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CONDITIONS OF BLOOD IN DISEASE.

ports a similar result from the examination of the blood of some other patients to whom we have given the oil. As far as I am aware, however, chemical observations lead to the conclusion, that in phthisis a deficient proportion of blood-corpuscles is the usual peculiarity. Struck with this circumstance, I took pains to collect, chiefly from Simon, analyses of the blood in different diseases, and I have placed before you averages of the proportion of blood-corpuscles and albumen in certain diseases, with a view to compare them with phthisis.

You will observe that there are two diseases which present a singular similarity to phthisis, in their proportions of albumen, and of corpuscles. These are rheumatism, and diabetes. Now it is a remarkable fact, that rheumatism is the malady for the treatment of which cod-liver oil was first introduced into this country, and for which it has been so largely and successfully employed elsewhere. The variety of rheumatism in which it was most effectual is that in which the impoverished condition of blood is most likely to occur.

Dr. Percival,* half a century since, observes,-" Men and women advanced in years, whose fibres may be supposed to have acquired a degree of rigidity, find surprising effects from it (cod-oil). Some who have been cripples for many years, and not able to move from their seats, have after a few weeks' use of it been able to go with the assistance of a stick, and, by a longer continuance, have enjoyed the pleasing satisfaction of being restored to the natural use of their limbs, which for a long time before had been a burden to them. Two cases lately occurred in which the oil had an extraordinary effect, even on young persons whose ages did not exceed ten years. Guaiacum, calomel, blisters, &c., were tried on both these patients, but with so little benefit that opiates were given merely to procure temporary relief. Their lower limbs seemed to be a burden to them, and they had such an appearance of distortion, that no hopes of relief could be well entertained. In compliance with the particular request of their parents, the cod oil was given. The one obtained a perfect cure, the other nearly so; the latter having a little distortion in his back, is prevented the use of his legs. So general (adds Dr. Percival) has been the use of the oil with us, that we dispense fifty or sixty gallons annually; and the good effects of it are so well known amongst the poorer sort, that it is particularly requested by them for almost every lameness. Except bark, opium, and mercury, I believe no medicine in the materia medica is likely to be of more service, and I should wish for a more general use of it, in order to prove that * Dr. Thomas Percival; Works Literary, Moral, and Medical, vol. iv. p. 354.

G

the above account of its good effects is no exaggeration."

I am strongly impressed with the value of the remedy in diabetes. It is true that this disease involves an additional element, which it is not easy to suppose amenable to such a remedy as fish oils, but the benefit derived in many respects is often remarkable.

In the month of April, 1848, a patient came under my care who had been affected with diabetes for some months, and had taken creasote and other medicines with little advantage At the time I first saw her, the quantity of urine passed in twenty-four hours amounted to ten pints.

The following table will show her progress under the cod-liver oil treatment.

This patient afterwards passed unavoidably under other care; and, owing to a misunderstanding, did not resume the cod liver oil, which had been from temporary causes intermitted. She took a variety of remedies, including sulphur, hydrochloric acid, opium, and alkalies. Drachm doses of carbonate of soda for a time acted

favourably, but on the whole she retrograded. Her weight, which in June, 1848, was 107 pounds, had fallen, by December, 1849, to 88 pounds. Her appearance was haggard, and there was threatening of pulmonary disease. The cod oil was resumed, and even then with temporary advantage, but she ultimately relapsed and sank.

The theory which I have now proposed in explanation of one mode of action of the oil, namely, through an influence exerted on the proportion of red corpuscles, is in harmony with the fact that its good effects are specially produced in women, and children; for in them the relative proportion of corpuscles is stated by chemists to be small.

I may add that the remedy has afforded me most satisfactory results in neuralgia and sciatica, when those complaints were associated with anæmia. Whenever arterial or venous murmurs indicate such a condition, a rapid improvement may be expected to follow the administration of the oil, even without the assistance of ferruginous medicines. In some disturbed manifestations of the nervous system, which seem to be more moral than physical, the presence of a weak, small pulse, has sometimes led me to give the oil, and with signal success. Do not think that I dwell on this subject from any love of fanciful hypotheses. When the light issuing from a certain number of facts seems to converge towards a particular point of explanation, it is useful to try the applicability of that explanation to analogous facts, and thus to entertain, I do not say to adopt, a sort of tentative theory, or "prudens quæstio." If the theory prove universally applicable, we obtain a law; if the explanation

be found incorrect, it is yet seldom fruitless: indeed the proof of its inadequacy serves to narrow the field of inquiry; and to increase the probability that the next step towards the attainment of truth may be in the right direction. Time is sometimes lost in the laborious accumulation of miscellaneous facts. Numerism is productive only by the proportion of sagacity or intellectual intuition, applied in the selection and appreciation of facts. There is an aristocracy in facts as well as in races, and the mind should be taught to discern their prerogative dignity. "The naturalist who cannot or will not see that one fact is often worth a thousand, as including them all in itself, and that it first makes all the others facts;—who has not the head to comprehend, or the soul to reverence a central experiment or observation (what the Greeks would perhaps have called â protophænomenon), will never receive an auspicious answer from the oracle of nature."*

To apply these observations to our immediate subject, let me remark that changes produced on the blood by diseases, or remedies, may fairly be placed amongst cardinal facts. It can scarcely be doubted that if a professor accomplished in chemistry were officially connected with every hospital, such facts might be so collected, and collated, as to render the discoveries of this important science available in a remarkable degree for the advancement of practical medicine.

Should further observation confirm what has been suggested in this lecture regarding the influence of fish oils on the composition of the circulating fluid, we shall

* H. N. Coleridge. "The Friend," vol. iii. p. 156. London,

1844.