DEVELOPMENT IN NINETEENTH CENTURY 327 



than the control tests with Calmette's anti-venom serum. Vital 

 called the serum anti-ophidic, and he reported 21 cases of bite of 

 venomous reptiles with recovery, without any appreciable clinical 

 symptoms. The strength of this anti-ophidic serum is shown by 

 the fact that even a fraction of a milligram of the snake- venom 

 causes severe symptoms to appear when injected into lower ani- 

 mals. In three of the 21 cases, the symptoms appeared almost 

 immediately after the bite of the snake, and were most pronounced 

 in type. In these three cases, however, 20 cc. to 60 cc. of the anti- 

 ophidic was injected and recovery took place, notwithstanding two 

 hours had elapsed in one case, and three hours in another case. 

 Vital has also prepared a special serum for the bite of rattlesnakes. 



In India, 22,000 persons and 60,000 cattle die each year from 

 the bites of the poisonous ophidia. Many of these deaths can now 

 be prevented by inoculation of the anti-venene. In tuberculosis 

 the mortality has been reduced 50%. Koch's wonderful discovery 

 is an enduring monument to his greatness. In Germany alone 

 90,000 persons die annually from tuberculosis. This gives us an 

 idea of the far-reaching influence of Koch's marvelous discovery. 



Blood analysis has had much to do with the development of 

 surgery, and affords a most valuable diagnostic aid. Without this 

 contribution from the science of hematology the development of 

 surgery would never have reached its present state. This is not the 

 place to enter upon any discussion of blood analysis except as it 

 pertains to surgical diagnosis, by means of which the broad field of 

 operative surgery has been enlarged. In speaking of blood analysis 

 a reference only will be made to the influence it has upon operat- 

 ive surgery. Blood analysis makes certain the diagnosis in some 

 surgical diseases, it aids in the diagnosis of other diseases, and it 

 helps to diagnosticate a condition, where from unconsciousness, 

 inability to speak, insanity, or malingering, a history is unattain- 

 able. The chief points to ascertain are the number of erythro- 

 cytes, the leukocytes, the ratio of one to the other, the number 

 of blood plaques, and the ratio to each other, the size, form, and 

 contents of the blood-cells, the amount of hemoglobin and of fibrin, 

 the specific gravity of the blood, and bacteria contained in it. The 

 erythrocytes or red blood globules normally exist in the blood in 

 the proportion of about 5,500,000 in a cubic millimeter. The term 

 oligoc}^t hernia indicates a deficiency in the number of red blood 

 globules, or a diminution of their relative proportion. The term 

 poikilocytosis indicates an irregularity in the shape and size of the 

 globules, and an increase in the red blood globules is called poly- 

 cythemia. Now oligocythemia is observed in hemorrhages, anemia, 

 etc. Polycythemia is observed in cases, where there is a loss of 

 fluid from the blood as in cholera, severe diarrhea, etc. The leuko- 



