134 
After a careful perusal of these lectures, 
one finds himself impressed with the author’s 
ability to go behind the returns, to draw the 
line between good and bad work, to catch or 
to predict the drift of things; and this is the 
peculiar merit of the book. Indignant at the 
attitude of some American physicians, Dr. 
Belfield treats their shallow objections with 
deserved contempt, sometimes even with harsh- 
ness; but he preserves throughout the critical 
insight which might be expected of a follower 
of Tyndall and of Koch, and holds very fast 
indeed to that which is good. 
To biologists it is of great interest to ob- 
serve that pathologists are passing beyond the 
‘germ’ theory, and are looking towards the 
unexplored country of unorganized ferments, 
ptomaines, etc., for the sources of disease, 
precisely as they themselves have gone thither 
to search for the causes of fermentation, of 
cellular digestion, and for many of the more 
intricate phenomena of physiology. The future 
of cellular biology seems to lie in these obscure 
ferments and ptomaines, affording a golden 
opportunity for the physiological chemist. 
Dr. Belfield states his subject summarily as 
follows (Pp. ol): — 
‘¢ Bacteria then, which, by virtue of their ubiquity, 
are in constant and frequently recurring contact 
with the animal body, are, like other minute bodies, 
organized and unorganized, frequently introduced 
into the body through solutions of continuity of the 
integuments, or through intact skin and mucous 
membranes, particularly by way of the lungs. 
‘The burning question in pathology to-day is, in 
what degree are the various species of bacteria, present 
in human tissues during certain morbid conditions, 
to be regarded as the cause of the morbid processes 
with which they are respectively associated?”’ 
If we look for his answer, we find farther 
on that investigations carried on with rigid 
exactitude justify us in accepting provisionally 
the causal relation in some degree, but not so 
far as to exclude other like causes. 
Illness may be caused by the not living prod- 
ucts of putrefactions, as well as by the living 
organisms which abound in and probably pro- 
duce putrefactions. But in the latter case the 
disease may be farther extended to fresh, 
healthy individuals by infection: in the former 
it cannot be. This points, in the one case, to 
a self-perpetuating cause; in the other, to one 
of limited powers. Moreover, good evidence 
exists that the boiled products of putrefaction 
which may produce illness owe their septic 
action to substances of obscure composition 
(ptomaines?) manufactured by the bacteria 
of putrefaction. This line of thought leads to 
the important conclusion (p. 42), — 
SCIENCE. 
“‘Hence we are logically driven, by all this work, to 
the belief that septicaemia implies the introduction 
into the animal either of living bacteria, or of a sub- 
stance which has acquired noxious properties through 
previous vital activity of these organisms. 
‘‘More recent experiments have demonstrated, how- 
ever, that the etiology of . . . septicaemia is by no 
means restricted to putrid infection. [For it was no- 
ticed by Schmidt that] the introduction or production 
in the blood of fibrin-ferment in considerable quan- 
tity produces effects identical with those of putrid 
infection — septicaemia.”’ 
It has since been asserted that pepsin and 
trypsin produce similar effects. Ifso, we may 
find eventually a cause behind the bacteria, — 
a fibrin-ferment-liberating cause (p. 44) : — 
‘‘Tt would appear, athough not for all cases demon- 
strated, that the . . . features common to the various 
forms of septicaemia are attributable to the rapid lib- 
eration of fibrin-ferment in the blood; and that any 
agent — organized or unorganized, putrid or fresh — 
capable of effecting such liberation may induce the 
disease.”’ 
So with the cause of suppuration. Belfield 
looks even beyond the germ-theory, beyond the 
bacteria involved, and with the eye of a biolo- 
gist perceives that (p. 51) 
‘‘Suppuration must be regarded, then, as indicat- 
ing the presence of an element foreign to the living 
animal cells; which may be induced directly [as by 
the introduction of a powerful irritant, e.g., Croton- 
oil], or indirectly as an incident in the life of various 
fungi [e.g., bacteria]. . . . Practically, we may regard 
acute suppuration as proof of the access of external 
irritant matter, organized or unorganized.”’ 
Antiseptic surgery is then easily defined. It 
is not a hissing spray, nor (p. 60) 
‘‘Simply a question as to the relative anti-bacterial 
properties of this, that, and the other so-called anti- 
septic agents. It is an attempt to prevent the en- 
trance into, as well as the formation within, a wound 
of all substances, organized and unorganized, which 
can interfere with cell-nutrition.”’ 
Enough has been said to show the spirit of 
these lectures. They take a broad but thought- 
ful and critical view of the various questions 
involved, treating the scoffers who speak with- 
out knowledge as they richly deserve, and 
taking a rather conservative view of the work 
done in the direction of protective vaccination ; 
displaying everywhere the thorough training of 
a German laboratory, and closing with a moral 
which all scientific men and all believers in 
rational medicine will do well to read, mark, 
and inwardly digest (p. 114): — 
‘“‘ And when we consider the problems already half 
solved, the questions to whose solution the way ap- 
pears open through the same methods already suc- 
cessfully applied to anthrax and tuberculosis, we may ~ 
hope for results to which present knowledge shall seem — 
[Von. IIL, No. 52. 
‘ 
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