NA PORE 
477 
THURSDAY, MARCH 22, 1883 
PATHOLOGICAL ANATOMY 
A Text-Book of Pathological Anatomy and Pathogenesis. 
By Ernst Ziegler. Translated and Edited for English 
Students by Donald MacAlister, M.A., M.B., St. John’s 
College, Cambridge. 8vo. (London: Macmillan and 
Co., 1883.) 
OR some years the student of medicine has felt 
the want of an English manual of modern Patho- 
logical Anatomy. He has been compelled either to trust 
entirely to his teacher, or to consult works and memoirs 
little adapted for beginners. This felt want the English 
edition of Ziegler’s Pathology, when completed, will in 
great part meet. The author believing ‘that the learner 
gains a readier grasp of his subject when it is first 
presented to him as a uniform and coherent system of 
doctrine,” has, by avoiding “ much matter of controversy,” 
succeeded in making a clear and concise statement of 
each subject treated. In this the author has been well 
seconded by the editor, who, by carefully revising and 
amending the original, by adding numerous references to 
English and French memoirs, and by otherwise with 
characteristic ability adapting the work for English 
readers, has greatly enhanced its value. 
Although the authors have kept the student chiefly in 
view in preparing this manual, a glance at the small 
print and the numerous references given, will at once 
prove that those desirous of gaining an exhaustive know- 
ledge of the subject, and those engaged in special investi- 
gations, have not been neglected. It seems to us that 
this is by far the best plan for a text-book. It is to be 
regretted that students at the present day read so little. 
In many instances they content themselves with “learning” 
in order afterwards to retail what they purchase from their 
teachers ; or what is worse, when they are unfortunate 
enough not to have their teacher as one of their examiners, 
they “get up’’ an endless number of often useless facts, 
derived from all possible sources, before presenting them- 
selves for examination. This waste of time and energy 
in great part results from the want of good text-books. 
The books available are generally too large, they are 
often quite beyond the grasp of the beginner, and at the 
same time not a little out of date. In order to be able to 
utilise fully the opportunities now offered for gaining a 
practical knowledge of pathology, and other allied sub- 
jects, lectures are not.enough; there must be something 
to fall back upon, by means of which the impressions 
received from the teacher may be tested, something that 
will form a foundation on which an intelligent knowledge 
of the subject may be built. We believe that the work 
before us will serve this purpose, and that it will be 
equally useful to the teacher by enabling him to take for 
granted that the fundamental facts of his science can be 
again and again referred to as the student requires, and 
by providing short, concise statements which he can 
modify at will, and to which he can add much that is of 
historical interest, or that is too recent for any manual, 
however complete, to contain. 
The volume now published deals with General Patho- 
logical Anatomy. It is divided into seven sections. Those 
VoL. XXv11.—No, 699 
on Malformations, Inflammation, Tumours, and Bacteria 
deserve especial mention. In treating these subjects the 
authors have been careful to avail themselves of all the 
recent investigations, not only in Pathology, but also in 
Embryology and other branches of Biology, and by 
making free use of small print and giving abundant 
references, they have succeeded in drawing up a more 
complete account than exists in any other English manual. 
In a very suggestive introductory chapter some of the 
special terms used by pathologists are defined, and the 
functions of pathological anatomy indicated. In the 
section on the Formative Disturbances of Nutrition 
the researches of Strasburger and Flemming on the 
changes in cells and nuclei during subdivision are con- 
sidered, and a diagram showing indirect cell-diyision is 
introduced. In speaking of cell-multiplication it is pointed 
out that the proposition, “The stronger the external 
stimulus the greater the proliferation,” cannot be accepted ; 
that “one can at most admit that very slight stimuli, 
sufficient merely to excite the cell without injuring it, 
may perhaps call into play its power of multiplication; 
but nothing has been experimentally established concern- 
ing the nature, the action, or the mode of application of 
such stimuli”; further, that “when the nutritive and 
formative activities of a cell are morbidly increased, the 
effect is due to augmentation of the physiological stimuli 
or diminution of the physiological resistances to growth, 
or the direct influence of external stimuli”; the factors 
probably favouring proliferation being (1) an increased 
capacity in the cell to assimilate nutriment, (2) an in- 
creased supply of nourishment, (3) the removal of the 
normal checks to growth. In the same chapter there is 
an account of the origin of epithelium, fibrous and adi- 
pose tissue, and of new blood-vessels ; and, in the chap- 
ter immediately following, an account of the origin of 
pus-corpuscles and of the mode in which tissues are 
regenerated. 
Tubercle and other allied diseases, such as lupus, 
leprosy, and glanders, are spoken of as “‘ Infective Granu- 
lomata.” A tubercle is defined from a histological point 
of view as “a non-vascular cellular nodule which does 
not grow beyond a certain size, and at a certain stage of 
its development becomes caseous”; but it is afterwards 
pointed out that when Koch’s recent investigations are 
taken into consideration it must be spoken of as “a cel- 
lular nodule containing within it the specific tuberculous 
virus, the bacillus tuberculosis.” 
Among these infective granulomata we have the new 
disease known as ‘‘actinomycosis,” which is associated 
with the presence of the peculiar fungus Actinomyces. 
In this disease the infection probably starts from the 
mouth, and results in the formation of granulations and 
fibrous tissue and in suppuration. 
The classification of tumours has long been a puzzle 
to pathologists. Later writers have more and more recog- 
nised their relation to the embryonic layers, and now we 
have, we believe for the first time in an English text-book, 
a purely embryological arrangement, tumours being divided 
by the authors into: (1) those derived from the mesoblast 
—the connective-tissue tumours ; (2) those containing 
elements derived from epithelial cells—the epithelial 
tumours. This classification, which commends itself by 
its simplicity, is likely to be generally adopted. 
v 
