60 JOURNAL AND PROCEEDINGS 



specific affection, associated with catarrh, inflammation and 

 haemoptysis, did not look upon these as the cause of it. 



The credit of further elaborating and establishing this 

 view is due to Rene Theodore Hyacinth Laenfiec, a Frenchman. 

 Bayle had grasped the fundamental idea, but his explanation 

 of the different phases, by which tul)erculoHis manifested 

 itself, was a trifle hazy in parts. His keen observations had 

 shown him sometimes the hard, opaque, cartilaginous granu- 

 lations, which showed no tendency to softeii, sometimes the 

 tiny, soft, numerous, seed-like bodies, for which he invented 

 the term miliary, and which he noticed tended to break down. 

 To distinguish the two, he named the first "granular 

 phthisis," the second " tubercular i)hthisis." Here we see 

 exemplified how the feeble flickerings and glimmerings of 

 supposition brighten and burn steadily, until at last the 

 benign rays of truth shine into the minds of men. 



Laennec claimed a specific nature for phthisis and denied 

 its inflammatory origin, claiming that all phthisis was tuber- 

 cular, and that in Bayle' s granular form the nodules were 

 tubercles which had undergone fibroid change. 



The large infiltrated masses, and also the nodules, he 

 maintained began as a grey, transparent mass, which subse- 

 quently softened, became cheesy or caseous, broke down into 

 pus, and was in coughing discharged, and led to the subse- 

 quent formation of cavities. 



This simple view of phthisis was disputed by some of the 

 greatest authorities, and at all poiiits. That the grey and 

 yellow tubercles believed by Laennec to be different stages in 

 one and the same process, sometimes occurring in the nodular 

 form and sometimes in the diffuse, were of the same nature. 

 Whether caseation was pathognomonic of tubercle, and 

 whether tubercle was allied to inflammation in any way, and 

 what the relation was. 



The great German anatomist and pathologist of the last 

 century, Virchozv, revived the discussion, and entirely changed 

 the aspect of it by restricting the term tubercle to the small 

 miliary form of the disea.se, and fell into the grievous error 

 of regarding this as a lymphatic new growth, liable to break 



