191 



known. Again, very small objects (such as the cephalic 

 ganglia of beetles) can be accurately adjusted to the knife and 

 cut with precision. — T. Hawksley. 



Corpuscular Blood;elements in the Urine in Bright's Disease.— 

 Most general practitioners of medicine, when called upon to 

 investigate an obscure case of Bright's Disease, have probably 

 felt the want of some more definite guides to the exact con- 

 dition of the kidneys than those furnished by the proportion 

 of albumen in the renal secretion, or the character of the tube- 

 casts wliich the urine contains ; and although it seems at 

 first sight an arduous task to attempt supplying the student 

 Avith any additional aid beyond that afforded by the admirable 

 manuals published by Doctor Dickinson, and, more recently, 

 by Doctor Grainger Stewart, yet my connexion with the 

 hospital has enabled me to carry on some researches Avhich, 

 enlightened by the new discoveries in regard to pus and 

 mucus, may serve to render certain doubtful cases of this 

 affection somewhat clearer than they would be without such 

 assistance. It seems remarkable, indeed, how meagre are 

 the references to the diagnostic importance of blood in the 

 urine made in the monograms above mentioned ; the former 

 of these gentlemen observing in respect to casts (p. 18): — " If 

 pus [white blood] cells are included, the inflammatory or 

 catarrhal state has taken such hold of the tubes that the 

 epithelial cells are replaced by pus-globules. Blood-globules 

 will show that there has existed enough congestion to rupture 

 the Malpighian capillaries." While the latter dismisses the 

 subject with little more than the statement (p. 15) : — " And, 

 lastly, some [casts] are found in which blood-corpuscles in 

 varying quantity are present. Along with the tube-casts, 

 and sometimes in large quantity, blood-corpuscles altered by 

 the action of the fluid in which tliey lay [sic], are found." 



As, however, the important advance in pathological science, 

 to which I have alluded, is still spoken of in this country 

 under the title of " Cohnheim's alleged Discovery," it may 

 not be unnecessary to advert briefly to its merits and the 

 testimony which supports it. Dr. Cohnheim, as the readers 

 of this Journal are aAvare (see number of this Journal for 

 Oct., 1869, pp. 549 — 552), first published his theory of 

 inflammation, and detailed the original and ingenious ex- 

 periments from which it was built up, in a leading article in 

 ' Virchow's Archives' for September, 1867, which soon 

 attracted everywhere the notice of histologists. According to 

 Colt^iheim the process of pyogenesis consists, first, in a partial 

 interruption of the flow of blood by which the red corpuscles 

 move more slowly tlu-ough, or almost block up, the capil- 



