it occurs, because
certain ulcers have special seats of election--for example, the varicose
ulcer in the lower third of the leg, the perforating ulcer on the sole
of the foot, and so on.

#The Healing Sore.#--If a portion of skin be excised aseptically, and no
attempt made to close the wound, the raw surface left is soon covered
over with a layer of coagulated blood and lymph. In the course of a few
days this is replaced by the growth of _granulations_, which are of
uniform size, of a pinkish-red colour, and moist with a slight serous
exudate containing a few dead leucocytes. They grow until they reach the
level of the surrounding skin, and so fill the gap with a fine velvety
mass of granulation tissue. At the edges, the young epithelium may be
seen spreading in over the granulations as a fine bluish-white pellicle,
which gradually covers the sore, becoming paler in colour as it
thickens, and eventually forming the smooth, non-vascular covering of
the cicatrix. There is no pain, and the surrounding parts are healthy.