MEDICAL SCIENCE AND PEACTICE. 



551 



had caused the direction of too great a degree 

 of attention to details and single symptoms, 

 with a synthetic or constructive method, under 

 which a disposition has arisen to regard dis- 

 ease in a larger and more comprehensive man- 

 ner ; to view more prominently the relation of 

 morbid tissues and functions to the organism 

 generally; to emphasize less the variations 

 than the constitutional form of the disease; 

 and "to recognize, in some way or another, 

 the indefinable 'life' which is hardly known 

 to pathological anatomy." Under this syn- 

 thetical spirit the study of the ancient doctrine 

 of humoral pathology, which seeks for the 

 causes of disease, or of its first effects, in the 

 fluids of the body, has been revived. Kecent 

 progress in pathology has, therefore, been most 

 largely due to microscopic study. Substantial 

 and important aid has been given by organic 

 chemistry, but that science has not probably 

 fulfilled the expectations it excited some years 

 ago, and seems hitherto to have occasioned 

 some disappointment. Only the ultimate re- 

 sults of morbid processes can, as a rule, be 

 recognized by chemical tests too far removed 

 from the processes themselves to throw much 

 light upon them, and their application to path- 

 ological conditions is so ambiguous that no 

 safe deductions can be drawn from such tests. 

 Pathology has also received little aid from 

 therapeutics. 



By the establishment of a common basis of 

 elementary morbid lesions occurring in every 

 part of the body, the same morbid processes 

 are seen to take place in different structures of 

 the body, with primarily the same effects, which 

 are modified only by the function and charac- 

 ter of the tissue of the part involved. The 

 abnormal increase of connective tissue in the 

 structure of any organ, for instance, ends in 

 contraction, compression, and obliteration of 

 the structural elements, with consequent loss 

 of function. Inflammation occurring in any 

 tissue leads to effusion, extravasation, and sup- 

 puration. All the elementary processes of 

 pathology may be seen in different tissues and 

 organs, producing the same effects, only that 

 the effects are manifested in a manner peculiar 

 to each part; with the same fundamental le- 

 sion the disease is the same essentially, although 

 wholly distinct in appearance. Since the great 

 bulk of disease can be resolved into these fun- 

 damental processes, a scientific and durable 

 foundation for pathology is established which 

 is of the highest value and significance for phil- 

 osophical medicine. Under this view, diseases 

 of different organs, which, until their essential 

 elements were demonstrated, appeared to have 

 nothing in common, are now seen to be results 

 of the same process. Thus, a great tendency 

 may be observed at work toward the codifica- 

 tion and unification of disease, and the resolution 

 of complex forms into the simplest elements. 



Pathology as a science has also made a great 

 advance in the discovery of the microphytic 

 origin of certain specific diseases. Several af- 



fections of this class have been shown to be 

 caused by the development of minute organisms 

 within the system ; and it is affirmed that sep- 

 tica3mia has been traced to septic bacteria, re- 

 lapsing fever to the spirilla, ague to the bacil- 

 lus malaria, leprosy to the lepra bacilli, tuber- 

 culosis to the tubercle micrococcus, splenic fever 

 to the bacillus anthracis, and the condition 

 termed " chyluria " is caused by a nematoid 

 known as the filaria. The multiplication of 

 such organisms in the blood, and their conse- 

 quent aggregation in the spleen, supplies a sat- 

 isfactory explanation of the salient phenomena 

 of diseases of this class ; and it is naturally in- 

 ferred that other affections of a similar type 

 have a like origin. 



The more recent development of the micro- 

 phytic or germ theory of disease is exemplified 

 by the researches of Drs. Klebs and Tommasi 

 Crudelli into the cause of the malarious prop- 

 erties of the Eoman Campagna, which they 

 have traced directly to an organism (the bacil- 

 lus malaricK) inhabiting the soil ; and in the re- 

 searches of Professor Klebs and Dr. Schuller, 

 which have indicated a micrococcus spreading 

 rapidly in the blood and tissues as the probable 

 cause of tubercular and scrofulous diseases. M. 

 A. Laveran has made a report upon certain 

 forms of organisms which he has found in the 

 blood of patients suffering from malarial dis- 

 eases, while he has not noticed them in other 

 persons, the remarkable susceptibility of which 

 to the influence of quinine may go far to ac- 

 count for the potency of that medicine in such 

 diseases. Experiments made by Krebs, Tizzini, 

 and Bruntlecht to determine a microphytic or- 

 igin for typhoid fever have resulted in the dis- 

 covery of organisms which they have associated 

 with the cause of that disease, but they are not 

 yet regarded as fully conclusive. Drs. H. C. 

 Wood and Henry Formad, acting in co-opera- 

 tion with the National Board of Health of the 

 United States, have made experiments in rela- 

 tion to the transmission of diphtheria, the re- 

 sults of which indicate that that disease is also 

 caused by micrococci which may exist within 

 the system in different degrees of activity 

 moderate in ordinary sore-throat, intense and 

 malignant in diphtheria. 



On the other hand, M. Bouchardat, acting 

 under the direction of the municipal authori- 

 ties of Paris, has examined the sanitary effects 

 of some of the mephitic odors with which that 

 city has been troubled, and has concluded that 

 they are not seriously injurious in the absence 

 of microphytic germs, unless the gases that 

 occasion them are present in such bulk as to 

 operate as poisons. A commission has also 

 been engaged in Paris in the examination of 

 the effect of cemeteries on the public health, 

 and has found that under all ordinary condi- 

 tions of good management they are free from 

 the deleterious qualities that have been popu- 

 larly ascribed to them. It is not denied, how- 

 ever, that cemeteries may be so carelessly kept 

 as to become dangerous. 



