200 
A year’s progress in medicine. 
ing the subject of diagnosis, especially in linman medicine. 
This subject too is too vast to dwell upon long. The study of 
the blood cells, the leucocytes, the red cells, the plaques, etc., is 
helping us to a new and unexpected means of diagnosis, which 
in its way, promises as much variety as the other subject of bac¬ 
teriology. The number of cells and of each kind of cell in the 
cubic millimetre of blood at various times ; as after a night’s 
rest ; after a meal; after meals of certain definitely known con¬ 
stituents ; under circumstances of active exercise, of sleep, of 
sedentary work, in the thousand and one diseases to which man 
and the lower animals are liable. Not only the number of 
these cells, varying on occasion, but their size, and shape, mono- 
nucleated, multinucleated; their response to the various 
staining reagents,—here is an almost infinite variety. We are 
only on the threshold of the great building which our children 
and our children’s children are destined to see. There is now 
added to our means of diagnosis, an increasingly powerful and 
certain help, the value of which is too dimly conceived. I could 
dwell upon this topic a long time, but dare not. 
The diagnosis of diseases of the stomach in the human sub¬ 
ject especially, is now greatly aided by this same clinical labora¬ 
tory, by the giving of test meals and their subsequent examina¬ 
tion, to determine the digestive power of the stomach ; the exami¬ 
nation of the stomach contents in important cases, in medico-legal 
as well as individually, simply diagnostic. Thus in regard to 
the diagnosis of diseases of the kidney, we have the conjoined 
examination of the urine and the blood. A little blood from the 
end of the finger may settle the question of malaria, or typhoid 
fever, or some other disease. A little blood and a little urine 
may determine whether we have a malignant disease of the 
urinary passages,—permits us to estimate the probabilities of a 
generalization of the malignant growth. 
Again in the clinical laboratory in conjunction with the 
physiological, we may determine the action of medicine and dis¬ 
eases under the most favorable circumstances, so far as the lower 
animals are concerned, and by analogy we may reason not more 
or less accurate conclusions for the human subject; the results 
are promising. Taken altogether, the laboratory work of to-day 
is carrying the modern physician to a place in practical diag¬ 
nosis and therapeutics beyond the brightest dreams of the fathers 
in medicine. To this may be added the progress in sanitation, 
the municipal. State and personal means by which we may pro¬ 
tect our homes, schools, and other buildings, may be improved 
