256 LECTURE XI. 



larger than perhaps is necessary, for it seems indeed that 

 here and there mistakes have slipped in, which should, I 

 think, be again removed from the history of the affection. 

 But unquestionably there is a state in which coloured 

 elements are met with in the blood that do not belong to 

 it. Isolated observations in support of this fact have 

 already for a considerable length of time * been upon 

 record, and indeed first occur in the history of melanotic 

 tumours, concerning which it has frequently been de- 

 clared that in their neighbourhood minute black particles 

 are met with in the vessels, and the opinion put forward 

 that from this source the melanotic dyscrasia arose. But 

 this is not quite the condition which is meant when me- 

 lanaemia is now-a-days spoken of. In the last ten years 

 not a single observation has been made known which in 

 any way adds to our knowledge concerning the passage 

 of the particles of melanotic tumours into the blood. 



The first observation concerning that class of diseases 

 which in a narrower sense of the word is designated me- 

 lanaemia, was made by Heinrich Meckel in the case of a 

 lunatic a short time after I had published my description 

 of leukaemia. Meckel found that here too the spleen was 

 enlarged in a very considerable degree and pervaded by 

 black pigment, and he therefore ascribed the change in 

 the blood to an absorption of coloured particles from the 

 spleen. The next observation I made myself (and that 

 too in a class of cases which afterwards proved very fruit- 

 ful) in the case of an ague-patient, who had long been 

 afflicted with a considerable enlargement of the spleen ; 

 for I found h^the blood of his heart cells containing pig- 

 ment. Meckel had only observed free granules and 



* Dr. Stiebel, sen., of Frankfort-on-the-Maine, calls my attention to the fact that 

 he had already in a review of Schonlein's Clinical Lectures (in Haser's Archiv'), 

 mentioned the occurrence of {lment-cells in the blood. 



Note to the Second Edition. 



